Family processAinsley Jenicek, Miles Cooke, Heather B MacIntosh, Tamara Sussman, Aline Bogossian
This scoping review provides an overview of empirical research and practice-based literature that addresses direct clinical practice with chosen families-familial relationships that are not based on biology or law. Given the prevalence of chosen family among sexual and gender minorities as well as the amount of research that underlines chosen family as an important social support, this paper aims to synthesize recommendations for clinical work with chosen families and to highlight gaps in the literature. Using the five-step Arksey and O'Malley (2005) scoping review process, four electronic databases were systematically searched to identify papers that address working with chosen family in care-related fields, including social work, couple and family therapy, and nursing. Twenty-seven articles were included in this review and seven themes were identified by these authors that culminated in recommendations for clinical practice: (a) educate oneself about diverse family forms and address biases; (b) invite self-definition of "family"; (c) proactively include chosen family; (d) consider legal and policy barriers; (e) refer chosen family members to sources of support; (f) encourage people to create or maintain chosen family; and (g) engage in sexual and gender minority affirmative practices generally. The existing literature focuses primarily on individual services that involve chosen family as needed, but do not explicitly focus on dynamic and systemic needs. Further research into systemic work with chosen family is needed.
Family processBrian D Doss, Shayna Guttman, Maya Metser-Waldman, Nirvi Ajmera, Alex Dopp
Relationship distress is a prevalent issue with significant economic and societal consequences, including increased mental and physical health problems, decreased workplace productivity, and increased absences. Although couple therapy has been shown to improve relationship and individual well-being, its high costs limit accessibility. Digital relationship interventions provide a cost-effective alternative. However, limited research has assessed the cost-benefit of such programs using experimental designs. This study conducted a cost-benefit analysis of the OurRelationship program using data from two randomized controlled trials (RCTs). The Washington State Institute for Public Policy (WSIPP) cost-benefit model was applied to quantify economic benefits across four domains-depression, anxiety, alcohol misuse, and insomnia-relative to a waitlist control. Program costs were estimated at $280 per individual, and benefits were assessed in terms of healthcare savings, productivity gains, and labor market outcomes. The primary analysis found that, for every dollar spent on the OurRelationship program, $6.60 was saved in societal costs. Sensitivity analyses suggested benefit-cost ratios ranging from $1.88 to $22.06 depending on assumptions regarding the number of participants, duration of effects, and magnitude of program impact. Findings suggest that the OurRelationship program yields substantial economic benefits, making it a viable investment for policymakers, employers, and healthcare systems. The study supports broader implementation of efficacious digital relationship interventions and highlights the importance of economic evaluations in guiding funding decisions for relationship support programs. Further research should explore the long-term benefits and applicability across diverse populations.
Family processMichal Shamai, Uri Carmel-Kraiem, Osnat Cohen-Ganor
The article describes a first psychological support project for families living in the seam zone between Israel and areas controlled by the Palestinian Authority. Since October 7th, the proximity to the border and potential of terrorist infiltration into communities have generated heightened anxiety among residents, alongside concern for family members enlisted to reserve duty or on mandatory service. Therefore, the Family Therapy Unit of Menashe Regional Council initiated a psychological support program designed to strengthen families' resources and enhance their ability to cope with the ongoing stress and anxiety. The intervention was based on an integration of the narrative approach and emotionally focused therapy (EFT). These approaches were chosen for their grounding in positive and humanistic psychology, which highlights family resilience and can be applied in a focused, short-term intervention. The intervention protocol and a case example are described in detail. Additionally, an attempt to evaluate the project under wartime conditions is described, including its limitations. The evaluation method included a quantitative component and a content analysis of one open-ended question focused on the family's experiences with the intervention. The results indicated a significant reduction in parents' stress and in their perceptions of children's stress, but no significant difference in family resilience. Consistent with previous studies, participants experienced the therapeutic relationship as the most meaningful factor rather than the techniques employed. The article concludes with a call for further evaluation of such interventions in war zones and disaster-affected regions across diverse sociocultural and political contexts.
