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This study deals with the systematic investigation of cardiovascular problems in Covid-19 and multiple trauma patients hospitalized in special units, relying on radiology and analgesia stereotypes. Abnormal heart rhythm, which includes high heart rate, irregular heart rate and slow heart rate, can be one of the complications of Corona disease. Also, some of the drugs used for Corona may have side effects such as lowering the heart rate. For example, in one of the recent studies, after starting treatment with Remdesivir, some patients experienced a drop in heart rate. In this study, doctors used dopamine injections to stabilize the patient's heart rate during the 5-day period of Redemsivir treatment, and the patients' heart problems resolved spontaneously at the end of the treatment. Corona virus damages the heart in different ways. The formation of a blood clot is one of the serious complications of Corona, which in some cases leads to death. Its symptoms include severe pain in the chest (heart and lungs), as well as shortness of breath. If the infection caused by Corona disease is severe enough to damage the lungs, less oxygen reaches the heart, which can also reduce the delivery of nutrients to the heart. Therefore, the heart needs more oxygen. The lack of this oxygen and nutrients causes damage to the heart muscles, which is accompanied by pain. Among the other causes of heart pain during the Corona disease, we can mention the inflammation of the heart muscle (myocarditis) and the inner wall of the heart (pericarditis), which can be caused by viral infections. At first, scientists thought that this inflammation was caused by the direct attack of the Corona virus on the heart muscle, but with further research, it became clear that this condition is a result of the overreaction of the body's immune system to the infection caused by the virus and can Another reason for pain in the chest and heart and arrhythmia (irregular heartbeat). [ FROM AUTHOR] Copyright of Journal of Pharmaceutical Negative Results is the property of ResearchTrentz and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
Background: Interoception - the processing of the internal state of the body - has been consistently tied to well-being and mental health, which in turn have been severely challenged by the COVID-19 pandemic. Moreover, the fact that symptoms of COVID-19 (high temperature, shortness of breath, fatigue, and even gastro-intestinal problems) directly alter interoceptive signals has fueled people's tendency to constantly check their internal bodily state. Objectives: In this longitudinal study we tested for changes in interoception and psychophysiological health and well-being during different stages of the pandemic in 2020 and assessed their potential association. To highlight this association, we combined both subjective (i.e., self-reported questionnaires) and objective (i.e., measures of heart rate variability, HRV and of interoceptive accuracy) measures. Methods: 245 Italian participants who had completed the Multidimensional Assessment of Interoceptive Awareness (MAIA-2) prior to the onset of the pandemic, repeated the questionnaire during the first national lockdown in Italy, and four months after restrictions. Participants also completed survey measures of depression (PHQ-9), anxiety (STAI), and sleep disturbance (PSQI). A sub-sample of 28 participants, who had completed the heartbeat counting task (HCT) and a measure of heart rate variability (HRV), was tested again remotely, in the same time windows, using phone applications and photoplethysmography. Results: While performance in the HCT remained unvaried, MAIA-2 scores consistently increased from before the pandemic to the national lockdown, and remained largely unvaried after four months. The national lockdown was associated with the lowest psychophysiological health and well-being, as evidenced by a decrease in HRV compared to before the pandemic and by higher scores in self-reported depression, anxiety, and sleep disturbance compared to four months after the lockdown. Interestingly, psychophysiological health and well-being were predicted by specific regulatory components of interoception (e.g., the ability to regulate distress by focusing on body sensations and experiencing one's body as safe and trustworthy). Conclusions: Our results suggest an increased attention towards visceral signals during the COVID-19 pandemic, and highlight the positive role of specific components of interoception in contributing to well-being, suggesting that novel interventions aimed at increasing interoception may be developed to protect against stressful life events such as COVID-19.
