The effect of tai chi on psychosocial well-being : a systematic review of randomized controlled trials

Objective : This systematic review aimed to critically appraise published clinical trials designed to assess the effect of Tai Chi on psychosocial well-being.

Data Sources : Databases searched included MEDLINE, CINAHL, EMBASE, HEALT, PsycINFO, CISCOM, the Cochrane Central Register of Controlled Trials of the Cochrane Library, and dissertations and conference proceedings from inception to August 2008.

Review Methods : Methodological quality was assessed using a modified Jadad scale. A total of 15 studies met the inclusion criteria (i.e. English publications of randomized controlled trials with Tai Chi as an intervention and psychological well-being as an outcome measure), of which eight were high quality trials. The psychosocial outcomes measured included anxiety (eight studies), depression (eight studies), mood (four studies), stress (two studies), general mental health three studies), anger, positive and negative effect, self-esteem, life satisfaction, social interaction and self-rated health (one study each).

Results : Tai Chi intervention was found to have a significant effect in 13 studies, especially in the management of depression and anxiety. Although the results seemed to suggest Tai Chi is effective, they should be interpreted cautiously as the quality of the trials varied substantially. Furthermore, significant findings were shown in only six high quality studies. Moreover, significant between group differences after Tai Chi intervention was demonstrated in only one high quality study (the other three significant results were observed in non-high quality studies). Two high quality studies in fact found no significant Tai Chi effects.

Conclusion : It is still premature to make any conclusive remarks on the effect of Tai Chi on psychosocial well-being.

Psychological and cumulative cardiovascular effects of repeated angry ruminaton and visuospatial suppression

Brooding rumination is associated with depressed mood, increased negative affect, prolonged anger and inhibited cardiovascular (CV) recovery. Distraction from rumination on a stressful interpersonal encounter is associated with faster CV recovery and decreased negative affect. Studies have suggested that a concurrent visuospatial (VS) task inhibits the maintenance of imagery associated with the perseveration of intrusive negative memories. 120 healthy participants were recruited for the study. As an analogue of repeated angry rumination, the authors explored the effects of repeated visual recall of a provocative confederate and the subsequent impact of two visuospatial (VS) distraction tasks on negative affect, blood pressure (BP) and heart rate (HR). Repeated recall of the provocation generated repeatedly elevated HR with a cumulative trend that may have CV disease risk implications for chronic ruminators. VS distraction did not aid recovery compared with the Control task.

Longitudinal evaluation of a risk-factor model for adolescent suicidality

This research developed two best-fitting structural equation models of risk factors for adolescent depression and suicidality: a core model, which included parenting factors, gender, depression, and suicidality, and an extended model, which also encompassed personality traits (Introversion and Impulsivity) and mood factors (Anxiety and Anger). Further, this research investigated the consistency of model fit across time (Le., 1 month & 12 months) and samples, and explored the effectiveness of the ReachOut! Internet site as a psychoeducational prevention strategy for adolescent depression and suicidality. Gender, age, and location differences were also explored. Participants were 185 Year-9 students and 93 Year-10 students aged 14 - 16 years, from seven secondary schools in regional and rural Victoria. Students were given a survey which included the Parental Bonding Instrument (Parker, Tupling, & Brown, 1979), the Millon Adolescent Personality Inventory (Millon, Green, & Meagher, 1982), the Profile of Mood States Inventory (McNair & Lorr, 1964), items on suicidal behaviour including some questions from the Revised Adolescent Suicide Questionnaire (Pearce & Martin, 1994), and questions on loss and general demographics. Results supported an indirect model of risk factors, with family factors directly influencing personality factors, which in turn influenced mood factors, including depression, which then influenced suicidality. At the theoretical level, results supported Attachment Theory (Bowlby, 1969), demonstrating that perceived parenting styles that are warm and not overly controlling are more conducive to an adolescent's emotional well-being than are parenting styles that are cold and controlling. Further, results supported Millon's theory of personality (1981), demonstrating that parenting style influences a child's personality. Short-term intervention effects from the internet site were a decrease in Introversion for the full sample, and decreased Inhibition and Suicidality for a high-risk subgroup. Long-term age effects were decreased Inhibition and increased Anxiety for the fall sample. There was also a probable intervention effect for Depression for the high-risk subgroup. No location differences for the risk factors were found between regional and rural areas.