Neuropsychopharmacologia Hungarica : a Magyar Pszichofarmakologiai Egyesulet lapja = official journal of the Hungarian Association of PsychopharmacologyAdrienne Incze
Bodily awareness has become a central therapeutic factor in psychodynamic and body-oriented psychotherapies, yet its clinical effects and theoretical status remain insufficiently integrated. This paper offers a clinically grounded account of bodily awareness work in Psychodynamic Movement and Dance Therapy (PMT), conceptualising the body as the primary medium of lived experience rather than as an object of intervention. Drawing on phenomenology, developmental psychoanalysis, and clinical theory, the paper argues that therapeutic change in PMT unfolds through prereflective, embodied processes that precede verbal reflection and symbolic articulation. To integrate these perspectives, it introduces the concept of the global mode of experience, defined as an amodal, prereflective organisation of experience in which bodily sensation and affective vitality are lived as an integrated whole. Rooted in Daniel Stern's work, this mode is understood as a stable, activatable capacity rather than a regressive state, with orientation to the reality of the here-and-now fundamentally preserved. The paper positions the global mode of experience as a clinically orienting framework for understanding both the therapeutic effects and the limitations of bodily awareness work, highlighting the importance of timing, containment, and indication in psychodynamic movement and dance therapy. (Neuropsychopharmacol Hung 2026; 28(3): 141-154)
International journal of mental health nursingLaurence Cobbaert
Iatrogenic harm in psychotherapy remains under-recognised, despite longstanding evidence that psychological treatments can produce adverse effects. This omission is consequential in eating disorder care, where treatment is often intensive, prolonged and characterised by significant power asymmetries alongside poor long-term outcomes. This article examines iatrogenic harm in the context of eating disorders through an epistemic justice and intersectional framework. Drawing on qualitative and lived-experience-led scholarship, it argues that iatrogenesis is produced through structural features of mental health systems, including rigid diagnostic practices and manualised treatment models, limited professional accountability and the marginalisation of experiential knowledge. Treatment dropout and the attribution of treatment failure to patients are examined as mechanisms that obscure harm and inflate perceptions of treatment safety and effectiveness. Rather than rejecting evidence-based psychotherapy, the article calls for epistemic pluralism, routine monitoring and reporting of iatrogenesis and meaningful co-production as prerequisites for ethical, accountable and humane eating disorder care.
Stress and health : journal of the International Society for the Investigation of StressJuan C Meléndez, Tatiana Navarro, Jesus González-Moreno, Maria Fernanda Reyes, Encarnacion Satorres, Iraida Delhom
Older adults exposed to prolonged sociopolitical violence often experience chronic stress that may undermine adaptive coping processes. Instrumental reminiscence, which focuses on recalling past experiences of successfully managing adversity, has been proposed as a strategy potentially associated with greater coping flexibility in later life. This study examined whether participation in an instrumental reminiscence programme was associated with changes in coping strategies among older adults registered as victims of armed conflict in Catatumbo, Colombia. A quasi-experimental controlled design with repeated measures (pre-intervention, post-intervention, 2-month follow-up) was conducted with 64 community-dwelling adults aged 60 years and older (intervention n = 37; control n = 27). The intervention consisted of 8 weekly 90-min instrumental reminiscence sessions, while the comparison group received psychoeducational sessions. Coping strategies were assessed using the Coping with Stress Questionnaire. Linear mixed-effects models were used to examine Group × Time interactions. Significant interactions were observed for problem-solving focus, positive reappraisal, social support seeking, overt emotional expression, negative self-focus, and avoidance (all p < 0.001). Compared with controls, the intervention group was characterised by higher post-intervention scores on problem-solving focus, positive reappraisal, social support seeking, and avoidance, and lower scores on overt emotional expression and negative self-focus; these differences were maintained at follow-up. No significant effects were found for religious coping. Participation in the instrumental reminiscence programme was associated with changes in multiple self-reported coping strategies among older adults exposed to chronic conflict-related stress.
