Mindfulness Between the Sheets: Does a Brief Mindfulness Intervention Improve Community-Dwelling Populations' Sexual Experiences and Motivations, and Are Effects Moderated by Attachment Insecurity?

Research is increasingly linking mindfulness with better relationship outcomes. Less clear is whether these benefits extend to the sexual domain or whether the benefits of mindfulness are moderated by individual characteristics. Accordingly, the current report tested whether a brief online mindfulness intervention improved the cognitive, affective, and behavioral aspects of sexual experiences and whether effects varied by attachment anxiety and avoidance. Participants (N = 90) first completed a measure of attachment before reporting their sexual experiences each day for 7-days. Participants then listened to a mindfulness recording every day for 4 weeks. Finally, sexual experiences were reported on every day for 7 days again. Consistent with previous studies, no benefits of the mindfulness intervention were detected for more avoidant persons. Less consistent with expectation, however, the mindfulness intervention did not improve sexual outcomes in general, nor did it buffer other-focused avoidance-based sexual motivations or bolster sexual communal strength among more anxiously attached persons. However, the intervention did increase reports of positive sexuality among more anxious persons. Results are discussed in terms of the differential utility and limits of short mindfulness interventions looking to enhance sexual functioning in different populations and the potential mechanisms behind the presence and absence of effects.

Containing Attachment Concerns: Does Trait Mindfulness Buffer the Links between Attachment Insecurity and Maladaptive Sexual Motivations?

Individuals reporting greater insecure attachment are more likely to report maladaptive sexual motivations, such as sex to avoid negative relational and personal outcomes (e.g., conflict). Despite the costs of such sexual motivations, research is less clear regarding what might buffer the extent to which attachment insecurities manifest in such motives. The current study examined whether trait mindfulness moderates the links between attachment insecurity and maladaptive sexual motives. Participants (N = 194) completed measures of trait mindfulness, general sexual motivations, and attachment. As predicted, the links between attachment anxiety and having sex to cope and affirm the self were eliminated among individuals reporting higher levels of the acting with awareness facet of trait mindfulness. No such buffering effects were seen for attachment avoidance. Instead, acting with awareness mindfulness appeared to increase the extent to which more avoidantly attached individuals reported coping and self-affirmation-based sexual motives. These findings contribute to knowledge regarding the potential utility and limits of mindfulness in relational and sexual contexts, perhaps suggesting that mindfulness may help anxiously attached individuals manage the extent to which attachment concerns manifest in maladaptive sexual motivations. Findings of the study may inform both theory regarding mindfulness in interpersonal functioning and how mindfulness interventions might be deployed in sex therapy contexts.

A brief self-compassion intervention for adolescents with type 1 diabetes and disordered eating: a feasibility study.

AIM: To examine the feasibility and acceptability of a brief self-compassion intervention for adolescents with type 1 diabetes and disordered eating behaviour. METHODS: Twenty-seven adolescents with type 1 diabetes were recruited and randomized to receive the brief (two 2.5-h sessions) self-compassion intervention, either in the intervention group (n=11) or in a waitlist control group (n=8). The intervention was adapted from the standardized eight-session 'Making Friends with Yourself' programme, and sessions were delivered 1 week apart. Acceptability was assessed through qualitative questionnaires and feasibility was assessed based on session attendance and recruitment metrics. Possible changes to disordered eating behaviour, self-care behaviours, diabetes-related distress, self-compassion, stress and glycaemic control were also assessed. RESULTS: Nineteen participants completed the study, and they reported an increased sense of common humanity (acknowledging that we are not alone), mindfulness, and coping resources. In terms of feasibility, recruitment took longer than expected (8 months) and not all participants were able to attend both sessions (nine could only attend one of the two sessions). CONCLUSIONS: While self-compassion is a strong conceptual fit for the issues of type 1 diabetes and disordered eating behaviour in adolescence, and the intervention content appears acceptable, feasibility issues were such that brief self-compassion programmes will probably need to be adapted into digital interventions for future research. (Trial registration number: ANZCTR 12619000541101).

Do patient factors influence embryologists' decisions to freeze borderline blastocysts?