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SCOPO DEL LAVORO: Long COVID is defined as the continuation of symptoms much longer than usually expected or the persistence of symptoms despite the recovery of the infection. While research on long COVID is in full swing, only little attention has been paid to the associated psychiatric symptoms. In particular, the association between long COVID and somatic symptom disorders (SSD) has been overlooked. Beyond anxiety and depression symptoms, patients with COVID-19 present a high risk to develop SSD. SSD, previously known as somatoform disorders, have been defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as persistent and clinically significant somatic symptoms accompanied by excessive and disproportionate health-related thoughts, feelings and behaviours regarding the symptoms. Noviello et Al (2021) in their study show that acute SARS-CoV-2 infection may affect the brain-gut axis. Five months after the acute infection, mild gastroenterological symptoms persist, in particular in patients reporting diarrhea in the acute phase of the infection. Infected patients are also at increased risk of chronic fatigue and somatoform disorders, thus supporting the hypothesis that both functional gastrointestinal (like IBS) and somatoform disorders may have a common biological origin. IBS present an impairment in interoception and high levels of alexithymia. Interoception refers to the ability to accurately detect internal body changes. Alexithymia is a personality construct that implies difficulties identifying and describing one's own feelings, limited imaginative processes, an externally oriented cognitive style, and difficulties in distinguishing between feelings and bodily sensations. This construct is associated with many disorders, such as gastrointestinal pathologies. Given the relationship between long covid disease and gastrointestinal somatoform disorders (like IBS), and between interoceptive abilities and Irritable Bowel Syndrome, then it's conceivable a mediating role of interoceptive abilities in long covid IBS that deserves to be analyzed. MATERIALI E METODI: Subjects: All the patients aged between 18 and 60 years who tested positive at least 5 months before. Measures: - Toronto Alexithymia Scale - Hospital Anxiety and Depression Scale - Structured Assessment of Gastrointestinal Symptoms (SAGIS) questionnaire - Heart Rate Variability - Blood samples were collected between 8:30 am and 9:00 am. RISULTATI: There is a deficiency in interoceptive skills and high levels of alexithymia in patients with IBS and who have been infected with covid. CONCLUSIONI: In a current society, undermined by the psychophysical consequences of covid, Identifying factors that affect the well-being like Interoception training (as it is a learned skill), renders possible an intervention to modify some of these factors or promote a better understanding of patients with IBS who experience alternate periods of remission and relapse. .
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Background: Neurodivergence has been established as associated with a significant number of co-occurring physical conditions, particularly for autistic individuals who are at risk for increased pain, hypermobility (including Ehlers-Danlos Syndrome) and gastrointestinal problems. However, data, so far, has been focused on adults and generally limited to discussions of condition prevalence alone. Method(s): The following article will present a topical review of the literature considering evidence for increased physical health concerns within neurodivergent populations, particularly autistic individuals, with a focus on the impact that these physical health concerns may have in an educational setting. Results and discussion: The impact of physical health concerns within neurodivergent populations in an educational setting may be concerning. Such populations may face a range of challenges in obtaining appropriate support for physical conditions. We discuss a number of said challenges including;communication challenges, misattributing physical health symptoms as a part of neurodivergence, and a history of not being believed, which limits symptomatic reporting. We further consider the potential impact these physical health concerns may have on scholastic and social development, such as impacts for attainment and attendance. Furthermore, we provide recommendations for teachers, parents/carers and other allied professionals in young people's lives, on supporting young neurodivergent people with physical health concerns.Copyright © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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How protected is one against COVID-19 after vaccination? IgG antibodies are an important part of the artillery for the immune system's defense against the SARS-CoV-2 virus, and its levels are predictive of protection against infection. The amount of antibodies produced by some individuals is exponentially higher than by others. This difference represents important variance in the future susceptibility to COVID-19 infection. The current study was conducted to determine whether individuals were able to estimate how many antibodies they produced after their COVID-19 vaccinations. 166 participants (18-60 years old, 103 female) were recruited to the laboratory 14-60 days post-vaccination, and a blood sample was taken for analysis. Participants were asked to estimate on a scale from 0-10 how many antibodies they had produced, and were also asked how protected they felt from COVID-19 due to vaccination. Both self-predicted antibody levels (r(162) = 0.17, p = 0.028), and feelings of protection against COVID-19 (r(162) = 0.20, p = 0.009) were significantly related to their actual IgG spike antibody titers. Results from this study suggest that individuals are able to predict their IgG titers after COVID-19 vaccination. These results hold relevance in two domains. Firstly, they suggest individuals who sense they have low protection, probably do. Such information can help individuals make informed choices about self-protective behaviors. Secondly, results provide empirical evidence for the transmission of immune information through humoral pathways of interoception. These findings open the door for future work in the intriguing domain of immune interoception.
