Research Article Summary Project EDUR 7130 Lindsay Mims The Effects of Yoga on the Symptoms Associated with

Attention Deficit Disorder

Topic: The Effects of Yoga on the Symptoms Associated with Attention Deficit Disorder

For my research topic I decided to look at the effects of yoga and meditation on mental illnesses, specifically attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD). Yoga has recently started becoming more popular as a natural treatment alternative or addition for reducing symptoms such as stress and anxiety and increasing ability to function. My goal for this project was to find out if there was any validity to this new holistic treatment option. After researching this topic and related topics I found that there was a significant number of studies conducted that supported using yoga and meditation as treatment options for not only ADHD, but a variety of other physical, mental, and emotional problems as well.

Experimental Studies

Article: Butler, L. D., Waelde, L. C., Hastings, A. T., Chen, X. H., Symons, B., Marshall, J., Kaufman, A., Nagy, T. F., Blasey, C. M., Seibert, E. O., & Spiegel, D. (2008). Meditation with Yoga, Group Therapy with Hypnosis, and Psychoeducation for Long-Term Depressed Mood: A Randomized Pilot Trial. Journal of Clinical Psychology, 64(7), 806-820. Introduction: This study was conducted to examine the difference of effects of meditation with yoga including psychoeducation versus group therapy with hypnosis including psychoeducation versus psychoeducation only. This was done by studying individuals with documented long-term depressed mood. Method: The researchers used an experimental model by randomly assigning the 46 participants into one of the three groups mentioned above. The participants were recruited by answering ads in press releases, newspapers, internet, flyers, and mailings in the San Francisco Bay Area. Of the over 350 responses to the ads 68 were determined to be eligible according to the DSM-IV diagnosis, 52 of those chose to enroll, but 6 withdrew. The meditation group met for eight weekly sessions of two hours each, also participated in a four hour retreat, and a booster session in the twelfth week. The hypnosis intervention group met for ten weekly sessions of one and a half hours each and a two hour booster session in the twelfth week. Depression symptoms were measured with the Hamilton Rating Scale for Depression (HRSD), dysthymia symptoms were measured using the 27-item Cornell Dysthymia Rating Scale-Self Report (CDRS-SR), and treatment history was assessed with a self-report questionnaire. Results: The results showed that the CDRS scores decreased for both the meditation group and the hypnosis group and HRSD scores decreased in all three groups, but none of these decreases were statistically significant. Same results were true at the nine month follow up. Discussion: The researchers determined that they did find the beginning of promising support for the use of yoga and psychoeducation or group therapy with hypnosis and psychoeducation as a treatment to reduce symptoms in long-term depressed mood sufferers. The researchers, however, were not able to prove statistical significance with this study. Critique: Although I liked the idea behind this study, I thought it was very ambitious and seemed to incorporate too much. I feel they did not need to have so many different groups with so many different aspects to them. Also, the sample size was much too small for a study of this type.

Article: Descilo, T., Vedamurtachar, A., Gerbarg, P. L., Nagaraja, D., Gangadhar, B. N., Damodaran, B., Adelson, B., Braslow, L. H., Marcus, S., & Brown, R. P. (2010). Effects of a yoga breath intervention alone and in combination with an exposure therapy for post-traumatic stress disorder and depression in survivors of the 2004 South- East Asia tsunami. Acta Psychiatrica Scandinavica, 121, 289-300. Introduction: This study was conducted to look at the effects of yoga breath (with and without a trauma reduction exposure technique) on post-traumatic stress disorder and depression. The study was done specifically looking at survivors of the 2004 Asian tsunami. Method: The researchers used an experimental design using 183 participants, all of whom were survivors of the tsunami. Each survivor had to score 50 or above on the Post-traumatic Checklist17 (PCL-17) in order to qualify, and were then assigned to one of three groups (yoga breath intervention, yoga breath intervention followed by 3-8 hours of trauma reduction exposure technique, or a 6-week wait list). The yoga breath intervention included teaching four different breath techniques; the group was an 8 hour program given in 2 hour sessions over a four day period. The group using yoga breath intervention followed by 3-8 hours of trauma reduction exposure technique attended the same sessions types as the previous group, but then a few days afterwards they were given three to five individual 1 to 3 hour sessions using Traumatic incident reduction (TIR). Baseline testing used not only the PCL-17, but also the Beck Depression Inventory (BDI-21) and the General Health Questionnaire (GHQ-12). Each of these same tests was administered to the participants of each group at 6 weeks, 12 weeks, and 24 weeks. Results: The results showed that PTSD scores decreased by 60 percent at 6 weeks and 24 weeks in both of the treatment groups, but there was not a significant difference in how much the scores decreased between the two groups. Also, the effects of depression were 90 percent lower at 6 weeks and 24 weeks in both treatment groups. The effects on general health scores decreased significantly as well in both of the treatment groups, (decreased 9.8 for yoga breath, and 11.5 for yoga breath plus TIR). Discussion: The researchers determined there were significant decreases in PTSD, depression, and effects on general health in both treatment groups. However, they were unable to find any significant differences in score changes between the two treatment groups the administers to the participants. Critique: I thought this was an interesting study, especially because they used one specific group from a wide spread tragedy. My biggest issue with this study was that I did not see their point in having two different treatment groups as well as a control group. I feel it would have worked better with just one treatment group.

