Neuroimaging Correlates of Cognitive Behavioral Therapy for Insomnia (CBT-I): A Systematic Literature Review.

Cognitive behavioral therapy for insomnia (CBT-I) is the gold-standard non-pharmacological treatment for insomnia, a complex disorder that comprises psychological, behavioral, and physiological components. This systematic literature review aimed to evaluate a growing body of exploratory studies that have examined CBT-I treatment effects using neuroimaging assessment. Nine studies met current review selection criteria, of which six studies compared insomnia groups with good sleepers, waitlist, and/or control groups. CBT-I administration varied in treatment length and duration across the studies, as did neuroimaging assessment, which included task-based and resting-state functional magnetic resonance imaging (fMRI), and structural magnetic resonance imaging (MRI). Functional connectivity abnormalities were observed in participants, including reduced engagement in task-related brain regions and apparent difficulties in regulating default mode brain areas that appeared to reverse following CBT-I treatment. Taken together, the neuroimaging results complement behavioral measures of treatment efficacy, indicating support for the effectiveness of CBT-I treatment in the recovery of brain function and structure.

The association between sleep quality and telomere length: A systematic literature review.

Several sleep parameters present an elevated risk for processes that contribute to cellular aging. Short sleep duration, sleep apnoea, and insomnia are significantly associated with shorter telomeres, a biological marker of cellular aging. However, there has been no review or analysis of studies that have examined the association between the psychological construct of sleep quality and telomere length. The present study aimed to provide a systematic review of the association between sleep quality and telomere length. A systematic review of English articles was conducted using MEDLINE/PubMed, PsycINFO, Google Scholar, and Web of Science electronic databases, with the final search conducted on 3rd September 2021. Search terms included sleep quality, poor sleep, insomnia, sleep difficulties, sleep issue*, non-restorative sleep, telomere*, cellular aging, and immune cell telomere length. Study eligibility criteria included human participants aged 18 years or older and a reproducible methodology. Study appraisal and synthesis were completed using a systematic search in line with a PICOS approach (P = Patient, problem, or population; I = Intervention, prognostic factor, exposure; C = Comparison, control, or comparator; O = Outcomes; S = Study designs). Twenty-two studies met review inclusion criteria. Qualitative synthesis of the literature indicated insufficient evidence overall to support a significant association between sleep quality and telomere length. Limitations across studies were addressed, such as the assessment of examined constructs. Findings highlight important targets for future research, including the standardised operationalisation of the sleep quality construct and experimental study designs. Research in this area has clinical significance by identifying possible mechanisms that increase the risk for age-related disease and mortality. PROSPERO Registration No.: CRD 42021233139.

EcoMeditation Modifies Brain Resting State Network Activity.

Background: The tendency of the mind to wander, a characteristic of the brain's default mode network (DMN), correlates with increased unhappiness and self-referential processing and is a deterrent to establishing a consistent meditation practice. The objective of this study was to test the impact of a secular physiological method of meditation. We hypothesized that EcoMeditation would produce increases in neural communication in brain regions associated with compassion and prosociality and decreases in self-referencing networks, such as the DMN, and that these changes would be found in the experimental group, but not the control group. Methods: Participants (n=38) were randomized into two groups, and the final sample consisted of 25 participants. One group listened daily to a 22-minute EcoMeditation audio track, while the other used an active control. Functional magnetic resonance imaging (fMRI) was used to assess brain function before and after four weeks of practice. Mystical experiences, as well as psychological conditions, such as anxiety and depression, were measured. Results: Participants in the EcoMeditation group showed significantly increased connectivity between the bilateral hippocampus and the bilateral insula, compared to pre-intervention. In addition, significant decreases of connectivity between the bilateral hippocampus and the midprefrontal and left dorsolateral prefrontal cortices occurred. EcoMeditation participants also scored significantly higher for mystical experiences than the control group. The results for emotional states were mixed, with one assessment finding increased positive mood, but another finding increased negative affect. Conclusion: After only four weeks, participants using EcoMeditation demonstrated brain states similar to meditation adepts with thousands of hours of traditional practice.

App-Based Delivery of Clinical Emotional Freedom Techniques: Cross-Sectional Study of App User Self-Ratings.

