Clinical Associate Professor, Stanford Department of Psychiatry & Behavioral Sciences
HS Clinical Assistant Professor, UCSF Department of Psychiatry & San Francisco VA Health Care System
Staff Psychologist: Women's Mental Health Program, San Francisco VA Health Care System
Academic visitor: Oxford Mindfulness Center, Department of Psychiatry, Oxford University
Psychology Post-doctoral Fellowship: UCSF/San Francisco VA Health Care System
Psychology Pre-doctoral Internship: UCSF/San Francisco VA Health Care System
Psychology Education: Pacific Graduate School of Psychology, Palo Alto University (2008)
Clinical Research Associate: Department of Psychiatry, Tufts University School of Medicine
Research Fellow: Genetics Division, Department of Medicine, Boston Children's Hospital,Harvard Medical School
Medical Education: Fudan University, Shanghai Medical College, Shanghai, China (1994)
- Global Mental Health
- Women's Wellness and Mental Health
- Mindfulness-based Programs & Trauma Recovery
Clinical Associate Professor, Psychiatry and Behavioral Sciences - Medical Psychiatry
Director, Mindfulness Program, Stanford Center for Integrative Medicine (2019 - Present)
Boards, Advisory Committees, Professional Organizations
International Advisory Committee, Institute of Psychology, Chinese Academy of Sciences (2017 - Present)
International Advisory Committee, ACCESS MBCT (2017 - Present)
Certificate, Jon Kabat-Zinn Certified MBSR Trainer & Supervisor, Mindfulness-based Stress Reduction (2018)
PhD, Pacific Graduate School of Psychology, Palo Alto University, Clinical Psychology (2008)
Medical Education, Fudan University, Shanghai Medical College, Medicine (1994)
Community and International Work
Trainer & Supervisor
WHO's Problem Management Plus (PM+)
Chinese Academy of Sciences, Institute of Psychology & Chinese Psychological Society
Licensed Mental Health Providers in China
Opportunities for Student Involvement
The Psychological Effect of Internet-Based Mindfulness-Based Stress Reduction on the Survivors of Breast Cancer During the COVID-19
FRONTIERS IN PSYCHIATRY
2021; 12: 738579
Objective: To examine the efficacy and the role of engagement of an internet-based Mindfulness-based Stress Reduction (iMBSR) for survivors of breast cancer (BC) during the COVID-19 period from January to March in 2020 in China. Methods: 48 survivors of BC were divided into the absentees group and the iMBSR groups according to their attending to the standardized, group-based, 8-week iMBSR. Based on practice time, survivors of BC in the iMBSR were categorized into three subgroups: group 1 (<30 min/day), group 2 (30-60 min/day), and group 3 (>60 min/day). In addition, participants were classified as partial attendees (<4 sessions) and completers (more than 4 sessions) of the iMBSR groups. All participants were evaluated for symptoms of depression, anxiety and insomnia at baseline, mid-intervention, and post-intervention. Results: After an 8-week iMBSR practice, at mid-intervention and post-intervention, participants in iMBSR group had significant improvement in scores and reduction rates of depression, anxiety, and insomnia compared to absentees. Scores of depression and insomnia, reduction rates of depression at post-intervention, scores of anxiety, reduction rates of anxiety and insomnia at mid-intervention and post-intervention, had significant differences among subgroups of practice time. Daily practice time was positively related to reduction rates of depression, anxiety and insomnia at post-intervention in the iMBSR group. Conclusion: Internet-based MBSR showed efficacy in reducing psychological symptoms among survivors of BC. For survivors of BC, iMBSR practice has a potential dose-response efficacy, with a threshold of >30 min daily practice for most optimal symptoms reduction. Trial Registration: Registration number is [ChiCTR2100044309].
View details for DOI 10.3389/fpsyt.2021.738579
View details for Web of Science ID 000708390200001
View details for PubMedID 34658972
View details for PubMedCentralID PMC8514713
Patterns of posttraumatic stress disorder and posttraumatic growth among women after an earthquake: A latent profile analysis.
