1 1140 209 EFFICACY OF YOGA VS COGNITIVE BEHAVIORAL THERAPY VS STRESS EDUCATION FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER: A RANDOMIZED CLINICAL TRIAL. IMPORTANCE: GENERALIZED ANXIETY DISORDER (GAD) IS COMMON, IMPAIRING, AND UNDERTREATED. ALTHOUGH MANY PATIENTS WITH GAD SEEK COMPLEMENTARY AND ALTERNATIVE INTERVENTIONS, INCLUDING YOGA, DATA SUPPORTING YOGA'S EFFICACY OR HOW IT COMPARES TO FIRST-LINE TREATMENTS ARE LACKING. OBJECTIVES: TO ASSESS WHETHER YOGA (KUNDALINI YOGA) AND COGNITIVE BEHAVIORAL THERAPY (CBT) FOR GAD ARE EACH MORE EFFECTIVE THAN A CONTROL CONDITION (STRESS EDUCATION) AND WHETHER YOGA IS NONINFERIOR TO CBT FOR THE TREATMENT OF GAD. DESIGN, SETTING, AND PARTICIPANTS: FOR THIS RANDOMIZED, 3-ARM, CONTROLLED, SINGLE-BLIND (MASKED INDEPENDENT RATERS) CLINICAL TRIAL, PARTICIPANTS WERE RECRUITED FROM 2 SPECIALTY ACADEMIC CENTERS STARTING DECEMBER 1, 2013, WITH ASSESSMENT ENDING OCTOBER 25, 2019. PRIMARY ANALYSES, COMPLETED BY FEBRUARY 12, 2020, INCLUDED SUPERIORITY TESTING OF KUNDALINI YOGA AND CBT VS STRESS EDUCATION AND NONINFERIORITY TESTING OF KUNDALINI YOGA VS CBT. INTERVENTIONS: PARTICIPANTS WERE RANDOMIZED TO KUNDALINI YOGA (N = 93), CBT FOR GAD (N = 90), OR STRESS EDUCATION (N = 43), WHICH WERE EACH DELIVERED TO GROUPS OF 4 TO 6 PARTICIPANTS BY 2 INSTRUCTORS DURING TWELVE 120-MINUTE SESSIONS WITH 20 MINUTES OF DAILY HOMEWORK. MAIN OUTCOMES AND MEASURES: THE PRIMARY INTENTION-TO-TREAT OUTCOME WAS ACUTE GAD RESPONSE (CLINICAL GLOBAL IMPRESSION-IMPROVEMENT SCALE SCORE OF MUCH OR VERY MUCH IMPROVED) AFTER 12 WEEKS AS ASSESSED BY TRAINED INDEPENDENT RATERS. RESULTS: OF 538 PARTICIPANTS WHO PROVIDED CONSENT AND WERE EVALUATED, 226 (MEAN [SD] AGE, 33.4 [13.5] YEARS; 158 [69.9%] FEMALE) WITH A PRIMARY DIAGNOSIS OF GAD WERE INCLUDED IN THE TRIAL. A TOTAL OF 155 PARTICIPANTS (68.6%) COMPLETED THE POSTTREATMENT ASSESSMENT. COMPLETION RATES DID NOT DIFFER (KUNDALINI YOGA, 60 [64.5%]; CBT, 67 [74.4%]; AND STRESS EDUCATION, 28 [65.1%]: CHI2 = 2.39, DF = 2, P = .30). RESPONSE RATES WERE HIGHER IN THE KUNDALINI YOGA GROUP (54.2%) THAN IN THE STRESS EDUCATION GROUP (33.%) (ODDS RATIO [OR], 2.46 [95% CI, 1.12-5.42]; P = .03; NUMBER NEEDED TO TREAT, 4.59 [95% CI, 2.52-46.19]) AND IN THE CBT GROUP (70.8%) COMPARED WITH THE STRESS EDUCATION GROUP (33.0%) (OR, 5.00 [95% CI, 2.12-11.82]; P < .001; NUMBER NEEDED TO TREAT, 2.62 [95% CI, 1.91-5.68]). HOWEVER, THE NONINFERIORITY TEST DID NOT FIND KUNDALINI YOGA TO BE AS EFFECTIVE AS CBT (DIFFERENCE, 16.6%; P = .42 FOR NONINFERIORITY). CONCLUSIONS AND RELEVANCE: IN THIS TRIAL, KUNDALINI YOGA WAS EFFICACIOUS FOR GAD, BUT THE RESULTS SUPPORT CBT REMAINING FIRST-LINE TREATMENT. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIER: NCT01912287.	2021	

2 2577  57 YOGA FOR GENERALIZED ANXIETY DISORDER: DESIGN OF A RANDOMIZED CONTROLLED CLINICAL TRIAL. GENERALIZED ANXIETY DISORDER (GAD) IS A COMMON DISORDER ASSOCIATED WITH SIGNIFICANT DISTRESS AND INTERFERENCE. ALTHOUGH COGNITIVE BEHAVIORAL THERAPY (CBT) HAS BEEN SHOWN TO BE THE MOST EFFECTIVE FORM OF PSYCHOTHERAPY, FEW PATIENTS RECEIVE OR HAVE ACCESS TO THIS INTERVENTION. YOGA THERAPY OFFERS ANOTHER PROMISING, YET UNDER-RESEARCHED, INTERVENTION THAT IS GAINING INCREASING POPULARITY IN THE GENERAL PUBLIC, AS AN ANXIETY REDUCTION INTERVENTION. THE PURPOSE OF THIS INNOVATIVE CLINICAL TRIAL PROTOCOL IS TO INVESTIGATE THE EFFICACY OF A KUNDALINI YOGA INTERVENTION, RELATIVE TO CBT AND A CONTROL CONDITION. KUNDALINI YOGA AND CBT ARE COMPARED WITH EACH OTHER IN A NONINFERIORITY TEST AND BOTH TREATMENTS ARE COMPARED TO STRESS EDUCATION TRAINING, AN ATTENTION CONTROL INTERVENTION, IN SUPERIORITY TESTS. THE SAMPLE WILL CONSIST OF 230 INDIVIDUALS WITH A PRIMARY DSM-5 DIAGNOSIS OF GAD. THIS RANDOMIZED CONTROLLED TRIAL WILL COMPARE YOGA (N=95) TO BOTH CBT FOR GAD (N=95) AND STRESS EDUCATION (N=40), A COMMONLY USED CONTROL CONDITION. ALL THREE TREATMENTS WILL BE ADMINISTERED BY TWO INSTRUCTORS IN A GROUP FORMAT OVER 12 WEEKLY SESSIONS WITH FOUR TO SIX PATIENTS PER GROUP. GROUPS WILL BE RANDOMIZED USING PERMUTED BLOCK RANDOMIZATION, WHICH WILL BE STRATIFIED BY SITE. TREATMENT OUTCOME WILL BE EVALUATED BI-WEEKLY AND AT 6MONTH FOLLOW-UP. FURTHERMORE, POTENTIAL MEDIATORS OF TREATMENT OUTCOME WILL BE INVESTIGATED. GIVEN THE INDIVIDUAL AND ECONOMIC BURDEN ASSOCIATED WITH GAD, IDENTIFYING ACCESSIBLE ALTERNATIVE BEHAVIORAL TREATMENTS WILL HAVE SUBSTANTIVE PUBLIC HEALTH IMPLICATIONS.	2015	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