BACKGROUND: The burgeoning area of mobile health (mHealth) has experienced rapid growth in mobile apps designed to address mental health issues. Although abundant apps offer strategies for managing symptoms of anxiety and stress, information regarding their efficacy is scarce. OBJECTIVE: This study aimed to assess the effect of an mHealth app on user self-ratings of psychological distress in a sample of 270,461 app users. The Tapping Solution App guides users through the therapeutic protocols of Clinical Emotional Freedom Techniques (EFT), an evidence-based psychophysiological intervention that combines acupressure with elements of cognitive and exposure therapies. METHODS: App users provided self-ratings of emotional intensity before and after app sessions (termed "tapping meditations") using an 11-point Subjective Units of Distress scale. App user data for 23 tapping meditations, which addressed psychological symptoms of anxiety and stress, were gathered between October 2018 and October 2019, totaling 380,034 completed app sessions. RESULTS: Across 12 anxiety-tapping meditations, the difference in emotional intensity ratings from presession (mean 6.66, SD 0.25) to postsession (mean 3.75, SD 0.30) was statistically significant (P<.001; 95% CI -2.92 to -2.91). Across 11 stress-tapping meditations, a statistically significant difference was also found from presession (mean 6.91, SD 0.48) to postsession (mean 3.83, SD 0.54; P<.001; 95% CI -3.08 to -3.07). The results are consistent with the literature on the efficacy of Clinical EFT for anxiety and stress when offered in conventional therapeutic formats. CONCLUSIONS: The findings provide preliminary support for the effectiveness of the mHealth app in the immediate reduction of self-rated psychological distress. As an adjunct to professional mental health care, the app promises accessible and convenient therapeutic benefits.

Portion perfection and Emotional Freedom Techniques to assist bariatric patients post surgery: A randomised control trial.

BACKGROUND: Although significant health improvements are indicated from weight-loss following bariatric surgery, many individuals are unable to lose weight or maintain their weight-loss. The current study aimed to assess whether post-surgery care comprising Emotional Freedom Techniques (EFT), an emerging energy psychology intervention, combined with a behaviour-based nutrition and portion control eating plan in an online self-guided delivery would aid weight-loss and maintenance in bariatric patients. METHODS: A 6-month randomised controlled parallel-group trial. Participants (N = 343; aged 21-69 years; BMI ≥30 kg/m2) had undergone bariatric surgery (12 + months prior) and were randomly assigned to one of three treatment groups: Portion Perfection for Bariatric Patients (PPBP; n = 109), PPBP combined with an eight-week online self-paced EFT treatment (n = 107), and a treatment as usual (TAU) control (n = 127). Participants completed measures of BMI, emotional eating, uncontrolled eating, food cravings, and self-esteem at 8-week post-treatment (n = 158) and 6-month follow-up (n = 109). RESULTS: Mixed-design analyses of variances were conducted to examine the effect of the interventions on outcome measures (pre-intervention, 8-week post-intervention, and 6-month follow-up). Emotional eating decreased significantly from pre-intervention to post-intervention for the PPBP and PPBP with EFT groups, and at 6-month follow-up for the TAU group only. There were no statistically significant between-group differences in other outcome variables. However, at 6-months the PPBP with EFT group experienced the greatest improvements in emotional eating (-16.33%), uncontrolled eating (-9.36%), and self-esteem (+4.43%), compared to PPBP only or TAU. CONCLUSION: The effect of EFT combined with the eating plan on psychological variables was largely inconsistent with prior research and discussion of how this may be optimised in future trials is discussed. CLINICAL TRIAL REGISTRATION: ACTRN12616001257459.

Does psychological capital mediate the impact of dysfunctional sleep beliefs on well-being?

Dysfunctional sleep beliefs are strongly involved in sleep difficulties, which in turn negatively predict psychological health and well-being. In contrast, psychological capital (PsyCap) is a positive cognitive resource, comprising four dimensions (hope, self-efficacy, resilience, and optimism), that positively predicts psychological well-being. Significant associations between sleep beliefs and well-being, and PsyCap and well-being are detailed; however, research on their interrelations (among sleep beliefs, well-being, and PsyCap) remains scarce. This cross-sectional study aimed to elucidate the relationships among the variables. The convenience sample consisted of 123 Australian working adults. Participants completed an online survey comprising four empirically established measures (Dysfunctional Beliefs and Attitudes about Sleep Scale, Psychological Well-being Scale, Psychological Capital Questionnaire, and a social desirability scale). Hypotheses were derived from Conservation of Resources (COR) theory, which underlines the importance of cognitive mechanisms that guide adaptive psychological responses. Results were consistent with hypotheses: dysfunctional sleep beliefs significantly and negatively predicted PsyCap, and PsyCap mediated the relationship between sleep beliefs and well-being. Findings suggested that PsyCap, which can be developed, may help buffer the adverse effects of sleep beliefs to benefit well-being. Replication of model coefficients in larger samples and future testing of PsyCap training within sleep-hygiene practices are recommended.