Asian journal of psychiatry
It is well known that women are more vulnerable than men to mental health problems following disasters. However, the patterns of posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) among women are unclear. This study was conducted to investigate the profiles of PTSD and PTG among women after an earthquake and determine the predictors of profile membership. A total of 1487 women (Mage = 40.66 years, SD = 10.39) completed questionnaires assessing PTSD, PTG, trauma exposure during an earthquake, trauma history, and demographic information. A three-step latent profile analysis was used. Five profiles were identified: mild PTSD/mild PTG (12.4% of the sample), moderate PTSD/moderate PTG (39.4%), high PTSD/moderate PTG (9.6%), mild PTSD/high PTG (17.5%) and high PTSD/high PTG (21.1%). Women who were older, had been injured, or felt horrible and those whose houses were severely damaged in the earthquake were more likely to be in profiles characterized by higher levels of PTSD and PTG, whereas women with lower education levels were more likely to be in profiles characterized by higher levels of PTSD but lower levels of PTG. The results of this study provide a foundation for providing psychological assistance for particular groups of women.
View details for DOI 10.1016/j.ajp.2019.10.014
View details for PubMedID 31648926
Interpersonal psychotherapy versus treatment as usual for PTSD and depression among Sichuan earthquake survivors: a randomized clinical trial.
Conflict and health
2014; 8: 14
Without effective treatment, PTSD and depression can cause persistent disability in disaster-affected populations.Our objective was to test the efficacy of Interpersonal Psychotherapy (IPT) delivered by trained local personnel compared with treatment as usual (TAU) for Posttraumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD) among adults affected by the Sichuan 2008 earthquake. A small randomized controlled trial of IPT + TAU versus TAU alone was delivered by local mental health personnel in Shifang, China. Between July 2011 and January 2012, 49 adults ≥ 18 years with PTSD, MDD or both were enrolled and randomized to 12 weekly sessions of IPT + TAU (27) or TAU (22) alone x 12 weeks. IPT was then offered to the TAU group. Unblinded follow up assessments were conducted at three and six months. IPT was a 12 session, weekly one hour treatment delivered by local personnel who were trained and supervised in IPT. TAU was continuation of prescribed psychotropic medication (if applicable) and crisis counseling, as needed. MAIN OUTCOME(S) AND MEASURES (S): Clinician Administered PTSD Scale (CAPS) PTSD diagnosis; Structured Clinical Interview for DSM-IV (SCID) for MDD diagnosis. Secondary measures included PTSD/depression symptoms, interpersonal conflict/anger, social support, self-efficacy and functioning.Using an intent-to-treat analysis, 22 IPT + TAU and 19 TAU participants were compared at three months post-baseline. A significantly greater reduction of PTSD and MDD diagnoses was found in the IPT group (51.9%, 30.1%, respectively) versus the TAU group (3.4%, 3.4%, respectively). Despite the small sample, the estimates for time-by-condition analyses of target outcomes (2.37 for PTSD (p = .018) and 1.91 for MDD (p = .056)) indicate the improvement was better in the IPT + TAU condition versus the TAU group. Treatment gains were maintained at 6 months for the IPT group. A similar treatment response was observed in the TAU group upon receipt of IPT.This initial study shows that IPT is a promising treatment for reducing PTSD and depression, the two major mental health disorders affecting populations surviving natural disaster, using a design that builds local mental health care capacity.ClinicalTrials.Gov number, NCT01624935.