Article: Granath, J., Ingvarsson, S., Thiele, U., & Lundberg, U. (2006). Stress Management: A Randomized Study of Cognitive Behavioural Therapy and Yoga. Cognitive Behaviour Therapy, 35(1), 3-10. Introduction: This study was conducted to examine the difference of effects of cognitive behavioral therapy versus a Kundaliniyoga program on stress management. Method: The researchers used an experimental model. In the end there were 33 participants, mostly women, all of whom were from a large Swedish company in the financial sector. The participants were randomly assigned to either the cognitive behavior therapy group or the yoga group, and were either put in an all female group or a co-ed group, making four groups in all. Each group had 10 sessions over a four month period. Questionnaires were given (including the Perceived Stress Scale (PSS), Daily Stressors, Maastricht Questionnaire, MMPI-2 Anger subscale, and the Quality of Life Inventory (QOLI)), blood pressure and heart rate were taken, and urine samples were taken two weeks before and two weeks after the four month period. Results: The results showed that the PSS scores decreased significantly in participants in all groups. The ratings for anger were significantly lower in the cognitive behavior therapy group, but not in the yoga group. The QOLI scores did not have significant increases within any of the groups. Discussion: The researchers determined that they were able to find reason to believe that cognitive behavior therapy and/or yoga are good treatment options to help with stress related symptoms. The results showed significant decreases in almost all stress-related variables from both groups. Critique: The researchers found significant evidence to support the positive effects of cognitive behavior therapy and with yoga in lowering stress related symptoms, but I feel that this would have even more validity if there had been a control group to compare results with. Also, there wasnt any follow up data after the initial data collection two weeks after the completion of the sessions.

Article: Mehta, S., Mehta, V., Mehta, S., Shah, D., Motiwala, A., Vardhan, J., Mehta, N., & Mehta, D. (2011). Multimodal Behavior Program for ADHD Incorporating Yoga and Implemented by High School Volunteers: A Pilot Study. International Scholarly Research Network (ISRN) Pediatrics, 2011, 780745. Introduction: This study was conducted to find out if their low-cost resource approach to ADHD therapy would be practical approach to treating children in developing countries. The study was done in a town in India called Nahibabad. Method: The researchers used a single-subject experimental design. The study was conducted in a school of 910, which accounted for almost half of the towns children, and came from a wide variety of socioeconomic backgrounds. All children were between the ages of 6 and 11, and 98% were either Hindu or Muslim. 80 of these children were diagnosed with ADHD, and 76 of those enrolled into the program. Each group consisted of about 8 to 12 children and was conducted by high school volunteers who were recommended by their teachers. The program had one hour sessions each school day and used yoga postures, meditation program, and behavioral play therapy. After six weeks the participants yoga performance was measured by using a yoga posture score which measured five different aspects of eight different yoga poses; children could receive a score between 0 and 2. Results: The results were measured from a baseline score of 40. Results showed that all of the children improved an average of 29.5 points, or a 73.9% improvement, on their yoga posture scores. For the meditation results there was no baseline, but at 6 weeks the children were able to maintain the humming sound of breath for 7.85 seconds on average, which was similar to a control group done afterwards. Discussion: The researchers determined that children with ADHD can have noteworthy benefits from implementing a peer-mediated multimodal behavior program that includes yoga and meditation. From this study more than 50% of the children improved academically as well as in behavior. Critique: I thought this study showed a fresh and new idea that could greatly help countries and communities that do not have the resources to treat children with ADHD. The only real critique I have is that there needs to be further evidence on this topic and related topics, and also there was never a mention of whether the evidence was actually statistically significant.