Stress and health : journal of the International Society for the Investigation of StressNicola S Schutte, Adam J Rock
This study consolidated the association of mindfulness with perceived stress found across studies. A meta-analysis examined the relationship between mindfulness and perceived stress in 56 samples, which included a total of 24,494 participants. The weighted effect size of r(55) = -0.40, 95% CI [-0.36, 0-44], p = 0.0001, showed that greater mindfulness was associated with less perceived stress. Studies assessing mindfulness using the Mindful Attention Awareness Scale or the Five Facet Mindfulness Questionnaire showed substantial effect sizes, as did studies assessing stress using the Perceived Stress Scale. Even though the present meta-analysis does not show causality, the results suggest a possible bidirectional relationship between mindfulness and perceived stress. The nonjudgmental awareness comprising mindfulness may facilitate an appraisal of life events and challenges that results in events and challenges as being perceived as less stressful. Lower perceived stress may free cognitive resources that promote mindfulness.
European journal of psychotraumatologyAustin M Hahn, Sudie E Back, Daryl R Hesse, Carla Kmett Danielson, Katherine L Mills, Emma L Barrett, Therese K Killeen, Michaela Buckhannon, Rachel L Tomko, M…
Background: Posttraumatic stress disorder (PTSD) and substance use disorders (SUD) frequently co-occur during adolescence and are associated with substantial functional impairment and elevated risk for chronic comorbidity. Despite strong evidence supporting integrated, trauma-focused treatments for adults with PTSD + SUD, the adolescent treatment literature remains limited.Objective: This review synthesizes current evidence on the integrated treatments for co-occurring PTSD + SUD problems among adolescents and youth, with emphasis on evaluating the strength of the evidence and identifying key directions for future research.Method: Targeted searches identified randomized controlled trials, open trials, pilot studies, and feasibility studies evaluating treatments for adolescents with PTSD + SUD problems. Studies were included if they reported PTSD and/or substance use outcomes. Findings from the adult PTSD + SUD literature were reviewed to inform developmentally appropriate adaptation for youth.Results: The adolescent evidence base is sparse. Risk Reduction Through Family Therapy (RRFT) is the only integrated treatment supported by multiple randomized controlled trials, demonstrating durable improvements in PTSD symptoms and substance use. Preliminary evidence also supports Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure for Adolescents (COPE-A). Across studies, trauma-focused treatment was not associated with increased substance use and was generally acceptable to adolescents. However, conclusions are constrained by small samples, heterogeneous interventions, and limited long-term and implementation data.Conclusions: Integrated, trauma-focused psychotherapies appear safe and promising for adolescents with co-occurring PTSD + SUD problems. Larger trials, mechanistic research, and implementation-focused studies are needed to inform best practices and expand access to effective care.
International journal of qualitative studies on health and well-beingLi-Ting Chen, Hsin-Tien Hsu, Meei-Fang Lou, Chia-Yi Wu, Cheng-Han Lin, Yueh-Hsiu Lin
BACKGROUND: Most applications for depression lack comprehensive theoretical integration and qualitative assessments of university students' needs remain insufficient. OBJECTIVE: This study aimed to explore the needs and experiences of university students with depressive symptoms and develop a theory-driven app design framework tailored to the target population. METHODS: A post-positivist qualitative framework was used to recognize the value of subjective experience. Semi-structured interviews were conducted with 32 students with moderate to moderately severe depression. Reflexive thematic analysis was used to identify themes in the data. RESULTS: Three themes emerged: app design, help-seeking processes, and core features of cognitive behavioral therapy. Students emphasized the importance of discreet, user-friendly design, such as positive naming, privacy protection, and flexible reminder functions. Although some expressed concerns regarding the empathy and reliability of artificial intelligence, others valued its anonymity and capacity to provide immediate support. Regarding theoretical integration, participants considered monitoring emotions and physical sensations essential but also highlighted the need for diverse and personalized methods. The conceptualization of self-monitoring data was considered useful for facilitating clinical consultations. CONCLUSION: Students considered theory-based health education as effective for improving mental health knowledge and promoting help-seeking awareness. The findings support clinical decision-making in developing more effective digital tools.