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The proceedings contain 48 papers. The topics discussed include: mental and physical health in informal caregiving and associations with relationship quality between caregiver and care recipient - a pilot study;immune-mediated early endocrine response during tumorigenesis;characterization of circulating dendritic cells in major depressive disorder;immune age correlates with cardiorespiratory fitness, but not with general intelligence;investigation of the relationship between immune age and vaccination against SARS-CoV-2;the steroid hormone dehydroepiandrosterone (DHEA) counteracts the consequences of psychological trauma on immunocellular ageing and mitochondrial bioenergetics;prediction of antibody levels after COVD-19 vaccination: evidence for immune interoception;and temporal dynamics of cytokine changes in blood, cerebrospinal fluid and brain tissue of endotoxemic rats.
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Emotional eating is a commonly described phenomenon reported by individuals across the weight spectrum. Not only does existing evidence suggest it is not an effective emotion regulation strategy, but emotional eating is also associated with difficulty losing weight during weight loss interventions and other negative health outcomes. The majority of existing work in the area of emotional eating has focused on the broad dimensions of negative and positive affect. Yet, there are data suggesting that different emotions appear to produce different changes in eating behaviors, suggesting the importance of investigating the influence of discrete emotions on eating. The lack of understanding regarding eating in response to boredom in particular, is a major gap in the current literature. Moreover, little is known about individual characteristics that could make some individuals more vulnerable to "bored eating." Given data suggesting interoception as central to other forms of dysregulated eating, as well as its theoretical relevance, the current study focused on interoceptive ability as a vulnerability factor for bored eating. Utilizing an experimental design, Study 1 examined boredom as a trigger of snacking behaviors in a laboratory setting. Due to COVID-19, data collection was terminated early, but preliminary results provided tentative support for a causal role of boredom in food consumption. Study 2 was a cross-sectional, correlational extension of Study 1. Consistent with predictions, Study 2 found that boredom proneness was a significant predictor of emotional eating, even when accounting for the broad dimensions of negative and positive affect. Inconsistent with hypotheses, the association between boredom proneness and emotional eating was not moderated by interoception. Findings have implications for the prevention and treatment of emotional eating. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
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Alexithymia has been linked to risky or problematic alcohol use, with a common interpretation invoking deficient emotion regulation and use of alcohol to cope with distress. An alternative explanation positing a general deficit of interoception in alexithymia suggested that poor awareness of internal cues of overconsumption may promote excessive drinking. The present study assessed predictions based on these hypotheses in 337 young adult alcohol users recruited online. Participants completed validated questionnaire indices of alcohol use, alexithymia, emotion regulation, interoceptive sensibility, and sensitivity to reward and punishment. Alcohol use was positively correlated with alexithymia and reward sensitivity, and negatively correlated with emotion regulation as expected, but was uncorrelated with interoceptive sensibility. Alexithymia was not significantly correlated with most dimensions of interoceptive sensibility but was highly negatively correlated with emotion regulation. Hierarchical regression controlling for demographic variables indicated that alexithymia, emotion regulation, sex, and sensitivity to reward and punishment were significant predictors of alcohol use levels. Bootstrapped mediation test controlling for all other variables indicated mediation of the association between alexithymia and alcohol use by deficient emotion regulation but not interoceptive sensibility. Results supported the emotion regulation deficit interpretation of the association of alexithymia with alcohol use. Limitations concerning interoception measurement, online samples, self-report measures, cross-sectional designs, and collection of data during the COVID-19 pandemic are discussed. Future research could follow up on these findings by testing interoceptive accuracy in addition to interoceptive sensibility in relation to alexithymia and alcohol use.
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The Framing Effect (FE) demonstrated that the way two alternatives are displayed affects people's inclination to make a specific choice, showing a risk aversion when alternatives are displayed on positive frames and risk seeking in negative frames. Risk seeking in negative frames is closely linked to loss aversion. Moreover, classical research and the salience-of-losses hypothesis argues that stress may enhance the FE and loss aversion. Recent studies also suggest that the trait interoception and alexithymia could interact and moderate the framing susceptibility. However, experimental paradigms on stress could ignore variables such as threat perception. In this sense, COVID-19 pandemic has become a powerful real-life stressor in many countries. We aimed to study how real-life stressors influence decision-making under risk. A total of 97 participants were divided into a control (n = 48) and an experimental group (n = 49). The experimental group were exposed to a stressor manipulation, a 5 min COVID-19 lockdown documentary. Our results show that COVID-19-related stressors significantly decreased bet acceptance regardless of the frame, also reducing loss aversion. Moreover, interoception was a significant predictor of loss aversion under stress conditions. Our results do not support classical research on stress and FE.
