Cynthia Price | University of Washington (original) (raw)

Papers by Cynthia Price

Brain Sciences, Sep 29, 2023

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Identity, Jan 2, 2019

Identity distress occurs within a variety of psychiatric conditions. Reliable tools for assessing... more Identity distress occurs within a variety of psychiatric conditions. Reliable tools for assessing identity-related functioning among clinical populations are greatly needed. The Self-Concept and Identity Measure (SCIM) is a brief self-report scale designed to assess healthy and disturbed identity dimensions. This measure has been validated within normative but not treatment seeking samples. The present study used an a priori confirmatory approach to replicate the SCIM's factor structure among disadvantaged women enrolled in treatment for chemical dependence (N = 216). The original three-factor structure and item loadings generally replicated within this diagnostically diverse, significantly impaired sample. Higher SCIM scores were also associated with other problems, such as emotion dysregulation and depression. Results support the SCIM's use and scoring with clinical populations.

Brain Sciences, 2023

Journal of Bodywork and Movement Therapies, 2007

This paper describes and advocates the practice of presence as a tool of healing and transformati... more This paper describes and advocates the practice of presence as a tool of healing and transformation in the manual therapies. The authors discuss the advantages and effects of presence in the therapist, methods and reasons for promoting presence in the client, and the relational aspects of presence within the client-therapist relationship. Specific exercises and therapy vignettes are provided to supply the reader with examples of the role of presence in clinical work. It is the authors' opinion that the concept of presence may become a common denominator for understanding the effectiveness of somatic approaches in bodycentered therapies. Presence, when properly understood and applied, should have new and profound influence on all therapeutic modalities. There would seem to be no reason that the practice of presence would be excluded from any therapy session except for lack of training, understanding, and experience on the part of the practitioner. The practitioner's sensitive accompaniment is fundamental to the client's journey towards body-centered self-awareness. The client's progress towards body-centered self-awareness has many stages of growth, and is comparable to a spiritual pilgrimage-there are places of reflection, resistance, reaffirmation, and insight. The somatic therapist has the role of supporting this journey through the facilitation of presence.

Alternative Therapies in Health and Medicine, Nov 1, 2007

Context-Preliminary studies of body therapy for women in trauma recovery suggest positive results... more Context-Preliminary studies of body therapy for women in trauma recovery suggest positive results but are not specific to women with post-traumatic stress disorder (PTSD) and chronic pain. Objective and Participants-To examine the feasibility and acceptability of body-oriented therapy for female veterans with PTSD and chronic pain taking prescription analgesics. Design and Setting-A 2-group, randomized, repeated-measures design was employed. Female veterans (N=14) were recruited from a Veterans Affairs (VA) healthcare system in the Northwest United States (VA Puget Sound Health Care System, Seattle, Washington). Participants were assigned to either treatment as usual (TAU) or treatment as usual and 8 weekly individual body-oriented therapy sessions (mindful awareness in body-oriented therapy group). Measures-Written questionnaires and interviews were used assess intervention acceptability; reliable and valid measures were administered at 3 time points to evaluate measurement acceptability and performance; and within-treatment process measures and a participant postintervention questionnaire assessed treatment fidelity. Intervention-A body-oriented therapy protocol, "Mindful Awareness in Body-oriented Therapy" (MABT) was used. This is a mind-body approach that incorporates massage, mindfulness, and the emotional processing of psychotherapy. Results-Over 10 weeks of recruitment, 31 women expressed interest in study participation. The primary reason for exclusion was the lack of prescription analgesic use for chronic pain. Study participants adhered to study procedures, and 100% attended at least 7 of 8 sessions; all completed in-person post-treatment assessment. Written questionnaires about intervention experience suggest increased tools for pain relief/relaxation, increased body/mind connection, and increased trust/ safety. Ten of 14 responded to mailed 3-month follow-up. The response-to-process measures indicated the feasibility of implementing the manualized protocol and point to the need for longer sessions and a longer intervention period with this population.

Complementary Therapies in Clinical Practice, May 1, 2007

The study purpose was to examine dissociation in body therapy for women receiving psychotherapy f... more The study purpose was to examine dissociation in body therapy for women receiving psychotherapy for childhood sexual abuse. An initial intervention study provided an opportunity to examine dissociation; the sample of 24 women received eight, one-hour body therapy sessions. The Dissociative Experiences Scale served as the predictor variable, and the outcome measures reflected psychological and physical health, and body connection. Repeated measures analysis of variance was used to examine dissociation reduction across time. Pearson correlations were used to describe associations between the relative change in dissociation and outcomes. The results demonstrated that the greatest change was the reduction of dissociation; there was an incremental effect across time and a strong association between change in dissociation and health outcomes. High dissociation at baseline (moderate levels) predicted positive outcomes. The results demonstrated the importance of moderate dissociation as an indicator of distress, and the central role of dissociation reduction in health and healing.

