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Why zebras don't get ulcers
\"Combining ... research with a healthy dose of good humor and ... advice, [this book] explains how prolonged stress causes or intensifies a range of physical and mental afflictions, including depression, ulcers, colitis, heart disease, and more. It also provides ... guidance to controlling our stress responses\"--Amazon.com.
One Nation Under Stress
2013
Everyone is talking about stress. From 1970 to 1980, 2,326 academic articles appeared with the word “stress” in the title. In the decade between 2000 and 2010 that number jumped to 21,750. Has life become ten times more stressful, or is it the stress concept itself that has grown exponentially over the past forty years? This book argues that our national infatuation with the therapeutic culture has created a middle-class moral imperative to manage the tensions of daily life by turning inward, ignoring the social and political realities that underlie those tensions. The book shows that although stress is often associated with conditions over which people have little control—workplace policies unfavorable to family life, increasing economic inequality, war in the age of terrorism—the stress concept focuses most of our attention on how individuals react to stress. A proliferation of self-help books and dire medical warnings about the negative effects of stress on our physical and emotional health all place the responsibility for alleviating stress-though yoga, deep breathing, better diet, etc.—squarely on the individual. The stress concept has come of age in a period of tectonic social and political shifts. Nevertheless, we persist in the all-American belief that we can meet these changes by re-engineering ourselves rather than tackling the root causes of stress. Examining both research and popular representations of stress in cultural terms, the book traces the evolution of the social uses of the stress concept as it has been transformed into an all-purpose vehicle for defining, expressing, and containing middle-class anxieties about upheavals in American society.
Lipid Oxidation in Health and Disease
2015
Lipid oxidation has long been regarded as a deleterious process responsible for lipid rancidity, loss of function, and generation of toxic products. However in recent years, research has also focused on the non-detrimental physiological and pathological effects of these chemical reactions. This book provides an up-to-date review of the role of oxidized lipid products in physiological and pathophysiological processes. Topics include the mechanisms of lipid oxidation, antioxidant defenses, lipid oxidation products, cell signaling, and the roles of oxidized lipids in specific diseases. The book also discusses drug targeting and the therapeutic potential of oxidized lipids.
Widen the window : training your brain and body to thrive during stress and recover from trauma
\"A pioneering researcher gives us a new understanding of stress and trauma, as well as the tools to heal and thrive\"-- Provided by publisher.
Effectiveness of Group Problem Management Plus, a brief psychological intervention for adults affected by humanitarian disasters in Nepal: A cluster randomized controlled trial
by
Wang, Xueqi
,
Dawson, Katie S.
,
Jordans, Mark J. D.
in
Adaptation, Psychological
,
Adolescent
,
Adult
2021
Globally, 235 million people are impacted by humanitarian emergencies worldwide, presenting increased risk of experiencing a mental disorder. Our objective was to test the effectiveness of a brief group psychological treatment delivered by trained facilitators without prior professional mental health training in a disaster-prone setting.
We conducted a cluster randomized controlled trial (cRCT) from November 25, 2018 through September 30, 2019. Participants in both arms were assessed at baseline, midline (7 weeks post-baseline, which was approximately 1 week after treatment in the experimental arm), and endline (20 weeks post-baseline, which was approximately 3 months posttreatment). The intervention was Group Problem Management Plus (PM+), a psychological treatment of 5 weekly sessions, which was compared with enhanced usual care (EUC) consisting of a family psychoeducation meeting with a referral option to primary care providers trained in mental healthcare. The setting was 72 wards (geographic unit of clustering) in eastern Nepal, with 1 PM+ group per ward in the treatment arm. Wards were eligible if they were in disaster-prone regions and residents spoke Nepali. Wards were assigned to study arms based on covariate constrained randomization. Eligible participants were adult women and men 18 years of age and older who met screening criteria for psychological distress and functional impairment. Outcomes were measured at the participant level, with assessors blinded to group assignment. The primary outcome was psychological distress assessed with the General Health Questionnaire (GHQ-12). Secondary outcomes included depression symptoms, posttraumatic stress disorder (PTSD) symptoms, \"heart-mind\" problems, social support, somatic symptoms, and functional impairment. The hypothesized mediator was skill use aligned with the treatment's mechanisms of action. A total of 324 participants were enrolled in the control arm (36 wards) and 319 in the Group PM+ arm (36 wards). The overall sample (N = 611) had a median age of 45 years (range 18-91 years), 82% of participants were female, 50% had recently experienced a natural disaster, and 31% had a chronic physical illness. Endline assessments were completed by 302 participants in the control arm (36 wards) and 303 participants in the Group PM+ arm (36 wards). At the midline assessment (immediately after Group PM+ in the experimental arm), mean GHQ-12 total score was 2.7 units lower in Group PM+ compared to control (95% CI: 1.7, 3.7, p < 0.001), with standardized mean difference (SMD) of -0.4 (95% CI: -0.5, -0.2). At 3 months posttreatment (primary endpoint), mean GHQ-12 total score was 1.4 units lower in Group PM+ compared to control (95% CI: 0.3, 2.5, p = 0.014), with SMD of -0.2 (95% CI: -0.4, 0.0). Among the secondary outcomes, Group PM+ was associated with endline with a larger proportion attaining more than 50% reduction in depression symptoms (29.9% of Group PM+ arm versus 17.3% of control arm, risk ratio = 1.7, 95% CI: 1.2, 2.4, p = 0.002). Fewer participants in the Group PM+ arm continued to have \"heart-mind\" problems at endline (58.8%) compared to the control arm (69.4%), risk ratio = 0.8 (95% CI, 0.7, 1.0, p = 0.042). Group PM+ was not associated with lower PTSD symptoms or functional impairment. Use of psychosocial skills at midline was estimated to explain 31% of the PM+ effect on endline GHQ-12 scores. Adverse events in the control arm included 1 suicide death and 1 reportable incidence of domestic violence; in the Group PM+ arm, there was 1 death due to physical illness. Study limitations include lack of power to evaluate gender-specific effects, lack of long-term outcomes (e.g., 12 months posttreatment), and lack of cost-effectiveness information.