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Long COVID, in which disease-related symptoms persist for months after recovery, has led to a revival of the discussion of whether neuropsychiatric long-term symptoms after viral infections indeed result from virulent activity or are purely psychological phenomena. In this review, we demonstrate that, despite showing differences in structure and targeting, many viruses have highly similar neuropsychiatric effects on the host. Herein, we compare severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), human immunodeficiency virus 1 (HIV-1), Ebola virus disease (EVD), and herpes simplex virus 1 (HSV-1). We provide evidence that the mutual symptoms of acute and long-term anxiety, depression and post-traumatic stress among these viral infections are likely to result from primary viral activity, thus suggesting that these viruses share neuroinvasive strategies in common. Moreover, it appears that secondary induced environmental stress can lead to the emergence of psychopathologies and increased susceptibility to viral (re)infection in infected individuals. We hypothesize that a positive feedback loop of virus-environment-reinforced systemic responses exists. It is surmised that this cycle of primary virulent activity and secondary stress-induced reactivation, may be detrimental to infected individuals by maintaining and reinforcing the host's immunocompromised state of chronic inflammation, immunological strain, and maladaptive central-nervous-system activity. We propose that this state can lead to perturbed cognitive processing and promote aversive learning, which may manifest as acute, long-term neuropsychiatric illness.
ABSTRACT
Emotional eating is a commonly described phenomenon reported by individuals across the weight spectrum. Not only does existing evidence suggest it is not an effective emotion regulation strategy, but emotional eating is also associated with difficulty losing weight during weight loss interventions and other negative health outcomes. The majority of existing work in the area of emotional eating has focused on the broad dimensions of negative and positive affect. Yet, there are data suggesting that different emotions appear to produce different changes in eating behaviors, suggesting the importance of investigating the influence of discrete emotions on eating. The lack of understanding regarding eating in response to boredom in particular, is a major gap in the current literature. Moreover, little is known about individual characteristics that could make some individuals more vulnerable to "bored eating." Given data suggesting interoception as central to other forms of dysregulated eating, as well as its theoretical relevance, the current study focused on interoceptive ability as a vulnerability factor for bored eating. Utilizing an experimental design, Study 1 examined boredom as a trigger of snacking behaviors in a laboratory setting. Due to COVID-19, data collection was terminated early, but preliminary results provided tentative support for a causal role of boredom in food consumption. Study 2 was a cross-sectional, correlational extension of Study 1. Consistent with predictions, Study 2 found that boredom proneness was a significant predictor of emotional eating, even when accounting for the broad dimensions of negative and positive affect. Inconsistent with hypotheses, the association between boredom proneness and emotional eating was not moderated by interoception. Findings have implications for the prevention and treatment of emotional eating. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