Global health actionConstance Boyde, Lara-Luna Ehrenschneider, Jana Brückner, Joy-Mariella Donisch, Mara Siebenmorgen, Katharina Thomas, Christina Hunger-Schoppe
Children and adolescents undergoing cancer treatment, along with their families, experience psychological and emotional distress. Music therapy is increasingly acknowledged as an intervention that may foster emotion regulation, coping, and communication; however, family involvement remains insufficiently delineated. This scoping review maps evidence on family involvement in music therapy for paediatric oncology, characterises the forms and intensity of participation, summarises intervention features and reported outcomes, and identifies limitations and research gaps. Following PRISMA-ScR guidelines, a systematic search was conducted in PSYNDEX, PubMed, The Cochrane Library, and Embase (2010-2025). Studies were eligible if they examined music therapy interventions or structured music-therapy-based interventions in paediatric oncology and involved family members at any level of participation. Eighteen studies met the inclusion criteria and were synthesised descriptively. Across the studies, reported outcomes included reductions in anxiety, stress, and pain, as well as improvements in mood, quality of life, and family interaction. Family involvement ranged from primarily observational and reflective roles to direct participation in shared music-making and, in some cases, therapist-guided parent-led facilitation. Interaction-focused and parent-directed approaches were most often described as supporting emotional connectedness, shared coping, and family resilience. Methodological heterogeneity, small sample sizes, and inconsistent conceptualisations of family involvement limited comparability. The reviewed literature suggests that family involvement in music therapy may support psychosocial well-being and relational functioning within paediatric oncology. However, the available evidence is heterogeneous and primarily descriptive. Future research would benefit from clearer conceptualisations of family involvement and more methodologically comparable studies to clarify mechanisms of change and long-term effects.
Scandinavian journal of primary health careIsak Erling, Carl Anton Waltersson, Margda Waern, Maria Tillfors, Sara Hed, Maria Åberg, Stefan Wiktorsson, Anne Ingeborg Berg
BACKGROUND: Although interest in existential perspectives on health is growing, little is known about how such perspectives are experienced by older adults in primary care. The aim of this study was to understand how older adults who took part in a primary care-based existential group treatment describe the role of existential challenges in relation to their health and in primary care. METHODS: Seventeen patients (75+) with psychological distress who had completed a 7-week existential group treatment took part in individual interviews. Transcripts were analyzed using thematic analysis. RESULTS: Three main themes were derived from the participants' experiences: (1) Existential challenges are embedded in health in later life; (2) Existential challenges are not usually addressed in primary care consultations; and (3) Engagement with existential challenges is possible within primary care. Older adults with psychological distress describe existential challenges in terms of age-related losses which raise questions of health-related agency. However, barriers to addressing existential challenges in this care setting persist in the form of time constraints, perceived ageism and a one-sided focus on physical health. Relational and trustful healthcare encounters helped to overcome these barriers, as did the existential group treatment. CONCLUSION: While existential challenges are embedded in older adults' health, addressing these issues is not yet an integrated part of primary care services. In search of existential health in Swedish primary care, relational and trustful healthcare encounters as well as structured existential interventions, were found to facilitate the integration of existential perspectives in older adults' primary care experience.