Envisioning Indochina : the spatial and social ordering and imagining of a French colony

The emergence of Indochina in the French imagination was articulated in both representational and institutional modes. Representation involves the transmission of colonial ideals through more obtuse means; that is, through literary texts, travelogues, exhibitions, film and advertising. However, these textual sites feed from and invest in a material situation, which was the institutional arm of colonialism. Indochina was institutionally articulated in cartographic maps and surveys, in the new social spaces of cities and towns, in architectural and technological forms, through social technologies of discipline and welfare and in cultural and religious organisations. The aim of this thesis is to analyse, across a number of textual sites, the representation and institutionalisation of Otherness through the politics of space in the French colony of Indochina, Indochine in this sense becomes a spatial discourse. The French constructed a mental and physical space for Indochina by blanketing and suffocating the original cultural landscape, which in fact had to be ignored for this process to occur. What actually became manifest as a result of this projection stemmed from the French imagination. Just as the French manipulated space, language also underwent the same process of reduction. The Vietnamese script was latinised to make it more 'useable' and ‘accessible’. Through christening the union of Indochina; initiating a comprehensive writing reform; and renaming the streets in the colonial cities, the French used language us another tool for 'making transparent'. Furthermore, the colonial powers established a communication and transport network throughout the colony in an attempt to materialise their fictive (artificial) vision of a unified French Indochinese space. The accessibility and design of these different modes of transport reflected the gendered, racial and class divisions inherent in the colonial establishment. At the heart of representing and institutionalising Indochina was the desire to control and contain. This characterised French imperial ordering of space in the city and the rural areas. In rural areas land was divided into small parcels and alienated to individuals or worked into precise grids for the rubber plantation. In urban centres the native quarter was clearly demarcated from the European quarter which functioned as its modern, progressive Other. The rationale behind this segregation was premised on European, nineteenth century discourses of race, class, gender and hygiene. Influenced by Darwinian and neo-Lamarkian theories of race, this biological discourse identified the 'working class', 'women' and 'the native' as not only biologically but also culturally inferior. They were perceived as a potential, degenerative threat to the biological, cultural and industrial development of the nation. In the colonial context, space was thus ordered and domesticated to control the native population. Coextensively, the literature which springs from such a structure will be tainted by the same ideas, and thus the spaces it formulates within the readers mind feed on and reinforce this foundation. Examples of gender and indigenous narratives which contest this imaginative, transparent topography are analysed throughout this thesis. They provide instances of struggle and resistance which undermine the ideal/stereotypical level of architectural and planned space and delineate an alternative insight into colonial spatial and social relations. The fictional accounts of European women and indigenous writers both challenge and reaffirm the fixity of some of these idealised colonial boundaries. In various literary, historical, political, architectural and cinematic discourses Indochina has been und continues to be depicted as a modern city and exotic Utopia. Informed by the mood of nostalgia, exotic images of Indochina have resurfaced in contemporary French culture. France's continued desire to create, control and maintain an Indochinese space in the French public imagination reinforces the multi-layered, interconnected and persistent nature of colonial discourse.

