Saybrook University
  • San Francisco, California, United States
Recent publications
The concepts of Mind-body medicine (MBM), and non-mind body complementary medicine practices among Haitians in Little Haiti, Florida are unexplored. This article investigated five non-habituated MBM modalities and practices within the Haitian culture. An additional objective of this article was to determine whether a relationship could exist among the mbm and non-mbm modalities in the indigenous culture in Miami-Dade County, Florida, looking at the cultural and traditional medicine practices. A literature survey shows adherence through cultural health beliefs and spiritual conduits of the indigenous culture. The result shows that MBM modalities are salient within this group, and awareness or exposure to MBM and non-MBM modalities can be essential in cultural health beliefs formation, and practices. In a COVOD-19 era these modalities can help alleviate the ill-consequences. Knowledge and embrace of the modalities are paramount while maintaining traditional medicine and cultural traditions. Further research is needed.
We examined psychiatric comorbidities moderation of a 2-site double-blind randomized clinical trial of theta/beta-ratio (TBR) neurofeedback (NF) for attention deficit hyperactivity disorder (ADHD). Seven-to-ten-year-olds with ADHD received either NF (n = 84) or Control (n = 58) for 38 treatments. Outcome was change in parent-/teacher-rated inattention from baseline to end-of-treatment (acute effect), and 13-month-follow-up. Seventy percent had at least one comorbidity: oppositional defiant disorder (ODD) (50%), specific phobias (27%), generalized anxiety (23%), separation anxiety (16%). Comorbidities were grouped into anxiety alone (20%), ODD alone (23%), neither (30%), or both (27%). Comorbidity (p = 0.043) moderated acute effect; those with anxiety-alone responded better to Control than to TBR NF (d = − 0.79, CI − 1.55– − 0.04), and the other groups showed a slightly better response to TBR NF than to Control (d = 0.22 ~ 0.31, CI − 0.3–0.98). At 13-months, ODD-alone group responded better to NF than Control (d = 0.74, CI 0.05–1.43). TBR NF is not indicated for ADHD with comorbid anxiety but may benefit ADHD with ODD. Clinical Trials Identifier: NCT02251743, date of registration: 09/17/2014
Background Recent work has shown that obesity may be a risk factor for severe COVID-19. However, it is unclear to what extent individuals have heard or believe this risk factor information, and how these beliefs may predict their preventive behaviors (e.g., weight management behaviors or COVID-19 preventive behaviors). Previous work has primarily looked at overall risk likelihood perceptions (i.e., not about obesity as a risk factor) within general populations of varying weight and concentrated on COVID-19-related preventive behaviors. Therefore, this prospective cohort study explored whether beliefs about obesity as a risk factor and overall risk likelihood perceptions predicted weight management and COVID-19 preventive behaviors over the next 16 weeks in individuals with obesity or overweight. Methods Participants were 393 individuals in the US who joined a commercial weight management program in January, 2021. We leveraged the mobile program’s automatic measurement of real-time engagement in weight management behaviors (e.g., steps taken), while surveys measured risk beliefs at baseline as well as when individuals received COVID-19 vaccination doses (asked monthly) over the next 16 weeks. Mixed effects models predicted engagement and weight loss each week for 16 weeks, while ordinal logistic regression models predicted the month that individuals got vaccinated against COVID-19. Results We found that belief in obesity as a risk factor at baseline significantly predicted greater engagement (e.g., steps taken, foods logged) in program-measured weight management behaviors over the next 16 weeks in models adjusted for baseline BMI, age, gender, and local vaccination rates (minimally adjusted) and in models additionally adjusted for demographic factors. Belief in obesity as a risk factor at baseline also significantly predicted speed of COVID-19 vaccination uptake in minimally adjusted models but not when demographic factors were taken into account. Exposure to obesity risk factor information at baseline predicted greater engagement over 16 weeks in minimally adjusted models. Conclusions The results highlight the potential utility of effective education to increase individuals’ belief in obesity risk factor information and ultimately promote engagement or faster vaccination. Future research should investigate to what extent the results generalize to other populations.