Article: Peck, H. L., Kehle, T. J., Bray, M. A., & Theodore, L. A. (2005). Yoga as an Intervention for Children With Attention Problems. School Psychology Review, 34(3), 415-424.

Introduction: The idea behind this study was to look at the effects of yoga on improving attention. Specifically the researchers looked at the effects of time on task in elementary school children with attention problems. Method: The researchers used an experimental study design with ten elementary school students for participants. All participants were between the ages of 6 and 10, were in grades 1, 2, or 3, and were not diagnosed with ADHD but demonstrated attention problems. The researchers looked at the percentage of time the students were on task and determined a baseline by observing the participants in class doing their morning work. The observations were done in 10 minute blocks broken down into 10 second intervals. After baseline measures were taken the school psychologist set up classroom time with each teacher to incorporate the yoga exercises into the school day. The students were then observed in the same manner two times per week for seven weeks. Results: The results showed a large effect size (1.51 to 2.72) towards on task behavior for the average of each grade level group. At follow up these numbers decrease somewhat but were still significantly higher than the baseline numbers. Discussion: This study showed that attention, or time on task, can be improved with the use of yoga. Also, the fact that the time on task did not return to baseline numbers after the yoga exercises were no longer practiced would indicate that it could potentially change behavior permanently or semi permanently. Critique: This was one of my favorite articles that I found on my topic. I felt that looking at time on task was a great way to measure attention, especially in elementary school children. I did feel that the results were not laid out in the most comprehensible way, and that they could have done a much better job organizing and explaining that section of their study.

Other Quantitative Studies

Article: Harrison, L.J., Manocha, R., & Rubia, K. (2004). Sahaja Yoga Meditation as a Family Treatment Programme for Children with Attention Deficit-Hyperactivity Disorder. Clinical Child Psychology and Psychiatry, 9(4), 479-497. Introduction: This article looked at the effects of meditation on children with ADHD and their families. Specifically the study was done using the techniques of Sahaja Yoga Meditation (SYM) as a treatment method. Method: This article discusses a survey study that was conducted by having children with ADHD and their parents participate in a 6-week program of clinic sessions twice a week for 90 minutes as well as regular meditation at home. Participants were recruited by putting ads in a local newspaper, and by discussing it in a lecture that was open to parents of children with ADHD. If the children scored above threshold, 15 or higher on the Conners Parent-Teacher Questionnaire, for ADHD they were eligible for the study. In the end there were 48 children, 41 boys and 7 girls, but only 44 families because four sets of children were siblings. There were three types of questionnaires given in order to assess the treatment, child self-report questionnaires (Burnett Self-Scale), parent-rated questionnaires (Conners Parent-Teacher Questionnaire), and examiner testing (Peabody Picture Vocabulary Test) and interviews, all of which were given at the beginning, half way through, and at the end of the 6 week period. They also looked at the parents perceived results from the meditation sessions using the Child-Parent Relationship Scale. Results: The researchers found that at baseline from parent reports, although there was no significant difference in scores due to gender or participant group, children from single-parent homes had significantly high ADHD scores than children from two-parent homes. The average scores of the children who provided data on the Conners Parent-Teacher Questionnaire both before and after treatment decreased from 22.54 to 14.62, which showed a 35% improvement rate, and in a fair amount of children they were able to decrease medication. 92% of the parents who participated said they felt their child/children had benefitted from the SYM treatment. Discussion: Having personal experience with the effects someone with ADHD can have on a person I found this article interesting. I felt this article looked at a part of this disorder that most people dont, which is how it affects the entire family as a unit. The article says their trial showed that SYM has the potential to be a good form of treatment for children with ADHD when used in conjunction with the whole family, and I think that would a great alternative to look into. Critique: I felt like the study itself was done very well and had good results, but feel it may have been more valid and reliable if they had had a control group to compare their results to. Also, the sample size seemed pretty small for a survey study of this type, and having more participants may have helped the reliability as well. Also, this seemed like it may have been the first study of its kind, where it incorporated the entire family and it didnt address anything about that.

