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Background/Aims: Mindfulness-based stress reduction (MBSR) has enhanced cognition, positive emotion, and immunity in younger and middle-aged samples; its benefits are less well known for older persons. Here we report on a randomized controlled trial of MBSR for older adults and its effects on executive function, left frontal asymmetry of the EEG alpha band, and antibody response. Methods: Older adults (n = 201) were randomized to MBSR or waiting list control. The outcome measures were: the Trail Making Test part B/A (Trails B/A) ratio, a measure of executive function; changes in left frontal alpha asymmetry, an indicator of positive emotions or approach motivation; depression, mindfulness, and perceived stress scores, and the immunoglobulin G response to a protein antigen, a measure of adaptive immunity. Results: MBSR participants had a lower Trails B/A ratio immediately after intervention (p < 0.05); reduced shift to rightward frontal alpha activation after intervention (p = 0.03); higher baseline antibody levels after intervention (p < 0.01), but lower antibody responses 24 weeks after antigen challenge (p < 0.04), and improved mindfulness after intervention (p = 0.023) and at 21 weeks of follow-up (p = 0.006). Conclusions: MBSR produced small but significant changes in executive function, mindfulness, and sustained left frontal alpha asymmetry. The antibody findings at follow-up were unexpected. Further study of the effects of MBSR on immune function should assess changes in antibody responses in comparison to T-cell-mediated effector functions, which decline as a function of age.

This study uses National Violence against Women Survey data to investigate the differential impact of concomitant forms of violence (sexual abuse, stalking, and psychological abuse) and ethnicity on help-seeking behaviors of women physically abused by an intimate partner (n=1,756). Controlling for severity of the physical abuse, women who experienced concomitant sexual abuse were less likely to seek help, women who experienced concomitant stalking were more likely to seek help, whereas concomitant psychological abuse was not associated with help-seeking. Ethnic differences were found in help-seeking from friends, mental health professionals, police and orders of protection. Implications for service outreach are discussed.

Objective-The goal was to describe the accuracy of the Edinburgh Postnatal Depression Scale (EPDS), Beck Depression Inventory II (BDI-II), and Postpartum Depression Screening Scale (PDSS) in identifying major depressive disorder (MDD) or minor depressive disorder (MnDD) in low-income, urban mothers attending well childcare (WCC) visits during the postpartum year.Design/Methods-Mothers (N=198) attending WCC visits with their infants 0 to 14 months of age completed a psychiatric diagnostic interview (standard method) and 3 screening tools. The sensitivity and specificity of each screening tool were calculated in comparison with diagnoses of MDD or MDD/MnDD. Receiver operating characteristic curves were calculated and the areas under the curves for each tool were compared to assess accuracy for the entire sample (representing the postpartum year) and sub-samples (representing early, middle and late postpartum time frames). Optimal cut-points were calculated.Results-At some point between 2 weeks and 14 months postpartum, 56% of mothers met criteria for either MDD (37%) or MnDD (19%). When used as a continuous measures, all scales performed equally well (areas under the curves of ≥ 0.8). With traditional cut-points, the measures did not perform at the expected levels of sensitivity and specificity. Optimal cut-points for the BDI-II (≥14 for MDD, ≥11 for MDD/MnDD) and EPDS (≥9 for MDD, ≥7 for MDD/MnDD) were lower than currently recommended. For the PDSS, the optimal cut-point was consistent with current guidelines for MDD (≥80) but higher than recommended for MDD/MnDD (≥ 77). Conclusions-Large proportions of low-income, urban mothers attending WCC visits experience MDD or MnDD during the postpartum year. The EPDS, BDI-II and PDSS have high accuracy in identifying depression but cutoff points may need to be altered to more accurately identify depression in urban, low-income mothers.

This study examined whether shame-proneness is associated with dissociation among abused women. Participants were 99 hospitalized women with and without reported histories of childhood sexual abuse. Hypotheses were that childhood sexual abuse and shame-proneness would each be associated with dissociation, and that the relationship between sexual abuse and dissociation would be greater among women with higher shame-proneness. Multiple regression analysis indicated that shame-proneness was independently related to dissociation, but childhood sexual abuse was not. As predicted, the combination of shame-proneness and childhood sexual abuse was associated with dissociation.

