Preliminary findings support the potential of yoga as a complementary treatment of depressed patients who are taking anti-depressant medications but who are only in partial remission. The purpose of this article is to present further data on the intervention, focusing on individual differences in psychological, emotional and biological processes affecting treatment outcome. Twenty-seven women and 10 men were enrolled in the study, of whom 17 completed the intervention and pre- and post-intervention assessment data. The intervention consisted of 20 classes led by senior Iyengar yoga teachers, in three courses of 20 yoga classes each. All participants were diagnosed with unipolar major depression in partial remission. Psychological and biological characteristics were assessed pre- and post-intervention, and participants rated their mood states before and after each class. Significant reductions were shown for depression, anger, anxiety, neurotic symptoms and low frequency heart rate variability in the 17 completers. Eleven out of these completers achieved remission levels post-intervention. Participants who remitted differed from the non-remitters at intake on several traits and on physiological measures indicative of a greater capacity for emotional regulation. Moods improved from before to after the yoga classes. Yoga appears to be a promising intervention for depression; it is cost-effective and easy to implement. It produces many beneficial emotional, psychological and biological effects, as supported by observations in this study. The physiological methods are especially useful as they provide objective markers of the processes and effectiveness of treatment. These observations may help guide further clinical application of yoga in depression and other mental health disorders, and future research on the processes and mechanisms.

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With limited efficacy of medications for symptom relief, non-medication treatments may play an important role in the treatment of irritable bowel syndrome (IBS), the most common functional gastrointestinal (GI) disorder. This study aimed to evaluate the efficacy of two self-regulation strategies for symptom relief and mood management in IBS patients. Thirty-five adult participants meeting ROME III criteria for IBS were enrolled, 27 of the 35 participants (77%) completed treatment and pre- and post-treatment visits (89% women, 11% men; M (SD) age = 36 (13)), and 20 of the 27 (74%) completed a 6-month follow-up. Participants were randomly assigned to 16 biweekly group sessions of Iyengar yoga or a walking program. Results indicated a significant group by time interaction on negative affect with the walking treatment showing improvement from pre- to post-treatment when compared to yoga (p < .05). There was no significant group by time effect on IBS severity. Exploratory analyses of secondary outcomes examined change separately for each treatment condition. From pre- to post-treatment, yoga showed significant decreases in IBS severity measures (p < .05), visceral sensitivity (p < .05), and severity of somatic symptoms (p < .05). Walking showed significant decreases in overall GI symptoms (p < .05), negative affect (p < .05), and state anxiety (p < .05). At 6-month follow-up, overall GI symptoms for walking continued to significantly decline, while for yoga, GI symptoms rebounded toward baseline levels (p < .05). When asked about self-regulated home practice at 6 months, significantly more participants in walking than in yoga practiced at least weekly (p < .05). In sum, results suggest that yoga and walking as movement-based self-regulatory behavioral treatments have some differential effects but are both beneficial for IBS patients, though maintenance of a self-regulated walking program may be more feasible and therefore more effective long term.

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Two studies were conducted to determine the anger-attenuating effects of nicotine as a function of trait hostility. The 1st study examined the effects of nicotine on diary ratings of anger during a 24-hr period in a natural setting in 30 smokers and 30 nonsmokers. Participants took part in 2 monitoring sessions involving the administration of a nicotine patch and a placebo patch. Participants were categorized as high or low on trait hostility on the basis of their scores on the Cook-Medley Hostility scale. Administration of the nicotine patch, compared with the placebo patch, resulted in a significant reduction in diary reports of anger from 24% to 13% in high-hostile participants. In low-hostile participants, nicotine had no effect on reports of anger during the day. The anger-palliative effects of nicotine were greatest among participants more frequently reporting anger on the placebo-patch day. These effects were independent of smoking status and gender. The 2nd study, which was restricted to high-hostile smokers (n = 19) and nonsmokers (n = 23), found that, compared with a placebo patch, administration of nicotine resulted in significant reductions in reports of anger in smokers and nonsmokers. The results of these 2 studies clearly link nicotine to reduced reports of anger in high-hostile individuals.

Objectives: Previous research suggests that mechanisms related to afferent and efferent components of the baroreflex are associated with blood pressure level and mood, and that mood as a component of subjective well-being may be mediated by changes in blood pressure. This study examines these mechanisms in 213 healthy women and men. Methods: Evaluation of spontaneous baroreflex activity using the sequence technique under resting conditions in the laboratory was followed by 2 days of 24-h ambulatory blood pressure recording and diary ratings of mood. Results: Patterns of components of the baroreflex loop were significant predictors of 24-h ambulatory blood pressure mean level, its circadian variability, and daily ratings of mood. Three mechanisms were found to be involved in the regulation: (1) interaction between gains of afferent and efferent cardiac components of the baroreflex, (2) gain of afferent signals related to fast cardiac responses to baroreceptor activation, and (3) gain of afferent signals related to late cardiac responses to baroreceptor inhibition. The interaction of afferent/efferent components of baroreflex loop appears to independently determine mean levels of systolic blood pressure and positive (happy) mood. The effect of the baroreceptor activation mechanism on subjective well-being (indexed by happy and alert moods) was mediated by the wake/sleep systolic blood pressure difference. Additionally, the baroreceptor inhibitory mechanism effect on subjective well-being (indexed by stressed and sleepy moods) was mediated by the wake/sleep diastolic blood pressure difference. Conclusions: Evaluation of the baroreflex components and their interaction provides important information about blood pressure and mood beyond that provided by baroreflex sensitivity and potential for the evaluation of risk for hypertension and mood disturbance in healthy people.

Variations in heart rate variability (HRV) have been associated with major depressive disorder (MDD), but the relationship of baseline HRV to treatment outcome in MDD is unclear. We conducted a pilot study to examine associations between resting baseline HRV and MDD treatment outcome. We retrospectively tested several parameters of HRV in an MDD treatment study with escitalopram (ESC, N=26) to generate a model of how baseline HRV related to treatment outcome, and cross-validated the model in a separate trial of MDD treatment with Iyengar yoga (IY, N=16). Lower relative power of very low frequency (rVLF) HRV at baseline predicted improvement in depressive symptoms when adjusted for age and gender (R2>.43 and p<0.05 for both trials). Although vagal parasympathetic measures were correlated with antidepressant treatment outcome, their predictive power was not significant after adjusting for age and gender. In conclusion, baseline resting rVLF was associated with depression treatment outcome in two independent MDD treatment studies. These results should be interpreted with caution due to limited sample size, but a strength of this study is its validation of the rVLF predictor in an independent sample. rVLF merits prospective confirmation as a candidate biomarker.

Compared ambulatory blood pressure (BP) and heart rate (HR) in 30 paramedics during a 24-hr workday and a 24-hr nonworkday. During the 24-hr period as a whole, there were no BP differences between the workday and the nonworkday, but HR was higher during the nonworkday than during the workday. Systolic BP (SBP) recorded in the ambulance on the workday was elevated 9.8 mm Hg, compared to SBP recorded in a car on the nonworkday; it was also 7.2 mm Hg higher at the scene of an accident and at the hospital than during nonworkday activities. Ratings of moods in diaries indicated that paramedics felt more unhappiness, stress, and sadness and less feelings of pleasantness at work than at home. Rather than being elevated for the entire 24-hr period, work BP seemed to reflect the relatively high stress associated with specific situations in the work of a paramedic.