Article: Jensen, P, S., Stevens, P. J., & Kenny, D. T. (2012). Respiratory Patterns in Students Enrolled in Schools for Disruptive Behaviour Before, During, and After Yoga Nidra Relaxation. J Child Fam Stud, 21(1), 667-681. Introduction: This article was done to look at the effects of one session of Yoga Nidra on the breathing patterns of boys with disruptive behaviors. Breathing patterns are more atypical in children with disruptive behaviors, but very little research has been done in this area. Method: The researchers utilized a correlational study design for this article. The participants were seven boys, ages 10 to 15 years old, six of who had diagnosed mental disorders. All of the participants were attending a special school for children with disruptive behaviors. There were also three participants who were all girls without documented disruptive behaviors, and these were used as the control group. All of the boys had already participated in a 14 week yoga program that included posture and breathing techniques. The yoga session the boys participated in for this study was a total of 15 minutes long. Data was collected once five minutes before practicing Yoga Nidra, 10 minutes during the yoga, and five minutes afterwards, and all participants were lying down facing upwards during data collection. To collect and analyze the data the Compumedics thoracic and abdominal Respiratory Inductive Plethysmography (RIP) and Summit IP software was used. Also used were Conners Teacher Revised: Long Version (CTRS-R:L), State Trait Anxiety Inventory (STAI), and State Trait Anxiety Inventory for Children (STAIC) to determine behavior, anxiety, and self-esteem levels. Results: The research showed that there was a reduction in anxiety based on STAIC and STAI results, but it was not significant for either. The breathing patterns for the boys compared to the girls were much more irregular. The breathing patterns for each boy were displayed individually, but overall the breathing patterns during and/or after was much more regular than those before the yoga session. Discussion: This study showed that overall the yoga session seemed to decrease anxiety, and help improve breathing patterns, although none of these findings were significant. There was also a larger study conducted over 18 months, and the results from these participants were included in their data. Critique: I thought the researchers in this study had a really good idea for their research, but I did think there were quite a few problems with it. First of all, the sample size was very small, and I felt the control group would have been more meaningful if it had been males as well. Also, the results for the breathing patterns were not calculated in a way that could be compared to anything, they were simply shown individually which did not seem to have much validity for Anything.

Article: Saper, R. B., Eisenberg, D. M., Davis, R. B., Culpepper, L., & Phillips, R. S. (2004). Prevalence and Patterns of Adult Yoga Use in the United States: Results of a National Survey. Alternative Therapies, 10(2), 44-49. Introduction: This study was done to see how prevalent the practice of yoga is in the United States. This study looks at the patterns of yoga practice in the United States as well. Method: The researchers used a survey study design to collect their data. They conducted a nationally representative telephone survey of English-speaking adults, excluding institutionalized individuals, non-English speakers, and people without telephones. When contacting a household with more than one resident only one member was selected at random to participate. All survey participants were asked In your lifetime have you ever used yoga?, if yes they were considered yoga users and asked if they had used yoga in the past 12 months, if yes they were considered current yoga users. A small percentage of participants classified as current yoga users were asked additional questions about their yoga use. Questions for current yoga users included the following: Have you used yoga for wellness?, For which health conditions, if any, have you used yoga in the past 12 months?, In general, how helpful has yoga been for your health condition in the past 12 months?, In the past 12 months, did you spend money for a professional for your yoga, and/or for books, classes, equipment, or any other items related to yoga?, and for those who had medical doctors, they asked if they disclosed their yoga use to their doctors, why or why not?. Results: The results showed that only 7.5% of respondents had used yoga at least once in their lifetime. Of those who had used yoga ever before 49.3% reported using it within the past 12 months, which is 3.7% of all participants. There were no significant differences between current and past yoga users in regards to sociodemographic factors or health status factors. Discussion: This study stated that it was the first published report of yoga prevalence and patters of use in the United States using a nationally representative sample. The percentage of respondents that said they have used yoga before in their lifetime was extremely smaller than I would have expected, and it makes me wonder what the number would be today as it becomes more popular in the U.S. Critique: This survey was a great way to look at the prevalence of yoga in the United States. I did however, think it was strange that the data was collected in 1998 and it took until 2004 for it to become published. Also, they did not do much in explaining how the survey participants were randomly selected; they just said they were a nationally representative sample.