Gender, race/ethnicity, and personality are markers of significant psychosocial and biological variability. Each may have implications for allostatic load and resulting inflammatory processes, yet findings have been largely mixed. We investigated whether women, minorities, and those higher in Neuroticism and lower in Extraversion were at risk for elevated circulating levels of the proinflammatory cytokine interleukin (IL)-6 in a sample of 103 middle aged and older urban primary care patients. Regression analyses controlling for age, education, current depression levels, and chronic medical conditions revealed that women, minorities, and individuals lower in Extraversion had higher circulating levels of IL-6. Analyses of more specific personality traits revealed that the sociability and positive emotions components of Extraversion were unassociated with IL-6, but the activity facet--reflecting dispositional vigor and energy--was robustly associated with IL-6. The difference between high (+1 Standard Deviation (SD)) and low (−1 SD) trait activity was sufficient to shift IL-6 levels beyond a previously established high risk cut-point in both white and minority women. These findings suggest that while broad group differences between genders and races/ ethnicities exist, personality represents an important source of individual differences in inflammation within groups. Future work should examine to what extent IL-6 levels are linked to temperament or genetic activity levels vs. physical activity itself, and whether IL-6 levels may be reduced by boosting regular activity levels in demographic segments such as women and minorities who appear susceptible to greater inflammation.

This study examined the effects of a Mindfulness-Based Stress Reduction (MBSR) program on psychological functioning and inflammatory biomarkers in women with histories of interpersonal trauma. The 8-week MBSR program was conducted at a community-based health center and participants (N = 50) completed several measures of psychological functioning at study entry as well as 4 weeks, 8 weeks, and 12 weeks later. Inflammatory biomarkers were assayed from blood collected at each assessment. A series of linear mixed model analyses were conducted to measure the effect of attendance and time on the dependent variables. Time was associated with significant decreases in perceived stress, depression, trait and state anxiety, emotion dysregulation, and post-traumatic stress symptoms as well as increases in mindfulness. Session attendance was associated with significant decreases in interleukin (IL)-6 levels. This pilot study demonstrated the potential beneficial effects of MBSR on psychological functioning and the inflammatory biomarker IL-6 among trauma-exposed and primarily low-income women. Decreases in inflammation have implications for this population, as interpersonal trauma can instigate chronic physiological dysregulation, heightened morbidity, and premature death. This study’s preliminary results support efforts to investigate biological remediation with behavioral interventions in vulnerable populations.

Objective To examine whether shame-proneness mediates the relationship between women's histories of childhood sexual abuse and their current partner and family conflict and child maltreatment. Previous research has found that women with childhood sexual abuse histories experience heightened shame and interpersonal conflict. However, research examining the relationship of shame to interpersonal conflict is lacking. Method Participants were 129 mothers of children enrolled in a summer camp program for at-risk children from financially disadvantaged families. Data were collected on women's childhood abuse histories, shame in daily life, and current interpersonal conflict involving family conflict, intimate partner conflict (verbal and physical aggression), and child maltreatment. Results Consistent with our hypothesis, the results of hierarchical regressions and logistic regression indicated that shame significantly mediated the association between childhood sexual abuse and interpersonal conflict. Women with sexual abuse histories reported more shame in their daily lives, which in turn was associated with higher levels of conflicts with intimate partners (self-verbal aggression and partner-physical aggression) and in the family. Shame did not mediate the relationship between mothers' histories of sexual abuse and child maltreatment. Conclusion The role of shame in the intimate partner and family conflicts of women with sexual abuse histories has not been examined. The current findings indicate that childhood sexual abuse was related to interpersonal conflicts indirectly through the emotion of shame. Practical Implications These findings highlight the importance of investigating the role of shame in the interpersonal conflicts of women with histories of childhood sexual abuse. Healthcare professionals in medical and mental health settings frequently treat women with abuse histories who are involved in family and partner conflicts. Assessing and addressing the links of abused women's shame to interpersonal conflicts could be important in clinical interventions.