Goals: This study aimed to understand the neurocognitive symptoms associated with gluten exposure in individuals with self-reported celiac disease (CD) and nonceliac gluten sensitivity (NCGS).Background: While gluten-induced neurocognitive impairment (GINI; eg, "celiac fog" or "brain fog") is commonly described by individuals with CD and NCGS, there are little data regarding the prevalence and symptoms associated with these experiences.Study: A 9-question online survey was accessed by 1396 individuals (1143 with CD; 253 with NCGS). Forced choice and free-response questions were asked of participants to obtain a description of neurocognitive symptoms experienced after gluten ingestion. Freeresponse answers were coded using a coding structure developed based on the Health-Related Quality of Life Instrument. Results:The majority of survey participants (89% of CD and 95% of NCGS) reported having GINI symptoms. When describing symptoms, the most common word descriptors for both groups were difficulty concentrating, forgetfulness, and grogginess. Timing of symptoms, including onset and symptom peak, were similar across the 2 groups. Coding of free responses found the most common references were to cognitive, physical, psychological, and overall quality of life impacts.Conclusions: This survey suggests that GINI is common and may be severe in both individuals with CD and NCGS. Cognitive impairment and decline in physical functioning may be similar to that occurring in other illnesses, such as lupus. Clinical follow-up with both individuals with CD and NCGS should include assessment of GINI symptoms. Further research is warranted, including the development of a patient-reported outcome measure including neurocognitive effects of gluten exposure.
Breathwork techniques and therapies offer a set of practical interventions for clinical mental health counselors (CMHCs) and are viable methods for integrating physiological sensitivities in treatment by way of the relaxation response. We discuss an organizing framework of breathwork practices and identify three broad categories of breathwork within the field: deep relaxation breathing, mindfulness breathwork, and yogic breathing. Each style is distinct in how it is applied and in the specific respiratory patterns that users are instructed to use. We also aim to elaborate the physiological effects, clinical research outcomes, and applicability of breathwork for treating mental illness. Overall, research findings indicate that breathwork may be efficacious for treating anxiety, depression, and posttraumatic stress disorder. Despite preliminary evidence for breathwork's efficacy for treating common psychological distress, more research is needed to evaluate its utility for treating a wider range of mental illness. CMHCs are encouraged to incorporate breathwork techniques in their clinical treatment programs but must appraise the value of each technique individually.
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