Papers by Hiroe Hu
NEJM evidence, Apr 23, 2024
The diverse roles of the hormone oxytocin in physiological homeostasis, milk let-down, maternal a... more The diverse roles of the hormone oxytocin in physiological homeostasis, milk let-down, maternal and social affiliative behaviors, emotion regulation, and cognition have been studied across various disciplines.1 Among them, preclinical studies have demonstrated an effect of oxytocin on ingestive behaviors. In this issue of NEJM Evidence, Plessow et al.2 report results of a well-designed, randomized, double-blind, placebo-controlled clinical trial to evaluate the effects of intranasal oxytocin (24 IU daily in divided doses) on weight loss in participants who are obese. Despite extensive preclinical studies demonstrating that oxytocin reduces food intake3 and preliminary clinical trials supporting the potential use of oxytocin as an antiobesity medication in humans.
NEJM Evidence, 2024
The diverse roles of the hormone oxytocin in physiological homeostasis, milk let-down, maternal a... more The diverse roles of the hormone oxytocin in physiological homeostasis, milk let-down, maternal and social affiliative behaviors, emotion regulation, and cognition have been studied across various disciplines.1 Among them, preclinical studies have demonstrated an effect of oxytocin on ingestive behaviors. In this issue of NEJM Evidence, Plessow et al.2 report results of a well-designed, randomized, double-blind, placebo-controlled clinical trial to evaluate the effects of intranasal oxytocin (24 IU daily in divided doses) on weight loss in participants who are obese. Despite extensive preclinical studies demonstrating that oxytocin reduces food intake3 and preliminary clinical trials supporting the potential use of oxytocin as an antiobesity medication in humans.
Psychiatry and Clinical Neurosciences, 2024
Vasopressin or arginine-vasopressin (AVP) is a neuropeptide molecule known for its antidiuretic e... more Vasopressin or arginine-vasopressin (AVP) is a neuropeptide molecule known for its antidiuretic effects and serves to regulate plasma osmolality and blood pressure. The existing literature suggests that AVP plays a multifaceted-though less well-known-role in the central nervous system (CNS), particularly in relation to the pathophysiology and treatment of mood disorders. Animal models have demonstrated that AVP is implicated in regulating social cognition, affiliative and prosocial behaviors, and aggression, often in conjunction with oxytocin. In humans, AVP is implicated in mood disorders through its effects on the hypothalamic-pituitary-adrenal (HPA) axis as well as on the serotoninergic and glutamatergic systems. Measuring plasma AVP has yielded interesting but mixed results in mood and stress-related disorders. Recent advances have led to the development of copeptin as a stable and reliable surrogate biomarker for AVP. Another interesting but relatively unexplored issue is the interaction between the osmoregulatory system and mood disorder pathophysiology, given that psychotropic medications often cause dysregulation of AVP receptor expression or signaling that can subsequently lead to clinical syndromes like syndrome of inappropriate diuresis and diabetes insipidus. Finally, pharmaceutical trials of agents that act on V1a and V1b receptor antagonists are still underway. This narrative review summarizes: (1) the neurobiology of the vasopressinergic system in the CNS; (2) the interaction between AVP and the monoaminergic and glutamatergic pathways in the pathophysiology and treatment of mood disorders; (3) the iatrogenic AVP dysregulation caused by psychotropic medications; and (4) the pharmaceutical development of AVP receptor antagonists for the treatment of mood disorders.
Global Advances in Health and Medicine, 2019
Background We describe the study design and protocol of a pragmatic randomized controlled trial (... more Background We describe the study design and protocol of a pragmatic randomized controlled trial (RCT) Acupressure for Children in Treatment for a Childhood Cancer (ACT-CC). Objective To describe the feasibility and effectiveness of an acupressure intervention to decrease treatment-related symptoms in children in treatment for cancer or recipients of a chemotherapy-based hematopoietic stem cell transplant (HSCT). Design Two-armed RCTs with enrollment of 5 to 30 study days. Setting Two pediatric teaching hospitals. Patients Eighty-five children receiving cancer treatment or a chemotherapy-based HSCT each with 1 parent or caregiver. Intervention Patients are randomized 1:1 to receive either usual care plus daily professional acupressure and caregiver delivered acupressure versus usual care alone for symptom management. Participants receive up to 20 professional treatments. Main Outcome A composite nausea/vomiting measure for the child. Secondary Outcomes Child’s nausea, vomiting, pain,...