RESEARCH QUESTION: To investigate whether patient factors influence the decision to freeze a blastocyst with low implantation potential. DESIGN: This experimental study assessed 170 practicing embryologists from a variety of countries who were recruited via an online survey. Participants were currently practicing embryologists, who grade blastocysts as part of this role. The survey presented decision-making 'vignettes' to participants. These included specific patient information, as well as an image of an expanded blastocyst that was of borderline quality for inner cell mass and trophectoderm, for which the embryologist selected whether or not to freeze. High/low maternal age, the presence/absence of other top quality blastocysts, and the presence/absence of previously unsuccessful IVF cycles were systematically varied within the patient information in a 2 × 2 × 2 design. Participants reported how likely they would be to freeze a particular blastocyst on a scale of 1 (Extremely Unlikely) to 7 (Extremely Likely), and whether or not they would ultimately freeze each blastocyst (Yes or No). RESULTS: Lower maternal age, no other high-quality blastocysts within the cohort, and multiple unsuccessful IVF cycles were associated with greater likelihood of recommending to freeze (P < .001). Furthermore, significant interactions among all three patient factors were noted. CONCLUSION: This study provides evidence suggesting that when faced with an uncertain blastocyst, factors pertaining to the patient (maternal age, the presence/absence of other top quality blastocysts, and the presence/absence of previously unsuccessful IVF cycles) influence the decision to freeze.

Distinguishing postpartum and antepartum depressive trajectories in a large population-based cohort: the impact of exposure to adversity and offspring gender.

BACKGROUND: Distinguishing temporal patterns of depressive symptoms during pregnancy and after childbirth has important clinical implications for diagnosis, treatment, and maternal and child outcomes. The primary aim of the present study was to distinguish patterns of chronically elevated levels of depressive symptoms v. trajectories that are either elevated during pregnancy but then remit after childbirth, v. patterns that increase after childbirth. METHODS: The report uses latent growth mixture modeling in a large, population-based cohort (N = 12 121) to investigate temporal patterns of depressive symptoms. We examined theoretically relevant sociodemographic factors, exposure to adversity, and offspring gender as predictors. RESULTS: Four distinct trajectories emerged, including resilient (74.3%), improving (9.2%), emergent (4.0%), and chronic (11.5%). Lower maternal and paternal education distinguished chronic from resilient depressive trajectories, whereas higher maternal and partner education, and female offspring gender, distinguished the emergent trajectory from the chronic trajectory. Younger maternal age distinguished the improving group from the resilient group. Exposure to medical, interpersonal, financial, and housing adversity predicted membership in the chronic, emergent, and improving trajectories compared with the resilient trajectory. Finally, exposure to medical, interpersonal, and financial adversity was associated with the chronic v. improving group, and inversely related to the emergent class relative to the improving group. CONCLUSIONS: There are distinct temporal patterns of depressive symptoms during pregnancy, after childbirth, and beyond. Most women show stable low levels of depressive symptoms, while emergent and chronic depression patterns are separable with distinct correlates, most notably maternal age, education levels, adversity exposure, and child gender.

Associations between neurocognitive functioning and social and occupational resilience among South African women exposed to childhood trauma.

Background: Prior research on adaptation after early trauma among black South African women typically assessed resilience in ways that lacked contextual specificity. In addition, the neurocognitive correlates of social and occupational resilience have not been investigated. Objective: The primary aim of this exploratory study was to identify domains of neurocognitive functioning associated with social and occupational resilience, defined as functioning at a level beyond what would be expected given exposure to childhood trauma. Methods: A sample of black South African women, N = 314, completed a neuropsychological battery, a questionnaire assessing exposure to childhood trauma, and self-report measures of functional status. We generated indices of social and occupational resilience by regressing childhood trauma exposure on social and occupational functioning, saving the residuals as indices of social and occupational functioning beyond what would be expected given exposure to childhood trauma. Results: Women with lower non-verbal memory evidenced greater social and occupational resilience above and beyond the effects attributable to age, education, HIV status, and depressive and posttraumatic stress symptoms. In addition, women with greater occupational resilience exhibited lower semantic language fluency and processing speed. Conclusion: Results are somewhat consistent with prior studies implicating memory effects in impairment following trauma, though our findings suggest that reduced abilities in these domains may be associated with greater resilience. Studies that use prospective designs and objective assessment of functional status are needed to determine whether non-verbal memory, semantic fluency, and processing speed are implicated in the neural circuitry of post-traumatic exposure resilience.

Planteamiento: Las investigaciones previas sobre la adaptación después del trauma temprano entre las mujeres negras de Sudáfrica generalmente evaluaban la resiliencia de maneras que carecían de especificidad contextual. Además, no se han investigados los correlatos neurocognitivos de la resiliencia social y ocupacional. Objetivo: El objetivo principal de este estudio exploratorio fue identificar los dominios del funcionamiento neurocognitivo asociados con la resiliencia social y ocupacional, que se define como el funcionamiento en un nivel mayor de lo que se esperaría dada la exposición al trauma infantil. Métodos: Una muestra de mujeres negras sudafricanas, N = 314, completó una batería neuropsicológica, un cuestionario que evaluaba la exposición al trauma infantil y medidas de auto informe de su funcionamiento. Generamos índices de resiliencia social y ocupacional mediante la regresión de la exposición al trauma infantil en el funcionamiento social y laboral, conservando los residuos como índices de funcionamiento social y laboral más allá de lo esperado dada la exposición al trauma infantil. Resultados: Las mujeres con menor memoria no verbal mostraron una mayor resiliencia social y ocupacional por encima y más allá de los efectos atribuibles a la edad, la educación, el estado del VIH y los síntomas de depresión y estrés postraumático. Además, las mujeres con mayor resiliencia ocupacional mostraron menor fluidez del lenguaje semántico y de velocidad de procesamiento. Conclusión: Los resultados son algo consistentes con los estudios previos que implican los efectos de la memoria en el deterioro después del trauma, aunque nuestros hallazgos sugieren que las habilidades reducidas en estos dominios pueden asociarse a una mayor resiliencia. Se necesitan estudios que usen diseños prospectivos y una evaluación objetiva del estado funcional para determinar si la memoria no verbal, la fluidez semántica y la velocidad de procesamiento están implicadas en los circuitos neuronales de la resiliencia a la exposición postraumática.