Getting your life back on track after stroke : a phase II multi-centered, single-blind, randomized, controlled trial of the Stroke Self-Management Program vs. the Stanford Chronic Condition Self-Management Program or standard care in stroke survivors

Background Self-management is seen as a primary mechanism to support the optimization of care for people with chronic diseases such as symptomatic vascular disease. There are no established and evidence-based stroke-specific chronic disease self-management programs. Our aim is to evaluate whether a stroke-specific program is safe and feasible as part of a Phase II randomized-controlled clinical trial.
Methods Stroke survivors are recruited from a variety of sources including: hospital stroke services, local paper advertisements, Stroke South Australia newsletter (volunteer peer support organization), Divisions of General Practice, and community service providers across Adelaide, South Australia. Subjects are invited to participate in a multi-center, single-blind, randomized, controlled trial. Eligible participants are randomized to either;
• standard care,
• standard care plus a six week generic chronic condition self-management group education program, or,
• standard care plus an eight week stroke specific self-management education group program.
Interventions are conducted after discharge from hospital. Participants are assessed at baseline, immediate post intervention and six months.
Study Outcomes The primary outcome measures determine study feasibility and safety, measuring, recruitment, participation, compliance and adverse events.
Secondary outcomes include:
• positive and active engagement in life measured by the Health Education Impact Questionnaire,
• improvements in quality of life measured by the Assessment of Quality of Life instrument,
• improvements in mood measured by the Irritability, Depression and Anxiety Scale,
• health resource utilization measured by a participant held diary and safety.

Conclusion The results of this study will determine whether a definitive Phase III efficacy trial is justified.

Reinforcement sensitivity theory : a paradigm for understanding the motivational processes underlying alcohol use

Provides an examination of the processes which motivate individuals to drink alcohol. It was found that heavier drinkers are highly sensitive to reward yet more likely to experience negative affect, both generally, and in response to alcohol-related cues. Based on these findings a model focusing on the links between personality, mood and craving for alcohol was developed.

A multi-component assessment model for monitoring training distress among athletes

We report the initial validation of a multi-component assessment model for monitoring training distress among athletes. The model combines measures of mood disturbance with measures of perceived stress and symptom intensity. Altogether, 492 athletes completed the 10-item Perceived Stress Scale (PSS-10; Cohen et al., 1983), the 24-item Brunel Mood Scale (BRUMS; Terry et al., 2003), and a checklist of 19 symptoms associated with acute overtraining (Fry et al., 1994). Six training distress factors were identified by an exploratory factor analysis: ‘‘depressed mood’’, ‘‘perceived vigour’’, ‘‘physical symptoms’’, ‘‘sleep disturbance’’, ‘‘perceived stress’’, and ‘‘general fatigue’’. Comparisons of group means of these factors with a previously validated inventory were consistent with theoretical predictions and provided evidence of construct validity. Internal consistency of the subscales was also confirmed, with Cronbach alphas ranging from 0.72 to 0.86. Together, these findings suggest that this multi-component model provides a sound conceptual basis for the assessment of training distress among athletes.

Relationship between inflammatory cytokines and self-report measures of training overload

It has been purported that inflammatory cytokines may be responsible for the aetiology of overtraining. The aim of the present study was to investigate the relationship between self-reported measures of overtraining and inflammatory cytokines. Eight elite male rowers were monitored in their natural training environment for 8 weeks prior to the 2007 Rowing World Championships. During this period of intense endurance training, self-report measures of overtraining and inflammatory cytokines (Interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-12p70, and Tumor Necrosis Factor (TNF)-) were assessed fortnightly. Consistent with previous findings, proinflammatory cytokines IL-1β and TNF- were significantly associated (p ≤ 0.05) with measures of depressed mood, sleep disturbances, and stress. Similarly, IL-6 was significantly associated (p ≤ 0.01) with measures of depressed mood, sleep disturbances, and fatigue. These results are consistent with previous hypotheses describing how overtraining may be caused by excessive cytokine release, and lend further support for a cytokine hypothesis of overtraining.