3   44  36 A CASE SERIES ON THE EFFECTS OF KRIPALU YOGA FOR GENERALIZED ANXIETY DISORDER. GENERALIZED ANXIETY DISORDER (GAD) IS A PREVALENT PSYCHIATRIC DISORDER ASSOCIATED WITH SUBSTANTIAL IMPAIRMENT AND POOR TREATMENT RESPONSE. YOGA INFLUENCES PROCESSES THAT ARE LINKED TO THE MAINTENANCE OF GAD INCLUDING MINDFULNESS, ANXIETY, AND HEART RATE VARIABILITY, BUT HAS YET TO BE EVALUATED AMONG PEOPLE WITH THE DISORDER. THE PRESENT STUDY IS A FIRST STEP TOWARD DOCUMENTING THE EFFICACY OF YOGA FOR REDUCING WORRY AMONG PEOPLE WITH GAD USING A SINGLE-SUBJECT AB DESIGN CASE SERIES AND DAILY RATINGS OF WORRY. STANDARDIZED SELF-REPORT MEASURES OF WORRY, TRAIT ANXIETY, EXPERIENTIAL AVOIDANCE, MINDFULNESS, AND HEART RATE VARIABILITY WERE ASSESSED PRE- AND POST-INTERVENTION. THREE PARTICIPANTS WITH PRIMARY GAD RECEIVED EIGHT TWICE-WEEKLY KRIPALU YOGA SESSIONS FOLLOWING A BASELINE DATA COLLECTION PERIOD. ALL PARTICIPANTS SHOWED SYSTEMATIC IMPROVEMENT IN DAILY WORRY RATINGS ON AT LEAST ONE INDEX AND ALL SCORES ON SELF-REPORTED MEASURES OF WORRY, ANXIETY, EXPERIENTIAL AVOIDANCE, AND MINDFULNESS CHANGED IN THE EXPECTED DIRECTION FOLLOWING YOGA (WITH ONE OR TWO EXCEPTIONS). PARTICIPANTS ALSO SHOWED IMPROVED HEART RATE VARIABILITY DURING A WORRY PERIOD FROM PRE- TO POST-INTERVENTION. YOGA HAS THE POTENTIAL TO IMPROVE THE PROCESSES LINKED TO GAD AND SHOULD STIMULATE FURTHER RESEARCH IN THIS AREA.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
4 1543  30 KUNDALINI YOGA FOR GENERALIZED ANXIETY DISORDER: AN EXPLORATION OF TREATMENT EFFICACY AND POSSIBLE MECHANISMS. THE AIM OF THIS STUDY WAS TO EXAMINE THE EFFICACY OF KUNDALINI YOGA IN REDUCING SYMPTOMS OF GENERALIZED ANXIETY DISORDER (GAD) COMPARED TO A COMMON TREATMENT-AS-USUAL CONDITION USING COGNITIVE TECHNIQUES. A SECONDARY OBJECTIVE WAS TO EXPLORE POTENTIAL TREATMENT MECHANISMS. FEMALES AGED 24 TO 75 YEARS WITH GAD ( N = 49) RECEIVED EITHER AN 8-WEEK KUNDALINI YOGA INTERVENTION ( N = 34) OR AN 8-WEEK TREATMENT-AS-USUAL CONDITION ( N = 15). THE YOGA CONDITION RESULTED IN LOWER LEVELS OF ANXIETY RELATIVE TO THE TREATMENT-AS-USUAL CONDITION. FURTHERMORE, CHANGES IN SOMATIC SYMPTOMS MEDIATED TREATMENT OUTCOME FOR KUNDALINI YOGA. KUNDALINI YOGA MAY SHOW PROMISE AS A TREATMENT FOR GAD, AND THIS TREATMENT MIGHT CONVEY ITS EFFECT ON SYMPTOM SEVERITY BY REDUCING SOMATIC SYMPTOMS.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
5   91  56 A MULTICOMPONENT YOGA-BASED, BREATH INTERVENTION PROGRAM AS AN ADJUNCTIVE TREATMENT IN PATIENTS SUFFERING FROM GENERALIZED ANXIETY DISORDER WITH OR WITHOUT COMORBIDITIES. OBJECTIVES: THE AIM OF THIS STUDY IS TO EVALUATE THE EFFICACY AND TOLERABILITY OF SUDARSHAN KRIYA YOGA (SKY) COURSE IN GENERALIZED ANXIETY DISORDER (GAD) OUTPATIENTS, WHO AFTER EIGHT WEEKS OF AN APPROPRIATE DOSE OF TRADITIONAL THERAPY HAD NOT YET ACHIEVED REMISSION. SUBJECTS: THE ADULT PARTICIPANTS (18-65 YEARS) WERE OUTPATIENTS WITH A PRIMARY DIAGNOSIS OF GAD WITH OR WITHOUT COMORBIDITIES ON THE MINI-INTERNATIONAL NEUROPSYCHIATRIC INTERVIEW (MINI). PARTICIPANTS HAD A MINIMUM OF EIGHT WEEKS STANDARD TREATMENT WITH AN APPROPRIATE DOSE OF A STANDARD PRESCRIPTION ANXIOLYTIC, A CLINICIAN GLOBAL IMPRESSION-SEVERITY (CGI-S) SCORE OF 5-7, A HAMILTON ANXIETY SCALE (HAM-A) TOTAL SCORE >/=20 INCLUDING A SCORE OF >2 ON THE ANXIOUS MOOD AND TENSION ITEMS. MATERIALS AND METHODS: FORTY-ONE PATIENTS WERE ENROLLED IN AN OPEN-LABEL TRIAL OF THE SKY COURSE AS AN ADJUNCT TO STANDARD TREATMENT OF GAD AT THE START CLINIC FOR MOOD AND ANXIETY DISORDERS, A TERTIARY CARE MOOD AND ANXIETY DISORDER CLINIC IN TORONTO. THE SKY COURSE WAS ADMINISTERED OVER FIVE DAYS (22 H TOTAL). SUBJECTS WERE ENCOURAGED TO PRACTICE THE YOGA BREATHING TECHNIQUES AT HOME FOR 20 MIN PER DAY AFTER THE COURSE AND WERE OFFERED GROUP PRACTICE SESSIONS FOR 2 H ONCE A WEEK LED BY CERTIFIED YOGA INSTRUCTORS. THE PRIMARY OUTCOME MEASURE WAS THE MEAN CHANGE FROM PRE-TREATMENT ON THE HAM-A SCALE. PSYCHOLOGICAL MEASURES WERE OBTAINED AT BASELINE AND FOUR WEEKS AFTER COMPLETING THE INTERVENTION. RESULTS: THIRTY-ONE PATIENTS COMPLETED THE PROGRAM (MEAN AGE 42.6 +/- 13.3 YEARS). AMONG COMPLETERS, SIGNIFICANT REDUCTIONS OCCURRED IN THE PRE- AND POST-INTERVENTION MEAN HAM-A TOTAL SCORE (T=4.59; P<0.01) AND PSYCHIC SUBSCALE (T=5.00; P</=0.01). THE RESPONSE RATE WAS 73% AND THE REMISSION RATE 41% AS MEASURED ON THE HAM-A. CONCLUSION: THE RESULTS OF THIS SMALL PILOT TRIAL SUGGEST THAT THE SKY COURSE REPRESENTS A POTENTIALLY VALUABLE ADJUNCT TO STANDARD PHARMACOTHERAPY IN PATIENTS WITH GAD OR TREATMENT-RESISTANT GAD, AND WARRANTS FURTHER INVESTIGATION. IN PARTICULAR, CHANGES IN WORRY AND BODY SYMPTOMS SHOWED SIGNIFICANT IMPROVEMENTS THAT MAY FURTHER OUR UNDERSTANDING OF THE MECHANISM OF CHANGE IN THE TOLERANCE OF ANXIETY AND WORRY.	2012	
                                                                                                                                                                                                                                                                                                                                                              