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B Neurological and neurophysiological changes associated with SARS-CoV-2 infection: New observations, new mechanisms b Muhammed Ali Haidar, Hussam Jourdi, Zeinab Haj Hassan, OHanes Ashekyan, Manal Fardoun, Mark Wehbe, Ghassan Dbaibo, Hassan Zaraket, Ali Eid, & Firas Kobeissy B Circular RNAs in the brain: A possible role in memory? b Esmi Zajaczkowski & Timothy Bredy B Heart matters: Cardiac dysfunction and other autonomic changes in Parkinson's disease b Martin Trinidad Herrero, Valeria Gonçalves, Lorena Cuenca-Bermejo, Emiliano Fernandez-Villalba, Sebastian Martin-Balbuena, Maria da Silva Fernandes, & Carla Scorza B Complex inclusion bodies and defective proteome hubs in neurodegenerative disease: New clues, new challenges b Amit Mishra, Arun Upadhyay, Naveen Sundaria, Rohan Dhiman, Vijay Prajapati, & Amit Prasad B Brains that fire together wire together: Inter-brain plasticity underlies learning in social interactions b Simone Shamay-Tsoory B Animal and cellular models of Alzheimer's disease: Progress and future approaches b David Baglietto-Vargas, Laura Trujillo-Estrada, Elisabeth Sanchez-Mejias, Raquel Sanchez-Varo, Juan Antonio Garcia-Leon, Cristina Nuñez-Diaz, Jose Carlos Davilla, Javier Vitorica, Frank LaFerla, Ines Moreno-Gonzalez, & Antonia Gutierrez B Neuroscience - The new English major?. [Extracted from the article] Copyright of Neuroscientist is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
This study aims to determine the formation of cognitive abilities and self-assessment among students of the special physical training in security forces program. A total of 96 students aged 18 to 24 years completed 12 close-ended questions, i.e., 6 knowledge awareness (KA) and 6 ideomotor awareness questions (IA). The 13th question was aimed at self-assessment of their own answers. Based on the Dunning–Kruger effect, comparing all positive answers to KA and IA questions with the self-assessment answer showed that 51% of first-year students provided positive answers with a 50% self-assessment rate, indicating a balanced self-assessment. The percentage of positive answers for the second-year students totaled 51%, with a 70% self-assessment rate, indicating overassessment. The percentage of positive answers totaled 82% for the third-year students, with a 62% self-assessment rate, indicating underassessment. To help students to become proficient requires balancing theory and experience, classroom and practice, where they incorporate a “student-as-instructor” modality to the entire curriculum, not only to the limited selected courses of the special forces training. Using the active learning technique helps students to gain exposure to a stimulating and interactive environment. We stress a teaching modality that includes learning by doing and having the student act as a teacher. In this role, participants maximize their learning through interoceptive awareness, feeling, and applying course material in a more comprehensively factual setting.
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Objectives: Interoception refers to the multidimensional representation of the internal states of the body, including sensation, appraisal, integration, and regulation. COVID-19 targets internal respiratory, temperature and gastrointestinal systems, thus posing a threat to humans that causes anxiety. Here, we examined the relationship between interoceptive sensibility and COVID-19 anxiety during the first UK national lockdown, when uncertainties surrounding the virus were at their peak.Methods: Between April and July 2020, N = 232 individuals across four age-categories completed questionnaires measuring interoceptive sensibility (BPQ-SF and MAIA-2), an adapted State-Trait-Anxiety Inventory (STAI) to assess COVID-19 anxiety, and a Perceived Quality of Life (QoL) questionnaire.Results: Higher scores on the BPQ-SF were related to higher levels of COVID-19 anxiety, while the MAIA-2 subscales Not Worrying, Attention Regulation, and Trusting of bodily signals were related to lower levels of COVID-19 anxiety. Age was related to lower levels of COVID-19 anxiety yet showed no significant (Bonferroni-corrected) relationship with interoceptive dimensions. Trait anxiety, Not Worrying, perceived quality of work, and COVID-19-related media consumption emerged as significant predictors of COVID-19 anxiety.Conclusion: Findings suggest that interoceptive dimensions differentially relate to COVID-19 anxiety irrespective of age, with implications for managing health anxiety and adaptive behaviour during a pandemic across the lifespan.