In this study, we found that a 5-session group psychological treatment delivered by nonspecialists modestly reduced psychological distress and depression symptoms in a setting prone to humanitarian emergencies. Benefits were partly explained by the degree of psychosocial skill use in daily life. To improve the treatment benefit, future implementation should focus on approaches to enhance skill use by PM+ participants.
ClinicalTrials.gov NCT03747055.
Journal Article
A randomized controlled trial of a transdiagnostic cognitive-behavioral intervention for Afro-descendants’ survivors of systemic violence in Colombia
by
Murray, Laura K.
,
Babcock, Lori
,
Escobar-Roldán, Ivan D.
in
Adult
,
African Continental Ancestry Group - psychology
,
Aged
2018
Exposure to violence has negative consequences on mental health. Armed-conflict in Colombia has widely affected Afro-descendants in the Pacific region. Evidence regarding effectiveness of mental health interventions is lacking in low-income settings, especially in areas with active conflict. The objective of this study is to evaluate an individualized Common Elements Treatment Approach (CETA), a transdiagnostic psychotherapy model based on Cognitive-Behavioral Therapy, for adult trauma survivors.
A referred sample of 521 adult Afro-descendants from Buenaventura and Quibdó, Colombia, experiencing significant sadness, suffering or fear (score>0.77 in Total Mental Health Symptoms), with history of traumatic experiences, and with associated functional impairment were randomly allocated to CETA intervention, standby group without intervention, but under monthly monitoring, or a Narrative Community-Based Group Therapy. CETA was provided by trained Lay Psychosocial Community Workers without previous mental health experience, supervised by psychologists, during 12-14 weekly, 1.5-hour sessions. Symptoms were assessed with a locally validated survey built based on the Hopkins Symptom Checklist, the Harvard Trauma Questionnaire, the PTSD CheckList-Civilian Version, a qualitative study for additional general symptoms and a gender-specific functional impairment scale. CETA was compared with the control group and the intervention effects were calculated with mixed models using intention to treat analysis. Participant completion of follow-up was 75.1% and 13.2% voluntarily withdrew. Reduction in post-traumatic stress symptoms was significant in both municipalities when comparing intervention and control groups (mean difference), with a with a moderate effect size in Buenaventura (Cohen's d = 0.70) and a small effect size in Quibdó (d = 0.31). In Buenaventura, the intervention also had significant effects on depression (large effect size d = 1.03), anxiety (large effect size d = 0.80) and functional impairment (moderate effect size d = 0.70). In Quibdó, it had no significant effect on these outcomes. Changes in Total Mental Health Symptoms were not significant in neither city.
This trial suggests that CETA, can be effective in improving depression, anxiety, post-traumatic stress and function among victims of systematized violence in low-income and active conflict settings. Nonetheless, the difference of effectiveness between the two cities of intervention may indicate that we cannot assume that a mental health intervention known to be effective in one setting will be effective in another, even in similar circumstances and population. This may have special importance when implementing and reproducing these types of intervention in non-controlled circumstances. Further research should address these concerns. Results can be of use by governmental decision-makers when defining mental health programs for survivors.
ClinicalTrials.gov NCT01856673 (https://clinicaltrials.gov/ct2/show/NCT01856673).
Journal Article
Adrenaline and the inner world : an introduction to scientific integrative medicine
2006
This accessible work is the first in more than seventy-five years to discuss the many roles of adrenaline in regulating the \"inner world\" of the body. David S. Goldstein, an international authority and award-winning teacher, introduces new concepts concerning the nature of stress and distress across the body's regulatory systems. Discussing how the body's stress systems are coordinated, and how stress, by means of adrenaline, may affect the development, manifestations, and outcomes of chronic diseases, Goldstein challenges researchers and clinicians to use scientific integrative medicine to develop new ways to treat, prevent, and palliate disease.
Goldstein explains why a former attorney general with Parkinson disease has a tendency to faint, why young astronauts in excellent physical shape cannot stand up when reexposed to Earth's gravity, why professional football players can collapse and die of heat shock during summer training camp, and why baseball players spit so much.
Adrenaline and the Inner World is designed to supplement academic coursework in psychology, psychiatry, endocrinology, cardiology, complementary and alternative medicine, physiology, and biochemistry. It includes an extensive glossary.