Apel, Annett/ Greim, Brigitte/ König, Nicolaus/ Zettl, Uwe K. Frequency of Current Utilisation of Complementary and Alternative Medicine by Patients with Multiple Sclerosis. J Neurol 2006, 253, 1331–1336.
Abstract
Objective The purpose of the study was to examine the frequency and  characteristics of complementary and alternative medicine (CAM) use among patients with multiple sclerosis (MS). Method In order to collect sociodemographic and disease related variables as well as aspects of CAM utilisation 254 MS patients were examined with an interview. The investigation was completed by data of the neurological examination. Results At the time of investigation 67.3% of the MS patients reported that they were currently using one or more CAMs. Overall, most of the overall utilized therapies (90.6%) were chosen as a complement and 9.4% as an alternative therapy. Users of complementary medicine were more severely affected by the MS than non-users and had a longer duration of illness. No sociodemographic differences were found between users and non-users. When evaluating the efficacy of CAM, patients reported improvement in 67.1%, no influence in 32.3% and worsening in 0.6% of the cases. 3.7% of the CAM therapies were accompanied by minor side effects. Conclusions Since MS patients are frequently using CAM despite the absence of clinically proven efficacy and appraise it positively, further research on the motivation for utilisation and on objective effects of CAM are needed.

Bellizzi, Keith M./ Blank, Thomas O. Predicting Posttraumatic Growth in Breast Cancer Survivors. Health Psychology 2006, 25(1), 47–56.
Wide variability exists with respect to how breast cancer survivors respond to common psychological and psychosocial challenges of their disease, ranging from posttraumatic stress disorder to posttraumatic growth. This cross-sectional study examined contextual, disease-related, and intraindividual predictors of posttraumatic growth in 224 randomly selected breast cancer survivors. A series of hierarchical regression analyses found that age at diagnosis, marital status, employment, education, perceived intensity of disease, and active coping accounted for 34%, 35%, and 28% of the variance in growth in relationships
with others, new possibilities, and appreciation for life. These findings suggest that a more comprehensive model of growth will be helpful in understanding the various factors that play a role in breast cancer survivors’ perception of psychological and psychosocial growth.

Costanzo, Erin S./ Lutgendorf, Susan K./ Bradley, Sarah L./ Rose, Stephen L./ Anderson, Barrie. Cancer Attributions, Distress, and Health Practices Among Gynecologic Cancer Survivors. Psychosomatic Medicine 2005, 67, 972–980.
Objective: Personal beliefs about one’s medical condition have been related to health behaviors and psychological distress among individuals with serious illness. We examined whether beliefs about cause of cancer and prevention of recurrence were associated with health practices and distress in 134 long-term endometrial and cervical cancer survivors.
Methods: Participants completed questionnaires assessing depressive symptoms, anxiety, health behavior, and beliefs about factors that may have caused their cancer and prevented recurrence.
Results: Genetics/heredity was rated as the most important cancer cause, followed by stress, God’s will, hormones, and environmental factors. Medical screening was rated as most important in preventing recurrence, followed by positive attitude and prayer. Stronger causal attributions were generally associated with elevated depressive symptomatology and anxiety, but women citing potentially controllable causes were more likely to be practicing healthy behaviors. Similarly, women citing health behaviors as important in preventing recurrence reported greater anxiety but were more likely to practice positive health behaviors. Health behavior and lifestyle attributions interacted with health practices in predicting distress. For example, among women who had not made positive dietary changes, rating lifestyle as important in preventing recurrence was associated with greater distress, whereas among women who had made a positive change in diet, this belief was associated with less distress.
Conclusions: Results suggest that stronger attributions are associated with greater distress, but engaging in behavior believed to be important in preventing cancer or recurrence may ameliorate this distress.