ENeuro, Jun 1, 2023

Interoception, the representation of the body's internal state, serves as a foundation for emotio... more Interoception, the representation of the body's internal state, serves as a foundation for emotion, motivation, and wellbeing. Yet despite its centrality in human experience, the neural mechanisms of interoceptive attention are poorly understood. The Interoceptive/Exteroceptive Attention Task (IEAT) is a novel neuroimaging paradigm that compares behavioral tracking of the respiratory cycle (Active Interoception) to tracking of a visual stimulus (Active Exteroception). Twenty-two healthy participants completed the IEAT during two separate scanning sessions (N = 44) as part of a randomized control trial of mindful awareness in body-oriented therapy (MABT). Compared with Active Exteroception, Active Interoception deactivated somatomotor and prefrontal regions. Greater self-reported interoceptive sensibility (MAIA scale) predicted sparing from deactivation within the anterior cingulate cortex (ACC) and left-lateralized language regions. The right insula, typically described as a primary interoceptive cortex, was only specifically implicated by its deactivation during an exogenously paced respiration condition (Active Matching) relative to selfpaced Active Interoception. Psychophysiological interaction (PPI) analysis characterized Active Interoception as promoting greater ACC connectivity with lateral prefrontal and parietal regions commonly referred to as the dorsal attention network (DAN). In contrast to evidence relating accurate detection of liminal interoceptive signals such as the heartbeat to anterior insula activity, interoceptive attention toward salient signals such as the respiratory cycle may involve reduced cortical activity but greater ACC-DAN connectivity, with greater sensibility linked to reduced deactivation within the ACC and language-processing regions.

Global advances in health and medicine, 2021

Background The demand for complementary and integrative health (CIH) is increasing by patients wh... more Background The demand for complementary and integrative health (CIH) is increasing by patients who want to receive more CIH referrals, in-clinic services, and overall care delivery. To promote CIH within the context of primary care, it is critical that providers have sufficient knowledge of CIH, access to CIH-trained providers for referral purposes, and are comfortable either providing services or co-managing patients who favor a CIH approach to their healthcare. Objective The main objective was to gather primary care providers’ perspectives across the northwestern region of the United States on their CIH familiarity and knowledge, clinic barriers and opportunities, and education and training needs. Methods We conducted an online, quantitative survey through an email invitation to all primary care providers (n = 483) at 11 primary care organizations from the WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) region Practice and Research Network (WPRN). The survey questions covered talking about CIH with patients, co-managing care with CIH providers, familiarity with and training in CIH modalities, clinic barriers to CIH integration, and interest in learning more about CIH modalities. Results 218 primary care providers completed the survey (45% response rate). Familiarity with individual CIH methods ranged from 73% (chiropracty) to 8% (curanderismo). Most respondents discussed CIH with their patients (88%), and many thought that their patients could benefit from CIH (41%). The majority (89%) were willing to co-manage a patient with a CIH provider. Approximately one-third of respondents had some expertise in at least one CIH modality. Over 78% were interested in learning more about the safety and efficacy of at least one CIH modality. Conclusion Primary care providers in the Northwestern United States are generally familiar with CIH modalities, are interested in referring and co-managing care with CIH providers, and would like to have more learning opportunities to increase knowledge of CIH.

PsycTESTS Dataset, 2012

Interoceptive awareness involves several mind-body dimensions and can be evaluated by self-report... more Interoceptive awareness involves several mind-body dimensions and can be evaluated by self-report with the Multidimensional Assessment of Interoceptive Awareness (MAIA), which has been translated and validated in several countries and is being used in research and clinical contexts. This study systematically translated the MAIA with six additional items using a focus group and evaluated its psychometric properties in a respondent sample of 204 Portuguese university students (52% females; M ¼ 21.3, SD ¼ 3.9 years). Based on exploratory factor analysis, we refined the tool into a 33-item version and tested it in a separate sample (n ¼ 286; 63% females; M ¼ 21.3, SD ¼ 4.7 years). We then conducted confirmatory factor analysis and examined test-retest reliability and convergent and discriminant validity. We confirmed an acceptable model fit for this Portuguese version (MAIA-P) with 33 items and seven scales; it showed good construct validity and acceptable temporal

