Emotional Acceptance Research Articles

Indeed Death is nearer; Moderating Role of Resilience in the Relationship between Fear of COVID-19 and Death Anxiety

Purpose: To determine the moderating effect of resilience for Fear of COVID-19 in predicting death anxiety among COVID sufferers and general population of Pakistan.
 Methodology: A cross-sectional study was conducted on adults (N=300), COVID-19 sufferers (n=150) and general population (n=150) from 24th September 2021 to 10th June 2022. All participants who fulfilled the inclusion/exclusion criteria were included. Data collection was done by purposive sampling technique from different universities, institutions and hospitals of Pakistan. The questionnaires were filled out by participants, for this purpose revised death anxiety (RSAD), Connor-Davidson resilience (CD-RISC) and Fear of COVID-19 (FCV-19S) scales were used to access death anxiety, resilience and Fear of COVID-19. After data collection, data were used for further analysis using SPSS 21. Descriptive measurements were calculated for scales and subscales. Moderation analysis was used to find out moderating effect of resilience for fear of COVID-19 in predicting death anxiety among COVID-19 sufferers and general population.
 Findings: The alpha coefficient of all scales and subscales ranged from .64 to .93. Mean, standard deviation and skewness, kurtosis values fulfilled the assumption of normal distribution of data. Moderating effect of resilience for fear of COVID-19 in predicting death anxiety, showed significant interaction effect of resilience and fear of COVID-19 on death anxiety only among COVID-19 sufferers, the interaction effect found to be explain 3.4% variance on death anxiety. The computation of slopes of model graph for these results indicates that t=1.34 (p>.001) for lower level of resilience, t=4.81 (p<.001) for middle level and t=5.67 (p<.001) for higher level. Values shows significance of moderation for middle and higher level of resilience among COVID-sufferers. A significant increase was observed in death anxiety with respect to increase in fear of COVID-19 at moderate and higher level of resilience. But moderating effect of resilience for fear of COVID-19 in predicting death anxiety among general population was non-significant.
 Recommendations: Providing training about prevention strategies of COVID-19 through media can help people to deal with it. Various strategies such as acceptance of anxiety and negative emotions, maintaining a healthy lifestyle, social contacts and fostering self-efficacy should be recommended to include in psychological interventions for treatment of death anxiety and effectively cope up with fear of COVID-19. It would be beneficial to include more targeted variables that were not available in this study, such as social benefits, social support, use of health, and welfare services.

Rewriting Women: A Critique of Misogyny, Structure and Agency in the Novels of K. R. Meera- A Review

Purpose: The purpose of this review paper is to highlight the fact that lack of state support creates violence and injustice. Women, as a minority, and as a gender, need to be recognized, and protected. The age-old notion of patriarchy still has its roots running through the lives of our society. Equality if not given, is exercised and asserted by K. R. Meera’s characters. Transgression occurs when limits are drawn and tightened. The State has its responsibilities toward its subjects irrespective of their gender. If violated, they should be enforced by appropriate judicial measures. This paper establishes that the only way to assure social justice for women, the paper establishes. Design: Based on the secondary sources, a method has been designed to reveal the very basic human tendency to ask for what is allowed to every other sect. Society might have drawn boundaries, which if transgressed would invite punishment. Rejection of emotional acceptance is considered to be against human rights. For a human, irrespective of gender, there’s no necessity to surrender his/her individual freedom and happiness. The happiness of a woman need not be sacrificed just for the sake of her family. This research largely depends on the findings from research journals from Google Scholar, ResearchGate, SSRN, Elsevier, Academia, and Shodhganga for identifying the research gap. To highlight the key aspects of the research, ABCD analysis is used. The interviews and social posts of the author also give much insight into the different aspects of the research question. The literary compositions of the author are the major source of research. Findings: The main finding of the research is that the law of the country and its administration support the privileged, all-powerful patriarchy. The finding also includes a discussion about the insecurity of women under such a system and how it becomes one of the reasons for the chaos that goes on within the country. Transgression is one of the powerful methods adopted under such situations by the women of K. R. Meera’s novels, a reflection of what we get to see around, especially through social media and this is where the research paper stands out in its finding. The research paper explores the nature of a self-subsistent, self-reliant woman in the making of powerless patriarchy. Originality: This research is unique as full-fledged research on the author’s works is yet to be done. It doesn’t further discuss the proven elements that are found in the research journals published. Most of them explore the hindrances patriarchy creates in framing the identity of women, mainly in the light of a single text of the author. But they never discuss how women use violence as a means to secure themselves from the all-powerful people protected by the system. The concept of justice and its failure to protect women of the country is never mentioned or studied in the papers already published or researched based on the author’s novels. Thus, the research is original in its area and findings. Paper Type: Review Paper

Feasibility, acceptability, and effectiveness of school-based dance movement psychotherapy for children with emotional and behavioral difficulties.