Engum, Anne. The Role of Depression and Anxiety in Onset of Diabetes in a Large Population-Based Study. Journal of Psychosomatic Research 2007, 62, 31– 38.
Abstract
Objective: Recent research has shown that depression may predict incident diabetes. The aims of the study are to investigate if symptoms of depression and anxiety precede the onset of diabetes or vice versa and to examine if mediating factors may explain such associations.
Methods: A prospective population-based study (N=37,291) investigating the associations between symptoms of depression/anxiety and diabetes was conducted.
Results: Individuals reporting symptoms of depression and anxiety at baseline had increased risk of onset of type 2 diabetes at 10-year follow-up. No gender differences were found. The analyses did not reveal underlying factors that mediated the association. Baseline diagnosis of diabetes was not associated with subsequent symptoms of anxiety or depression among males or females. Conclusion: Diabetes did not predict symptoms of depression or anxiety. Symptoms of depression and anxiety emerged as significant risk factors for onset of type 2 diabetes independent of established risk factors for diabetes, such as socioeconomic factors, lifestyle factors, and markers of the metabolic syndrome. The comorbidity between depression and anxiety may be the most important factor.

Gist, Wendy. Living with Multiple Sclerosis and Treatment Approaches. Positive Health November 2006, 19-22.
About 85.000 people in the UK suffer from Multiple Sclerosis (MS), according to the Multiple Sclerosis Society.' Every week around 50 more people in the UK are diagnosed with MS.' More and more are becoming increasingly aware, either from movies or television, that MS is an incapacitating disease that affects the central nervous system. Many want to get involved in helping those suffering from MS. In order to accomplish this task, an overview of alternative therapies will be helpful.

Gold, Stefan M./ Irwin, Michael R. Depression and Immunity: Inflammation
and Depressive Symptoms in Multiple Sclerosis. Neurol Clin 2006, 24, 507–519.
An increasing body of evidence suggests that patients who have major depressive disorder show alterations in immunologic markers including increases in proinflammatory cytokine activity and inflammation. Animal models of a depression-like syndrome called ‘‘sickness behavior’’ have shown clearly that cytokines are implicated in the development of these symptoms. Inflammation of the central nervous system (CNS) is a pathologic hallmark of multiple sclerosis (MS). Patients affected by this disease also show a high incidence of depression. Accumulating evidence for cytokine-mediated sickness behavior from animal studies suggests that some aspects of depression and fatigue in MS may be linked to inflammatory markers. This article reviews the current knowledge in the field and illustrates how the sickness behavior model may be applied to investigate depressive symptoms in inflammatory neurologic diseases such as MS.

Hart, Jane. Diabetes and Complementary Therapies Research Review and Clinical Applications. Alternative & Complementary Therapies—December 2006, 263-267.

Hemming, Laureen/ Maker, David. Complementary Therapies in Palliative Care: A Summary of Current Evidence. British Journal of Community Nursing 10(10), 448-452.

Hommel, Kevin A./ Chaney, John M./ Wagner, Janelle L./ Jarvis, James N.
Learned Helplessness in Children and Adolescents with Juvenile Rheumatic Disease. Journal of Psychosomatic Research 2006, 60, 73–81.
Abstract
Objective: To examine a learned helplessness conceptualization of psychological sequela in children and adolescents with juvenile rheumatic diseases (JRD) via an experimental procedure utilizing behavior–outcome contingent and noncontingent feedback.
Methods: Thirty-eight children and adolescents with JRD completed measures of transient affect, self-efficacy for functional ability, and causal attributions prior to and immediately following a computerized learned helplessness induction procedure.
Results: Children across contingent and noncontingent feedback conditions experienced decreased positive affect with a slightly more pronounced decline in the noncontingent condition. Noncontingent feedback resulted in poorer internalization of success for problem solving, while contingent feedback resulted in greater internalization of success for problem solving. Additionally, posttreatment control self-efficacy was significantly greater for children in the contingent condition that initiallyendorsed higher levels of internal task attributions.
Conclusions: Children with JRD who experience behavior–outcome contingency in their environment may develop increased perceptions of control over functional ability. Furthermore, environmental noncontingency may result in poorer internalization of success, whereas contingent reinforcement may enhance cognitive appraisal mechanisms (i.e., causal attributions) associated with favorable disease outcome. Despite a modest decline in positive affect for children in the noncontingent condition, mood dysfunction is not entirely explicable within the context of noncontingent reinforcement.