Article: Vancampfort, D., De Hert, M., Knapen, J., Wampers, M., Demunter, H., Deckx, S., Maurissen, K., & Probst, M. (2011). State anxiety, psychological stress and positive well-being responses to yoga and aerobic exercise in people with schizophrenia: a pilot study. Disability and Rehabilitation, 33(8), 684-689. Introduction: This article was done to look at to what degree, if at all, the state of anxiety, stress, and well-being changed in people who suffer from schizophrenia after performing one session of yoga and aerobic exercise. Method: This article discusses a correlational study that was done with 40 individuals, 22 males and 18 females, with schizophrenia or schizoaffective disorder and who all scored at least a four on a clinical global impression severity (CGIS) scale. The first week participants participated in a 30-minute habituation yoga session and a 20-minute aerobic exercise session, but the order of these two session types was randomly assigned to control for session order having an effect on the results. There was also a 20-minute session during with participants were to sit quietly in a room and were allowed to read if they chose to do so, this was considered the control condition. Measurements were taken before and just after the yoga, aerobic exercise, and control sessions. State anxiety was measured using the State Anxiety Inventory (SAI), while psychological stress and positive well-being were measured using the Subjective Exercise Experiences Scale (SEES). Results: The research showed that there was a significant decrease in state anxiety after both yoga and aerobic exercise, but relatively no change after the control condition. A significant decrease in psychological stress was also found after yoga as well as aerobic exercise, while no difference was noted after the control condition. Subjective-well being significantly increased after both yoga and aerobic exercise, while there was no change seen after the control condition. Discussion: This study was the first of its kind in that no other study had been performed to look at the effects of a single session of yoga and aerobic exercise on the state anxiety, psychological stress, and well-being in people with schizophrenia. This study strengthens the idea that yoga and aerobic exercise in general increase a sense of well-being and decrease stress and anxiety. Critique: I thought this was a very interesting study, and it seemed to have some positive outcomes. In my opinion it was almost too specific though and seemed to have such a tiny area of relevance, not only was the study for people who have schizophrenia, but also looked at yoga AND aerobic exercise, and only looked at the results after ONE session. One limitation of this study that I feel to be a very important factor was that they did not measure their data again after a day, a week, a month, etc. to see how long or even if the effects lasted.

Article: Yoshihara, K., Hiramoto, T., Sudo, N., & Kubo, C. (2011). Profile of mood states and stressrelated biochemical indices in long-term yoga practitioners. BioPsychoSocial Medicine,5(1), 6. Introduction: This article looks at the relationship between long-term yoga practice and moods and stress levels. It also looks at mental state and urinary stress-related biochemical indices. Method: This article discusses correlational study done using 38 healthy adult females who had practiced yoga for at least two years, and 37 healthy adult females of the same ages who had never practiced yoga before. The participants who were long-term yoga practitioners, on average, practiced 2.94 times per week for an average of 1.37 hours for each session. All participants were over the age of 20, but younger than 60, they had to have not taken any medication within the last month, have any illnesses, or a history of physical or mental illness. All of the participants were to collect a urine sample and evaluate themselves using the POMS on tension-anxiety, depression, anger-hostility, vigor, fatigue, and confusion. The urine sample was in order to look at biopyrrin, 8-OHdG, cortisol and creatinine. Results: The researchers found that the long-term yoga group showed a lower total mood disturbance, tension-anxiety, anger-hostility, and fatigue scores with the POMS than the non yoga group. But there were no significant differences in depression and confusion between groups according to the POMS. The 8-OHdG level in urine tended to be slightly lower in the long-term yoga group, however not significantly, and no significant differences in any of the other enzymes tested in the urine. Discussion: In general this study showed that people who are long-term yoga practitioners have lower mood problems, such as tension-anxiety, anger-hostility, and fatigue. The researchers mentioned that yoga was found to be as effective as relaxation at reducing anxiety over time. Critique: I thought it was interesting that this study looked at differences in the participants urine as well, it is said to be the first study of this kind to use this type of measurement, although it did not show any significant differences. I also thought that this was a very small sample size for this type of study, it seems like there would have been a large number of women to choose from who do and do not practice yoga.