BackgroundSchools have been increasingly employing dance movement psychotherapists to support children cope with daily worries and stress, express and understand their emotions, develop self-awareness and self-esteem. However, evidence on the impact of dance movement psychotherapy as a tool for prevention of mental health difficulties in childhood remains limited.MethodsSixteen children (aged 7–9) with mild emotional and behavioral difficulties from two primary schools were randomly assigned to a Dance Movement Psychotherapy (DMP) intervention or to a waiting list, within a larger pilot cross-over randomized controlled study which aimed to (a) test whether all elements of study design can work together and run smoothly in a full-scale RCT; and (b) investigate the effectiveness of arts therapies in improving children’s health related quality of life (HRQOL; EQ-5D-Y), wellbeing and life functioning (Child Outcome Rating Scale; CORS), emotional and behavioral difficulties (Strengths and Difficulties Questionnaire; SDQ), and duration of sleep (Fitbits). The therapeutic process was also evaluated through interviews with children, participant observations, the Children’s Session Rating Scale (CSRS), and ratings of adherence to the therapeutic protocol.ResultsThe findings indicated that DMP led to improvements in children’s life functioning, wellbeing, duration of sleep, emotional and behavioral difficulties, but not in quality of life. The improvements were maintained at the follow-up stages, up to 6 months post-intervention. Interviews with children also suggested positive outcomes, such as self-expression; emotional regulation; mastery and acceptance of emotions; improved self-confidence and self-esteem; reduced stress; and development of positive relationships. However, children would have preferred smaller groups and longer sessions.ConclusionThis study indicated that all outcome measures would be suitable for inclusion in a larger randomized controlled trial, though the EQ-5D-Y is not recommended as a stand-alone measure due to its lack of sensitivity and specificity for young participants. The adherence to the therapeutic protocol ratings differed between children and adults, highlighting the need to include children’s voice in future research. Strategies are also proposed of how to conduct randomization of participants in ways that do not hinder the therapeutic process.

The role of emotion regulation in couples' stress communication and dyadic coping responses.

Partners' ability to cope together in the face of stress-commonly known as dyadic coping (DC)-can promote individual and couple well-being. However, little is known about the predictors of DC, including partners' emotion regulation. This study examined (a) whether emotion regulation abilities are associated with partners' DC responses, and (b) whether these associations are mediated by partners' engagement in stress communication in a community sample of different-gender couples (N=239). Couples completed self-report measures to assess their stress communication and DC responses (supportive, negative, and common DC) and six dimensions of emotion regulation (emotional awareness, acceptance, clarity, goal-orientation, regulation strategies, and impulse control). Results from structural equation modelling analysis confirmed expected associations between stress communication and partners' supportive and common DC responses. Additionally, only associations with women's emotion regulation emerged significant. First, women's emotional awareness was associated with more supportive DC from men and common DC through increases in women's stress communication. Second, women who endorsed emotional acceptance engaged in less supportive DC towards their partner. Third, women's goal-orientation was associated with less supportive DC from each partner and common DC through decreases in men's stress communication. There were no associations with men's emotion regulation. Collectively, findings suggest that although women may manage their negative emotions in ways that are adaptive for their individual well-being, these benefits may not always affect relationship functioning in the same way. Clinical implications and future research directions are discussed.

Negative emotion and nonacceptance of emotion in daily life.