6 1188  39 EVIDENCE MAP OF YOGA FOR DEPRESSION, ANXIETY, AND POSTTRAUMATIC STRESS DISORDER. BACKGROUND: THIS STUDY DESCRIBES EVIDENCE OF YOGA'S EFFECTIVENESS FOR DEPRESSIVE DISORDERS, GENERAL ANXIETY DISORDER (GAD), PANIC DISORDER (PD), AND POSTTRAUMATIC STRESS DISORDER (PTSD) IN ADULTS. WE ALSO ADDRESS ADVERSE EVENTS ASSOCIATED WITH YOGA. METHODS: WE SEARCHED MULTIPLE ELECTRONIC DATABASES FOR SYSTEMATIC REVIEWS (SRS) PUBLISHED BETWEEN 2008 AND JULY 2014, RANDOMIZED CONTROLLED TRIALS (RCTS) NOT IDENTIFIED IN ELIGIBLE SRS, AND ONGOING RCTS REGISTERED WITH CLINCALTRIALS.GOV. RESULTS: WE IDENTIFIED 1 SR ON DEPRESSION, 1 FOR ADVERSE EVENTS, AND 3 ADDRESSING MULTIPLE CONDITIONS. THE HIGH-QUALITY DEPRESSION SR INCLUDED 12 RCTS (N = 619) THAT SHOWED IMPROVED SHORT-TERM DEPRESSIVE SYMPTOMS (STANDARDIZED MEAN DIFFERENCE, -0.69, 95% CONFIDENCE INTERVAL, -0.99 TO -0.39), BUT THERE WAS SUBSTANTIAL VARIABILITY (I2 = 86%) AND A HIGH RISK OF BIAS FOR 9 STUDIES. THREE SRS ADDRESSING MULTIPLE CONDITIONS IDENTIFIED 4 NONRANDOMIZED STUDIES (N = 174) FOR GAD/PD AND 1 RCT (N = 8) AND 2 NONRANDOMIZED STUDIES (N = 22) FOR PTSD. WE SEPARATELY FOUND 1 RCT (N = 13) FOR GAD AND 2 RCTS (N = 102) FOR PTSD. COLLECTIVELY, THESE STUDIES WERE INCONCLUSIVE FOR THE EFFECTIVENESS OF YOGA IN TREATING GAD/PD AND PTSD. THE HIGH-QUALITY SR FOR ADVERSE EVENTS INCLUDED 37 PRIMARY REPORTS (N = 76) IN WHICH INVERSION POSTURES WERE MOST OFTEN IMPLICATED. WE FOUND 5 ONGOING TRIALS (3 FOR PTSD). CONCLUSIONS: YOGA MAY IMPROVE SHORT-TERM DEPRESSIVE SYMPTOMS, BUT EVIDENCE FOR GAD, PD, AND PTSD REMAIN INCONCLUSIVE.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
7 1260  34 FINDINGS FROM A PROVIDER-LED, MINDFULNESS-BASED, INTERNET-STREAMED YOGA VIDEO ADDRESSING THE PSYCHOLOGICAL OUTCOMES OF BREAST CANCER SURVIVORS. THE AIM OF THIS STUDY WAS TO EXPLORE THE PSYCHOLOGICAL OUTCOMES OF A MINDFULNESS-BASED INTERNET-STREAMED YOGA VIDEO IN BREAST CANCER SURVIVORS. A ONE-GROUP, REPEATED-MEASURES, PURPOSIVE SAMPLE USING A DIRECTED QUALITATIVE DESCRIPTIVE AND CONVERGENT MIXED-METHODS APPROACH WAS USED. PARTICIPANTS WERE RECRUITED FROM BREAST ONCOLOGY PRACTICES ACROSS 2 SETTINGS IN THE NORTHEASTERN UNITED STATES IN APRIL 2019. EDUCATION ABOUT THE VIDEO WAS PROVIDED, AND THE LINK TO THE VIDEO WAS SENT TO PARTICIPANTS. DEMOGRAPHIC INFORMATION, KNOWING PARTICIPATION IN CHANGE SHORT FORM (KPCSF), SHORT WARWICK-EDINBURGH MENTAL WELL-BEING SCALE (WEMWBS), AND THE GENERALIZED ANXIETY DISTRESS SCALE (GAD-7) WERE OBTAINED AT BASELINE AND AT 2 AND 4 WEEKS. A SEMISTRUCTURED INTERVIEW WAS CONDUCTED AT 4 WEEKS. THIRTY-FIVE WOMEN (MEAN AGE = 56 YEARS) PARTICIPATED. A ONE-GROUP, REPEATED-MEASURES ANALYSIS OF VARIANCE INDICATED STATISTICALLY SIGNIFICANT CHANGES OCCURRED IN ALL MEASURES BETWEEN WEEK 0 AND WEEK 4: DECREASED GAD (T = -2.97, P = .004), IMPROVED WEMWBS (T = 2.52, P = .008), AND INCREASED KPC (T = 2.99, P = .004). QUALITATIVE FINDINGS SUGGEST THE OVERALL EXPERIENCE OF THE VIDEO WAS POSITIVE AND THE WOMEN WOULD RECOMMEND ITS USE TO OTHERS. IMPROVEMENTS IN ALL PSYCHOLOGICAL MEASURES WERE ACHIEVED WITH VIDEO USE. FINDINGS INDICATE AN IMPROVEMENT IN PSYCHOLOGICAL MEASURES AND SUPPORT THE THEORY OF KNOWING PARTICIPATION IN CHANGE. THIS WORK FURTHER CONTRIBUTES TO ACCESSIBLE, FLEXIBLE INTERVENTIONS AVAILABLE THROUGH THE INTERNET AND/OR MOBILE APPLICATIONS AIMED AT IMPROVING BREAST CANCER SURVIVORSHIP.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
8  620  47 DEVELOPMENT, VALIDATION, AND FEASIBILITY OF A GENERIC YOGA-BASED INTERVENTION FOR GENERALIZED ANXIETY DISORDER. CONTEXT: EVIDENCE SUGGESTS THAT YOGA EFFECTIVELY MANAGES ANXIETY, BUT TECHNIQUES ARE DERIVED FROM DIFFERENT YOGA SCHOOLS. THIS PAPER DESCRIBES THE DEVELOPMENT, VALIDATION, AND FEASIBILITY OF A GENERIC YOGA-BASED INTERVENTION IN PATIENTS WITH GENERALIZED ANXIETY DISORDER (GAD). METHODS: THE FIRST PART OF THE STUDY CONSISTED OF DESIGNING A GENERIC YOGA MODULE FROM THE TRADITIONAL AND CONTEMPORARY YOGIC LITERATURE AND INPUTS FROM TEN EXPERIENCED YOGA PRACTITIONERS. THE CONTENT WAS VALIDATED USING A CASE-VIGNETTE METHOD FROM 28 YOGA EXPERTS. THESE YOGA EXPERTS RATED THE USEFULNESS OF THE PRACTICES ON A SCALE OF 1-5 (5-EXTREMELY USEFUL). THE SECOND PART CONSISTED OF TESTING THE FEASIBILITY OF THIS VALIDATED GENERIC YOGA INTERVENTION IN AN OPEN-LABEL CLINICAL TRIAL IN PATIENTS WITH GAD. TWO WEEKS OF TEN SUPERVISED YOGA SESSIONS (SYS) WERE OFFERED BY A TRAINED YOGA THERAPIST TO