2 - Mind/Body Medicine Flashcards

1
Q

Mind/Body medicine was previously interchangeable with what terms?

A
  • Psychosomatic medicine
  • Health psychology
  • Behavioral medicine
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2
Q

What is the definition of mind-body medicine?

A
  • practices that focus on the interactions among the brain, mind, body, and behaviour, with the intent to use the mind to affect physical functioning and promote health
  • emphasizes an approach that enhances a person’s capacity for self-knowledge and self-care
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3
Q

What is the Placebo Effect?

A
  • well known effect
  • RCT’s must be “placebo-controlled”
  • believed to be mediated through both cognitive (expectation and belief) and conditioning mechanisms
  • in most placebo-controlled trials, placebos improve symptoms for approx 1/3 of control subjects
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4
Q

Describe the placebo effect and other ethical considerations?

A

Ethical issues - deception, loss of trust

-Use of placebos in clinical practise is common

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5
Q

Does placebo effect still work if they are told they are getting it?

A

Yes they can - slide 19

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6
Q

What are some types of mind-body therapies?

A
  • Relaxation & Stress Reduction (progressive muscle relaxation, breathing exercises)
  • Hypnosis
  • Guided imagery
  • Meditation
  • Tai Chi/ Qi gong
  • Yoga
  • Biofeedback
  • Cognitive-Behavioral Therapies (CBT)
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7
Q

What are the common mind-body therapies?

A
  • deep breathing exercises
  • meditation
  • yoga, tai chi, qi gong
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8
Q

Impact of _____ on the body is well documented, as well as improvements in health that result from relaxation strategies

A

stress

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9
Q

Types of _______ techniques include meditation, biofeedback, hypnosis, guided imagery and progressive muscle relaxation, tai chi, yoga, deep breathing.

A

relaxation

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10
Q

Describe 4-7-8 breath

A
Breath in for 4 secs through nose
Hold for 7 secs
Breath out for 8 secs through mouth
-4-8 cycles 
-2 times/day
-anytime feeling anxious

Good for all patients, but especially for:

  • anxiety/panic attacks
  • increases ratio of parasympathetic to sympathetic activity
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11
Q

What is meditation?

A

a variety of techniques aimed to focus or control one’s attention

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12
Q

What do most types of meditation involve?

A
  • a quiet location
  • a specific, comfortable position (sitting, lying, standing, walking)
  • a focus of attention (ex on breath, mantra)
  • an open attitude (letting distractions come and go without judging them)
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13
Q

What is meditation used for?

A
  • anxiety
  • depression
  • pain
  • stress
  • insomnia
  • coping with emotional/physical symptoms associated with chronic illnesses
  • overall health and well-being
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14
Q

What are the 2 common forms of meditation?

A

1) Transcendental Meditation (TM)

2) Mindfulness meditation

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15
Q

Describe Transcendental Meditation

A
  • Focusing attention on the repetition of a mantra (a word, sound or phrase repeated silently)
  • Goal to achieve state of relaxed awareness
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16
Q

Describe Mindfulness Meditation

A
  • Focusing attention in the present, common to focus on breath
  • Focus on what is being experienced without reacting or judging it
  • Learn to experience thoughts/emotions with greater balance and acceptance
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17
Q

Can meditation enhance student performance?

A

Yes - slide 34

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18
Q

What are some daily mindfulness activities?

A
  • mindful eating
  • mindful walking
  • mindfulness during routine activities (shower, washing hands, b/p)
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19
Q

How does meditation work?

A

Thought to work by affecting the autonomic nervous system

  • Decreasing activity of sympathetic nervous system
  • Increasing activity of parasympathetic nervous system
20
Q

Describe hypnosis

A
  • Well studied mind-body therapy
  • Known since late 18th century
  • “A state of consciousness involving focused attention and reduced peripheral awareness characterized by an enhanced capacity for response to suggestion”
21
Q

What does hypnosis involve?

A

Involves guided phases of physical relaxation and attention control:

  • Progressive relaxation using imagery - induction
  • Deepening techniques (further relaxation)
  • Symptom specific suggestions
22
Q

What is hypnosis beneficial for?

A

many chronic pain conditions and painful medical procedures

23
Q

Are children or adults more hypnotizable ?

A

children - less boundaries between imagination and reality

24
Q

What has hypnosis been shown to be effective for?

