Ryan Matlow, PhD

Abstract

STUDY OBJECTIVES: Poor sleep impedes children's cognitive, emotional, and psychosocial development. Pediatric sleep dysregulation is common, and children who live in communities of low socioeconomic status (SES) experience additional risk factors for short sleep duration and poor sleep quality. School-based training in mindfulness and yoga-informed practices can improve children's behavior and well-being, but effects on objectively measured sleep are unknown.METHODS: Effects of a school-based health and mindfulness curriculum, which taught practices such as paced breathing, on sleep and stress were examined in 115 children (49 girls, ages eight to 11 at baseline). 58 children in a community of low socioeconomic status (SES) received the curriculum twice weekly for two years. 57 children in an SES-matched community engaged in their usual physical education class instead. In-home ambulatory polysomnography and perceived social stress were measured from all children at three timepoints: at baseline (i.e., prior to curriculum exposure) and at two yearly follow-ups.RESULTS: Children receiving the curriculum gained an average of 74 minutes of total sleep time, and 24 minutes of rapid eye movement (REM) sleep, per night over the two-year study period. Children not receiving the curriculum experienced a decrease in total sleep time averaging 64 minutes per night, with no changes in REM sleep. Sleep improved within the first three months of curriculum exposure, in a dose-dependent fashion. Higher curriculum engagement (e.g., using the breathing exercises outside of class) was associated with larger gains in total and REM sleep duration. Aggregate within-group changes in social stress were not significant. However, among children receiving the curriculum, those who experienced larger gains in total and REM sleep duration also experienced larger increases in perceived social stress.CONCLUSIONS: A school-based health and mindfulness curriculum improved children's objectively measured sleep over two years. Social stress did not mediate these effects; instead, mindfulness training may have increased awareness of environmental stressors, while developing tools to reduce stress vulnerability.

View details for DOI 10.5664/jcsm.9508

View details for PubMedID 34170222

View details for DOI 10.1056/NEJMp2103956

View details for PubMedID 33951356

View details for Web of Science ID 000698984300640

Abstract

Purpose: Few of the existing evidence-based interventions for child trauma exposure were specifically designed to address experiences and outcomes of complex developmental trauma. Stanford's cue-centered therapy (CCT) was designed to address this gap by offering a flexible, integrative, and insight-oriented treatment approach that is grounded in principles of neuroscience, developmental trauma, client empowerment, and allostasis. This article reviews the CCT rationale, treatment components, evidence base, and training approach.Recent findings: Studies demonstrate promising outcomes indicating CCT effectiveness in reducing child and caregiver posttraumatic stress, and in improving child functioning. Further research, however, is needed to identify which clients are best-suited for CCT (versus other available child trauma treatments) and to identify which components of CCT are most critical for addressing complex developmental trauma.Summary: CCT advances the field of child trauma treatment by offering an intervention approach focused on addressing complex developmental trauma. Positive treatment and training outcomes indicate utility of CCT for clients and clinicians. Innovations in research and training approaches are needed to further dissemination and implementation of CCT and other related child trauma interventions for complex developmental trauma.

View details for DOI 10.1007/s40501-021-00241-3

View details for PubMedID 33898161

View details for DOI 10.1016/j.jadohealth.2020.05.014

View details for PubMedID 32718514

View details for DOI 10.1056/NEJMp1814340

View details for Web of Science ID 000454731200003

View details for Web of Science ID 000549804100006

View details for PubMedID 30462590

View details for Web of Science ID 000552225100018

Abstract

The current longitudinal study examined the relative impact of symptoms and appraisals as well as contextual and demographic factors on women's subsequent readiness to leave a relationship following intimate partner abuse. An ethnically diverse sample of women (N = 177) completed measures assessing posttrauma appraisals, symptoms, dependence on the perpetrator, and abuse characteristics. One year later, women reported on their readiness to leave the relationship. Regression analyses revealed that readiness to leave was (a) positively predicted by fear appraisals, (b) negatively predicted by shame appraisals, and (c) significantly associated with additional contextual factors (i.e., dependence on the perpetrator, stalking behaviors).

View details for DOI 10.1177/1077801215590668

View details for PubMedID 26077326

Abstract

BACKGROUND: Youth with psychiatric disorders are at increased risk of tobacco use. Outpatient mental health settings have received little investigation for delivering tobacco treatment. This study obtained formative data to guide development of a tobacco cessation program for transitional age youth with co-occurring psychiatric disorders with a focus on outpatient mental health settings. METHODS: Applying qualitative methods, we analyzed transcripts from interviews with 14 mental health clients (aged 16-23) and 8 mental health providers. RESULTS: The youth identified internal (nicotine addiction and mood), social, parental, and media influences to their use of tobacco. Providers' viewed youth tobacco use as a normative developmental process, closely tied to management of psychiatric symptoms, supported by parents, and of lower priority relative to youth alcohol and illicit drug use. Youth and providers believed that clinicians can do more to address tobacco use in practice and emphasized nonjudgmental support and nondirective approaches. Top recommended quitting strategies, however, differed notably for the youth (cold turkey, support from friends, physical activity, hobbies) and providers (cessation pharmacotherapy, cessation groups, treatment referrals). CONCLUSIONS: Mental health providers' greater prioritization of other substances and view of youth smoking as developmentally normative and a coping strategy for psychopathology are likely contributing to the general lack of attention to tobacco use currently. Integrating care within mental health settings would serve to reach youth in an arena where clinical rapport is already established, and study findings suggest receptivity for system improvements. Of consideration, however, is the apparent disconnect between provider and youth recommended strategies for supporting cessation.

View details for DOI 10.1093/ntr/nts343

View details for Web of Science ID 000322093700012

View details for PubMedID 23322765

View details for DOI 10.1037/a0027655

View details for Web of Science ID 000319307800007