Nonacceptance of emotion is consistently linked with increased levels of psychopathology and diminished well-being. Research has found that negative emotion and nonacceptance of emotion are positively associated cross-sectionally but has yet to directly investigate temporal associations between these constructs. Given that negative emotions are frequently the target of negative thoughts and other emotions, and that acceptance of emotion is associated with prospective decreases in negative emotion, we hypothesized that the temporal relation between negative emotion and nonacceptance of emotion is bidirectional. The present study examined the association between these variables during people's daily lives using an experience sampling methodology. Multilevel modeling was used for all analyses, including hierarchical generalized linear modeling and log-normal hurdle modeling. A total of 187 women from the United States and Australia reported negative emotion and nonacceptance of emotion 14 times a day for 5 days. Negative emotion and nonacceptance of emotion were positively associated contemporaneously. Across time, nonacceptance of emotion was prospectively and positively associated with the intensity of negative emotion independent of immediately prior negative emotion, and negative emotion intensity was prospectively and positively associated with nonacceptance of emotion independent of immediately prior nonacceptance. Results support a bidirectional model of negative emotion and nonacceptance of emotion wherein each variable predicts increases in the other across time. Our findings elucidate how individuals fall into maladaptive emotional patterns that are difficult to break and could possibly pave the way to the development and maintenance of psychopathology. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

초등학교 프로젝트 수업의 교사-학생 상호작용 특성 분석

Objectives This study focused on the interaction between teachers and students among the various characteristics of project based learning, and attempted to reveal the characteristics by observing project-based elementary school classes. Methods To this end, The AF analysis was used to analyze the language interaction between teachers and students, and the CLASS analysis was used to analyze the ‘emotional support, classroom organization, and instructional support’ interaction between teachers and students. In addition, Pearson's correlation analysis was conducted to confirm the correlation between the Flanders area analysis, the Flanders Top 10 Index, and the CLASS analysis. In addition, Classes were classified by type to confirm the results of the interaction analysis of ‘emotional support, classroom organization, and instructional support’ according to the type of language interaction, and the results were compared. Results First, In the project based learning, the ratio of items 0 (others) was the highest, followed by items 5 (lecture), items 9 (student-led remarks), and items 4 (teacher's questions). Second, In the project based learning, the index in which teachers accept students' opinions or emotions and the index in which students take the initiative in asking and speaking were high. In addition, the index of teachers asking questions using students' remarks was also high. On the other hand, In the project based learning, the index in which teachers criticize students or justify teachers' authority was low. Third, In the project based learning, the flow of ‘teacher's lecture-nonverbal situation-teacher's lecture’ was high. Fourth, In the project based learning, the ‘emotional support’ area was the highest, followed by the ‘classroom organization’ and ‘instructional support’ area. However, the average for all three areas showed a moderate or higher level, and the deviation was not large, showing a similar tendency. Conclusions First, Project based learning is a class that utilize directive remarks from teachers to induce student-led inquiry activities. Second, Project based learning is a class that emphasizes the attitude of warm-hearted acceptance of students' opinions or emotions without advocating the authority of teachers. Third, Project based learning is a class with a high percentage of students leading throughout the class. Fourth, Project based learning is a class that mainly utilize teachers' questions as feedback on students' remarks. Fifth, Project based learning is a class in which non-verbal situations such as student-led inquiry activities or waiting time for student to think account for a high percentage. Sixth, The flow of project based learning is at a very high rate of ‘teacher's lectures-nonverbal situations-teacher's lectures’. Seventh, Project based learning is a class in which interactions through ‘emotional support, classroom organization, and instructional support’ appear positively.

Intensive short-term dynamic psychotherapy (ISTDP) offers unique procedures for acceptance of emotion and may contribute to the process-based therapy movement

A variety of contemporary cognitive behavioral therapy (CBT) frameworks have collectively converged on acceptance of emotion as a therapeutic process central to producing positive outcomes. However, evidence shows that not all patients respond to these treatments, such as those with more severe and complicated symptomatology and more entrenched emotion avoidance tendencies. Intensive short-term dynamic psychotherapy (ISTDP) is a specific, highly active, emotion-focused model of therapy grounded in empirical research that was designed to treat complex patients with entrenched emotion avoidance behaviors. This paper presents the clinical techniques of ISTDP to illustrate its methods of facilitating acceptance of emotion, which is likely unfamiliar to many CBT therapists. Leaders of the field in CBT have recently made calls for psychotherapy, including CBT, to move toward a focus on process-based therapy (PBT), which seeks to highlight and investigate promising change processes and their related change procedures, no matter their original therapeutic framework. In introducing ISTDP techniques to CBT and PBT researchers and therapists, we seek to stimulate awareness, curiosity, and further collaboration in the study and use of these techniques in the hopes that ISTDP may contribute to the PBT movement.