Sublime Wong Kar-wai

In the films of Wong Kar-wai one finds a double or parallel sensing of the sublime. Numerous characters are seen to experience perceptual moments of unbounded terror, where they are faced with the weight, enormity or formlessness of objects, things, and natural phenomena that they cannot initially or fully comprehend. These ‘textual’ sublime moments are simultaneously rendered receptively, experientially sublime through the way Wong Kar-wai conjures up a series of refracted, defamiliarised images of heightened intensity, such as bejeweled juke boxes, incandescent lampshades, thick waterfalls, and wispy cigarette smoke rising. Such awesome images are of artifice and nature, conjoined, blurred, or delineated, so that the sublime moment is of the postmodern moment, irrational and irregular, and ‘monstrous’ because of it. In the films of Wong Kar-wai, character and viewer become aligned in a process of identification in which each recognizes their mortality, and inadequacy, in the face of such dazzling, incomprehensible moments that trace across the retina of the eye. The pleasure and the pain of this is something that I will explore in this paper, using such sublime films as Fallen Angels, Chungking Express, Happy Together, In the Mood for Love, 2046, and Blueberry Nights, to illustrate my arguments.

Vitamin D deficiency may play a role in depression

Vitamin D is known to be widely deficient in Western populations. The implications of this in terms of bone health are increasingly understood, yet its impact on other health areas, particularly mental health, is unclear. Recent data suggests that hypovitaminosis D may be common, especially in the elderly. Other studies have suggested that low levels of vitamin D are associated with poor mood. There are a number of trials that have suggested a role for Vitamin D in the supplementary treatment of depression. Dose may be a critical issue, as sun exposure and dietary intake may be low and high doses may be required.

Dietary omega-3 fatty acids and depression in a community sample

To evaluate the association between omega-3 polyunsaturated essential fatty acids and depression, data regarding prevalence rates of self-reported depression and median daily dietary intakes of these fatty acids were obtained from an age-stratified, population-based sample of women (n = 755; 23-97 year) in the Barwon Statistical Division of south-eastern Australia. A self-report questionnaire based on Diagnostic and Statistical Manual-IV criteria was utilised to determine 12-month prevalence rates of depression in this sample, and data from biennial food frequency questionnaires examining seafood and fish oil consumption over a 6-year period were examined. Differences in median dietary intakes of omega-3 fatty acids between the depressed and nondepressed cohorts were analysed and results were adjusted for age, weight and smoking status. No significant differences in median intakes were identified between the two groups of women (median, interquartile range; depressed = 0.09g/day, 0.04-0.18 versus nondepressed = 0.11 g/day, 0.05-0.22, p = 0.3), although overall average intakes of omega-3 fatty acids were lower than recommended and rates of depression within this sample higher than expected, based on previous data. Further research that takes into account ratios of omega-6 to omega-3 polyunsaturated essential fatty acids, as well as other dietary sources of omega-3 fatty acids, is warranted.

Annual high-dose vitamin D3 and mental well-being: randomised controlled trial

Background Epidemiological evidence supports a relationship between vitamin D and mental well-being, although evidence from large-scale placebo-controlled intervention trials is lacking.

Aims To examine if vitamin D supplementation has a beneficial effect on mood in community-dwelling older women; if a single annual large dose of vitamin D has a role in the prevention of depressive symptoms; and if there is an association between serum 25-hydroxyvitamin D levels and mental health.

Method A double-blind, randomised, placebo-controlled trial of women aged 70 or older (the Vital D Study: ISRCTN83409867 and ACTR12605000658617). Participants were randomly assigned to receive 500 000 IU vitamin D3 (cholecalciferol) orally or placebo every autumn/winter for 3–5 consecutive years. The tools utilised at various time points were the General Health Questionnaire, the 12-item Short Form Health Survey, the Patient Global Impression–Improvement scale and the WHO Well-Being Index. Serum 25-hydroxyvitamin D levels were measured in a subset of 102 participants.

Results In this non-clinical population, no significant differences between the vitamin D and placebo groups were detected in any of the measured outcomes of mental health. Serum 25-hydroxyvitamin D levels in the vitamin D group were 41% higher than the placebo group 12 months following their annual dose. Despite this difference, scores from the questionnaires did not differ. Furthermore, there was no interaction between those on antidepressant/anxiety medication at baseline and the treatment groups.