THE RECRUITED PARTICIPANTS AND SUBSEQUENTLY ADVISED FOR HOME PRACTICE. A WEEKLY BOOSTER SYS WAS ALSO PROVIDED FOR THREE MONTHS AFTER 10SYS. RESULTS: YOGA EXPERTS (N = 28) OPINED THAT THE YOGA INTERVENTION WOULD BE HELPFUL IN PATIENTS WITH GAD WITH MINIMAL MODIFICATIONS. ALL EXPERTS OPINED THAT THE MODULE WAS EASY TO TEACH, LEARN AND PRACTICE. THE FINAL YOGA MODULE RETAINED 97.7% (42 OUT OF 43) ITEMS OF THE INITIAL MODULE. IN THE FEASIBILITY STUDY, (N = 20) PATIENTS WERE RECRUITED, AND FIFTEEN FOLLOWED-UP AFTER ONE MONTH. ALL PATIENTS WERE ABLE TO LEARN AND PRACTICE THE FINAL YOGA MODULE WITHIN TEN SESSIONS WITHOUT ANY SIGNIFICANT ADVERSE EFFECTS. THE SEVERITY OF ANXIETY REDUCED SUBSTANTIALLY AFTER THE TEN DAYS OF SYS AND THIS IMPROVEMENT WAS SUSTAINED FOR THE NEXT 4 WEEKS. CONCLUSION: THE DESIGNED GENERIC YOGA INTERVENTION WAS VALIDATED BY YOGA EXPERTS AND FOUND SAFE AND FEASIBLE IN PATIENTS WITH GAD. PATIENTS OBTAINED SIGNIFICANT SYMPTOM REDUCTIONS WHICH NEED TO BE CONFIRMED IN RANDOMIZED CONTROLLED TRIALS.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
9 2872  36 YOGA-ENHANCED COGNITIVE BEHAVIOURAL THERAPY (Y-CBT) FOR ANXIETY MANAGEMENT: A PILOT STUDY. COGNITIVE BEHAVIOURAL THERAPY (CBT) IS AN EFFECTIVE TREATMENT FOR GENERALIZED ANXIETY DISORDER, BUT THERE IS STILL ROOM FOR IMPROVEMENT. THE AIM OF THE PRESENT STUDY WAS TO EXAMINE THE POTENTIAL BENEFIT OF ENRICHING CBT WITH KUNDALINI YOGA (Y-CBT). PARTICIPANTS CONSISTED OF TREATMENT RESISTANT CLIENTS AT A COMMUNITY MENTAL HEALTH CLINIC. A TOTAL OF 32 PARTICIPANTS ENROLLED IN THE STUDY AND 22 COMPLETED THE PROGRAMME. AFTER THE Y-CBT INTERVENTION, PRE-POST COMPARISONS SHOWED STATISTICALLY SIGNIFICANT IMPROVEMENTS IN STATE AND TRAIT ANXIETY, DEPRESSION, PANIC, SLEEP AND QUALITY OF LIFE. RESULTS FROM THIS PRELIMINARY STUDY SUGGEST THAT Y-CBT MAY HAVE POTENTIAL AS A PROMISING TREATMENT FOR THOSE SUFFERING FROM GENERALIZED ANXIETY DISORDER. KEY PRACTITIONER MESSAGES: YOGA-ENHANCED COGNITIVE BEHAVIOURAL THERAPY (Y-CBT) MAY BE A PROMISING NEW TREATMENT FOR THOSE SUFFERING FROM GENERALIZED ANXIETY DISORDER. Y-CBT MAY ALSO REDUCE DEPRESSION IN THOSE SUFFERING FROM GENERALIZED ANXIETY. Y-CBT MAY REDUCE DEPRESSION AND ANXIETY IN A CLINIC POPULATION WHERE CLIENTS SUFFER FROM MULTIPLE DIAGNOSES INCLUDING GENERALIZED ANXIETY DISORDER.	2015	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
10  133  48 A PRAGMATIC PREFERENCE TRIAL OF THERAPEUTIC YOGA AS AN ADJUNCT TO GROUP COGNITIVE BEHAVIOUR THERAPY VERSUS GROUP CBT ALONE FOR DEPRESSION AND ANXIETY. BACKGROUND: YOGA HAS SEVERAL MECHANISMS THAT MAKE IT A PROMISING TREATMENT FOR DEPRESSION AND ANXIETY, INCLUDING PHYSICAL ACTIVITY, BEHAVIOURAL ACTIVATION, AND MINDFULNESS. FOLLOWING POSITIVE OUTCOMES FROM ADAPTED CBT INTERVENTIONS INCORPORATING MINDFULNESS-BASED PRACTICES, THIS STUDY EXPLORED THE EFFECTS OF A THERAPEUTIC YOGA PROGRAM AS AN ADJUNCT TO GROUP-BASED CBT FOR DEPRESSION OR ANXIETY. METHODS: THIS WAS A PRAGMATIC PREFERENCE TRIAL INVOLVING ADULTS DIAGNOSED WITH DEPRESSION OR ANXIETY IN A REGIONAL PRIMARY MENTAL HEALTHCARE SERVICE (N = 59), COMPARING TRANSDIAGNOSTIC GROUP CBT (N = 27) WITH TRANSDIAGNOSTIC GROUP CBT COMBINED WITH AN ADJUNCT THERAPEUTIC YOGA PROGRAM (N = 32). A PREFERENCE RECRUITMENT DESIGN ALLOWED ELIGIBLE PARTICIPANTS (N = 35) TO SELF-SELECT INTO THE ADJUNCT PROGRAM. THE DEPRESSION ANXIETY STRESS SCALE-21 (DASS) WAS ASSESSED AT BASELINE, POST-INTERVENTION, AND THREE-MONTHS FOLLOW UP. RESULTS: CBT + YOGA WAS AN ACCEPTABLE ALTERNATIVE TO CBT ALONE. SIGNIFICANT REDUCTIONS WERE OBSERVED IN TOTAL DASS SCORES AND THE 3 SUBSCALES OF THE DASS FOR BOTH GROUPS, HOWEVER CBT + YOGA SHOWED SIGNIFICANTLY LOWER DEPRESSIVE AND ANXIETY SYMPTOMS POST-INTERVENTION, COMPARED TO CBT ALONE. CBT + YOGA ALSO SHOWED SUSTAINED REDUCTIONS IN DEPRESSIVE SYMPTOMS OVER THREE-MONTHS, AND MORE RAPID REDUCTIONS IN DEPRESSIVE SYMPTOMS, COMPARED TO CBT ALONE. LIMITATIONS: THESE FINDINGS SHOULD BE CONSIDERED PRELIMINARY DUE TO THE MODERATE SAMPLE SIZE, WITH A RIGOROUS RANDOMISED CONTROL TRIAL NECESSARY TO DEFINITIVELY SUPPORT THE INTEGRATION OF YOGA WITHIN MENTAL HEALTH CARE TO AUGMENT THE BENEFITS AND UPTAKE OF TRANSDIAGNOSTIC CBT FOR DEPRESSION AND ANXIETY. CONCLUSIONS: COMPLEMENTING OTHER MINDFULNESS-BASED PRACTICES, THERAPEUTIC YOGA SHOWS PROMISE AS AN ADJUNCT TO TRANSDIAGNOSTIC CBT.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