Nonjudgmental Regard of Others: Investigating the Links Between Other-Directed Trait Mindfulness and Prejudice.

Although researchers predict that experiencing greater trait mindfulness should be related to less prejudiced attitudes towards others, the evidence has been inconsistent. We suggest that this is due to the narrow operationalizations of mindfulness that have been utilized thus far. Specifically, research to date has relied solely on mindfulness as it pertains to the self. We therefore examined an expanded definition of mindfulness to study the role of nonjudgmental attitudes towards others and its relation with prejudice. Using a new measure of Nonjudgmental Regard towards Others (NRO), the current study found that Ideological Acceptance, or judgments of another's actions, ideas, and personality, and Emotion Acceptance, or acceptance of another's emotions and emotional expressions, were independently associated with prejudiced attitudes towards numerous different outgroups such as drug users, people who are overweight, homosexuals, and people with disabilities. Furthermore, they were able to explain variance over and above the Five Facet Mindfulness Questionnaire, Social Dominance Orientation and Right-Wing Authoritarianism. Having a nonjudgmental regard towards others, not just the self, may be an important component of mindfulness that has not yet been explored.

576-P: Cocreating a Virtual Care Platform That Delivers Mental Health Support to Adults with Type 1 Diabetes (T1D) Living in Rural and Remote Communities

Introduction: While mental health (MH) is the cornerstone of diabetes care, access to MH support in rural and remote communities in British Columbia (BC) is limited. The purpose of this study was to design REACHOUT, a virtual care platform, to deliver peer-led MH support to adults with T1D in geographically marginalized communities in BC. Methods: The REACHOUT platform was co-created by our T1D Patient Partner Team (n=16) and experts in digital health, biomedical engineering, behavioural science, and rural health. REACHOUT is built as a customizable extension to the Rocket.chat open-source platform, deployed privately on Amazon Web Services servers in Canada; it offers various forms of encryption to maintain data security. We applied an Agile iterative development approach with multi-staged feedback from T1D Patient Partners and key stakeholders in a participatory action framework. Results: The REACHOUT app has three support delivery features: 1) 1-ON-1 SUPPORT delivered by an individual Peer Supporter (PS) self-selected by the participant from a library of PS profiles. Profiles include descriptors such as stage of life, hobbies, and interests, sociodemographic information, diabetes history and treatment etc. Mode, content, and structure of communication are driven entirely by participants’ support preferences and needs; 2) 24/7 COMMUNITY CHAT ROOMoffers “just-in-time” group support and accommodates needs for emotional validation, normalization, and non-judgmental acceptance; 3) VIDEO HUDDLES are monthly PS-led virtual group sessions highlighting a distress or resilience related theme (e.g. workplace bias and discrimination, cooking low-carb, insurance coverage challenges) . Conclusions: Launched in November 2021, the REACHOUT pilot supports 40 participants with 40 PS. Adoption and utilization patterns for each of the support delivery mechanisms are being monitored and will be compared in mid-2022. Disclosure T.S.Tang: None. P.Johal: None. A.Azhar: None. L.Fisher: Consultant; Ascensia Diabetes Care, Research Support; Eli Lilly and Company. W.H.Polonsky: Consultant; Abbott Diabetes, Boehringer Ingelheim International GmbH, Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Intuity Medical, Inc., Provention Bio, Inc., Sanofi. M.Görges: Research Support; Careteam Technologies Inc, Excelar Technologies, IDENTOS Inc, MedStack Inc, SecureKey Technologies Inc, Smile CDR Inc, Thrive Health, Xerus Medical. Funding Juvenile Diabetes Research Foundation (2-SRA-2020-986-S-B)

Evaluation of the Affect School as supplementary treatment of Swedish women with eating disorders: a randomized clinical trial