Baseline values of cardiovascular and respiratory parameters predict response to acute hypoxia in young healthy men.

The majority of the available works have studied distinct hypoxic responses of respiratory and cardiovascular systems. This study examines how these systems interact while responding to hypoxia and whether baseline metrics moderate reactions to a hypoxic challenge. Central hemodynamic, aortic wave reflection, and gas exchange parameters were measured in 27 trained young men before and after 10-min normobaric isocapnic hypoxia (10 % O2). Associations were assessed by correlation and multiple regression analyses. Hypoxic changes in the parameters of pulse wave analysis such as augmentation index (-114 %, p=0.007), pulse pressure amplification (+6 %, p=0.020), time to aortic reflection wave (+21 %, p<0.001) report on the increase in arterial distensibility. Specifically, initially compliant arteries blunt the positive cardiac chronotropic response to hypoxia and facilitate the myocardial workload. The degree of blood oxygen desaturation is directly correlated with both baseline values and hypoxic responses of aortic and peripheral blood pressures. The hypoxia-induced gain in ventilation (VE), while controlling for basal VE and heart rate (HR), is inversely associated with deltaHR and deltasystolic blood pressure. The study suggests that cardiovascular and respiratory systems mutually supplement each other when responding to hypoxic challenge.

Does kindness matter? Self-compassion buffers the negative impact of diabetes-distress on HbA1c.

BACKGROUND: Higher self-compassion is associated with mental and physical health benefits in both healthy and chronically ill populations. The current study investigated the role of self-compassion in predicting depression, diabetes-specific distress and HbA1c in patients with diabetes. AIMS: To assess the specific operationalization of negative emotionality that best predicted HbA1c and to test whether self-compassion would buffer HbA1c in patients with diabetes against the negative effects of distress. METHODS: Patients with diabetes (n = 110) completed measures assessing trait self-compassion, depression and diabetes-distress. HbA1c results were obtained through medical records. RESULTS: As expected, diabetes-specific distress was a better predictor of HbA1c than depression; self-compassion moderated the relationship between distress and HbA1c such that higher distress predicted higher HbA1c at lower levels of self-compassion, but not at higher levels of self-compassion. CONCLUSIONS: In addition to further demonstrating the link between distress and metabolic outcomes, these findings suggest that self-compassion might buffer patients from the negative metabolic consequences of diabetes-distress.

Predicting the patients who will struggle with anal incontinence: sensitivity to disgust matters.

AIM: Quality of life varies in patients with anal incontinence. The severity of symptoms is a surprisingly modest predictor, but they reliably elicit disgust. The current work assessed prospectively whether dispositional sensitivity to disgust predicted the quality of life in patients with anal incontinence. METHOD: Seventy-five patients with anal incontinence identified from the waiting list for the pelvic floor clinic at the Greenlane Clinical Centre, Auckland, New Zealand, completed questionnaires assessing symptom severity (Fecal Incontinence Severity Index) and disgust sensitivity (Disgust Sensitivity-Revised scale) prior to a first appointment. Three months later incontinence-specific (Fecal Incontinence Quality of Life Scale, FI QLS) and general quality of life (World Health Organization Quality of Life-BREF, WHOQOL-BREF) were assessed. RESULTS: Greater severity of symptoms prospectively predicted lower incontinence-specific quality of life (FI QLS lifestyle domain) and lower general quality of life (WHOQOL-BREF environmental domain). Greater disgust sensitivity predicted poorer psychological and environmental well-being, and moderated the link between symptom severity and outcome. Persons low in disgust sensitivity reported a higher quality of life when symptom severity was low, but those with a high disgust sensitivity had a low quality of life regardless of symptom severity. CONCLUSION: The functional status of patients with anal incontinence explains some but not all of the variation in quality of life. Emotional factors such as disgust appear to have a role. Disgust sensitivity warrants further attention.