Kim, Kyung Mee/ Fox, Michael H. Moving to a Holistic Model of Health among Persons with Mobility Disabilities. Qualitative Social Work 2006, 5(4), 470-488.
Abstract
This study investigates concepts of personal and environmental behavior among people with mobility disabilities leading to a holistic approach to health. Qualitative data were taken from face-to-face interviews with 18 people with mobility disabilities. The resultant holistic model of health for people with disabilities is a function of the interaction between the person and their environment. In order to enhance health for people with disabilities, it is important
to realize that disability and health can coexist. Health is attainable for people with disabilities, particularly when environmental and cultural barriers are confronted and addressed.

Pearson, Nancy J./ Johnson, Laura Lee/ Nahin, Richard L. Insomnia, Trouble Sleeping, and Complementary and Alternative Medicine. Analysis of the 2002 National Health Interview Survey Data. Arch Intern Med. 2006, 166, 1775-1782.
Background: Insomnia and other disorders that result in trouble sleeping are common in the United States and are often associated with chronic health conditions. Some individuals with insomnia or trouble sleeping use complementary and alternative medicine (CAM) therapies to treat their condition, but the prevalence of such use and the most common types of CAM therapies selected are not known.
Methods: Prevalence of insomnia or trouble sleeping and of CAM use for treating such conditions was examined using the 2002 National Health Interview Survey. Logistic regression was used to examine associations between
insomnia or trouble sleeping, comorbid conditions, and use of CAM treatments.
Results: The 12-month prevalence rate of insomnia or trouble sleeping was 17.4%. There was a strong positive association between adults who reported having insomnia or trouble sleeping and adults who reported 4 of 5
common conditions: obesity (adjusted odds ratio [OR], 1.15; 99% confidence interval [CI], 1.01-1.31), hypertension (OR, 1.32; 99% CI, 1.16-1.51), congestive heart failure (OR, 2.24; 99% CI, 1.60-3.14), and anxiety or depression (OR, 5.64; 99% CI, 5.07-6.29). Of those with insomnia or trouble sleeping, 4.5% used some form of CAM therapy to treat their condition.
Conclusions: According to the National Health Interview Survey analysis, over 1.6 million civilian, noninstitutionalized adult US citizens use CAM to treat insomnia or trouble sleeping. The details of this analysis will serve as a guide for future research on CAM therapies for sleep disorders.

Price, Donald D./ Craggs, Jason/ Verne, G. Nicholas/ Perlstein, William M./ Robinson, Michael E. Placebo Analgesia is Accompanied by Large Reductions in Pain-Related Brain Activity in Irritable Bowel Syndrome Patients. Pain 2007, 127, 63–72.
Abstract
Previous experiments found that placebos produced small decreases in neural activity of pain-related areas of the brain, yet decreases were only statistically significant after termination of stimuli and in proximity to when subjects rated them. These changes could reflect report bias rather than analgesia. This functional magnetic resonance imaging (fMRI) study examined whether placebo analgesia is accompanied by reductions in neural activity in pain-related areas of the brain during the time of stimulation. Brain activity of irritable bowel syndrome patients was measured in response to rectal distension by a balloon barostat. Large reductions in pain and in brain activation within pain-related regions (thalamus, somatosensory cortices, insula, and anterior cingulate cortex) occurred during the placebo condition. Results indicate that decreases in activity were related to placebo suggestion and a second factor (habituation/attention/conditioning). Although many factors influence placebo analgesia, it is accompanied by reduction in pain processing within the brain in clinically relevant conditions.