BackgroundDespite solid research there remains a large group of patients with eating disorders who do not recover. Emotion dysregulation has been shown to be a feature in the different eating disorders. A manualized group intervention developed in Sweden, the Affect School, aims to enhance emotional awareness and the ability to perceive and express emotions.AimThis study aimed to test the hypothesis that participation in the Affect School as a complement to ordinary eating disorder treatment would enhance awareness and regulation of emotions and reduce alexithymia and cognitive eating disorder symptoms in a sample of patients with eating disorders at a Swedish specialized outpatient clinic.MethodForty patients with various eating disorders were randomized to either participation in the Affect School as a supplement to treatment as usual (TAU), or to a TAU control group. Participants were assessed with the Eating Disorder Examination Questionnaire, the Deficits in Emotion Regulation Scale-36, and the Toronto Alexithymia Scale-20 at start, end of intervention, and at the 6- and 12-month follow-ups.ResultsNo significant differences were observed post-treatment but Affect School participants had improved significantly more than controls on eating disorder cognitions and behaviours and emotion dysregulation at the 6- and 12-month follow-ups and had significantly less alexithymia at the 6-month follow-up.ConclusionDifficulties with emotion recognition and/or regulation can complicate fulfilment of personal needs and obstruct communication and relationships with others. The present study indicates that adding Affect School group sessions to regular treatment enhances emotional awareness and emotion regulation and decreases eating disorder symptoms and alexithymia.Plain English summaryPatients with eating disorder diagnoses have described problems with emotional management, for example: lower emotional awareness and difficulties in using adaptive emotional regulatory strategies compared to people without eating disorders. It has been suggested that interventions aiming at enhancing emotional awareness and acceptance would be beneficial in treatment. In the present study we explored whether adding the Affect School to regular treatment would enhance awareness and regulation of emotions and decrease eating disorder symptoms. Forty women with an eating disorder were randomly allocated to either an additional participation in a group treatment for 8 weeks or usual treatment only. The treatment contained education on different affects such as joy, fear, interest, shame, anger, disgust, and worry. The education was followed by discussions on own experiences. Participants filled in self-assessment forms that measured eating disorder symptoms, emotional recognition, and emotion regulation before the start and at the end of the group treatment, and after 6 and 12 months respectively. The results when comparing the two groups suggested that the Affect School could be an effective additional treatment. Participants in the Affect School improved their scorings but the change took time and did not show until at the 6- and 12 months follow-ups.

Outcome of micro vascular reconstruction of the lower limb after resection of primary bone tumors

Background: Surgical and medical care for patients with bone and soft tissue tumors of the extremities continues to improve with advancement of chemotherapeutic strategies, surgical techniques, and understanding of pathogenesis. Aim and Objective: To Analysis of the results of lower limb preservation after neoplastic resection to reproduce an advisory algorithm for surgical decision making to achieve optimal functional results.Methods: This retrospective study was performed in the microsurgery unit Assiut university hospital between 2013 and 2019, involved (40) patients with primary malignant bone tumors and benign aggressive bone tumors who had wide local resection and reconstruction by vascularized fibula (osteoseptocutaneous flap). Results: The highest mean time of union rate was 5.75±2.06 for GCT. The least mean time of union rate was 3.86±1.21 forChondrosarcoma. the least Mean±SD of function was 2.83±0.75 in chondrosarcoma while the highest Mean±SD of emotional acceptance was 4±0.82 in Ewing sarcoma. The Mean±SD of pain were equal in both Ewing sarcoma and GCT. Conclusions: Benign aggressive tumors & primary malignant bone tumors now become not a rare tumor. Free vascularized fibular graft is one of several methods of bone reconstruction after bone tumor resection. Using as a means of reconstruction.

Psychological Resilience, Coping, and Distress in Admitted Patients With COVID-19 Infection.

Objective: To assess psychological resilience, coping, and related psychological distress in admitted COVID-19 patients. Predictors of subsequent development of posttraumatic stress symptoms (PTSS) and disability were also studied.Methods: Stable inpatients with COVID-19 (aged > 18 years with mild symptoms) admitted to a tertiary care hospital from April 2020 to December 2020 were recruited for the study. During admission, the patients were assessed for resilience, coping, and psychological distress using the 10-item Connor-Davidson Resilience Scale (CD-RISC-10), Brief COPE (Coping Orientation to Problems Experienced), and 4-item Patient Health Questionnaire (PHQ-4). Similarly, they were assessed at 4 weeks after discharge using the PTSD Checklist for DSM-5 and World Health Organization Disability Assessment Schedule.Results: A total of 176 patients were recruited for the study and assessed during their admission, and 102 were reassessed during follow-up. Of the patients, 17.6% during admission and 58.8% at follow-up had significant psychological distress (PHQ-4 score > 2). The mean ± SD CD-RISC-10 score was 27.94 ± 5.82. The most used coping strategies were emotional support, religion, and acceptance. Increased resilience was associated with better education (rs[100] = 0.265, P = .007), less psychological distress (r[100] = -0.596, P = .001), and healthy coping strategies. PHQ-4, PCL-5, and disability scores at follow-up were positively correlated (Pearson correlation). The multiple regression model statistically significantly predicted PTSS (F7, 94 = 2.660, P < .015, adjusted R2 = 0.103).Conclusions: COVID-19 patients with better resilience are associated with reduced psychological distress. Better resilient traits and reduced psychological distress may prevent ensuing PTSS and disability.