PLOS ONE, Nov 1, 2012

This paper describes the development of a multidimensional self-report measure of interoceptive b... more This paper describes the development of a multidimensional self-report measure of interoceptive body awareness. The systematic mixed-methods process involved reviewing the current literature, specifying a multidimensional conceptual framework, evaluating prior instruments, developing items, and analyzing focus group responses to scale items by instructors and patients of body awareness-enhancing therapies. Following refinement by cognitive testing, items were field-tested in students and instructors of mind-body approaches. Final item selection was achieved by submitting the field test data to an iterative process using multiple validation methods, including exploratory cluster and confirmatory factor analyses, comparison between known groups, and correlations with established measures of related constructs. The resulting 32-item multidimensional instrument assesses eight concepts. The psychometric properties of these final scales suggest that the Multidimensional Assessment of Interoceptive Awareness (MAIA) may serve as a starting point for research and further collaborative refinement.

Journal of Bodywork and Movement Therapies, 2006

The purpose of this study was to examine the effects of body-oriented therapy, as an adjunct to p... more The purpose of this study was to examine the effects of body-oriented therapy, as an adjunct to psychotherapy, for women in recovery from childhood sexual abuse. A two-group randomized design was employed. Eight women were recruited from a community sample and randomly assigned to an experimental group or wait-list control group. The experimental condition involved eight 1-h weekly sessions of body-oriented therapy, a combination of bodywork and the emotional processing of psychotherapy. The study examined changes in somatic and psychological symptoms, and the subjective experience of the intervention using a mixed method approach. Methods included interview, written questionnaire, and self-report outcome measures of psychological symptoms, dissociation, posttraumatic stress, and physical symptoms. Pre-post comparison of the two groups revealed remarkable decreases on SCL-90 global score, PTSD, number and severity of physical symptoms, and a trend toward decreased dissociation for the experimental compared to the control group. Qualitative results revealed the positive impact of body-oriented therapy on sense of inner security and psychotherapeutic progress.

BMC Complementary and Alternative Medicine, Jun 1, 2012

Results of a recent National Insitute of Drug Abusefunded pilot randomized controlled trial of Mi... more Results of a recent National Insitute of Drug Abusefunded pilot randomized controlled trial of Mindful Awareness in Body-oriented Therapy (MABT) for women in substance use disorder treatment showed improved substance use outcomes for MABT compared to treatment as usual. In addition 80% of the MABT participants maintained a daily mindful body awareness practice at nine month follow-up. The purpose of this subsequent study was to explore the perceived role of MABT and mindful body awareness practice in the recovery process.

Complementary Therapies in Clinical Practice, Nov 1, 2019

Background: and purpose: Pregnant women with a history of sexual trauma are at increased risk for... more Background: and purpose: Pregnant women with a history of sexual trauma are at increased risk for mood disorders. Mindfulness interventions delivered prenatally may reduce risk of mood disorders. The purpose of this pilot was to examine the feasibility and acceptability of Mindfulness-Based Childbirth and Parenting (MBCP) for women with a history of sexual trauma. Materials and methods: A one-group repeated measures design was employed, involving three assessments: baseline, post-intervention and at eight weeks postpartum. Twelve pregnant women were recruited and enrolled. Self-report measures and open-ended written questionnaires were used to assess health outcomes and intervention acceptability. Results: Results show high satisfaction with the program, an immediate reduction in prenatal anxiety, and longitudinal increase in interoceptive awareness skills. Conclusion: The results suggest the feasibility and acceptability of the MBCP approach for women with a history of sexual trauma.

Journal of Addictions Nursing, 2016

Background-It is postulated that interventions aimed at facilitating interoceptive awareness (i.e... more Background-It is postulated that interventions aimed at facilitating interoceptive awareness (i.e. awareness of inner body sensations) may facilitate regulation and improve substance use disorder (SUD) treatment outcomes. Objective-To better understand the role of interoceptive training in substance use disorder treatment, an identified gap in the literature. Methods-Based on a NIDA-funded pilot randomized clinical trial that used a two-group repeated measures design to examine Mindful Awareness in Body-oriented Therapy (MABT) for women in substance use disorder treatment. This study examined the experience of a subset of participants that received and completed MABT intervention in the larger original study. A qualitative study using a single Focus Group, participants were asked to respond to multiple questions regarding their current use of interoceptive awareness skills, perceived benefit, learning processes, and suggestions for program development. Interpretive analysis was used to describe the themes that emerged from the Focus Group responses. Results-Participants consistently used interoceptive awareness self-care skills learned in MABT. Interoceptive awareness training and daily practice were perceived as critical for emotional awareness, regulation and relapse prevention. In addition, findings highlight the relevance of MABT educational strategies such as touch and individual delivery to teach interoceptive awareness and self-care skills for women in SUD treatment. Conclusion-These findings suggest the positive role of interoceptive awareness in promoting relapse prevention among women in SUD treatment, important for guiding future research, and program development for this population that apply across health care disciplines.