Reyes-Ortiz, Carlos A. Spirituality/Medicine Interface Project Spirituality, Disability and Chronic Illness. Southern Medical Journal October 2006, 99(10), 1172-1173.

Samdup, Dawa Z./ Smith, Ronald G./ Song, Soon Il. The Use of Complementary and Alternative Medicine in Children with Chronic Medical Conditions. Am. J. Phys. Med. Rehabil 2006, 85(10), 842-846.
Abstract
Objectives: The objectives of this study were to examine whether progressive medical conditions lead to greater use of complementary and alternative medicine (CAM) as compared with more stable conditions, to see whether disease severity influences CAM use, and to identify the main motivations behind CAM use.
Methods: Subjects were selected from outpatient clinics at Hotel Dieu Hospital. Surveys were conducted by mail and telephone. Medical diagnosis and severity were obtained from medical files. Statistical tests included _2, Kruskal-Wallis, and correlations.
Results: One hundred ninety-four children were surveyed. The “progressive” group included 15 patients with Duchenne muscular dystrophy and 22 patients with cystic fibrosis. The “nonprogressive” group included 85 patients with cerebral palsy (CP), 49 with diabetes mellitus, and 23 with spina bifida. Twenty-three percent were using CAM. CP had the highest use; diabetes mellitus had the lowest. Popular therapies included massage and dietary/herbal remedies. Progressiveness had no impact on CAM use. Within the CP group, greater disease severity was associated with higher use (P _ 0.001). The main reason for CAM use was to complement conventional medicine.
Conclusions: Disease progressiveness had no impact on CAM use, but severity within the CP group did. Complementing conventional medicine was the main motive. Understanding the reasons and patterns of use of CAM is beneficial in efforts to improve the care of children with chronic medical conditions.

Schubert, Christian/ Noisternig, Bianca/ Fuchs, Dietmar/ König, Paul/ Chamson, Emil/ Mittnik, Stefan/ Schüßler, Gerhard/ Geser, Willi. Multi-Faceted Effects of Positive Incidents on Stress System Functioning in a Patient with Systemic Lupus Erythematosus. Stress and Health 2006, 22, 215–227.
Summary
This study on a patient with systemic lupus erythematosus (SLE) investigated the impact of positive emotionally pleasing incidents on hypothalamus-pituitary-adrenal (HPA) axis and cellular immune system activity under complex everyday conditions. A 52 year-old woman collected her entire urine for 56 days in 12-h intervals for the determination of cortisol and neopterin, a cellular immune parameter. Psychological variables were based on daily questionnaires and weekly interviews. Time series analysis consisted of ARIMA modeling and cross-correlational analysis. Positive everyday incidents were associated with three distinct emotional reactions: short-term positive reactions, anticipatory negative reactions, and long-term negative reactions. Short-term positive reactions were associated with a decrease in urine cortisol after 36 h and an increase after a total of 48 h, while urine neopterin increased 24 h after the incidents and decreased after a total of 84 h. Anticipatory negative reactions were associated with an initial increase in urine cortisol 24h before the incident occurred and with a subsequent decrease a total of 12 h following the incident. Long-term negative reactions were associated with an ultimate increase in urine neopterin 144h after the incidents. These findings empirically demonstrate that one specific category of positive everyday incidents can be associated with multiple emotional reactions that differ in valence (positive/negative) and duration (short-term/long-term), and also depend on whether an incident was expected (anticipated/not anticipated). This calls for a careful categorization of positive incidents when testing stress system functioning under complex everyday life conditions.