11 1557  51 LONG-TERM EFFECTS OF COGNITIVE-BEHAVIORAL THERAPY AND YOGA FOR WORRIED OLDER ADULTS. OBJECTIVES: COGNITIVE-BEHAVIORAL THERAPY (CBT) AND YOGA DECREASE WORRY AND ANXIETY. THERE ARE NO LONG-TERM DATA COMPARING CBT AND YOGA FOR WORRY, ANXIETY, AND SLEEP IN OLDER ADULTS. THE IMPACT OF PREFERENCE AND SELECTION ON THESE OUTCOMES IS UNKNOWN. IN THIS SECONDARY DATA ANALYSIS, WE COMPARED LONG-TERM EFFECTS OF CBT BY TELEPHONE AND YOGA ON WORRY, ANXIETY, SLEEP, DEPRESSIVE SYMPTOMS, FATIGUE, PHYSICAL FUNCTION, SOCIAL PARTICIPATION, AND PAIN; AND EXAMINED PREFERENCE AND SELECTION EFFECTS. DESIGN: IN THIS RANDOMIZED PREFERENCE TRIAL, PARTICIPANTS (N = 500) WERE RANDOMIZED TO A: 1) RANDOMIZED CONTROLLED TRIAL (RCT) OF CBT OR YOGA (N = 250); OR 2) PREFERENCE TRIAL (SELECTED CBT OR YOGA; N = 250). OUTCOMES WERE MEASURED AT BASELINE AND WEEK 37. SETTING: COMMUNITY. PARTICIPANTS: COMMUNITY-DWELLING OLDER ADULTS (AGE 60+ YEARS). INTERVENTIONS: CBT (BY TELEPHONE) AND YOGA (IN-PERSON GROUP CLASSES). MEASUREMENTS: PENN STATE WORRY QUESTIONNAIRE - ABBREVIATED (WORRY);(1)(,)(2) INSOMNIA SEVERITY INDEX (SLEEP);(3) PROMIS ANXIETY SHORT FORM V1.0 (ANXIETY);(4)(,)(5) GENERALIZED ANXIETY DISORDER SCREENER (GENERALIZED ANXIETY);(6)(,)(7) AND PROMIS-29 (DEPRESSION, FATIGUE, PHYSICAL FUNCTION, SOCIAL PARTICIPATION, PAIN).(8)(,)(9) RESULTS: SIX MONTHS AFTER INTERVENTION COMPLETION, CBT AND YOGA RCT PARTICIPANTS REPORTED SUSTAINED IMPROVEMENTS FROM BASELINE IN WORRY, ANXIETY, SLEEP, DEPRESSIVE SYMPTOMS, FATIGUE, AND SOCIAL PARTICIPATION (NO SIGNIFICANT BETWEEN-GROUP DIFFERENCES). USING DATA COMBINED FROM THE RANDOMIZED AND PREFERENCE TRIALS, THERE WERE NO SIGNIFICANT PREFERENCE OR SELECTION EFFECTS. LONG-TERM INTERVENTION EFFECTS WERE OBSERVED AT CLINICALLY MEANINGFUL LEVELS FOR MOST OF THE STUDY OUTCOMES. CONCLUSIONS: CBT AND YOGA BOTH DEMONSTRATED MAINTAINED IMPROVEMENTS FROM BASELINE ON MULTIPLE OUTCOMES SIX MONTHS AFTER INTERVENTION COMPLETION IN A LARGE SAMPLE OF OLDER ADULTS. TRIAL REGISTRATION: WWW. CLINICALTRIALS: GOV IDENTIFIER NCT02968238.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
12  524  50 COMPARISON OF COGNITIVE-BEHAVIORAL THERAPY AND YOGA FOR THE TREATMENT OF LATE-LIFE WORRY: A RANDOMIZED PREFERENCE TRIAL. BACKGROUND: THE PURPOSE OF THIS STUDY WAS TO COMPARE THE EFFECTS OF COGNITIVE-BEHAVIORAL THERAPY (CBT) AND YOGA ON LATE-LIFE WORRY, ANXIETY, AND SLEEP; AND EXAMINE PREFERENCE AND SELECTION EFFECTS ON THESE OUTCOMES. METHODS: A RANDOMIZED PREFERENCE TRIAL OF CBT AND YOGA WAS CONDUCTED IN COMMUNITY-DWELLING ADULTS 60 YEARS OR OLDER, WHO SCORED 26 OR ABOVE ON THE PENN STATE WORRY QUESTIONNAIRE-ABBREVIATED (PSWQ-A). CBT CONSISTED OF 10 WEEKLY TELEPHONE SESSIONS. YOGA CONSISTED OF 20 BIWEEKLY GROUP YOGA CLASSES. THE PRIMARY OUTCOME WAS WORRY (PSWQ-A); THE SECONDARY OUTCOMES WERE ANXIETY (PROMIS-ANXIETY) AND SLEEP (INSOMNIA SEVERITY INDEX [ISI]). WE EXAMINED BOTH PREFERENCE EFFECTS (AVERAGE EFFECT FOR THOSE WHO RECEIVED THEIR PREFERRED INTERVENTION [REGARDLESS OF WHETHER IT WAS CBT OR YOGA] MINUS THE AVERAGE FOR THOSE WHO DID NOT RECEIVE THEIR PREFERRED INTERVENTION [REGARDLESS OF THE INTERVENTION]) AND SELECTION EFFECT (WHICH ADDRESSES THE QUESTION OF WHETHER THERE IS A BENEFIT TO GETTING TO SELECT ONE INTERVENTION OVER THE OTHER, AND MEASURES THE EFFECT ON OUTCOMES OF SELF-SELECTION TO A SPECIFIC INTERVENTION). RESULTS: FIVE HUNDRED OLDER ADULTS WERE RANDOMIZED TO THE RANDOMIZED TRIAL (125 EACH IN CBT AND YOGA) OR THE PREFERENCE TRIAL (120 CHOSE CBT; 130 CHOSE YOGA). IN THE RANDOMIZED TRIAL, THE INTERVENTION EFFECT OF YOGA COMPARED WITH CBT ADJUSTED FOR BASELINE PSYCHOTROPIC MEDICATION USE, GENDER, AND RACE WAS 1.6 (-0.2, 3.3), P = .08 FOR THE PSWQ-A. SIMILAR RESULTS WERE OBSERVED WITH PROMIS-ANXIETY (ADJUSTED INTERVENTION EFFECT: 0.3 [-1.5, 2.2], P = .71). PARTICIPANTS RANDOMIZED TO CBT EXPERIENCED A GREATER REDUCTION IN THE ISI COMPARED WITH YOGA (ADJUSTED INTERVENTION EFFECT: 2.4 [1.2, 3.7], P < .01]). ESTIMATED IN THE COMBINED DATA SET (N = 500), THE PREFERENCE AND SELECTION EFFECTS WERE NOT SIGNIFICANT FOR THE PSWQ-A, PROMIS-ANXIETY, AND ISI. OF THE 52 ADVERSE EVENTS, ONLY TWO WERE POSSIBLY RELATED TO THE INTERVENTION. NONE OF THE 26 SERIOUS ADVERSE EVENTS WERE RELATED TO THE STUDY INTERVENTIONS. CONCLUSIONS: CBT AND YOGA WERE BOTH EFFECTIVE AT REDUCING LATE-LIFE WORRY AND ANXIETY. HOWEVER, A GREATER IMPACT WAS SEEN FOR CBT COMPARED WITH YOGA FOR IMPROVING SLEEP. NEITHER PREFERENCE NOR SELECTION EFFECTS WAS FOUND.	2020	
                                                                                                                                                                                                                                                                                                                                                            