bioRxiv (Cold Spring Harbor Laboratory), Jun 13, 2022

, motivation, and wellbeing. Interoceptive attention is qualitatively different from attention to... more , motivation, and wellbeing. Interoceptive attention is qualitatively different from attention to the external senses and may recruit a distinct neural system, but the neural separability of interoceptive and exteroceptive attention is unclear. We used a machine learning approach to classify neural correlates of interoceptive and exteroceptive attention in a randomized control trial of interoceptive training (MABT). Participants in the training and control groups attended fMRI assessment before and after an 8-week intervention period (N = 44 scans). The imaging paradigm manipulated attention targets (breath vs. visual stimulus) and reporting demands (active reporting vs. passive monitoring). Machine learning models achieved high accuracy in distinguishing between interoceptive and exteroceptive attention using both in-sample and more stringent out-ofmental states in a sustained interoceptive attention task. Participants were classified as maintaining an active reporting state for only ~90s of each 3-minute sustained attention period. Within this active period, interoceptive attention. These findings demonstrate that interoceptive and exteroceptive attention engage reliable and distinct neural networks; machine learning classifiers trained on this distinction show promise for assessing the stability of interoceptive attention, with implications for the future assessment of mental health and treatment response. .

Journal of Bodywork and Movement Therapies, 2004

This paper examines the psychological and somatic profile of women who seek bodywork as an adjunc... more This paper examines the psychological and somatic profile of women who seek bodywork as an adjunct to psychotherapy in recovery from childhood sexual abuse. The subjects were eight women who participated in a pilot-test comparison of body-oriented therapy. Measures included interview, life history questionnaire, physical symptoms checklist, and standardized psychological questionnaires. Results indicate symptom characteristics similar to those found in studies of this population, with high levels of distress and high numbers of physical symptoms. While clinical experience indicates that avoidance and denial of emotional aspects of somatic experience is common to survivors, the participants in this study articulated a relationship between their physical symptoms and their abuse. Clinically, this study points to the importance placed on somatic healing in recovery, characteristics of those who seek and can presumably benefit from body-oriented therapy, and the need for adequate training among bodyworkers who work with this population.

PubMed, Sep 30, 2005

Context: There has been little research on body therapy for women in sexual abuse recovery. This ... more Context: There has been little research on body therapy for women in sexual abuse recovery. This study examines body-oriented therapy--an approach focused on body awareness and involving the combination of bodywork and the emotional processing of psychotherapy. Objective: To examine the efficacy and the perceived influence on abuse recovery of body-oriented therapy. Massage therapy served as a relative control condition to address the lack of touch-based comparisons in bodywork research. Design: A 2-group, repeated measures design was employed, involving randomization to either body-oriented therapy or massage group, conducted in 8, hour-long sessions by 1 of 4 research clinicians. Statistical and qualitative analysis was employed to provide both empirical and experiential perspectives on the study process. Setting: Participants were seen in treatment rooms of a university in the northwestern United States and in clinician's private offices. Participants: Twenty-four adult females in psychotherapy for child sexual abuse. Interventions: Body-oriented therapy protocol was delivered in three stages, involving massage, body awareness exercises, and inner-body focusing process. Massage therapy protocol was standardized. Both protocols were delivered over clothes. Main outcome measures: The outcomes reflected 3 key constructs--psychological well being, physical well-being, and body connection. Repeated measures included: Brief Symptom Inventory, Dissociative Experiences Scale, Crime-Related Post Traumatic Stress Disorder Scale, Medical Symptoms Checklist, Scale of Body Connection and Scale of Body Investment. Results were gathered at 6 time points: baseline, 2 times during intervention, post-intervention, and at 1 month and 3 months follow-up, To examine the experiential perspective of the study process, written questionnaires were administered before and after intervention and at 1 month and 3 months follow-up. Results: Repeated measures analysis of variance (ANOVA) indicated significant improvement on all outcome measures for both intervention groups, providing support for the efficacy of body therapy in recovery from childhood sexual abuse. There were no statistically significant differences between groups; however, qualitative analysis of open-ended questions about participant intervention experience revealed that the groups differed on perceived experience of the intervention and its influence on therapeutic recovery.

