The technique of transforming symptom's symbol into emptiness (TSSE) is a new mind-body treatment method proposed by Tianjun Liu in 2008. It integrates Qigong and concrete object-image thinking rooted in traditional Chinese culture into modern psychotherapy and proposes that mental and physical problems can be alleviated or eliminated in the process of movement. Accordingly, the therapist needs to guide the client with various symptoms to psychological nothingness where the client cannot see or feel these symptoms, and the purpose of healing can be achieved through the experience of emptiness. TSSE is divided into static and dynamic operations and consists of 10 steps. The static operation includes trio relaxation exercises (the body, breath, and mind), identifying the target symptom, visualizing the target symptom as an object-image, visualizing a symbolic carrier, and filling out record sheet A. The dynamic operation includes trio relaxation exercises again, moving the symbolic object into the carrier, moving the carrier with the symbolic object into psychological nothingness, moving back and assessment, and filling out record sheet B. The effectiveness of TSSE can be evaluated by the therapist's judgment based on the client's performance and by the difference between the symptom impact scores recorded in sheets A and B. TSSE has been proven to be an effective psychosomatic treatment solution by some empirical studies conducted in China. Future research can combine other technologies, such as fMRI and fNIRS, to further explore the potential effective mechanisms of TSSE.

Serotonergic psychedelics and related substances have been explored as potential adjuncts in substance-assisted psychotherapy (SAPT) for treating various disorders. SAPT can be divided into three phases: preparation, administration and integration. Integration is commonly defined as the comprehension and effective application of insights from psychedelic experiences into everyday life. However, there is limited research regarding the most appropriate therapeutic approach during SAPT. In this article, we discuss the current evidence for different therapeutic frameworks for integration sessions when serotonergic psychedelics and entactogens are used as adjuncts to psychotherapy. We conducted a systematised review of the literature following PRISMA guidelines and searched PsycINFO, MEDLINE and Cochrane Library databases. The final synthesis included 75 clinical trials, mixed-methods investigations, treatment manuals, study protocols, quasi-experiments, qualitative investigations, descriptive studies, opinion papers, reviews, books and book chapters, published until 11 November 2022. The effects that various therapeutic approaches for integration sessions have on therapeutic outcomes have not been investigated by means of rigorous research. Most of the available evidence we retrieved was not supported by empirical data, thus limiting any conclusive statements regarding appropriate therapeutic frameworks for integration sessions for SAPT. Current clinical studies have used a range of therapeutic frameworks with the majority drawing from the humanistic-experiential tradition. While integration is regarded as crucial for the safe application of SAPT, there is currently an insufficient evidence base to suggest that any type of therapy is effective for guiding integration sessions. A systematic investigation of different therapeutic frameworks for integration and additional therapy-related factors is needed.

Diagnostic reasoning is an essential skill for optometry practice and a vital part of the curriculum for optometry trainees but there is limited understanding of how diagnostic reasoning is performed in optometry or how this skill is best developed. A validated and reliable self-reflective inventory for diagnostic reasoning in optometry, would enable trainees and registered practitioners to benchmark their diagnostic reasoning skills, identify areas of strength and areas for improvement.

A 41 item self-reflective inventory, the Diagnostic Thinking Inventory, used extensively in the medical field was adapted for use in optometry and called the Diagnostic Thinking Inventory for Optometry (DTI-O). The inventory measures two subdomains of diagnostic reasoning, flexibility in thinking and structured memory. Context based changes were made to the original inventory and assessed for face and content validity by a panel of experts. The inventory was administered to two groups, experienced (qualified) optometrists and second-year optometry students to establish validity and reliability of the self-reflective tool in optometry.

Exploratory Factor Analysis uncovered 13 domain specific items were measuring a single construct, diagnostic reasoning. One misfitting item was removed following Rasch analysis. Two unidimensional subdomains were confirmed in the remaining 12 items: Flexibility in Thinking (χ2 = 12.98, P = 0.37) and Structured Memory (χ2 = 8.74, P = 0.72). The 'Diagnostic Thinking Inventory for Optometry Short' (DTI-OS) tool was formed from these items with the total and subdomain scores exhibiting strong internal reliability; Total score C_α = 0.92. External reliability was established by test-retest methodology (ICC 0.92, 95% CI 0.83-0.96, P < .001) and stacked Rasch analysis (one-way ANOVA, F = 0.07, P = 0.80). Qualified optometrists scored significantly higher (P < .001) than students, demonstrating construct validity.