Oncological and functional outcomes of planned and unplanned excision of soft tissue sarcoma: A retrospective study

BackgroundIn soft tissue sarcomas, the oncological and functional outcomes between planned excision and unplanned excision with additional wide resection remains controversial. The purpose of this study is to determine the impact of unplanned excision on oncological and functional outcomes. MethodsA retrospective single-center study was performed. Patients with soft tissue sarcoma surgically treated in 2005–2019 were included in this study. A total of 120 patients consisting of planned excision (PE) group (n = 88), and unplanned excision (UE) group (n = 32) were included. Overall-survival (OS), local recurrence-free survival (LRFS), metastasis-free survival (MFS), disease-free survival (DFS), incidence rate of reconstructive surgery and musculoskeletal tumor society (MSTS) score were assessed. Propensity score matching method was used in statistical analysis. ResultsThe 5-year survival rate of OS, LRFS, MFS, and DFS did not differ between the PE and UE groups, however, rates of reconstructive surgery were higher in the UE group (PE: 48% vs. UE: 84%, p < 0.001). These results did not differ (PE: 41% vs. UE: 82%, p = 0.012) after propensity score matching was performed to align the backgrounds with difference in tumor size and depth. For MSTS score, the total score and “pain” and “emotional acceptance” scores were higher in the PE group before propensity score matching. The “pain” and “emotional acceptance” scores were higher in the PE group after propensity score matching also. ConclusionsUnplanned excision did not deteriorate oncological outcomes, however unplanned excision lead to unnecessary reconstructive surgery. Unplanned excision adversely affected patient-reported outcomes without worsening pure functional outcomes.

Mediating Role of Psychological Inflexibility as Transdiagnostic Factor in the Relationship Between Emotional Dysregulation and Sleep Problems With Symptoms of Emotional Disorders.

This study aims to investigate the mediating role of psychological inflexibility as a transdiagnostic factor in the relationship between emotional dysregulation and sleep problems with symptoms of emotional disorders. A total of 500 subjects from three universities were selected by random multistage clustering, and they completed the Pittsburgh Sleep Quality Index, Difficulties in Emotional Regulation Scale, and Acceptance and Action Questionnaire–II, Inventory of Depression and Anxiety Symptoms. The results of correlation coefficients revealed that there is a positive and significant correlation among emotional dysregulation, sleep problems, and psychological inflexibility with emotional disorders. In addition, the results showed that psychological inflexibility acts as a transdiagnostic factor that mediates the relationship between emotional dysregulation and sleep problems with symptoms of emotional disorders. These findings illustrate how emotional dysregulation and sleep problems affect emotional disorders through psychological inflexibility.

App-Based Mindfulness Meditation for People of Color Who Experience Race-Related Stress: Protocol for a Randomized Controlled Trial.