Conclusions The lack of improvement in indices of mental well-being in the vitamin D group does not support the hypothesis that an annual high dose of vitamin D3 is a practical intervention to prevent depressive symptoms in older community-dwelling women.

Regular exercise participation mediates the affective response to acute bouts of vigorous exercise

Physical inactivity is a leading factor associated with cardiovascular disease and a major contributor to the global burden of disease in developed countries. Subjective mood states associated with acute exercise are likely to influence future exercise adherence and warrant further investigation. The present study examined the effects of a single bout of vigorous exercise on mood and anxiety between individuals with substantially different exercise participation histories. Mood and anxiety were assessed one day before an exercise test (baseline), 5 minutes before (pre-test) and again 10 and 25 minutes post-exercise. Participants were 31 university students (16 males, 15 females; Age M = 20), with 16 participants reporting a history of regular exercise with the remaining 15 reporting to not exercise regularly. Each participant completed an incremental exercise test on a Monark cycle ergometer to volitional exhaustion. Regular exercisers reported significant post-exercise improvements in mood and reductions in state anxiety. By contrast, non-regular exercisers reported an initial decline in post-exercise mood and increased anxiety, followed by an improvement in mood and reduction in anxiety back to pre-exercise levels. Our findings suggest that previous exercise participation mediates affective responses to acute bouts of vigorous exercise. We suggest that to maximise positive mood changes following exercise, practitioners should carefully consider the individual's exercise participation history before prescribing new regimes.

Spectres in the city –De Chirico’s mythologized streetscapes

It is generally accepted that some of the unsettling scenes of the Italian metaphysical painter Giorgio de Chirico, arose from his response to the northern Italian city of Turin, a city he claimed a great affinity with. While de Chirico’s paintings and commentary of this period abound with references to Turin, there has been little investigation into how genuine these citied locations really are. We know that de Chirico’s preference for Turin arose from his passionate engagement with the writings of the philosopher
Friedrich Nietzsche and Nietzsche’s fondness for the city. Yet there is much evidence to suggest that Munich, the city of de Chirico’s early art school days permeated his imagery more completely; whereas Turin reflected his philosophical and aesthetic concerns. This article examines how cities have operated for the artist and how using iconography from both the world of the real and imagined produced powerful enigmatic images that evoked a profound mood of illusion and revelation.

N-acetyl cysteine for depressive symptoms in bipolar disorder - a double blind, randomized, placebo-controlled trial

Background: Treatment-resistant subthreshold depression is a major problem in bipolar disorder. Both depression and bipolar disorderare complicated by glutathione depletion. We hypothesized that treatment with N-acetyl cysteine (NAC), a safe, orally bioavailable precursor of glutathione, may improve the depressive component of bipolar disorder.

Methods: A randomized, double-blind, multicenter, placebo-controlled study of individuals (n 75) with bipolar disorder in the maintenance phase treated with NAC (1 g twice daily) adjunctive to usual medication over 24 weeks, with a 4-week washout. The two primary outcomes were the Montgomery Asberg Depression Rating Scale (MADRS) and time to a mood episode. Secondary outcomes included the Bipolar Depression Rating Scale and 11 other ratings of clinical status, quality of life, and functioning.

Results: NAC treatment caused a significant improvement on the MADRS (least squares mean difference [95% confidence interval]: 8.05 [13.16, 2.95], p .002) a n d most secondary scales at end point. Benefit was evident by 8 weeks on the Global Assessment of Functioning Scale and Social and Occupational Functioning Assessment Scale and at 20 weeks on the MADRS. Improvements were lost after washout. There was no effect of NAC on time to a mood episode (log-rank test: p .968) and no significant between-group differences inadverse events. Effect sizes at end point were medium to high for improvements in MADRS and 9 of the 12 secondary readouts.

Conclusions: NAC appears a safe and effective augmentation strategy for depressive symptoms in bipolar  disorder.