European journal of psychotraumatologyHui Fan, Jianing Zhang, Yishu Wang, Kunhao Yang, You Wang, Xueling Yang
Background: Evidence-based trauma interventions are predominantly developed in and for WEIRD (Western, Educated, Industrialized, Rich, Democratic) populations. In non-Western higher education settings, implementing these therapies is heavily hindered by severe shortages of mental health professionals and culturally rooted stigma against authority figures. Exploring scalable, context-sensitive models like task-sharing is crucial for global mental health equity.Objective: This study evaluated the efficacy and underlying mechanisms of a peer-delivered integrated intervention - combining Eye Movement Desensitization (EMD) and Imagery Rescripting (IR) - for traumatised Chinese university students.Method: In a randomised controlled trial (RCT) with an explanatory sequential mixed-methods design, 95 students with moderate post-traumatic stress were randomised to a peer-delivered EMD + IR group, a standalone IR group, or a care-as-usual (CAU) control. Outcomes (depression, anxiety, self-efficacy, resilience) were assessed across four 50-minute peer-led sessions at baseline, post-intervention, and one-month follow-up. Traumatic memory characteristics were monitored, and post-trial qualitative interviews were conducted to understand therapeutic mechanisms and the peer-led experience.Results: Both interventions showed improvements over time. While Group × Time interactions for depression, anxiety, and self-efficacy were non-significant, the EMD + IR group demonstrated superior stability in maintaining resilience gains at follow-up, whereas the standalone IR group showed a significant decline. Mediation analysis revealed resilience gains were driven by a multi-dimensional restructuring of traumatic memories (reduced vividness, arousal, and negative beliefs). Qualitatively, EMD provided a 'sensory-affective buffer' for clients and an operational 'safety net' for novices. The egalitarian peer identity dismantled hierarchical stigma, while robust supervision ensured provider safety.Conclusions: Task-sharing EMD + IR via trained peers is a feasible, culturally congruent strategy. This phased model offers a safe, destigmatizing pathway for accelerating symptom relief and fostering sustainable post-traumatic growth.This trial was registered at the Chinese Clinical Trial Registry (ChiCTR2400090611).
European journal of psychotraumatologyNicolás García-Mejía, Anja F Ernst, Miriam J J Lommen, Lea Seidel-Koulaxis, Julián D Moreno-Villamizar, Oliwia K Nadolna, Sara V Prada, Judith K Daniels
Background: Posttraumatic Stress Disorder (PTSD) treatment shows 40% of non-response rate despite the efficacy of evidence-based psychotherapies like Prolonged Exposure (PE), and Cognitive Processing Therapy (CPT). Understanding how PTSD symptoms change during treatment, and the mechanisms that precede, mediate, or moderate these changes, is essential for improving interventions.Objective: This systematic scoping review mapped how changes in PTSD have been studied during psychotherapy between 2000 and 2023, focusing on (1) research objectives, (2) PTSD conceptualization, (3) covariates and mechanisms included, (4) repeated measurement timing and frequency, and (5) statistical modelling of change.Methods: Following PRISMA guidelines, we searched scientific databases for English- and Spanish-language peer-reviewed studies. Eligible studies included adults diagnosed with PTSD, examined evidence-based psychotherapies, and incorporated at least three repeated in-treatment assessments. Excluded were pharmacological trials, case studies, and non-empirical articles. After a three-phase screening, 115 studies met inclusion criteria. Data were extracted on research objectives, measurements, demographics, and analytic methods, and summarized using descriptive statistics.Results: Most studies were conducted in the United States (82%) involving veterans or active military (50%). PE (50%) and CPT (31%) dominated the treatment landscape. A total of 207 research objectives were identified, grouped into 16 categories. The most frequent were temporal precedence, time-stable predictors, and identification of change trajectories. PTSD and depression were the most frequently measured constructs (83%), typically assessed session-by-session with an average of nine repeated measurements, aligned with protocol duration. Multilevel regression modelling was the predominant analytic strategy (48%).Conclusions: Future research should state causal aims openly and base measurement on theory and evidence rather than tradition. Exploratory studies are needed to build an accurate understanding of the timing of PTSD change. Crucially, no studies used ecological momentary assessment, and samples show limited generalizability. Finally, research efforts significantly increased since 2010, evidencing the importance of this type of research.