Qualitative Studies

Article: Bowler, D. E., Buyung-Ali, L. M., Knight, T. M., & Pullin, A. S. (2010). A systematic review of evidence for the added benefits to health of exposure to natural environments. Public Health, (10), 456. Introduction: This study was conducted to look at the benefits on health when exposed to natural or synthetic environments. The idea behind this was that the natural environments would have added benefits on health and well-being. Method: The researchers used a qualitative study design involving twenty four different studies. In order to be used a study had to meet the following criteria: collection of data on any measure of health or well-being after direct exposure to a natural environment and after exposure to a synthetic environment. The majority of the studies were controlled settings focusing on shortterm exposure to each of the environments. Some of the natural environments included public parks and green university campuses, while some of the synthetic environments included indoor and outdoor man made environments. Results: There were many different things looked at within the twenty four different studies, so for this study the researchers just looked at over all general well-being, specifically looking at emotions, attention, cardiovascular, endocrine, and immune function. Looking at effects over all the participants in the study reported improvements in energy, anxiety, anger, fatigue, and sadness, but found no improvements in attention or tranquility. Discussion: This study showed that a natural environment can improve overall well-being in a lot of ways, but did not find an improvement in attention or ADD specifically. I felt this would be a good study to look at in order to look at another type of natural approach on ADD besides yoga. Critique: I felt this study had an interesting idea of what it wanted to look at, but I thought the way they approached it wasnt very well done. They had a very broad meaning of health and wellbeing. I also felt that they didnt narrow down exactly what they were looking for enough. Lastly, they did no participant research of their own, only used others studies.

Article: Irvine, E. (2005). Case Study: Yoga Therapy for Attention Deficit Disorder. Positive Health, (111), 46. Introduction: This study was conducted to look at the effects of incorporating mother and child yoga on the everyday symptoms of child ADD. In this particular study yoga was chosen as a treatment option because it was suggested by the childs psychologist. Method: The researchers used a qualitative case study design. The participants were one mother and one son; the child is an eight year old boy with fairly severe ADD. The child struggles with most of the classic symptoms, such as trouble getting to sleep at night, anxiety, being agitated, inability to remember or focus, etc. It took between two and four hours every night for his mother to get him to fall asleep. The plan was to meet for four to six sessions to teach the breathing and body awareness and posture aspect of yoga therapy in order for them to continue at home. After these sessions and the continuation at home mother and son were able to cut the time it takes him to fall asleep from two to four hours, down to almost no time at all. Results: The results showed that after these sessions and the continuation at home mother and son were able to cut the time it takes him to fall asleep from two to four hours, down to almost no time at all. Overall they feel that the techniques they implemented into their lives have helped reduce the majority of his symptoms, which in turn alleviates stress and the amount of time dealing with the problems associated with ADD. Discussion: This study is a good example of a qualitative study for what I was trying to look at. Although it was only one person (or one set of people), it showed a drastic decrease in the childs ADD symptoms in a very short amount of time. Critique: I felt this study had a good idea behind it, but could have been done much better. First of all, there was only one child in the study which still gives great information, but it would be more relevant with more people. Next, the study was not very detailed with exactly what they did, how long, and the specific results. Hopefully if this is done in the future they will have more details involved.

Article: Kaley-Isley, L. C., Peterson, J., Fischer, C., & Peterson, E. (2010). Yoga as a Complementary Therapy for Children and Adolescents: A Guide for Clinicians. Psychiatry, 7(8), 20-32. Introduction: This study was done to evaluate yoga as an effective intervention for children and adolescents with health problems. The specific case looked at evaluates a child with mild asthma, attention deficit hyperactivity disorder, and recent onset obesity. Method: The researchers used a qualitative case study design. The participant in this study was a 12-year old boy who had been diagnosed with ADHD, mild asthma, and recent onset obesity, but his 14-year old sister and his mother both participated as well. The participant was recruited after the boys mother spoke with a psychiatrist about getting him help that avoided medication. The psychiatrist spoke to them about all of the health benefits for someone of any age, thought to come from practicing yoga. The boy and his sister began to practice yoga on a regular basis, and eventually the mother joined in as well. Results: The results showed that the boy was able to lose some weight from the practice of doing yoga. It also mentioned there were other health benefits for all family members that came from adding this in to their routine. Discussion: This study helps us to conclude that the practicing of yoga could be a good alternative to medicine for certain health problems. The 12-year old boy was able to lose weight and help reduce his asthma and ADHD symptoms. Critique: There were a lot of problems with this article. First of all the article contained a case study (which is what I reported on), but it also included another study in which they gathered together a number of articles to review them. I feel that because of this there was not nearly enough detail given to either study, especially the case study. I would hope that next time the researchers would take the time to give specifics on what type of yoga was practiced, how long, etc. as well as give much more detail about the results that came from it.