Reexamining the effect of emotional freedom techniques on stress biochemistry: A randomized controlled trial.

OBJECTIVE: In a direct replication of Church, Yount, and Brooks (2012), this study examined changes in stress biochemistry and psychological distress symptoms in 53 participants randomly allocated to one of three 60-min group interventions: Emotional Freedom Techniques (EFT), psychoeducation (PE), and no treatment (NT). The Symptom Assessment-45 (SA-45) was used to assess psychological distress symptoms. METHOD: Salivary cortisol assays were administered 30 min pre- and postintervention to test cortisol levels. The original study by Church et al. indicated the EFT group showed statistically significant improvements in anxiety (-58.34%, p < .05), depression (-49.33%, p < .002), overall severity of symptoms (-50.5%, p < .001), and symptom breadth (-41.93%, p < .001). The group also experienced a significant decrease in cortisol (-24.39%) compared to the PE group (-14.25%) and NT group (-14.44%). RESULTS: The present results indicated the EFT group experienced a significant decrease in cortisol greater than the original study (-43.24%, p < .05), but these results were not mirrored by subjective reports of psychological distress. The EFT group reduction in cortisol was significantly different from that of the PE group (-19.67%), and as expected, the posttreatment cortisol level detected among the EFT group was lower than that of the NT group (2.02%); however, there was not a statistically significant difference between the 2 groups. Additionally, there were no significant improvements in cortisol reduction among the NT and PE groups. CONCLUSIONS: Findings support the original study indicating EFT to be an efficient and effective brief treatment for reducing biological markers of stress. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Delineating the psychological and behavioural factors of successful weight loss maintenance.

Overweight and obesity present alarming global health problems including detrimental health risks that call for effective interventions. Considerable research has examined behavioural and psychological factors associated with weight loss to advance the field of obesity and overweight. In line with the literature, this study aimed to develop a behavioural and psychological profile based on factors of personality, eating behaviours, emotional functioning, physical well-being, and psychopathology. The sample consisted of 105 community participants who had reduced their bodyweight by at least 10% and had either successfully maintained their weight loss for a minimum 12-month period (n = 41) or had regained their weight loss within 12 months (n = 64). Participants completed an online survey comprising demographic items and four empirical measures (Mini Marker Personality Scale, Patient Health Questionnaire, Three-Factor Eating Questionnaire-Revised, and a food screening tool). Based on significant bivariate correlations results, four factors (fat intake, restrained eating, uncontrolled eating, and emotional eating) were entered into a binary logistic regression. Restrained eating was the only factor that significantly increased the likelihood of predicting successful long-term weight loss. Findings have implications for overweight and obesity future research, which may guide the direction of obesity and overweight treatments.

Brief EcoMeditation Associated With Psychological Improvements: A Preliminary Study.

BACKGROUND: A growing body of clinical research attests to the psychological and physiological benefits of meditation. EcoMeditation is a non-pharmacological therapeutic approach used to promote health and well-being, comprising four evidence-based techniques: The Quick Coherence Technique for regulating heart rate variability (HRV), Emotional Freedom Techniques (EFT), mindfulness, and neurofeedback. OBJECTIVES: This study investigated changes in psychological symptoms of anxiety, depression, posttraumatic stress disorder (PTSD), pain, and happiness following a one-day EcoMeditation training workshop delivered in a large-group format and at 3-months post-intervention. METHODS: A convenience sample of 208 participants (137 women, 71 men) aged between 21 and 87 years (M = 55.4 years; SD = 12.8 years) attended a one-day EcoMeditation training workshop. Participants completed a pen-and-paper survey pre-workshop and post-workshop, and an online survey three months following the EcoMeditation intervention. RESULTS: Post-workshop results revealed significant reductions in anxiety (-23.4%, p < .001), depression (-15.8%, p = .011), PTSD (-11.8%, p < .001), and pain (-18.5%, p < .001), while happiness scores increased significantly (+8.9%, p < .001). At 3-month follow-up, one-way repeated-measures ANOVA (N = 65) found significant decreases in anxiety between pre-test and post-test, and pain between pre-intervention and 3-month follow-up. Differences in depression and PTSD scores were not significant over time. Happiness scores significantly increased from pre-test to 3-month follow-up. However, post-hoc analyses suggested that the final sample size was inadequate to detect significant differences between time points. CONCLUSION: Findings provide preliminary support for EcoMeditation as a brief group-based stress reduction intervention with benefits for improved psychological functioning.