Annals of medicineYuyan Sun, Huimin Zhang, Huanhuan Wang, Huifang Jiao, Dandan Li, Caixiao Shi
BACKGROUND: To explore the perceived distress and knowledge, attitudes, and practices (KAP) regarding first-aid for pediatric trauma among pediatric nurses. MATERIAL AND METHODS: A cross-sectional study was conducted between May and August 2025 at four tertiary hospitals in Henan Province and included pediatric nurses. The Perceived Stress Scale (PSS-14) was used to assess perceived distress and perceived coping. A structured questionnaire was used to evaluate KAP regarding pediatric trauma first-aid. Latent profile analysis (LPA) was applied to identify distinct stress profiles. KAP scores >70% were considered good. RESULTS: The study included 472 pediatric nurses. The knowledge, attitude, and practice scores were 44 [40,46] (80% of maximum), 35.5 [32,38] (88.8% of maximum), and 29.04 ± 5.81 (72.6% of maximum), respectively, suggesting good KAP. The LPA identified four profiles: Profile 1 (high perceived distress + high perceived coping, 26.48%), Profile 2 (moderate perceived distress + moderate perceived coping, 47.88%), Profile 3 (moderate perceived distress + low perceived coping, 15.25%), and Profile 4 (low perceived distress + moderate perceived coping, 10.38%). The Profile 1 reported the highest perceived distress [24 (23, 25)] and the best perceived coping abilities [15 (13, 17)]. Consequently, this profile consistently scored highest in knowledge [44 (42, 49)] and attitude [37 (33, 39)], suggesting that effective coping mechanisms may buffer the negative effects of high stress. CONCLUSIONS: This study highlights the diverse stress profiles among pediatric nurses and their associations with pediatric trauma first-aid. The results emphasizing the importance of targeted interventions to enhance coping mechanisms. Future training programs should consider stress management strategies alongside skill development.
Global health actionPranil Man Singh Pradhan, Mark P Funnell, Reshu Agrawal Sagtani, Nikita Bhattarai, Biraj Karmacharya, Abhinav Vaidya, Kamlesh Khunti, Patrick J Highton
BACKGROUND: Despite the burden of tobacco use, access to cessation support in South Asia remains scarce. OBJECTIVE: This review evaluates the effectiveness of tobacco cessation interventions delivered in clinical settings in South Asia. METHODS: Five relevant databases were searched from inception to February 2025. Eligibility criteria included randomized and non-randomized studies evaluating behavioral, pharmacotherapy, and multicomponent interventions delivered in clinical settings in South Asia. Data on study setting and design, participant information, intervention, comparator, and outcomes were extracted. Meta-analyses using random-effect models were conducted where possible. Certainty of evidence was assessed using GRADE. RESULTS: Thirty-seven studies were included (22 randomized and 15 non-randomized). Interventions involved pharmacotherapy (n = 6; 16.2%), nicotine replacement therapy (n = 7; 18.9%), behavioral counseling (n = 12; 32.4%), or combined/multicomponent interventions (n = 12; 32.4%). Most studies were conducted in India (n = 26; 70.3%), followed by Pakistan (n = 6; 16.2%), Nepal (n = 3; 8.1%), and two studies (5.4%) were multi-country in India, Pakistan, and Bangladesh. Pooled analyses demonstrated higher quit rates among intervention versus control for continuous abstinence at 0-3 months (RR: 1.21, 95%CI: 1.06 to 1.37) and >3 months (RR: 1.68, 95%CI: 1.1.4 to 2.47), and for point abstinence at >3 months post-intervention (RR: 2.03, 95%CI:1.35 to 3.08). Heterogeneity was high for all analyses (I2 range: 94% to 97%). Combined behavioral and pharmacotherapy interventions were most effective (RR: 1.70, 95%CI: 0.98 to 2.92), although not statistically significant (p = 0.06). CONCLUSION: Tobacco cessation interventions delivered in clinical settings in South Asia are effective, particularly when combining behavioral support with pharmacotherapy. However, evidence is limited by methodological weaknesses.