View details for DOI 10.1186/1752-1505-8-14
View details for PubMedID 25254070
View details for PubMedCentralID PMC4172897
Intersection of suicidality and substance abuse among young Asian-American women: implications for developing interventions in young adulthood
ADVANCES IN DUAL DIAGNOSIS
2014; 7 (2): 90–104
The purpose of this paper is to provide a review of the current literature uncovering specific factors associated with self-harm and suicidality among young Asian American women, as well as to present the Fractured Identity Model as a framework for understanding these factors. This paper offers concrete suggestions for the development of culturally competent interventions to target suicidality, substance abuse, and mental illness among young Asian American women.Empirical studies and theory-based papers featured in peer-reviewed journals between 1990 and 2014 were identified through scholarly databases, such as PubMed, MEDLINE, PsycINFO, JSTOR, and Google Scholar.We identified several factors associated with suicidality among young Asian American women: (1) family dynamics, or having lived in a household where parents practice "disempowering parenting styles," (2) substance use/abuse, and (3) untreated mental illness(es), which are exacerbated by the stigma and shame attached to seeking out mental health services. The Fractured Identity Model by Hahm et al. (2014) is presented as a possible pathway from disempowering parenting to suicidal and self-harm behaviors among this population, with substance abuse playing a significant mediating role. Research limitations/implications - Our review focused on Asian American women, substance use among Asian Americans, and mental health among Asian Americans. Literature that focused on Asians living in Asia or elsewhere outside of the USA was excluded from this review; the review was limited to research conducted in the USA and written in the English language.The complex interplay among Asian American culture, family dynamics, gender roles/expectations, and mental health justifies the development of a suicide and substance abuse intervention that is tailored to the culture- and gender-specific needs of Asian Pacific Islander young women. It is imperative for professionals in the fields of public health, mental health, medicine, and substance abuse to proactively combat the "model minority" myth and to design and implement interventions targeting family dynamics, coping with immigration/acculturative stresses, mental illnesses, suicidal behaviors, and substance abuse among Asian-American populations across the developmental lifespan.This paper provides specific suggestions for interventions to adequately respond to the mental health needs of young Asian-American women. These include addressing the cultural stigma and shame of seeking help, underlying family origin issues, and excessive alcohol and drug use as unsafe coping, as well as incorporating empowerment-based and mind-body components to foster an intervention targeting suicidality among Asian-American women in early adulthood.
View details for DOI 10.1108/ADD-03-2014-0012
View details for Web of Science ID 000219640600006
View details for PubMedID 25031627
View details for PubMedCentralID PMC4095878
A randomized controlled trial of group cognitive behavioral therapy for Chinese breast cancer patients with major depression
JOURNAL OF PSYCHOSOMATIC OBSTETRICS AND GYNECOLOGY
2013; 34 (2): 60–67
This study aims to evaluate the effects of Group Cognitive Behavioral Therapy (GCBT) in treating major depression in Chinese women with breast cancer.Sixty-two breast cancer patients diagnosed with major depression were randomly assigned to GCBT group (N = 31) or a waiting list control group provided with an educational booklet (N = 31). The primary outcome measure was the 17-Item Hamilton Depression Rating Scale (17-HAMD). The second outcome measures were Self-Rating Anxiety Scale, Functional Assessment of Cancer Therapy - Breast and Self-Esteem Scale (SES). Assessments were carried out at completion of the study and six-month afterwards.Patients in the GCBT group had a significant reduction in the 17-HAMD mean score by 9 points (p < 0.001), more than any reduction among patients in the control group from baseline to the end of therapy and a significant 7 points (p < 0.001) more reduction from baseline to six-month follow-up. GCBT also yielded significantly greater improvement than the control group with regard to quality of life (QoL; p < 0.01) and self-esteem (p < 0.05). No significant differences were found between groups on improving anxiety (p > 0.05).The results of this trial suggest that GCBT is effective for treating major depression, as well as for improving QoL and self-esteem in breast cancer patients.Chictr.org ChiCTR-TRC-11001689.
View details for DOI 10.3109/0167482X.2013.766791
View details for Web of Science ID 000319748300002
View details for PubMedID 23646866
Protective factors for posttraumatic stress disorder symptoms in a prospective study of police officers
2011; 188 (1): 45–50
Although police officers are frequently exposed to potentially traumatic incidents, only a minority will develop chronic posttraumatic stress disorder (PTSD). Identifying and understanding protective factors could inform the development of preventive interventions; however, few studies have examined this. In the present prospective study, 233 police officers were assessed during academy training and again following 2 years of police service. Caucasian race, less previous trauma exposure, and less critical incident exposure during police service as well as greater sense of self-worth, beliefs of greater benevolence of the world, greater social support and better social adjustment, all assessed during academy training, were associated with lower PTSD symptoms after 2 years of service. Positive personality attributes assessed during training with the NEO Five-Factor Personality Inventory were not associated with lower PTSD symptoms. In a hierarchical linear regression model, only Caucasian race, lower critical incident exposure during police service, greater assumptions of benevolence of the world and better social adjustment during training remained predictive of lower PTSD symptoms after 2 years of police service. These results suggest that positive world assumptions and better social functioning during training may protect police officers from critical incident related PTSD.