BackgroundPeople of color (POC) who experience race-related stress are at risk of developing mental health problems, including high levels of stress, anxiety, and depression. Mindfulness meditation may be especially well suited to help POC cope, given its emphasis on gaining awareness and acceptance of emotions associated with discriminatory treatment. However, mindfulness meditation rarely reaches POC, and digital approaches could reduce this treatment gap by addressing traditional barriers to care.ObjectiveThis study will test the effectiveness of a self-directed app-based mindfulness meditation program among POC who experience elevated levels of race-related stress. Implementation outcomes such as treatment acceptability, adherence, and satisfaction will be examined.MethodsParticipants (n=80) will be recruited online by posting recruitment materials on social media and sending emails to relevant groups. In-person recruitment will consist of posting flyers in communities with significant POC representation. Eligible participants will be block randomized to either the intervention group (n=40) that will complete a self-directed 4-week mindfulness meditation program or a wait-list control condition (n=40) that will receive access to the app after study completion. All participants will complete measures at baseline, midtreatment, and posttreatment. Primary outcomes include changes in stress, anxiety, and depression, and secondary outcomes constitute changes in mindfulness, self-compassion, rumination, emotion suppression, and experiential avoidance. Exploratory analyses will examine whether changes in the secondary outcomes mediate changes in primary outcomes. Finally, treatment acceptability, adherence, and satisfaction will be examined descriptively.ResultsRecruitment began in October 2021. Data will be analyzed using multilevel modeling, a statistical methodology that accounts for the dependence among repeated observations. Considering attrition issues in self-directed digital interventions and their potential effects on statistical significance and treatment effect sizes, we will examine data using both intention-to-treat and per-protocol analyses.ConclusionsTo our knowledge, this will be the first study to provide data on the effectiveness of a self-directed app-based mindfulness meditation program for POC recruited based on elevated race-related stress, a high-risk population. Similarly, meaningful clinical targets for POC affected by stressors related to race will be examined. Findings will provide important information regarding whether this type of intervention is an acceptable treatment among these marginalized groups.Trial RegistrationClinicalTrials.gov NCT05027113; https://clinicaltrials.gov/ct2/show/NCT05027113International Registered Report Identifier (IRRID)DERR1-10.2196/35196

Associations between emotion regulation and remission following cognitive behavioural therapy for adults with bulimia nervosa.

Emotion regulation (ER) deficits are associated with illness severity in individuals with bulimia nervosa. We examined whether baseline ER abilities are associated with remission following enhanced cognitive behavioural therapy for eating disorders (CBT-E). Participants (N=50, 85.0% female) receiving CBT-E completed a measure (yielding a global score and six subscale scores) of ER pre-treatment. Remission was assessed by the Eating Disorder Examination at post-treatment and follow-up. Analyses tested associations between baseline ER and behavioural, cognitive, or full remission at post-treatment and three-month follow-up. Lower global ER abilities, measured by the Difficulties in Emotion Regulation Scale, were associated with lower likelihood of behavioural and full, but not cognitive, remission at post-treatment. Specifically, individuals low in emotional clarity and impulse control were less likely to be behaviourally remitted. Those low in emotional acceptance, awareness, clarity, or strategies to manage emotion were less likely to be fully remitted. Global ER scores were not associated with any remission type at follow-up. Baseline ER deficits were associated with lower likelihood of behavioural or full remission at post-treatment. However, ER was less associated with remission at follow-up, indicating that ER is most important during treatment. Findings highlight a need for targeted treatments aimed at improving ER.

Limb salvage surgery with endoprosthesis reconstruction in management of locally advanced primary bone tumours: a functional outcome evaluation

&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Endoprosthetic reconstruction using a custom-made metallic mega-endoprosthesis is one of the common modalities for limb salvage operation. The new promising advance of material science, design and fabrication of the endoprosthesis enable an immediate rehabilitation program and provide a durable and functional limb. The aim of the study was to evaluate the efficacy and functional outcome in patients with primary bone tumours treated by limb salvage surgery using endoprosthetic replacement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A total of 14 patients with primary bone tumour in major large joints of the body, selected between January 2019 to August 2020, were managed by limb salvage surgery via endoprosthetic replacement. This was a prospective study conducted at a Tertiary care Government Hospital in Kolkata, and all patients were followed up to a minimum of 1.5 years. The evaluation system used was proposed by Enneking, recommended by the musculoskeletal tumour society in addition to the radiologic evaluation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;At final follow-up, the mean musculoskeletal tumour society score was 89.71±3.58. The mean Knee Society Score of 9 patients was 85.55±3.64 and mean Harris hip score of 2 patients and Oxford shoulder score of 4 patients were 90.5 and 41.67 respectively by the end of 1.5 years. 12 (85.7%) patients did not have any complications. None of the cases had implant loosening or breakage, periprosthetic fracture, tumour recurrence or amputation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Endoprosthesis are excellent choices for the treatment of bone tumours with limb preservation in relation to pain, strength, and patient’s emotional acceptance as they reconstruct a limb with an acceptable oncologic, functional, and cosmetic result providing immediate weight-bearing capacity and generating a greater independence.&lt;/p&gt;

Emotional Schemas

Beck's cognitive model has stressed the influence of cognitive processing in eliciting and maintaining emotional disorders. The concept of schema is extended in Emotional Schema Therapy to account for beliefs, assumptions, and strategies that comprise problematic theories of emotion that result in unhelpful strategies of emotion regulation and acceptance of emotion. In the present paper the central concepts of Emotional Schema Therapy are elucidated and research supporting the model is reviewed.