Subject(s)
COVID-19 , Interoception , Anxiety/epidemiology , COVID-19/epidemiology , Communicable Disease Control , Humans , Interoception/physiology , Quality of LifeABSTRACT
Introduction During the course of coronavirus disease-2019 (COVID-19) pandemic, many neuropsychiatric manifestations of the disease have been observed while the precise pathophysiology remains unknown [1]. New variants of coronavirus such as the 501.V2 and B.1.1.7 have emerged and obscurities in pathogenesis have increased even further with these variants. Here, we describe a patient with long-term effects of COVID-19, manifesting first episode psychosis accompanied by Cotard's Syndrome (CS) after infection with the B.1.1.7 variant of SARS-CoV-2. Case A 41-year-old female with no adverse medical history was admitted to the emergency department with symptoms of loss of smell, myalgia and sore throat and COVID-19 infection was confirmed by a positive RT-PCR test result for the B.1.1.7 variant of coronavirus. Two months after the completion of treatment for COVID-19, the patient started to have thoughts of being annihilated by viral occupation of her body and of her nervous system getting decomposed. The patient's family brought her to the psychiatric emergency department. The patient was found to have strong suicidal ideations, referential thoughts, belief of being physically dead and her children being in danger of obliteration by COVID-19. Clinical evaluation of the mental state of the patient was significant for decreased speech output and speed as well as psychomotor activity. Nihilistic, persecutory and referential delusions with no insight were recorded. Upon hospitalization and treatment with olanzapine 20mg/day orally and electroconvulsive therapy, her psychiatric symptoms and suicidal ideation ameliorated. The patient was discharged from the hospital with olanzapine 20mg/day orally and she is currently being followed-up in our outpatient clinic. Discussion To the best of our knowledge, this is the first report of a patient who developed CS and psychotic symptoms associated with COVID-19 following infection with a new variant of coronavirus. CS is a rare self-perceptual anomaly with the presentation of nihilistic delusions. While the exact pathogenesis of CS remains unexplained, defective mechanisms of proprioception or interoception may lead to a self-misattribution following a perceptual dysfunction which might trigger CS [2]. Although blood tests indicated no systemic inflammation for the index patient, an indistinct neuroinflammatory process may lead to neurotoxicity that might result in perceptual disruption and CS or psychotic features, as suggested in previous reports [3]. Considering well-described anosmia and ageusia with COVÍD-19 and our case's symptoms after the infection, new variants of SARS-CoV-2 might affect the perceptual pathways. The angiotensin-converting enzyme-2 (ACE-2) receptor which might modulate smell and taste perception, has been identified as a potential viral receptor. Such interaction may disrupt chemosensory perception. Overall, COVID-19 may cause abnormal processing of perceptions. This in turn can lead to anosmia, ageusia and defective proprioception, resulting in self-misattributions as seen in the patient in the current case report who was diagnosed with CS. Clinicians should keep in mind that infections with the rapidly spreading B.1.1.7 variant of SARS-CoV-2 might result in more severe symptoms or long-term consequences of COVID-19 compared to other strains. No conflict of interest
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The current international crisis situation caused by the COVID-19 pandemic is having a strong psychological impact on our subjectivities. We are constantly threatened by the danger of i) being infected, ii) infecting other people, and (iii) by the loss of social relation. Departing from these premises, we here aim to investigate the psychological and neurodynamics of this complex phenomenon. First, we discuss about recent psychological and neuronal findings on fear and its disorders, related to an unbalanced intero-exteroceptive processing and emotional regulation. Secondly we move to the psychological and neuronal dynamics of self and others characterized by a temporo-spatial alignment with the world. Due to the neural overlap of emotion and self and the deep-reaching neuro-ecological layers of self, emotional feelings like fear and anxiety cannot be detached and dissociated from the world; they signify the world-brain relation, and, more specifically, our self-other relation. The deepest neuro-ecological and neuro-social layers of self are threatened by the loss of subjectivity, which is manifest in our loss of body and thus the fear of dying, and the loss of intersubjectivity that surfaces in our fear of infecting others, which reflect the intimate anchorage of the self with the world. In our opinion the pandemic of COVID-19 deeply affect our sense of self and its spatio-temporal neuronal dynamics providing the prerequisites for the manifestation of fear and existential anxiety, thus disrupting the brain-world relation with significant repercussions on our psyche and on our daily lives.
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BACKGROUND: Hypermobility is a poorly recognised and understood musculoskeletal disorder thought to affect around 20% of the population. Hypermobility is associated with reduced physiological and psychological functioning and quality of life and is a known risk factor for the development of an anxiety disorder. To date, no evidence-based, targeted treatment for anxiety in the context of hypermobility exists. The present intervention (ADAPT-Altering Dynamics of Autonomic Processing Therapy) is a novel therapy combining bio-behavioural training with cognitive approaches from clinical health psychology targeting the catastrophisation of internal sensations, with aim to improve autonomic trait prediction error. METHOD: Eighty individuals with diagnosed hypermobility will be recruited and the efficacy of ADAPT to treat anxiety will be compared to an Emotion-Focused Supportive Therapy (EFST) comparator therapy in a randomised controlled trial. The primary treatment target will be post therapy score on the Beck Anxiety Inventory, and secondary outcomes will also be considered in relation to interoception, depression, alexithymia, social and work adjustment, panic symptoms and dissociation. Due to COVID restrictions, the intervention will be moved to online delivery and qualitative assessment of treatment tolerance to online therapy will also be assessed. DISCUSSION: Online delivery of an intervention targeting anxiety would improve the quality of life for those experiencing anxiety disorder and help to reduce the £11.7 billion that anxiety disorders cost the UK economy annually. TRIAL REGISTRATION: World Health Organization ISRCTN17018615 . Registered on 20th February 2019; trial protocol version 2.