This study explores how EEG connectivity measures in children with ADHD ages 7–10 (n = 140) differ from an age-matched nonclinical database. We differentiated connectivity in networks, Brodmann area pairs, and frequencies. Subjects were in the International Collaborative ADHD Neurofeedback study, which explored neurofeedback for ADHD. Inclusion criteria were mainly rigorously diagnosed ADHD and a theta/beta power ratio (TBR) ≤ 4.5. Using statistical and machine learning algorithms, connectivity values were extracted in coherence, phase, and lag coherence at all Brodmann, subcortical, and cerebellar areas within the main networks in all EEG frequencies and then compared with a normative database. There is a higher rate of dysregulation (more than ± 1.97SD), in some cases as much as 75%, of the Brodmann pairs observed in coherence and phase between BAs 7, 10, and 11 with secondary connections from these areas to BAs 21, 30, 35, 37, 39, and 40 in the ADHD children as compared to the normative database. Left and right Brodmann areas 10 and 11 are highly disconnected to each other. The most dysregulated Brodmann Areas in ADHD are 7, 10, and 11, relevant to ADHD executive-function deficits and provide important considerations when developing interventions for ADHD children.
Health-promoting lifestyle behaviors (e.g., as measured by the HPLP-II) are associated with reductions in lifestyle disease mortality, as well as improved well-being, mental health, and quality of life. However, it is unclear how a weight-management program relates to a broad range of these behaviors (i.e., health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, and stress management), especially a fully digital program on which individuals have to self-manage their own behaviors in their daily lives (with assistance from a virtual human coach). In the context of a digital setting, this study examined the changes in health-promoting behaviors over 12 months, as well as the associations between health-promoting behaviors and weight loss, retention, and engagement, among participants who self-enrolled in a mobile CBT-based nutritionally focused behavior change weight management program (n = 242). Participants lost a statistically significant amount of weight (M = 6.7 kg; SD = 12.7 kg; t(80) = 9.26, p < 0.001) and reported significantly improved overall health-promoting lifestyle behaviors (i.e., HPLP-II summary scores), as well as, specifically, health responsibility, physical activity, nutrition, spiritual growth, stress management, and interpersonal relations behaviors from baseline to 6 months and from 6 months to 12 months (all ps < 0.008). Health-promoting behaviors at 6 months (i.e., learned health-promoting behaviors) compared to baseline were better predictors of retention and program engagement. A fully digital, mobile weight management intervention can improve HPLP-II scores, which, in turn, has implications for improved retention, program engagement, and better understanding the comprehensive effects of weight management programs, particularly in a digital setting.
Many veterans do not complete traditional trauma treatments; others may continue to struggle with posttraumatic stress disorder (PTSD) even after completing a full course of therapy (Blasé et al., in Int J Environ Res Public Health 18(7):Article 3329,, 2016). Heart rate variability (HRV) biofeedback (HRVB) is a non-invasive, non-pharmacological, breathing-based cardiorespiratory training technique that can reduce trauma symptoms and improve HRV parameters. Prior studies have demonstrated HRVB is well-tolerated by veterans with PTSD symptoms (Tan et al., in Appl Psychophysiol Biofeedback 36(1):27-35, 10.1007/s10484-010-9141-y, 2011; Schuman and Killian, in Appl Psychophysiol Biofeedback 44(1):9–20,, 2019). This randomized wait-list controlled pilot study tested a short mobile app-adapted HRVB intervention in combination with treatment as usual for veterans with military-related PTSD to determine if further investigation was warranted. We assessed veterans’ military-related PTSD symptoms, depression symptoms, and HRV time and frequency domain measures at baseline, after three clinical sessions, and one month later. This study combined clinical training and home biofeedback with a smartphone app and sensor to reinforce training and validate adherence. In the intervention group, depression and SDNN significantly improved, and we observed marginally significant improvements for PTSD Cluster B (intrusion) symptoms, whereas no significant improvements were observed in the control group. In addition, the brief protocol was acceptable to veterans with PTSD with over 83% of participants completing the study. However, adherence to home practice was low. Findings suggest brief HRVB interventions can decrease comorbid depression and improve overall autonomic function in veterans with PTSD; however, additional research on home biofeedback is necessary to determine the best strategies to increase adherence and which veterans would benefit from brief HRVB interventions.