Global Advances in Health and Medicine, 2019
Purpose Acupressure and therapeutic touch may be beneficial for symptom management and increasing... more Purpose Acupressure and therapeutic touch may be beneficial for symptom management and increasing general well-being for children undergoing cancer treatment. Acupressure has the benefit of stimulating targeted acupuncture points while providing therapeutic touch. We sought to explore the relationship between acupressure and the experience of well-being among children being treated for cancer who received acupressure. Methods In the Acupressure for Children in Treatment for a Childhood Cancer trial, hospitalized children received acupressure using specified acupressure points for symptom control as well as points for general well-being. Acupressure was delivered by professionals and by caregivers, following training by the professional. Qualitative data were collected through semistructured interviews with a purposive sample of professional acupressure providers (n = 3) and primary caregivers (n = 13), combined with participant observation during the acupressure intervention. Data w...
Cult Med Psychiatry, 2020
Interoceptive awareness is the conscious perception of sensations that
create a sense of the phys... more Interoceptive awareness is the conscious perception of sensations that
create a sense of the physiological condition of the body. A validation study for the Japanese translation of the Multidimensional Assessment of Interoceptive Awareness (MAIA) surprised with a factor structure different from the original English language version by eliminating two of eight scales. This prompted an exploration of the similarities and differences in interoceptive bodily awareness between Japanese and European Americans. Bicultural Japanese-Americans discussed concepts
and experiences in the two cultures. We conducted focus groups and
qualitative thematic analyses of transcribed recordings. 16 participants illustrated cross-cultural differences in interoceptive bodily awareness: switching between languages changes embodied experience; external versus internal attention focus; social expectations and body sensations; emphasis on form versus self-awareness; personal space; and mind–body relationship; context dependency of bodily awareness and self-construal. The participants explained key concepts that present challenges for a Japanese cultural adaptation of the MAIA, specifically the concept of self-regulation lost in the factor analysis. In Japanese culture, self-regulation
serves the purpose of conforming to social expectations, rather than achieving an individual self-comforting sense of homeostasis. Our findings will inform the next phase of improving the MAIA’s cross-cultural adaptation.
THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE, 2019
Objectives: Mindfulness-based interventions (MBIs) have become increasingly popular for treating ... more Objectives: Mindfulness-based interventions (MBIs) have become increasingly popular for treating various physical and mental disorders. An increase in mindfulness levels through the teaching of mindfulness meditation is the most well-studied mechanism of MBIs. Recent studies, however, suggest that an increase in mindfulness is also observed in physical or psychosocial interventions not explicitly labeled as MBIs, or what the authors call non-MBIs. The authors aimed to review what non-MBIs can increase mindfulness levels despite not explicitly teaching mindfulness meditation. Design: The authors conducted a literature search for studies that included a non-MBI study arm measuring pre-and postintervention mindfulness levels using one of the following eight validated self-reported mind-fulness questionnaires: Five-Faceted Mindfulness Questionnaire, Mindful Awareness and Attention Scale, Freiburg Mindfulness Inventory, Toronto Mindfulness Scale, Philadelphia Mindfulness Scale, Kentucky Inventory of Mindfulness Skills, Child and Adolescent Mindfulness Measure, and Cognitive and Affective Mindfulness Scale-Revised. The authors identified 69 non-MBI study arms from 51 independent studies of the non-MBI itself or as active controls of an MBI under investigation. The authors documented or calculated, if not provided, effect sizes (ES) for changes in mindfulness levels following these interventions. Results: Among the 69 non-MBI arms, 36 showed no effect for change in mindfulness (ES <0.20), 3 were indeterminate (no ES available or unable to calculate), 13 had small effects (0.20 < ES <0.5), 13 had medium effects (0.50 < ES <0.80), 3 had large effects (0.80 < ES <1.3), and 1 had a very large effect (ES >1.3) for change in mindfulness. Conclusions: Analysis of the characteristics of non-MBIs with significant increases in mindfulness levels suggested some commonalities between MBIs and non-MBIs, shedding light on a spectrum of mindfulness-related interventions and the possibility that there are many roads to developing mindfulness.