This study showed that the DTI-O and DTI-OS are valid and reliable self-reflective inventories to quantify diagnostic reasoning ability in optometry. With no other validated tool to measure this metacognitive skill underpinning diagnostic reasoning a self-reflective inventory could support the development of diagnostic reasoning in practitioners and guide curriculum design in optometry education.

The mindfulness and self-compassion (MSC) protocol has shown efficacy in reducing mental illness symptoms and increasing well-being. However, little is known on how the positive outcomes are produced. This study explores how reductions in experiential avoidance following MSC training may explain changes in the participants' levels of anxiety, depression, and well-being.

The 8-week protocol-based MSC training was delivered to 50 participants, and pre- to post- intervention changes in anxiety, depression, and well-being were measured. A series of mediation models were conducted, with changes in self-compassion as predictor, changes in experiential avoidance as mediator, and changes in mental health and well-being as outcome variables. Point estimates and bootstrap-corrected 95% confidence intervals were calculated to analyse indirect effects through experiential avoidance, by means of structural equation modeling (SEM).

Following MSC training, participants increased their levels of self-compassion, reduced experiential avoidance, and enhanced mental health (i.e., anxiety and depression symptoms) and well-being scores. Increases in self-compassion were associated with decreases in experiential avoidance, which in turn were connected with changes in anxiety, depression, and well-being from pre- to post-training. The indirect path through changes in experiential avoidance represented moderate to large proportions of the total effects of self-compassion change-scores on anxiety, depression, and well-being change-scores.

Reducing experiential avoidance and increasing psychological flexibility may be a key effect of MSC training linked to improvements of the participants' mental health and well-being scores. Self-compassion practices could exert effects on anxiety, depression and well-being mainly through promoting reductions in experiential avoidance.

Despite substantial evidence for their effectiveness in treating disordered eating and obesity, mindfulness-based treatments have not been broadly implemented among Veterans. A number of reviews have reported mindfulness to be beneficial in promoting healthy eating behaviors and weight loss among non-Veteran samples. We discuss this approach in the context of the Veterans Affairs system, the largest integrated healthcare provider in the U.S. and in the context of Veterans, among whom obesity is at epidemic proportions. In this article, we discuss what is known about treating obesity using a mindfulness approach, mindfulness interventions for Veterans, a new pilot mindfulness-based weight loss program designed for Veterans, and future directions for this type of obesity treatment in Veterans. We conclude that this population may be uniquely poised to benefit from mindfulness-based treatments.

Dissociation is understood as maladaptive coping and is common in children and adolescents. Treatment outcome studies show improvement in comorbid conditions suggesting the need to implement programs that target dissociative pathology.

To study the effect of practicing mindfulness among adolescents diagnosed with dissociative disorders.

It was a hospital-based repeated measures design.

7 adolescents participated in a mindfulness-based therapeutic program for 6 weeks.

Scores were expressed as mean ± standard deviation. Friedman test was used to assess significance of the difference in scores at various assessment phases. Wilcoxon signed rank test was used for post hoc analysis.

Participants were mostly female adolescents from rural, Eastern India. There was a significant reduction in dissociative experiences and significant improvement in mindfulness.

Incorporating mindfulness in clinical practice may prove effective in reducing dissociation and promoting adaptive functioning.

It has been found that support given to women with breast cancer has a positive effect upon their reactions to the illness and may even prolong their survival. Perceived support needs assessment in breast cancer women could be considered as a necessary part of nursing function.

The purpose of this study was to translate and culturally adapt the self-assessed support needs (SASN) questionnaire into Persian language and to investigate its psychometric properties.

After forward-backward translation of the questionnaire and making appropriate changes, we selected 160 women with breast cancer as our study sample. The psychometric properties of the SASN, including its internal consistency, test retest reliability, and construct validity were evaluated through the known-groups technique.

The calculated Kaiser Meyer Olkin was 0.756, indicating that the sample was sufficiently large to perform a satisfactory factor analysis. The six factors all together explained 50.7% of the variance; the first factor (diagnosing) explaining the biggest part of variance (10.9). Internal consistency reliability was 0.83 for the whole scale and the stability of test was 0.78. For the first factor, Cronbach's alpha was 0.90 and factor loadings of scale's items were found to deal with diagnosis subscale. The domains described patients' diagnosis, treatment, support, femininity and body image, family and friends and information.

The reliability and validity of the adapted version of the SASN was shown to be satisfactory. Thus, it can be used to investigate self-assessed support needs of Iranian women suffering from breast cancer since the SASN is a multi-domain scale.