Subject(s)
COVID-19 , Joint Instability , Anxiety/diagnosis , Anxiety/prevention & control , Humans , Joint Instability/diagnosis , Joint Instability/therapy , Quality of Life , SARS-CoV-2 , Treatment OutcomeABSTRACT
The global dissemination of COVID-19 creates confusion and ambiguity in nearly every aspect of life, including fear of contagion, heightened awareness of the mortality of self and family members, lack of power, and distrust of experts and decision-makers. In this stressful situation, the question arises as to what mechanisms distinguish between adaptive and maladaptive self-regulation. The theory of Motivated Cue-Integration (MCI) is a novel theory of self-regulation that provides a new perspective on the effect of COVID-19 on self-regulation deficiency as an example of psychological distress. Inspired by predictive coding, social cognition, embodied cognition, and experiential approach, MCI suggests that self-regulation is based on interaction between (1) high-level values and goals, (2) low-level interoceptive and exteroceptive signals, and (3) trust in epistemic authority or a significant other. Motivated Cue-Integration posits that individuals create meaning by making moment-to-moment predictions that affect their interpretation of the experience of ambiguity influenced by their relationship with epistemic authority. According to MCI, deficiency in self-regulation during COVID-19 could result either from over-sensitivity or under-sensitivity to low-level interoceptive and exteroceptive cues; rigidity or ambiguity of high-level goals, poor integration between the two levels of processing as well as distrust in epistemic authority. According to MCI, variations of these deficiencies may occur in various clinical phenomena such as alexithymia and somatization, as well as in social phenomena such as goal radicalization. Based on this reasoning, MCI claims that the mentalization of the relationship between interoceptive cues, exteroceptive cues, goals, and psychological needs of the person, as well as the improvement of confidence in epistemic authority, can promote adaptive self-regulation. Psychological intervention can foster trust in epistemic authority, increase the mentalization of interoceptive and exteroceptive cues, and their association with adaptive goals. As such, the integration of these elements in a way that facilitates incentives pathways and insight fosters a more integrated subjective experience, higher clarity of emotion, and positive internal dialogue which promotes action tendency.
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(1) Background. This research examined the feasibility, acceptability and outcomes of delivering a 6-week yoga-based meditation intervention to clinical teams of hospice professionals (HPs) at a large non-profit hospice organization. The intervention was designed to increase mind-body integration and combat burnout. This article was written for different audiences, including research scientists who study interoception, burnout, meditation, or yoga, designers of meditation interventions, and hospice organizations looking for ways to mitigate HP burnout. (2) Methods. The intervention was launched within clinical teams, beginning with a half-hour online introduction to the program and exposure to the week 1 meditation at each team's monthly all-staff meeting. Throughout the program, HPs could access the meditations on their own via their workplace computers, tablets, and smartphones. Online pre- and post-intervention surveys were submitted by 151 HPs, 76 of whom were exposed to the intervention and completed both surveys. The surveys assessed burnout using the Professional Fulfillment Index and mind-body integration using the Multidimensional Assessment of Interoceptive Awareness scales. (3) Results. Two-thirds of HPs who were present at a staff meeting where the program was introduced went on to do a meditation on their own at least once. Half of HPs expressed a desire to continue with access to the meditations after the 6-week program ended. Due to COVID-19 work from home restrictions, three-fourth of HPs did a meditation at home, 29% in a car between patient visits (not while driving), and 23% at the office. Higher interoceptive awareness was significantly related to lower burnout, particularly lower work exhaustion. Meditation frequency was significantly related to higher interoceptive awareness but not to burnout. Interpersonal disengagement was rare and temporary. (4) Conclusions. Findings showed that the yoga-based meditation intervention was feasible and acceptable and associated with higher interoceptive awareness. The results point to a role for interoceptive awareness in reducing the risk for burnout.