Brain research bulletinQiang Chen, Yating Zhang, Chenrui Liu, Yu Fu, Quan Gan, Zhuangfei Chen
BACKGROUND: This scoping review systematically compares the neural mechanisms underlying trait mindfulness and hypnosis susceptibility, focusing on three key dimensions: brain region activation, electroencephalographic (EEG) signals, and core brain networks. The aim is to elucidate potential shared mechanisms involved in conscious state modulation. METHODS: Through a comprehensive review of existing brain imaging and EEG studies, we found that both phenomena involve the prefrontal cortex and anterior cingulate cortex, enhanced theta and alpha EEG rhythms, and are closely related to the dynamic interaction between the salience network and the central executive network. RESULTS: These findings suggest their potential role in attentional regulation. Guided by the theory of predictive coding for interoception, we propose an integrative framework: trait mindfulness and hypnosis susceptibility jointly influence cognitive processes and alter self-conscious states through differential regulation. Specifically, trait mindfulness enhances perceptual inference and metacognitive awareness, whereas hypnosis susceptibility facilitates the acceptance of high-precision prior cues (suggestions) and promotes active inference. CONCLUSIONS: This framework provides a unified perspective for understanding the foundation of the two constructs and identifies directions for future research and clinical translation (e.g., anxiety interventions).
Brain research bulletinMi Zhang, Yongyi Li, Lijun Ma, Kai Wang, Xiaoming Li
This study used event-related potentials (ERPs), time-frequency analysis, and multivariate pattern analysis (MVPA) to investigate how hypnosis modulates visual and auditory processing. Twenty-two highly hypnotizable participants performed an independent oddball task. Under the hypnotic suggestion of "seeing without perceiving, hearing without listening," behavioral results showed that hypnosis reduced target detection accuracy and prolonged reaction times in both modalities, while false alarm rates remained low. ERP analysis revealed no significant difference in the N100 component between hypnosis and wakefulness, but hypnosis attenuated the late cognitive evaluation reflected by the P300 component. MVPA further showed that hypnosis delayed the onset of neural decoding to 160 ms in the visual pathway and to 120 ms in the auditory pathway from a baseline of 80 ms, and also reduced the temporal stability of neural representations. Time-frequency analysis of the visual task indicated that in the wakeful state, target stimuli elicited stronger delta-band (1-4 Hz) power than distractors, whereas hypnosis significantly diminished this neural representational specificity. These findings suggest that when individuals internalize hypnotic suggestions as personal goals, top-down regulatory mechanisms may alter neural temporal dynamics, reduce representational specificity, and lead to more homogeneous neural coding patterns, thereby decreasing perceptual efficiency while retaining weak decodability. This study provides neurobiological evidence for the neural mechanisms underlying perceptual dissociation during hypnosis.
BACKGROUND: Delirium and sleep disturbances are common among patients with acute myocardial infarction (AMI) admitted to the Cardiac Intensive Care Unit (CCU), often leading to increased mortality and prolonged hospitalization. Non-pharmacological interventions such as massage and aromatherapy may offer supportive benefits in managing these complications. METHODS: This parallel randomized clinical trial included 198 CCU patients diagnosed with AMI. Participants were randomly allocated into three groups: Group A received head and facial massage with lavender essential oil; Group B received massage with unscented sweet almond oil; Group C served as the control group with no massage. The intervention was administered twice daily for 20 min over two consecutive days. Delirium severity was assessed using the Neelon and Champagne Confusion Scale (NEECHAM), and sleep quality was evaluated using the St. Mary's Hospital Sleep Questionnaire (SMHSQ). RESULTS: Both intervention groups demonstrated significant improvements in sleep quantity and quality compared to the control group. Additionally, delirium severity was lower in the massage groups. These effects were sustained over time, suggesting the potential of head and facial massage-with or without aromatherapy-as a beneficial complementary therapy in cardiac care. CONCLUSION: Head and facial massage, whether combined with lavender aromatherapy or not, appears to be a safe, cost-effective, and practical method for improving sleep and managing delirium in CCU patients. Incorporating such complementary approaches into routine nursing care may enhance patient outcomes, reduce reliance on medication, and shorten hospital stays.