A
  • painful medical procedures (ex. bone-marrow aspirations and lumbar punctures)
  • post-op pain and anxiety
  • chronic headaches
  • chronic functional abdominal pain
  • chemotherapy induced N/V
  • cancer pain
  • fibromyalgia
25
Q

What is guided imagery?

A

A form of deliberate, directed day-dreaming - using the imagination in a purposeful way to support health and healing

26
Q

What does guided imagery create?

A
  • Creates sensory images by the mind - perceived by body to be almost as real as the actual events
  • Relaxed, trance-like state - relaxation response
  • Technique that gives the power back to the patient
  • Portable
27
Q

What has guided imagery been shown beneficial for?

A

pain, surgical preparation, depressive symptoms, anxious symptoms and quality of life

28
Q

What is biofeedback?

A
  • A technique that trains people to control certain bodily processes that normally are involuntary, in order to improve one’s health (ex. HR, BP, muscle tension and skin temperature)
  • Electrodes attached to the skin or scalp measure these processes and then are displayed on a monitor (giving you “feedback” from your body “bio”)
  • A person is trained to change their HR or BP through breathing exercises or techniques to control their emotions and increase their awareness
29
Q

What is PMR (progressive muscle relaxation)?

A
  • Systematically isolating a particular muscle group, creating tension for 8-10 seconds, then letting the muscle relax and the tension release
  • Some evidence that can be helpful for Tx of: insomnia, caregiver stress, adherence to CPAP in patients with sleep apnea
30
Q

What is Tai Chi?

A
  • Chinese martial art involving gentle, controlled movements, generally practiced now for exercise, stress management and health benefits
  • research shows improvements in balance, strength, attentiveness, sleep, anxiety, blood pressure and pain
31
Q

What is Qi Gong?

A
  • A type of moving meditation
  • Slow, coordinated postures, movements, breathing and meditation
  • Traditionally done to cultivate Qi or “life energy”
  • Practised for exercise, relaxation, meditation, wellness, and training for martial arts
32
Q

What is Yoga?

A
  • widely practiced
  • exercises involving controlled breathing, physical postures and meditation
  • shows evidence of helping: back pain, depression, stress, HTN
33
Q

What is Cognitive-Behavioral Therapy (CBT)?

A

-A type of therapy in which a patient works with a therapist to identify maladaptive cognitions (thoughts) and replace them with healthier thoughts and behaviours

34
Q

What has research shown CBT to be beneficial for?

A
  • anxiety and depression
  • insomnia
  • IBS
  • chronic pain
35
Q

Negative emotional states (depression, anxiety, hostility, social isolation, stress) linked to pathophysiological processes underlying _____

A

CVD

36
Q

How does relaxation therapy affect CVD?

A

Effect of relaxation therapies in rehabilitation and secondary prevention in patients with IHD:

  • Decrease resting HR, increased HR variability, improved exercise tolerance, increased HDL
  • Decreased anxiety and depression
  • Decreased angina, arrhythmias, and exercise induced ischemia
  • Decrease frequency of cardiac events and cardiac deaths
  • Return to work improved
37
Q

What are some mind-body therapies for Tx of headaches?

A

-biofeedback, CBT, hypnosis, meditation, and relaxation training can be effective Tx H/A’s

38
Q

What are some mind-body therapies for Tx of insomnia?

A
  • good evidence for progressive muscle relaxation, CBT

- some evidence for biofeedback

39
Q

What are some mind-body therapies for IBS?

A

-8-week mindfulness course

slide 58

40
Q

What are some mind-body therapies for chronic low back pain?

A

stress management, topic skills training, CBT

41
Q

What are some mind-body therapies for arthritis (OA, RA) ?

A

moderate evidence for benefit of relaxation, imagery, biofeedback, CBT

42
Q

What are some mind-body therapies for asthma?

A
  • breathing exercises beneficial

- some evidence for hypnosis in children

43
Q

What are some mind-body therapies for cancer?

A

Mind-body therapies on cancer related side effects to:

  • improve anxiety, depressive symptoms and quality of life
  • improve pain and fatigue
  • improve anticipatory nausea and vomiting in chemotherapy patient
44
Q

What are some mind-body therapies for immunity?

A
Emotional traits (both negative and positive) can influence people's susceptibility to infection
-Individuals who reported positive emotions had greater resistance to developing a cold after systemic exposure to a respiratory virus in a lab
45
Q

Are mind-body therapies safe?

A

Yes - generally safe.

46
Q

Same cautions for ____ as for any other exercise program.

A

yoga