Global Advances in Health and Medicine: Special Collection on Integral Psychiatry and the Science of Human Flourishing, 2019
Purpose: Acupressure and therapeutic touch may be beneficial for symptom management and increasin... more Purpose: Acupressure and therapeutic touch may be beneficial for symptom management and increasing general well-being for children undergoing cancer treatment. Acupressure has the benefit of stimulating targeted acupuncture points while providing therapeutic touch. We sought to explore the relationship between acupressure and the experience of well-being among children being treated for cancer who received acupressure. Methods: In the Acupressure for Children in Treatment for a Childhood Cancer trial, hospitalized children received acupressure using specified acupressure points for symptom control as well as points for general well-being. Acupressure was delivered by professionals and by caregivers, following training by the professional. Qualitative data were collected through semistructured interviews with a purposive sample of professional acupressure providers (n ¼ 3) and primary caregivers (n ¼ 13), combined with participant observation during the acupressure intervention. Data were analyzed using grounded theory methods. Results: Analysis of provider interview, caregiver interview, and participation observation yielded 3 prominent themes: (1) well-being elicited by acupressure, (2) well-being elicited by touch, and (3) well-being experienced as relational and inter-subjective. These themes, taken together, illustrate the intricate ways in which an intervention like acupressure can help alleviate the difficulties of a childhood cancer illness experience by promoting well-being in the child as well as the caregiver. Acupressure brought symptom relief, physical relaxation, and comforting touch to the child, allowing the caregiver to also feel relief and relaxation as caregiver-child experience of well-being are closely intertwined. Conclusions: Data from the 3 sources provided distinct and overlapping insights suggesting the versatile benefits of acupressure in promoting well-being during childhood cancer treatment. Professional acupressure combined with training of caregivers for childhood cancer may be a relational intervention that facilitates the experience of well-being for both the caregiver and the child.
Primary Care Sleep Medicine, 2014
Thesis Chapters by Hiroe Hu
MindRxiv Papers, 2019
While the effects of mindfulness practices on the self are not widely recognized, a reduction in ... more While the effects of mindfulness practices on the self are not widely recognized, a reduction in self-centered or “self-referential” processing stands as one of the central therapeutic mechanisms of mindfulness-based psychotherapy. In this literature-based research, I compared two cultural variations of mindfulness-based psychotherapy: Mindfulness-Based Cognitive Therapy (MBCT), developed recently in the West, and Morita Therapy, founded in Japan during the 1920’s based on Zen Buddhism. Despite the vast cultural/historical gap between them, they are strikingly similar in a number of respects. The most significant similarity is that they both use mindfulness as their primary therapeutic means; both, in turn, involve a change in the conception of ‘self’ via mindfulness. Despite the remarkable similarities, there are also discrepancies in their philosophies, methods, and techniques, which likely arose from the difference between the western individualistic and eastern collectivist values. Throughout this thesis, I show that the self can be understood as a two-layered structure. There is an inner layer—the operating locus of mindfulness—that function similarly irrespective of culture context, which may be responsible for some of the similarities between the therapies. There is also an outer layer that varies across cultures—a possible source of the differences in the therapies.
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Papers by Hiroe Hu
create a sense of the physiological condition of the body. A validation study for the Japanese translation of the Multidimensional Assessment of Interoceptive Awareness (MAIA) surprised with a factor structure different from the original English language version by eliminating two of eight scales. This prompted an exploration of the similarities and differences in interoceptive bodily awareness between Japanese and European Americans. Bicultural Japanese-Americans discussed concepts
and experiences in the two cultures. We conducted focus groups and
qualitative thematic analyses of transcribed recordings. 16 participants illustrated cross-cultural differences in interoceptive bodily awareness: switching between languages changes embodied experience; external versus internal attention focus; social expectations and body sensations; emphasis on form versus self-awareness; personal space; and mind–body relationship; context dependency of bodily awareness and self-construal. The participants explained key concepts that present challenges for a Japanese cultural adaptation of the MAIA, specifically the concept of self-regulation lost in the factor analysis. In Japanese culture, self-regulation
serves the purpose of conforming to social expectations, rather than achieving an individual self-comforting sense of homeostasis. Our findings will inform the next phase of improving the MAIA’s cross-cultural adaptation.
Thesis Chapters by Hiroe Hu
create a sense of the physiological condition of the body. A validation study for the Japanese translation of the Multidimensional Assessment of Interoceptive Awareness (MAIA) surprised with a factor structure different from the original English language version by eliminating two of eight scales. This prompted an exploration of the similarities and differences in interoceptive bodily awareness between Japanese and European Americans. Bicultural Japanese-Americans discussed concepts
and experiences in the two cultures. We conducted focus groups and
qualitative thematic analyses of transcribed recordings. 16 participants illustrated cross-cultural differences in interoceptive bodily awareness: switching between languages changes embodied experience; external versus internal attention focus; social expectations and body sensations; emphasis on form versus self-awareness; personal space; and mind–body relationship; context dependency of bodily awareness and self-construal. The participants explained key concepts that present challenges for a Japanese cultural adaptation of the MAIA, specifically the concept of self-regulation lost in the factor analysis. In Japanese culture, self-regulation
serves the purpose of conforming to social expectations, rather than achieving an individual self-comforting sense of homeostasis. Our findings will inform the next phase of improving the MAIA’s cross-cultural adaptation.