13 2796  32 YOGA THERAPY FOR OBSESSIVE COMPULSIVE DISORDER (OCD): A CASE SERIES FROM INDIA. YOGA IS AN ANCIENT SCIENCE WHICH HAS BEEN FOUND TO BE HELPFUL IN THE MANAGEMENT OF SEVERAL PSYCHIATRIC DISORDERS INCLUDING OBSESSIVE COMPULSIVE DISORDER (OCD). YOGA AS ADD-ON TREATMENT IN OCD MAY HELP ADDRESS ISSUES LIKE PARTIAL RESPONSE AND ADVERSE EFFECTS OF MEDICATIONS. HOWEVER, RESEARCH IN THIS AREA IS SPARSE, WHICH LED US TO EXPLORE IT THROUGH THIS CASE SERIES. IN THIS CASE SERIES WE HAVE DESCRIBED THE BENEFITS OF 1 MONTH OF YOGA AS ADD-ON TREATMENT IN PATIENTS WITH OCD. ALL PATIENTS WERE ON STABLE DOSES OF MEDICATIONS PRIOR TO AND DURING YOGA PRACTICE. PRE-POST ASSESSMENTS FOR THE CORE SYMPTOMS OF OBSESSION/COMPULSIONS AS WELL AS DEPRESSIVE AND ANXIETY SYMPTOMS WERE DONE. THE ASSESSMENTS SHOWED SIGNIFICANT IMPROVEMENT IN Y-BOCS AND HAM-D SCORES AFTER 1 MONTH OF YOGA. YOGA THERAPY COULD BE AN EFFECTIVE ADD-ON THERAPY FOR THE TREATMENT OF OCD.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
14  188  45 A RANDOMIZED PREFERENCE TRIAL OF COGNITIVE-BEHAVIORAL THERAPY AND YOGA FOR THE TREATMENT OF WORRY IN ANXIOUS OLDER ADULTS. BACKGROUND: WORRY IS A COMMON PROBLEM AMONG OLDER ADULTS. COGNITIVE-BEHAVIORAL THERAPY IS THE MOST STUDIED NONPHARMACOLOGICAL INTERVENTION AND IT HAS DEMONSTRATED EFFICACY IN REDUCING LATE-LIFE WORRY AND ANXIETY. ALTHOUGH THE EVIDENCE-BASE IS SMALLER, YOGA HAS BEEN SHOWN TO REDUCE ANXIETY AND STRESS. HOWEVER, LITTLE IS KNOWN ABOUT THE RELATIVE EFFECTIVENESS OF THESE TWO NONPHARMACOLOGICAL INTERVENTIONS. FURTHER, THE IMPACT OF PATIENT PREFERENCE ON OUTCOMES IS UNKNOWN.PURPOSE: THE PURPOSE TO THIS STUDY IS TO COMPARE THE EFFECTIVENESS OF COGNITIVE-BEHAVIORAL THERAPY (CBT) WITH YOGA FOR IMPROVING LATE-LIFE WORRY, ANXIETY, AND SLEEP. WE WILL ALSO EXAMINE THE EFFECTS OF PREFERENCE AND SELECTION ON OUTCOMES, ADHERENCE, AND ATTRITION. METHODS: WE ARE CONDUCTING A TWO-STAGE RANDOMIZED PREFERENCE TRIAL COMPARING CBT AND YOGA FOR THE REDUCTION OF WORRY IN A SAMPLE OF ANXIOUS OLDER ADULTS. FIVE HUNDRED PARTICIPANTS WILL BE RANDOMIZED TO EITHER THE PREFERENCE TRIAL (PARTICIPANTS CHOOSE THE INTERVENTION; N=250) OR TO THE RANDOMIZED TRIAL (PARTICIPANTS ARE RANDOMIZED TO ONE OF THE TWO INTERVENTIONS; N=250) WITH EQUAL PROBABILITY. CBT CONSISTS OF 10 TELEPHONE-BASED SESSIONS WITH AN ACCOMPANYING WORKBOOK. YOGA CONSISTS OF 10 WEEKS OF GROUP YOGA CLASSES (TWICE A WEEK) THAT IS MODIFIED FOR USE WITH OLDER ADULTS. CONCLUSIONS: THE STUDY DESIGN IS BASED ON FEEDBACK FROM ANXIOUS OLDER ADULTS WHO WANTED MORE NONPHARMACOLOGICAL OPTIONS FOR INTERVENTION AS WELL AS MORE INPUT INTO THE INTERVENTION THEY RECEIVE. IT IS THE FIRST HEAD-TO-HEAD COMPARISON OF CBT AND YOGA FOR REDUCING LATE-LIFE WORRY AND ANXIETY. IT WILL ALSO PROVIDE INFORMATION ABOUT HOW INTERVENTION PREFERENCE AFFECTS OUTCOMES. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT02968238.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
15  651  32 EAST MEETS WEST IN PSYCHIATRY: YOGA AS AN ADJUNCT THERAPY FOR MANAGEMENT OF ANXIETY. PURPOSE: PROVIDE YOGA FOR COPING AND SYMPTOM MANAGEMENT IN A LOCKED, ADULT INPATIENT PSYCHIATRIC UNIT. DESIGN: HATHA YOGA WAS OFFERED TO INPATIENTS WITH MOOD DISORDERS AND/OR PSYCHOSIS 3 TIMES PER WEEK IN THIS EVIDENCE-BASED PRACTICE CHANGE PROJECT. IMPACT ON SLEEP WAS EXAMINED USING RECORDED SLEEP HOURS. ANXIETY SYMPTOMS WERE ASSESSED USING 6 OF THE 7 SYMPTOMS RECORDED ON THE GENERALIZED ANXIETY DISORDERS (GAD) 7. SUSTAINABILITY OF BENEFITS WAS EXAMINED. A SELF-ASSESSMENT WAS CONDUCTED AT DISCHARGE TO DETERMINE ACQUISITION OF NEW COPING SKILLS. RESULTS: NO DIFFERENCE IN SLEEP HOURS OR INTERRUPTIONS WAS NOTED. A STATISTICALLY SIGNIFICANT INCREASE IN THE TOTAL ANXIETY SCORES (Z=-1.9815, P=0.02385) AND SUSTAINABILITY OF BENEFITS (Z=-2.0894, P=0.03662) BETWEEN THE FIRST AND SECOND YOGA CLASS WERE OBSERVED. A POSITIVE CHANGE FROM BASELINE IN SUSTAINABILITY OF SYMPTOMS FOR "LESS ANXIETY" (K=0.108) AND "MORE RELAXED" (K=0.083) WAS FOUND. THERE WAS A SIGNIFICANT INCREASE IN UTILIZATION OF YOGA (P=0.0015) AND MEDITATION (P=0.013) AS COPING MECHANISMS AT DISCHARGE. CONCLUSIONS: ADULTS IN AN ACUTE INPATIENT PSYCHIATRIC UNIT WHO PARTICIPATED IN YOGA PRACTICE IDENTIFIED YOGA AND MEDITATION AS NEWLY-ACQUIRED COPING MECHANISMS AND REPORTED SIGNIFICANT IMPROVEMENT IN ANXIETY SYMPTOMS WITH SUSTAINED BENEFITS RANGING FROM HALF DAY TO FULL DAY.	2019	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