Sigstad, Hanne Marie H./ Stray-Pedersen, Asbjorg/ Froland, Stig S. Coping, Quality of Life and Hope in Adults with Primary Antibody Deficiencies. Health and Quality of Life Outcomes 2005, 3, 31.
Abstract
Background. Living with a chronic disease, such as primary antibody deficiency, will often have consequences for quality of life. Previous quality-of-life studies in primary antibody deficiency patients have been limited to different treatment methods. We wanted to study how adults with primary antibody deficiencies manage their conditions and to identify factors that are conducive to coping, good quality of life and hope. 
Methods. Questionnaires were sent to all patients >20 years of age with primary antibody deficiencies who were served by Rikshospitalet University Hospital. The questionnaires consisted of several standardized scales: Ferrans and Powers Quality of Life Index (QLI), Short Form–36 (SF-36), Jalowiec Coping Scale (JCS), Nowotny Hope Scale (NHS), and one scale we devised with questions about resources and pressures in the past. Of a total of 91, 55 patients (aged 23-76 years) answered the questionnaires. The questionnaire study were supplemented with selected interviews of ten extreme cases, five with low and five with high quality of life scores.
Results. Among the 55 patients, low quality of life scores were related to unemployment, infections in more than four organs, more than two additional diseases, or more than two specific occurrences of stress in the last 2-3 months. Persons with selective IgA deficiency had significantly higher QLI scores than those with other antibody deficiencies. An optimistic coping style was most frequent used, and hope values were moderately high. Based on the interviews, the patients could be divided into three groups: 1) low QLI scores, low hope values, and reduced coping, 2) low QLI scores, moderate hope values, and good coping, and 3) high QLI scores, moderate to strong hope values, and good coping. Coping was related to the patients’ sense of closeness and competence. 
Conclusions. Low quality of life scores in adults with primary antibody deficiencies were linked to unemployment and disease-related strains. Closeness and competence were preconditions for coping, quality of life and hope. The results are valuable in planning care for this patient group.

Trief, Paula M./ Ouimette, Paige/ Wade, Michael/ Shanahan, Paul/ Weinstock, Ruth S. Post-traumatic Stress Disorder and Diabetes: Co-Morbidity and Outcomes in a Male Veterans Sample. Journal of Behavioral Medicine 2006, 29(5), 411-418.
The purpose of this study was to assess the prevalence and correlates of comorbid diabetes and Post-Traumatic Stress disorder(PTSD)and potential relationships between PTSD and diabetes outcomes. Male patients enrolled in a VA primary care database (N = 73,270) were classified as having diabetes from pharmacy records (N = 14,438) and grouped into those with diagnoses of PTSD with depression (N = 649), PTSD-only (N = 480), Depression-only (N = 1696), Other psychiatric diagnosis (N = 736), or No psychiatric diagnosis (N = 10,877) based on the Purpose of Visit diagnoses in the medical record. Outcomes included glycemic control (HbA1c), cholesterol and tryglycerides. Correlates were age, substance use disorder, other psychiatric diagnosis, number of primary care encounters, and medications. The prevalence of comorbid diabetes and PTSD was 8% (n = 1129). Of these, 57% (n = 649) had comorbid depression. Patients with PTSD and depression had higher rates of substance use disorder and higher cholesterol and LDL. Patients with depression had poorer glycemic control. Patients with PTSD and depression weighed more and had higher BMI than patients with neither diagnosis. Thus, male diabetes patients with PTSD and depression may be vulnerable to substance use disorders and to weight/lipid problems that can affect health. Depression is a likely contributor to poor glycemic control. Careful screening for mental health comorbidities is needed for diabetes patients.
 
Waldspurger Robb, Wendy J. Self-Healing: A Concept Analysis. Nursing Forum June 2006, 41(2), 60-77.
Complementary and alternative medicine (CAM) is a rapidly growing specialty within the health care field. One concept that appears central to the notion of CAM therapies is the concept of self-healing. Although “self-healing” is addressed within several bodies of literature, the concept is ill-defined within the context of CAM therapies, specifically energy -based healing modalities such as reiki therapy. The purpose of this paper is to investigate the concept of self-healing through a concept analysis using Walker and Avantês technique (1995). The resultant operational definition of self-healing was the result of 6 weeks of study and is not considered to be a final product, but merely a beginning step to understanding this unique phenomenon.

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