Quand bouger n’est plus synonyme de santé : une recension des traitements de l’exercice physique pathologique en troubles des conduites alimentaires

IntroductionPathological physical exercise is a central feature of eating disorder and is related to a poor prognosis. Only few evidence-based recommendations are currently available to guide caregivers in the management of “exerciser” patients. Objective. The purpose of this paper is to present the current state of knowledge regarding proposed treatments targeting specifically the management of pathological physical exercise in patients with any type of eating disorder. MethodThe literature search took place in March 2020 and has been updated in February 2021 in databases (PsycINFO, PubMed, MEDLINE, SPORTDiscuss, etc.). English keywords encompassing concepts associated with pathological physical exercise, any type of eating disorder, and treatment were used in various combinations. To be included in the study, the publications identified must be written in English or French and be quantitative or qualitative empirical articles, systematic reviews of the literature or meta-analyses, case studies or syntheses of clinical guidelines. ResultsThe synthesis of the studies highlights four main classes of pathological physical exercise treatment: adapted physical exercise treatment (n=6), cognitive-behavioral therapy (n=4), thermoregulation (n=1) and pharmacotherapy (n=1). The summary of currently available treatments for pathological exercise indicates benefits of adapted physical exercise and cognitive-behavioral therapy treatments, primarily. These treatments demonstrate efficacy in improving principally the qualitative components of pathological exercise (decrease of compulsion towards exercise, dysfunctional attitude towards exercise, rigidity towards exercise, exercise to regulate emotions and lack of pleasure during exercise and rule-based exercise) in addition to a favorable effect on other symptoms associated with eating disorder (increase of the body mass index, quality of life, motivational change stage and emotional acceptance as well as decrease of the global eating disorder severity, drive for thinness, perfectionism, depression symptoms and psychological distress). Treatments aimed at reducing pathological exercise should include adapted physical exercise combined with cognitive-behavioral therapy principles, principally. Also, pathological physical exercise treatment should (1) promote the benefit of group and pleasure to avoid ascetic and compulsive behaviors as well as provide a variety of movement, (2) include relaxation/rest intervals to reconnect with bodily sensations, (3) include psychoeducational interventions to learn to identify pathological physical exercise and (4) address emotions and cognitions related to exercise to change the function of behavior. Pharmacological treatments should be used only in specific cases and with great caution. ConclusionWhile this review points to a predominantly uni- or multi-disciplinary approach to the management of pathological physical exercise, the multidimensionality and complexity of this phenomenon dictates that it be managed holistically through a transdisciplinary team. In this regard, transdisciplinary programs that consider physical exercise as a complex phenomenon transcending sectors of activity must be seriously considered.

Contemplative practice, acceptance, and healing in moral injury

Moral injury is a soul struggle for many veterans. It includes a deep sense of regret, shame, and division within themselves due to morally injurious events. Spiritual practices like Centering Prayer are complementary disciplines that help veterans heal from moral injury and process embedded trauma, guilt, and shame. Contemplative practices can help with acceptance of difficult emotions and thoughts connected to past moral injury and help veterans refocus on values that are part of their community, faith, and social backgrounds. At the Loveland VA, a group of veterans are following the guidelines outlined by Contemplative Outreach for a Centering Prayer practice. The guidelines and the intended outcomes are outlined in this paper and include previously researched benefits of mindfulness and meditation-based practices for PTSD, which often co-occurs with moral injury. Veterans’ feedback from both in-person and online versions of the Centering Prayer group are included in the paper. While encouraged as an individual discipline, veterans are also encouraged to practice Centering Prayer within groups at the VA or in the community for deeper inter-relational healing and trust. Veteran peer supports provide links to Contemplative Prayer outreach groups as well as AA groups in the community. As a mindfulness-based spiritual practice with Judeo-Christian roots, Centering Prayer is a powerful addition to a chaplaincy program that promotes whole health healing and growth.