Recent developments in positive psychology and wellbeing research highlight the tremendous capacity for individual wellbeing within the context of a cross-cultural, ecological, and complex model. In this chapter, we propose a paradigm shift towards existential positive psychology, which integrates the dark (negative psychology) and the bright (positive psychology) sides of life to provide a more integrative and comprehensive model of wellbeing. We explore the dialectical interaction between these poles of human experience, with a particular emphasis on the importance of embracing and transforming suffering for cultivating sustainable wellbeing. We highlight some of the innovative ways in which existential positive psychology differs from traditional positive psychology and summarize self-transcendence as the thread that runs through the existential positive psychology paradigm. Our chapter concludes with a brief discussion of some potential implications of existential positive psychology for research and interventions.
The experiences of five multiracial women were documented in this study. A thematic analysis with a phenomenological framework was applied to the data analysis. Findings revealed five primary themes, including (a) experiences of microaggressions, (b) uniquely defined intersectionality, (c) making sense of one’s multiracial identity, (d) significance of relational support, and (e) openness and understanding. Limitations of the study, as well as some helpful recommendations for counselors, are discussed.
Introduction: We examined psychiatric comorbidities moderation of a 2-site double-blind randomized clinical trial of theta/beta-ratio (TBR) neurofeedback (NF) for attention deficit hyperactivity disorder (ADHD). Methods:Seven-to-ten-year-olds with ADHD received either NF (n=84) or Control (n=58) for 38 treatments. Outcome was change in parent-/teacher-rated inattention from baseline to end-of-treatment (acute effect), and 13-month-follow-up. Seventy percent had at least one comorbidity: oppositional defiant disorder (ODD) (50%), specific phobias (27%), generalized anxiety (23%), separation anxiety (16%). Comorbidities were grouped into anxiety alone (20%), ODD alone (23%), neither (30%), or both (27%). Results: Comorbidity (p=0.043) moderated acute effect; those with anxiety-alone responded better to Control than to TBR NF (d=-0.79, CI -1.55- -0.04), and the other groups showed a slightly better response to TBR NF than to Control (d=0.22~0.31, CI -0.3-0.98). At 13-months, ODD-alone group responded better to NF than Control (d=0.74, CI 0.05-1.43). Discussion: TBR NF is not indicated for ADHD with comorbid anxiety but may benefit ADHD with ODD.
Breathing at the resonance frequency (~ 6 breaths per min) produces resonance effects on baroreflex gain, blood pressure, vascular tone, and therapeutic benefits. Evgeny Vaschillo and Paul Lehrer have emphasized that the stimulation frequency is critical for producing resonance effects in the cardiorespiratory system. Although clinicians overwhelmingly use paced breathing to increase HRV, other promising methods exist. Vaschillo, Lehrer, and colleagues have shown that presenting non-respiratory stimulation at 0.1 Hz—pictures with an emotional valence or rhythmical muscle tensing—amplifies oscillations in heart rate, blood pressure, and vascular tone. Participants in the present study included 49 undergraduate students randomly assigned to one of six different orders of 5-min trials of 1, 6, and 12 muscle contractions per min (cpm), separated by 3-min buffer periods intended to minimize carryover. This randomized controlled trial replicated the Vaschillo et al. (Psychophysiology 48:927–936, 2011. finding that 6-cpm RSMT can produce a PkFreq of ~ 0.10 Hz, similar to 6-bpm RF breathing. RSMT at 1 and 6 cpm increased five time-domain metrics (HR Max–HR Min, RMSSD, SDNN, TI, and TINN), one frequency-domain metric (LF power), and three non-linear metrics (D2, SD1, SD2) significantly more than RSMT at 12 cpm. There were no differences between 1 and 6 cpm on these measures. The 1-cpm rate (~ 0.02 Hz) may have stimulated the hypothesized vascular tone baroreflex between 0.02 and 0.055 Hz. RSMT at 1 or 6 cpm provides clients with an alternative exercise for increasing HRV for patients who find slow-paced breathing challenging or medically unsafe.