bioRxiv (Cold Spring Harbor Laboratory), May 29, 2022

Interoception, the representation of the body's internal state, serves as a foundation for emotio... more Interoception, the representation of the body's internal state, serves as a foundation for emotion, motivation, and wellbeing. Yet despite its centrality in human experience, the neural mechanisms of interoception are poorly understood. The Interoceptive/Exteroceptive Attention Task (IEAT) is a novel neuroimaging paradigm that compares behavioral tracking of the respiratory cycle (Active Interoception) to tracking of a visual stimulus (Active Exteroception). Twenty-two healthy participants attended two separate scanning sessions (N=44 scans) during a randomized control trial of Mindful Awareness in Body-oriented Therapy (MABT). Compared to Active Exteroception, Active Interoception led to widespread cortical deactivation. Greater self-reported interoceptive awareness (MAIA scale) predicted sparing from deactivation along the anterior cingulate cortex (ACC) and left lateral prefrontal cortex. The right insula-typically described as a primary interoceptive cortex-was only specifically implicated by its deactivation during a paced respiration condition (Active Matching), relative to both Active Exteroception and Interoception. Instead, psychophysiological interaction analysis characterized Active Interoception as promoting greater ACC connectivity with lateral frontal and parietal regions commonly referred to as the Dorsal Attention Network. By comparing attention between highly accessible interoceptive and exteroceptive stimuli, these findings recast interoceptive attention as broadly inhibitory, linking greater interoceptive awareness to spared cortical inhibition within well-characterized attentional networks. In contrast to a literature that relates detection of liminal signals such as the heartbeat to anterior insula activity, attention towards accessible body sensations such as the breath may lead to a context of cortical inhibition in which sensory signals from the body may be better discerned. .

Brain Sciences, Sep 29, 2023

Identity, Jan 2, 2019

Brain Sciences, 2023

Journal of Bodywork and Movement Therapies, 2007

Alternative Therapies in Health and Medicine, Nov 1, 2007

Complementary Therapies in Clinical Practice, May 1, 2007

ENeuro, Jun 1, 2023

Global advances in health and medicine, 2021

PsycTESTS Dataset, 2012

PLOS ONE, Nov 1, 2012

Journal of Bodywork and Movement Therapies, 2006

BMC Complementary and Alternative Medicine, Jun 1, 2012

Complementary Therapies in Clinical Practice, Nov 1, 2019

Journal of Addictions Nursing, 2016

bioRxiv (Cold Spring Harbor Laboratory), Jun 13, 2022

Journal of Bodywork and Movement Therapies, 2004

PubMed, Sep 30, 2005

bioRxiv (Cold Spring Harbor Laboratory), May 29, 2022

Interoception, the representation of the body's internal state, serves as a foundation for emotio... more Interoception, the representation of the body's internal state, serves as a foundation for emotion, motivation, and wellbeing. Yet despite its centrality in human experience, the neural mechanisms of interoception are poorly understood. The Interoceptive/Exteroceptive Attention Task (IEAT) is a novel neuroimaging paradigm that compares behavioral tracking of the respiratory cycle (Active Interoception) to tracking of a visual stimulus (Active Exteroception). Twenty-two healthy participants attended two separate scanning sessions (N=44 scans) during a randomized control trial of Mindful Awareness in Body-oriented Therapy (MABT). Compared to Active Exteroception, Active Interoception led to widespread cortical deactivation. Greater self-reported interoceptive awareness (MAIA scale) predicted sparing from deactivation along the anterior cingulate cortex (ACC) and left lateral prefrontal cortex. The right insula-typically described as a primary interoceptive cortex-was only specifically implicated by its deactivation during a paced respiration condition (Active Matching), relative to both Active Exteroception and Interoception. Instead, psychophysiological interaction analysis characterized Active Interoception as promoting greater ACC connectivity with lateral frontal and parietal regions commonly referred to as the Dorsal Attention Network. By comparing attention between highly accessible interoceptive and exteroceptive stimuli, these findings recast interoceptive attention as broadly inhibitory, linking greater interoceptive awareness to spared cortical inhibition within well-characterized attentional networks. In contrast to a literature that relates detection of liminal signals such as the heartbeat to anterior insula activity, attention towards accessible body sensations such as the breath may lead to a context of cortical inhibition in which sensory signals from the body may be better discerned. .

Chapter 17 in Integrative Pain Management