Search

Background Cardiac arrest (CA) survivors experience continuous exposures to potential traumas though chronic cognitive, physical and emotional sequelae and enduring somatic threats (ESTs) (i.e., recurring somatic traumatic reminders of the event). Sources of ESTs can include the daily sensation of an implantable cardioverter defibrillator (ICD), ICD-delivered shocks, pain from rescue compressions, fatigue, weakness, and changes in physical function. Mindfulness, defined as non-judgmental present-moment awareness, is a teachable skill that might help CA survivors cope with ESTs. Here we describe the severity of ESTs in a sample of long-term CA survivors and explore the cross-sectional relationship between mindfulness and severity of ESTs. Methods We analyzed survey data of long-term CA survivors who were members of the Sudden Cardiac Arrest Foundation (collected 10-11/2020). We assessed ESTs using 4 cardiac threat items from the Anxiety Sensitivity Index-revised (items range from 0 'very little' to 4 'very much') which we summed to create a score reflecting total EST burden (range 0-16). We assessed mindfulness using the Cognitive and Affective Mindfulness Scale-Revised. First, we summarized the distribution of EST scores. Second, we used linear regression to describe the relationship between mindfulness and EST severity adjusting for age, gender, time since arrest, COVID-19-related stress, and loss of income due to COVID. Results We included 145 CA survivors (mean age: 51 years, 52% male, 93.8% white, mean time since arrest: 6 years, 24.1% scored in the upper quarter of EST severity). Greater mindfulness ([beta]: -30, p = 0.002), older age ([beta]: -0.30, p = 0.01) and longer time since CA ([beta]: -0.23, p = 0.005) were associated with lower EST severity. Male sex was also associated with greater EST severity ([beta]: 0.21, p = 0.009). Conclusion ESTs are common among CA survivors. Mindfulness may be a protective skill that CA survivors use to cope with ESTs. Future psychosocial interventions for the CA population should consider using mindfulness as a core skill to reduce ESTs., Author(s): Alexander M. Presciutti [sup.1] [sup.2] , Sarah M. Bannon [sup.1] [sup.2] , Jolin B. Yamin [sup.3] , Mary M. Newman [sup.4] , Robert A. Parker [sup.5] [sup.6] , Jonathan [...]

Chronic pain syndromes affect over one-third of the US adult population and often lead to significant disability and a reduced quality of life. Despite their high prevalence, causal links between chronic pain syndromes and anatomic abnormalities are often not apparent. Most current chronic pain treatments provide modest, if any, relief. Thus, there is a pressing need to understand the causal mechanisms implicated in chronic pain as a means to develop more targeted interventions for improvement in clinical outcomes and reduction in morbidity and financial burden. In the present manuscript, we summarize the current literature on treatment for chronic pain, and hypothesize that nonspecific chronic back pain (without a clear organic etiology, such as tumors, infections or fractures) is of psychophysiologic origin. Based on this hypothesis, we developed Psychophysiologic Symptom Relief Therapy (PSRT), a novel pain reduction intervention for understanding and treating chronic pain. In this manuscript, we provide the rationale for PSRT, which we have tested in a pilot trial with a subsequent larger randomized trial underway. In the proposed trial, we will evaluate whether non-specific chronic back pain can be treated by addressing the underlying stressors and psychological underpinnings without specific physical interventions. [ABSTRACT FROM AUTHOR]