The Pathways Model is an approach guiding the individual to combine self-care, habit change, and positive lifestyle changes, with professional healthcare interventions. There are multiple roles that a social work professional can adopt in guiding the individual in a Pathways recovery plan, including a coaching role, assessment, health education, lifestyle guidance, skills training, counselling, diversity specialist, and integrative care coordination. Spirituality, religious practices, and complementary therapies are important elements in integrative care. The professional social worker with the benefit of social work training is optimally suited to engage in these multiple therapeutic roles. A case narrative of a 49-year-old woman with hypertension and heart disease illustrates how a social worker can utilise various elements of social work practice to facilitate a client’s use of the Pathways Model.
Numerous studies have shown the beneficial role that spirituality can play in helping cancer survivors cope with the disease process, but there is limited research about the lived experiences of cancer survivors who have had a spiritually based meditation practice prior to diagnosis. The purpose of this study was to understand the meaning of the spiritual experiences of cancer survivors who were long-term Brahma Kumaris Raja Yoga meditation (BK-RYM) practitioners. A total of six participants with a history of cancer diagnosis were recruited from BK-RYM centers. Participants were interviewed in-depth, and the data were analyzed using interpretative phenomenological analysis (IPA). Seven superordinate themes were identified from a cross analysis of the participants’ narratives: (A) mental stability and clarity, (B) spiritual connection and self-empowerment, (C) personal relationship with God, (D) mind–body-soul healing practices, (E) empowering support system, (F) positive health outcomes, and (G) post-cancer spiritual growth. An additional singular theme emerged for one participant: (H) transient negative state of mind. These findings point toward the possibility that integrating spiritually focused meditation early in a cancer diagnosis may improve the quality of life and well-being of cancer survivors. Such spiritual measures may serve to reduce suffering as well as reduce healthcare costs by decreasing cancer-related emotional and physical complications.
Behavioral weight loss reduces risk of weight-related health complications. Outcomes of behavioral weight loss programs include attrition and weight loss. There is reason to believe that individuals’ written language on a weight management program may be associated with outcomes. Exploring associations between written language and these outcomes could potentially inform future efforts towards real-time automated identification of moments or individuals at high risk of suboptimal outcomes. Thus, in the first study of its kind, we explored whether individuals’ written language in actual use of a program (i.e., outside of a controlled trial) is associated with attrition and weight loss. We examined two types of language: goal setting (i.e., language used in setting a goal at the start of the program) and goal striving (i.e., language used in conversations with a coach about the process of striving for goals) and whether they are associated with attrition and weight loss on a mobile weight management program. We used the most established automated text analysis program, Linguistic Inquiry Word Count (LIWC), to retrospectively analyze transcripts extracted from the program database. The strongest effects emerged for goal striving language. In striving for goals, psychologically distanced language was associated with more weight loss and less attrition, while psychologically immediate language was associated with less weight loss and higher attrition. Our results highlight the potential importance of distanced and immediate language in understanding outcomes like attrition and weight loss. These results, generated from real-world language, attrition, and weight loss (i.e., from individuals’ natural usage of the program), have important implications for how future work can better understand outcomes, especially in real-world settings.
The evidence-based interconnection between mental health with lifestyle medicine practice is discussed. The extent to which physical health, and mental and behavioral health overlap are significant, and their interaction is seen in many ways. These bidirectional influences form a continuous thread through all lifestyle medicine pillars. The intersection of mental health and lifestyle should be considered and applied to provide optimal evidence-based lifestyle medicine for all patient populations who will benefit from the specific attention to diet, physical activity, relationships, stress, sleep, and substance use. Lifestyle medicine can be utilized to directly address and treat a range of mental health symptoms and disorders, and physical illnesses. In addition, behavior change skills and addressing the psychological factors contributing to barriers are crucial to helping patients reach their lifestyle medicine goals. Approaches to practice that attend to, and address, mental and behavioral health are relevant to and necessary for all types of providers who work within the lifestyle medicine framework.
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785 members
Donald Moss
  • College of Integrative Medicine and Health Sciences
Marc Pilisuk
  • School of Psychology and Interdisciplinary Inquiry
Luann Drolc Fortune
  • College of Integrative Medicine & Health Sciences
Danny Wedding
  • School of Humanistic and Clinical Psychology
Gerald Kozlowski
  • School of Clinical Psychology
San Francisco, California, United States