European journal of psychotraumatologySusan O'Donovan, Laura Ward, Ruth Melia
A traumatic childbirth can have negative consequences for mothers, as well as their children and partners. While eye movement desensitization and reprocessing (EMDR) is recommended in clinical guidelines as a treatment for post-traumatic stress disorder (PTSD) following childbirth, the specific application of EMDR for this population remains unclear. This scoping review aims to explore the extent of existing literature on the use of EMDR in the treatment of birth trauma. This review followed the PRISMA-ScR guidelines and included sources of evidence in which individuals or partners received EMDR treatment for birth trauma. Databases searched included PsycInfo, PubMed, the Cochrane Library, Embase, Scopus, and CINAHL, from inception of the database until approximately August 2025. Grey literature was also searched. Sources were limited to English-language publications. Two reviewers independently screened and extracted data from eligible quantitative and qualitative sources. Data were analysed in a descriptive and thematic manner. Data extraction included the sources' characteristics, outcomes, and results. Findings are presented in tabular and narrative formats. Twenty-nine sources of evidence were included, comprising randomized control trials, qualitative research, systematic reviews, and grey literature. Overall, EMDR showed promise in treating birth trauma, although the diversity of the evidence type and methodological design varied. This scoping review indicates that EMDR may be a promising intervention for birth trauma. However, the current evidence base is limited and heterogeneous in terms of study design type and outcome measures used. Further research is needed that includes long-term data, qualitative designs, diverse ethnicities, and the perspectives of partners.
Sleep medicineBhanu Prakash Kolla, Caroline S Mifsud, Alessio A Gugliotta, Jarrett W Richardson, Meghna P Mansukhani
BACKGROUND: Clinical hypnosis has shown some benefit for non-rapid eye movement (NREM) parasomnias; however, data regarding its effectiveness across the full spectrum of parasomnia subtypes, particularly rapid eye movement (REM) sleep behavior disorder (RBD), remain limited. We evaluated clinical outcomes of hypnosis for parasomnias treated at a quaternary sleep center. METHODS: We conducted a retrospective cohort study of patients referred for clinical hypnosis for parasomnia management. Demographic characteristics, parasomnia subtype, polysomnographic data, and concurrent medication use were extracted from the medical record. Treatment response was assessed using patient-reported symptom change and retrospectively assigned Clinical Global Impression-Improvement (CGI-I) scores derived from follow-up documentation. RESULTS: A total of 131 patients underwent at least one hypnosis session. Follow-up data were available for 76 patients (58%). Median follow-up was approximately six months. Overall, 41 patients (53.9%) reported subjective improvement. Among the 74 patients with assignable CGI-I scores, 24 (32.4%) were classified as responders (very much improved or much improved). An additional 19 (25.7%) showed minimal improvement. Treatment response varied by parasomnia subtype, with the highest response rate observed in NREM parasomnias (46.7% very much/much improved) and overlap parasomnias (44.4% very much/much improved). Modest improvement was observed in patients with RBD (33.3% very much/much improved). CONCLUSION: In this large retrospective cohort, clinical hypnosis was associated with subjective improvement in a subset of patients with NREM and REM parasomnias. Given its favorable safety profile, hypnosis may warrant further investigation as a low-risk adjunctive intervention for selected patients, including those with RBD.