16  181  48 A RANDOMIZED CONTROLLED TRIAL OF YOGA VS NONAEROBIC EXERCISE FOR VETERANS WITH PTSD: UNDERSTANDING EFFICACY, MECHANISMS OF CHANGE, AND MODE OF DELIVERY. BACKGROUND AND OBJECTIVES: POSTTRAUMATIC STRESS DISORDER (PTSD) IS A CHRONIC, DISABLING, AND PREVALENT MENTAL HEALTH DISORDER AMONG VETERANS. DESPITE THE AVAILABILITY OF EMPIRICALLY SUPPORTED PSYCHOTHERAPIES, MANY VETERANS REMAIN SYMPTOMATIC AFTER TREATMENT AND/OR PREFER TO SEEK COMPLEMENTARY AND INTEGRATIVE HEALTH APPROACHES, INCLUDING YOGA, TO MANAGE PTSD. THE RANDOMIZED CONTROLLED TRIAL (RCT) DESCRIBED HEREIN WILL EVALUATE THE EFFICACY OF A MANUALIZED YOGA PROGRAM AS COMPARED TO NONAEROBIC EXERCISE IN REDUCING PTSD SEVERITY AMONG VETERANS. A SECONDARY AIM OF THIS STUDY IS TO BETTER UNDERSTAND THE MECHANISMS OF CHANGE. METHODS: VETERANS (N = 192) WITH PTSD WILL BE RANDOMIZED TO HATHA YOGA OR NONAEROBIC PHYSICAL ACTIVITY CONTROL; BOTH GROUPS CONSIST OF 12 WEEKLY, 60-MIN GROUP OR ONLINE TRAINING SESSIONS WITH 15-20 MIN OF DAILY AT-HOME PRACTICE. OUTCOME MEASURES WILL BE ADMINISTERED AT BASELINE, MID-TREATMENT, POSTTREATMENT, AND 12-WEEK FOLLOW-UP. PROJECTED OUTCOMES: THIS STUDY WILL EVALUATE CHANGES IN PTSD SEVERITY (PRIMARY OUTCOME) AS WELL AS DEPRESSION, ANXIETY, ANGER, SLEEP PROBLEMS, AND PSYCHOSOCIAL DISABILITY (SECONDARY OUTCOMES). WE WILL ALSO USE MULTIPLE MEDIATION TO EXAMINE TWO POTENTIAL MODELS OF THE MECHANISMS OF CLINICAL EFFECT: THE ATTENTION MODEL (I.E., YOGA INCREASES ATTENTIONAL CONTROL, WHICH REDUCES PTSD SYMPTOMS), THE COPING MODEL (I.E., YOGA INCREASES DISTRESS TOLERANCE, WHICH IMPROVES COPING, WHICH REDUCES PTSD SYMPTOMS), AND THE COMBINATION OF THESE MODELS. THIS ASPECT OF THE STUDY IS INNOVATIVE AND IMPORTANT GIVEN THE ABSENCE OF AN EXISTING, COMPREHENSIVE MODEL FOR UNDERSTANDING YOGA'S IMPACT ON PTSD. ULTIMATELY, WE HOPE TO DEVELOP GUIDELINES FOR APPLICATION OF YOGA TO PTSD RECOVERY.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
17  187  58 A RANDOMIZED PREFERENCE TRIAL COMPARING COGNITIVE-BEHAVIORAL THERAPY AND YOGA FOR THE TREATMENT OF LATE-LIFE WORRY: EXAMINATION OF IMPACT ON DEPRESSION, GENERALIZED ANXIETY, FATIGUE, PAIN, SOCIAL PARTICIPATION, AND PHYSICAL FUNCTION. BACKGROUND: DEPRESSION, GENERALIZED ANXIETY, FATIGUE, DIMINISHED PHYSICAL FUNCTION, REDUCED SOCIAL PARTICIPATION, AND PAIN ARE COMMON FOR MANY OLDER ADULTS AND NEGATIVELY IMPACT QUALITY OF LIFE. THE PURPOSE OF THE OVERALL TRIAL WAS TO COMPARE THE EFFECTS OF COGNITIVE-BEHAVIORAL THERAPY (CBT) AND YOGA ON LATE-LIFE WORRY, ANXIETY, AND SLEEP; AND EXAMINE PREFERENCE AND SELECTION EFFECTS ON THESE OUTCOMES. OBJECTIVE: THE PRESENT ANALYSES COMPARED EFFECTS OF THE 2 INTERVENTIONS ON ADDITIONAL OUTCOMES (DEPRESSIVE SYMPTOMS, GENERALIZED ANXIETY SYMPTOMS, FATIGUE, PAIN INTERFERENCE/INTENSITY, PHYSICAL FUNCTION, SOCIAL PARTICIPATION); AND EXAMINED WHETHER THERE ARE PREFERENCE AND SELECTION EFFECTS FOR THESE TREATMENTS. METHODS: A RANDOMIZED PREFERENCE TRIAL OF CBT AND YOGA WAS CONDUCTED IN ADULTS >/=60 YEARS WHO SCORED >/=26 ON THE PENN STATE WORRY QUESTIONNAIRE-ABBREVIATED (PSWQ-A), RECRUITED FROM OUTPATIENT MEDICAL CLINICS, MAILINGS, AND ADVERTISEMENTS. COGNITIVE-BEHAVIORAL THERAPY CONSISTED OF 10 WEEKLY TELEPHONE SESSIONS. YOGA CONSISTED OF 20 BI-WEEKLY GROUP YOGA CLASSES. PARTICIPANTS WERE RANDOMIZED TO(1): A RANDOMIZED CONTROLLED TRIAL (RCT) OF CBT OR YOGA (N = 250); OR (2) A PREFERENCE TRIAL IN WHICH THEY SELECTED THEIR TREATMENT (CBT OR YOGA; N = 250). OUTCOMES WERE MEASURED AT BASELINE AND POST-INTERVENTION. RESULTS: WITHIN THE RCT, THERE WERE SIGNIFICANT BETWEEN-GROUP DIFFERENCES FOR BOTH PAIN INTERFERENCE AND INTENSITY. THE PAIN INTERFERENCE SCORE IMPROVED MORE FOR THE CBT GROUP COMPARED WITH THE YOGA GROUP [INTERVENTION EFFECT OF (MEAN (95% CI) = 2.5 (.5, 4.6), P = .02]. FOR THE PAIN INTENSITY SCORE, THE INTERVENTION EFFECT ALSO FAVORED CBT OVER YOGA [.7 (.2, 1.3), P < .01]. DEPRESSIVE SYMPTOMS, GENERALIZED ANXIETY, AND FATIGUE SHOWED CLINICALLY MEANINGFUL WITHIN-GROUP CHANGES IN BOTH GROUPS. THERE WERE NO CHANGES IN OR DIFFERENCE BETWEEN PHYSICAL FUNCTION OR SOCIAL PARTICIPATION FOR EITHER GROUP. NO PREFERENCE OR SELECTION EFFECTS WERE FOUND. CONCLUSION: BOTH CBT AND YOGA MAY BE USEFUL FOR OLDER ADULTS FOR IMPROVING PSYCHOLOGICAL SYMPTOMS AND FATIGUE. COGNITIVE-BEHAVIORAL THERAPY MAY OFFER EVEN GREATER BENEFIT THAN YOGA FOR DECREASING PAIN.	2022	
                                                                                                                                                                                                                                                                                                                     