Recent findings support the relevance of anxiety sensitivity (AS) and interoceptive exposure (IE) across emotional disorders. This study (a) evaluated levels of AS across different anxiety disorders, (b) examined change in AS over the course of transdiagnostic psychological intervention, and its relationship with outcome, and (c) described the implementation of IE to address AS with patients with different anxiety disorders. Participants (N=54) were patients who received treatment with the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) in two consecutive treatment trials. Participants completed a measure of AS at pre- and posttreatment, and multiple occasions during treatment. Symptom severity was assessed at pre- and posttreatment, and clinical information related to physical symptoms and IE were collected as part of routine clinical practice. Elevated AS was observed at pretreatment across diagnoses and decreases in AS were observed from pre- to posttreatment. Similar changes occurred across the diagnostic categories, notably coinciding with the introduction of IE. Change in AS was correlated with reduced symptom levels at posttreatment and 6-month follow-up. Patients with different anxiety disorders endorsed similar physical symptoms and practiced similar IE exercises with similar effects. Results provide preliminary support for the usefulness of IE as a treatment strategy across the spectrum of anxiety disorders, and additional support for the transdiagnostic relevance of AS.

Studies have shown that anxiety sensitivity (AS) is a risk factor in the development of pathological anxiety. Recent theoretical models emphasize the additional importance of how people handle their anxious experiences. The present study examined whether high AS and being fixated on the control and regulation of unwanted anxious feelings or being unable to properly modulate affect as needed lead to particularly problematic outcomes. We examined the interactive influence of AS and affect regulatory strategies on the frequency and intensity of anxiety symptoms. Questionnaires were completed by 248 young adults in the community. Results showed a general pattern with anxiety symptoms being the most severe when high AS was paired with affect regulatory difficulties. Of participants high in AS, anxious arousal and worry were heightened in the presence of less acceptance of emotional distress; anxious arousal, worry, and agoraphobic cognitions were heightened when fewer resources were available to properly modulate affect; and agoraphobic cognitions were heightened in the presence of high emotion expressiveness. As evidence of construct specificity, an alternative model with anhedonic depressive symptoms as a main effect and interaction effect (with regulatory strategies) failed to predict anxiety symptoms. However, anxiety sensitivity and less acceptance of emotional distress were associated with greater anhedonia. Results are discussed in the context of how and when affect regulatory behavior shifts individuals from normative anxiety to pathology.

This article reviews the theory, clinical application, and empirical findings on mindfulness-based cognitive therapy (MBCT) for mental health and addictive disorders. Expanding upon the research demonstrating the efficacy of cognitive-behavioral therapy (CBT) for addiction, this article develops and explores the rationale for combining mindfulness-based interventions with evidence-based CBTs in treating addictive disorders, with an emphasis on substance use disorders with co-occurring mood disorders. This article proposes that deficits in affect--regulation related to the behavioral and emotional effects of neurobiological changes that occur with long-term substance abuse--pose a unique set of challenges in early recovery. Prolonged use of addictive substances impairs the brain pathways that mediate certain affect regulation functions. These functions involve attention and inhibitory control, the saliency of and response to addictive versus natural reward stimuli, and the ability to detach or maintain perspective in response to strong emotional states. In treating this affective dysregulation, which can contribute to the vulnerability to relapse in the early stages of recovery, the affect-regulation-specific focus of MBCT adds a valuable element to augment CBT for addiction. Summarizing magnetic resonance imaging and positron emission tomography findings on the effects of MBCT and the neurobiology of drug addiction, this article outlines directions for further research on potential benefits of MBCT for the recovering individual. Finally, this article describes a structured protocol, developed at the Mount Sinai School of Medicine in New York City, which combines CBT with mindfulness-based intervention, for the treatment of affect-regulation issues specific to co-occurring addictive and mood disorders.

Recent innovations in psychological treatments have integrated mindfulness meditation techniques with traditional cognitive and behavioural therapies, challenging traditional cognitive and behavioural therapists to integrate acceptance- and change-based strategies. This article details how 2 treatments, mindfulness-based cognitive therapy and dialectical behaviour therapy, have met this challenge. We review the integration rationale underlying the 2 treatments, how the treatments combine strategies from each modality to accomplish treatment goals, implications for therapist training, and treatment effectiveness. In addition, we discuss the challenges of assessing the benefits of incorporating acceptance-based strategies. Both therapies have integrated acceptance-based mindfulness approaches with change-based cognitive and behavioural therapies to create efficacious treatments.