Article: Khalsa, S. B., Shorter, S. M., Cope, S., Grace, W. & Sklar, E. (2009). Yoga Ameliorates Performance Anxiety and Mood Disturbance in Yong Professional Musicians. Appl Psychophysiol Biofeedback, (34), 279-289. Introduction: This study was conducted in order to assess the benefits of yoga and meditation on young professional musicians. Specifically the researchers were looking at the change in anxiety and mood disturbance in the musicians. Method: The researchers used a qualitative study design for their research. The participants were recruited by sending an email announcement to all 150 Tanglewood summer fellows. A total of 45 fellows volunteered for the study, and were divided into three groups: yoga lifestyle intervention group, yoga and meditation only group, or control group. Both yoga groups attended three yoga and/or meditation classes every week for eight weeks, but the yoga lifestyle intervention group began the program with a two day intensive retreat which included two practice sessions of group yoga, meditation techniques, breath control, and conscious eating. Additionally, the yoga lifestyle intervention group attended a weekly problem-solving group discussion starting in the second week of the study, as well as a 60-minute private instruction session where an instructor was able to answer any questions about techniques. Results: The results showed that performance anxiety decreased for both yoga groups (yoga lifestyle and yoga only group), while it stayed the same for the control group. Both of the yoga intervention groups also showed significantly less anger/hostility and tension/anxiety than the control group did. In the long term follow up all participants reported that yoga and meditation had changed their musical performance abilities. Discussion: This study showed that yoga has a tendency to reduce musical performance anxiety. Overall the participants found the breath control techniques helped them manage performance anxiety more effectively. The study also showed that yoga and meditation helped to benefit overall mood. Critique: The idea used for this study was something I am sure is a very relevant problem. I did not find many problems within the study. My only critique would be that it could have been done with musicians from many different music schools rather than specific to participants of this one music program.

Article: Stankovic, L. (2011). Transforming Trauma: A Qualitative Feasibility Study of Integrative Restoration (iRest) Yoga Nidra on Combat-Related Post-Traumatic Stress Disorder. International Journal of Yoga Therapy, (21), 23-37. Introduction: The point of this study was to look at the effects of a form of mindfulness meditation, called Integrative Restoration (iRest), on military veterans suffering from posttraumatic stress disorder (PTSD). There has been an increasing popularity in using different types of meditation for a variety of treatment purposes, and this study was looking to bring some validity to this certain area. Method: The researchers used a qualitative study design when collecting their data. Participants were recruited using flyers posted an agency, but only 16 people could participate due to space restrictions. Of these 16 participants 15 were Vietnam veterans and one was an active-duty soldier who had served in Iraq, but five dropped out during the first three weeks of the study. The 11 that remained ranged in age from 42 to 68 years old and were a variety of ethnicities. The participants were assigned to one of two groups, and each group met for a two-hour class once per week for a total of eight weeks. During these sessions each person completed a weekly questionnaire, checked in, learned a new phase of the iRest process, completed an iRest worksheet to help them identify their feelings, emotions, thoughts, beliefs, etc., and practiced a 40-minute guided iRest session. After the guided session the classes ended with questions and discussions. Qualitative data was collected by recording the class sessions, weekly questionnaires self-rating symptoms, and the final questionnaire about the class series. Results: The results showed that all participants had positive initial experiences with the iRest and reported benefits throughout the study. The participants reported reductions in mental stress, physical pain, anxiety, anger, emotional volatility, blood pressure, and self-judgment, as well as the ability to relax easier, feel more positive emotions, and be more spiritually connected. Participants said that even minor changes in any of the above were extremely significant in improving their quality of life. Discussion: The researchers determined that the results support the idea that iRest classes could be very beneficial for military veterans suffering from PTSD. The classes seemed to improve a variety of emotional symptoms and help provide better mental clarity. Critique: I think this study is a great example of the benefits different types of yoga and meditation can have on certain mental, emotional, and physical problems. The main problems I found were that the sample was very small and was very oddly distributed.