18 2012  51 SUDARSHAN KRIYA YOGA PROGRAM IN POSTTRAUMATIC STRESS DISORDER: A FEASIBILITY STUDY. BACKGROUND: SUDARSHAN KRIYA YOGA (SKY), A BREATH-BASED YOGA INTERVENTION, HAS DEMONSTRATED SAFETY AND EFFICACY IN POSTTRAUMATIC STRESS DISORDER (PTSD) PATIENTS SUBSEQUENT TO NATURAL DISASTER OR WAR, BUT HAS NOT BEEN EXPLORED IN CIVILIANS WITH PTSD FROM A WIDER RANGE OF TRAUMA. WE HYPOTHESIZED THAT IT WOULD BE FEASIBLE TO CONDUCT A CLINICAL TRIAL OF SKY IN PTSD RESULTING FROM A WIDE RANGE OF TRAUMA. METHODS: OUTCOMES WERE FEASIBILITY MEASURES INCLUDING RATES OF ENROLLMENT AND RETENTION, ADHERENCE TO STUDY PROTOCOL; AS WELL AS CHANGES IN PTSD SYMPTOMS, OTHER MOOD SYMPTOMS, AND PHYSIOLOGICAL MEASURES. MALE AND FEMALE PARTICIPANTS AGED 18-75 YEARS WERE ENROLLED IN A FEASIBILITY TRIAL. THEY ATTENDED A 6-DAY LEARNING PHASE OF SKY FOLLOWED BY 7 SESSIONS OVER 11 WEEKS AS AN ADJUNCT TO THEIR USUAL TREATMENT. RESULTS: FORTY-SEVEN PARTICIPANTS WERE SCREENED AND 32 WERE ENROLLED OVER 9 MONTHS. CONSISTENT WITH RETENTION RATES OF OTHER PTSD TRIALS, 13 WITHDREW FROM THE STUDY PRIOR TO WEEK 12. TWENTY-ONE PARTICIPANTS MET INTERVENTION ATTENDANCE REQUIREMENTS, COMPLETED 95% OF PLANNED STUDY ASSESSMENTS AND WERE INCLUDED IN FINAL ANALYSES. PARTICIPANTS EXPERIENCED CLINICALLY SIGNIFICANT DECREASE IN PTSD SYMPTOMS ON THE POSTTRAUMATIC STRESS DISORDER CHECKLIST (PCL-5) SCORES AT WEEK 12 MEAN DIFFERENCE, MDIFF (STANDARD DEVIATION [SD]) = -10.68 (14.03), P = 0.004; COHEN'S D = 0.58, WHICH WAS SUSTAINED AT WEEK 24 MDIFF (SD) = -16.11 (15.20), P < 0.001; COHEN'S D = 0.91. CONCLUSIONS: IT IS POSSIBLE TO CONDUCT A CLINICAL TRIAL OF SKY IN A ROUTINE PSYCHIATRY CLINIC SERVING PATIENTS WITH PTSD DUE TO A WIDE RANGE OF TRAUMA. FUTURE STUDIES SHOULD INCLUDE AN RCT DESIGN.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
19 2641  53 YOGA FOR WARRIORS: AN INTERVENTION FOR VETERANS WITH COMORBID CHRONIC PAIN AND PTSD. OBJECTIVE: COMORBID CHRONIC PAIN AND POSTTRAUMATIC STRESS DISORDER (PTSD) IS COMMON IN VETERANS; THIS COMORBIDITY IS ASSOCIATED WITH INCREASED SEVERITY AND POORER PROGNOSIS WHEN COMPARED TO EACH OUTCOME ALONE. YOGA HAS BEEN SHOWN TO BE EFFECTIVE FOR CHRONIC PAIN AND PROMISING FOR PTSD, BUT YOGA FOR COMORBID PAIN AND PTSD HAS NOT BEEN EXAMINED. THIS ARTICLE OFFERS EMPIRICAL SUPPORT FOR A YOGA INTERVENTION FOR COMORBID CHRONIC PAIN AND PTSD IN A VETERAN POPULATION. METHOD: RESULTS ARE PRESENTED FROM A 4-YEAR PILOT YOGA INTERVENTION FOR COMORBID CHRONIC PAIN AND PTSD AT A LARGE, URBAN VETERANS AFFAIRS MEDICAL CENTER. BASED ON THE FEAR AVOIDANCE MODEL OF PAIN, THE INTERVENTION USED A CROSS-SECTIONAL, OPEN-TRIAL DESIGN WITH PRE- AND POSTMEASURES. T TEST ANALYSES WERE CONDUCTED ON PROGRAM COMPLETERS (N = 49; OUT OF 87 INITIALLY ENROLLED, 44% ATTRITION RATE), WHO WERE PRIMARILY AFRICAN AMERICAN (69%) AND MALE (61%) AND HAD A MEAN AGE OF 51.41 YEARS (SD = 11.32). RESULTS: RESULTS INDICATED TREND-LEVEL REDUCTIONS IN OVERALL PTSD SYMPTOMS, AS MEASURED BY THE PTSD CHECKLIST FOR DSM-5 (P = .02, D = 0.38) AND IN SYMPTOM CLUSTER SCORES OF NEGATIVE ALTERATIONS OF COGNITIONS AND MOOD (P = .03, D = 0.36) AND AROUSAL AND REACTIVITY (P = .03, D = 0.35). VETERANS REPORTED SIGNIFICANT IMPROVEMENT IN ABILITY TO PARTICIPATE IN SOCIAL ACTIVITIES (P < .001, D = 0.44) AND SIGNIFICANT REDUCTIONS IN KINESIOPHOBIA (FEAR OF MOVEMENT OR PHYSICAL ACTIVITY; P < .001, D = 0.85). ON A SATISFACTION MEASURE WITH A RANGE OF 1 (QUITE DISSATISFIED) TO 4 (EXTREMELY SATISFIED), THE MEAN RATING WAS 3.74 (SD = 0.33). CONCLUSION: YOGA IS A FEASIBLE AND EFFECTIVE INTERVENTION FOR VETERANS WITH COMORBID CHRONIC PAIN AND PTSD. (PSYCINFO DATABASE RECORD (C) 2020 APA, ALL RIGHTS RESERVED).	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
20  580  33 DESIGNING AND VALIDATION OF A YOGA-BASED INTERVENTION FOR OBSESSIVE COMPULSIVE DISORDER. SOME YOGA-BASED PRACTICES HAVE BEEN FOUND TO BE USEFUL FOR PATIENTS WITH OBSESSIVE COMPULSIVE DISORDER (OCD). THE AUTHORS COULD NOT FIND A VALIDATED YOGA THERAPY MODULE AVAILABLE FOR OCD. THIS STUDY ATTEMPTED TO FORMULATE A GENERIC YOGA-BASED INTERVENTION MODULE FOR OCD. A YOGA MODULE WAS DESIGNED BASED ON TRADITIONAL AND CONTEMPORARY YOGA LITERATURE. THE MODULE WAS SENT TO 10 YOGA EXPERTS FOR CONTENT VALIDATION. THE EXPERTS RATED THE USEFULNESS OF THE PRACTICES ON A SCALE OF 1-5 (5 = EXTREMELY USEFUL). THE FINAL VERSION OF THE MODULE WAS PILOT-TESTED ON PATIENTS WITH OCD (N = 17) FOR BOTH FEASIBILITY AND EFFECT ON SYMPTOMS. EIGHTY-EIGHT PER CENT (22 OUT OF 25) OF THE ITEMS IN THE INITIAL MODULE WERE RETAINED, WITH MODIFICATIONS IN THE MODULE AS SUGGESTED BY THE EXPERTS ALONG WITH PATIENTS' INPUTS AND AUTHORS' EXPERIENCE. THE MODULE WAS FOUND TO BE FEASIBLE AND SHOWED AN IMPROVEMENT IN SYMPTOMS OF OCD ON TOTAL YALE-BROWN OBSESSIVE-COMPULSIVE SCALE (YBOCS) SCORE (P = 0.001). A GENERIC YOGA THERAPY MODULE FOR OCD WAS VALIDATED BY EXPERTS IN THE FIELD AND FOUND FEASIBLE TO PRACTICE IN PATIENTS. A DECREASE IN THE SYMPTOM SCORES WAS ALSO FOUND FOLLOWING YOGA PRACTICE OF 2 WEEKS. FURTHER CLINICAL VALIDATION IS WARRANTED TO CONFIRM EFFICACY.	2016