Background Given that psychopharmacological approaches routinely used to treat mood-related problems may result in adverse outcomes in mood dysregulated adolescents at familial risk for bipolar disorder (BD), Mindfulness-Based Cognitive Therapy for Children (MBCT-C) provides an alternative effective and safe option. However, little is known about the brain mechanisms of beneficial outcomes from this intervention. Herein, we aimed to investigate the network-level neurofunctional effects of MBCT-C in mood dysregulated adolescents. Methods Ten mood dysregulated adolescents at familial risk for BD underwent a 12-week MBCT-C intervention. Resting-state functional magnetic resonance imaging (fMRI) was performed prior to and following MBCT-C. Topological metrics of three intrinsic functional networks (default mode network (DMN), fronto-parietal network (FPN) and cingulo-opercular network (CON)) were investigated respectively using graph theory analysis. Results Following MBCT-C, mood dysregulated adolescents showed increased global efficiency and decreased characteristic path length within both CON and FPN. Enhanced functional connectivity strength of frontal and limbic areas were identified within the DMN and CON. Moreover, change in characteristic path length within the CON was suggested to be significantly related to change in the Emotion Regulation Checklist score. Conclusions 12-week MBCT-C treatment in mood dysregulated adolescents at familial risk for BD yield network-level neurofunctional effects within the FPN and CON, suggesting enhanced functional integration of the dual-network. Decreased characteristic path length of the CON may be associated with the improvement of emotion regulation following mindfulness training. However, current findings derived from small sample size should be interpreted with caution. Future randomized controlled trials including larger samples are critical to validate our findings.
Background Mindfulness‐based cognitive therapy for children (MBCT‐C), as a psychotherapeutic intervention, has been shown to be effective for treating mood dysregulation (MD). While previous neuroimaging studies of MD have reported both pre‐treatment structural and functional alterations, the effects of MBCT‐C on brain morphological network organisation has not been investigated. Methods We investigated brain morphological network organisation in 10 mood‐dysregulated youth with familial risk for bipolar disorder and 15 matched healthy comparison youth (HC). Effects of 12 weeks of MBCT‐C were examined in the mood‐dysregulated youth. Topological properties of brain networks used for analyses were constructed based on morphological similarities in regional grey matter using a graph‐theory approach using MRI data. Results At baseline, compared with the HC group, the mood‐dysregulated group exhibited increased global efficiency (Eglob), decreased path length (Lp), and abnormal nodal properties, mainly in the limbic system. Right temporal pole alterations at baseline predicted change in Child and Adolescent Mindfulness Measure scores after treatment. The mood‐dysregulated group showed significant decreases in both the Eglob and Lp metrics after MBCT‐C, suggesting an improved capacity for optimal information processing. Changes in Lp were correlated with changes in Emotion Regulation Checklist scores. Our results show significant topological alterations in the mood‐dysregulated group as compared to controls at baseline. After MBCT‐C, disrupted topological properties in the mood‐dysregulated group were significantly reduced. Conclusion MBCT‐C may facilitate clinically meaningful changes in the brain structural network in mood‐dysregulated individuals.
The goal of the present investigation was to examine associations between emotion reactivity in global and specific distress tolerance domains. Participants were 113 undergraduates (65.5% female, 82.3% Caucasian; M age = 20.0, SD = 4.02, range = 18–45 years) who completed a battery of self-report measures. As hypothesized, the results indicate that, after controlling for sex and negative affectivity, greater levels of emotion reactivity were significantly associated with lower levels of global distress tolerance (12.5% unique variance) and the four specific distress tolerance domains: tolerance (8.6% unique variance), absorption (11.4% unique variance), appraisal (8% unique variance), and regulation (8.1% unique variance). These findings suggest that individuals who tend to react more strongly to their emotions have greater difficulty tolerating emotional distress, and interventions that target emotion reactivity may be an effective way to improve distress tolerance and reduce the risk of developing psychopathology among undergraduates.
Treatment options for bipolar disorder have been primarily studied in adults. However, there is a growing body of research of these treatments in youths with bipolar disorder. Despite this there is still a huge gap in clinical trials performed on adults and children and as this manuscript will show, extrapolating results of adult studies doesn't necessarily translate to successful treatment in youths. Furthermore, although medication is the cornerstone of treatment in children and adolescents with bipolar disorder, psychosocial interventions are of paramount importance. The current manuscript will review the empirical evidence available for both pharmacological and psychosocial treatment strategies. In addition, evidence for the use of medications in different stages of bipolar disorder, including acute manic and mixed states and bipolar depression is addressed. The use of combination therapy, the treatment of pediatric bipolar disorder comorbid with other psychiatric conditions and the management of treatment resistant mania is also discussed.
The experiences of African American couples facing prostate cancer include cancer concerns that intersect with sexuality, older age, and culture. We provide a review of concerns and counseling strategies and present an integrative approach through a case study. Future research on testing such approaches is encouraged.
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