Purpose: Widely used therapeutic approaches, such as cognitive-behavioral and mindfulness-based therapies, can improve pain and functioning in people with chronic back pain, but the magnitude and duration of their effects are limited. Our team developed a novel 12-week program, psychophysiologic symptom relief therapy (PSRT), to substantially reduce or eliminate pain and disability. This study examined whether PSRT helped more patients achieve large-magnitude (≥ 30%, ≥ 50%, ≥ 75%) reductions in back pain-related disability compared to mindfulness-based stress reduction (MBSR) and usual care (UC), and if the beneficial effects of PSRT were explained by reductions in pain-related anxiety following treatment.Patients and Methods: Data from a three-armed randomized controlled trial were used (N=35 adults with chronic back pain). Change scores (baseline to 4-, 8-, 13-, and 26-weeks post-enrollment) were computed for back pain disability (RDQ) and pain-related anxiety (PASS-20). Fisher's exact tests and mediation analyses were conducted.Results: Compared to MBSR and UC, PSRT helped significantly more patients achieve ≥ 75% reductions in back pain disability at all timepoints and in pain anxiety at all timepoints except 13-weeks. Change in pain anxiety significantly mediated the relationship between treatment group and change in back pain disability from baseline to 26-weeks.Conclusion: PSRT helped more patients achieve substantial reductions in disability than an established treatment (MBSR) and usual care. Findings indicate reduced pain anxiety may be a mechanism by which PSRT confers long-term benefits on disability. Importantly, this work aims to move the field toward more precise and effective treatment for chronic back pain. [ABSTRACT FROM AUTHOR]

Interviews are central to the application process for health service psychology (HSP) internships, the capstone of doctoral clinical training. Historically conducted primarily in-person, interviews involved considerable financial and time costs to applicants. Restrictions due to the COVID-19 pandemic caused a shift from inperson interviews to largely untested virtual interviews during the 2021 and 2022 Association of Psychology Postdoctoral and Internship Centers (APPIC) Matches. We drew on multiple sources of data from the APPIC Directory, National Matching Services, and APPIC post-Match surveys of applicants and internship training directors to learn about the magnitude of this shift; the influence of various considerations related to selecting virtual interview formats; and applicants' and sites' perceptions of the costs, benefits, and effectiveness of virtual interviews. Results suggest a seismic shift toward the use of virtual interviews, from~20% of programs in 2016-2018 to 89% in 2022. Sites reported limited concern (29%) over loss of information during virtual interviews to assess applicant fit and substantial concern (85%) over equity regarding applicant costs associated with in-person interviewing. Sites found the virtual format effective for ranking applicants (89%). Across 2021 and 2022, applicants reported high satisfaction with the Match (79%, vs. 82% for 2016-2018) and virtual interviews (76%). Consistent with reports from other health service professions, applicants endorsed postpandemic use of virtual interviews, expressed concern over missing out if choosing virtual interviews when programs offer both types and strongly endorsed mandating virtual-only interviews. We discuss implications and recommendations for the adoption of virtual interview formats for HSP internship training. [ABSTRACT FROM AUTHOR]

There are several "pain protocols" for EMDR, which may target general trauma memories, the specific accident/injury experienced, or even pain-related sensations and emotions, while the patient engages in bilateral stimulation-usually eye movements, but possibly taps or tones.[83] As detailed in several reviews,[87] there are numerous case reports and uncontrolled case series often reporting substantial pain reduction or elimination. Importantly, these treatments of comorbid trauma/CP emphasize the potential reversibility of both trauma symptoms and pain, and they may reduce pain more than PTSD-focused treatments do. The treatment studies of comorbid PTSD/CP described above were PTSD-centric; that is, they recruited patients with PTSD, used PTSD-focused treatments, and examined PTSD symptoms as the primary outcome. [Extracted from the article]

Little is known about how the overall employment conditions in a country impact the likelihood of employment of newly arrived refugees. In the current study, we compare employment and determinant of employment of highly educated Middle Eastern refugees to Michigan that arrived before and after the 2007 recession. We also look at self-reported barriers to employment. Results show that the general downturn of the economy made it substantially more difficult to secure employment, even for well-educated refugees. Thus, before the economic downturn, 22.9 % of refugees were unemployed as compared to 55.1 % once the recession had set in (p < 0.01). There were also substantially more self-reported barriers to employment after the economic downturn. The study points to the importance of understanding both individual characteristics and the general employment conditions in the new host country when studying variation in refugee employment success.