View details for DOI 10.1016/j.psychres.2010.10.034
View details for Web of Science ID 000291834900009
View details for PubMedID 21095622
View details for PubMedCentralID PMC3071439
A prospective study of predictors of depression symptoms in police
2010; 175 (3): 211–16
Police work is one of the most stressful occupations. Previous research has indicated that work stress and trauma exposure may place individuals at heightened risk for the development of depression symptomatology. This prospective longitudinal study was designed to examine predictors of depression symptoms in police service. Participants comprised 119 healthy police recruits from an ongoing prospective study. They completed baseline measures of depression symptoms, childhood trauma exposure, neuroticism, and self-worth during academy training. Follow-up measures of depression symptoms, PTSD symptoms, critical incident exposure, negative life events, and routine work environment stress were assessed after 12 months of police service. Hierarchical linear regression analysis was conducted to examine predictors of current levels of depression symptoms, controlling for baseline depression symptoms and current PTSD symptoms. Greater childhood trauma exposure, lower self-worth during training, and greater perceived work stress in the first year of police service predicted greater depression symptoms at 12 months. Depression symptoms at 1 year of police service were partly independent from PTSD symptoms at 12 months. Greater childhood trauma exposure and lower self-worth during training may be important variables to screen as risk factors for duty-related depression. Strategies to reduce routine work environment stress have the potential to decrease duty-related depression in law enforcement.
View details for DOI 10.1016/j.psychres.2008.11.010
View details for Web of Science ID 000274878000005
View details for PubMedID 20044144
View details for PubMedCentralID PMC3974967
Ethnic Differences in Beliefs Regarding Alzheimer Disease Among Dementia Family Caregivers
AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY
2009; 17 (11): 925-933
The purpose of this study was to examine ethnic differences in female dementia family caregivers' knowledge, attitudes, and beliefs about Alzheimer disease (AD).Baseline data were collected from 215 female caregivers before their participation in various psychoeducational intervention programs. Caregivers were questioned about the epidemiology, etiology, and treatment of AD. Logistic regressions and one-way analysis of variance were conducted to assess ethnic differences.Hispanic and Chinese caregivers were more likely to believe that AD is a normal part of aging and that AD can be diagnosed by a blood test than the white group. These beliefs about AD may delay help-seeking activities for these patients and their family caregivers.Increased public education about AD is needed in these communities. Results are discussed in terms of barriers to accessing information about AD and ways to improve public informational outreach activities, so that the intended audiences are reached more effectively.
View details for DOI 10.1097/JGP.0b013e3181ad4f3c
View details for Web of Science ID 000271657200003
View details for PubMedID 20104051
Low expression of catecholamine-O-methyl-transferase gene in obsessive-compulsive disorder
JOURNAL OF ANXIETY DISORDERS
2009; 23 (5): 660–64
This study examined peripheral catecholamine-O-methyl-transferase (COMT) gene expression in obsessive-compulsive disorder (OCD) patients and healthy controls. Participants included 35 first episode OCD patients and 31 age- and sex-matched healthy controls. Relative COMT gene expression levels were examined by real-time quantitative reverse transcription polymerase chain reaction (RT-PCR) in peripheral blood of all the subjects. COMT gene expression levels, normalized by glyceraldehyde-3-phosphate dehydrogenase (GAPDH), were significantly decreased in the OCD group compared with healthy controls (F=6.244, p=0.015). OCD patients showed a 32% down-regulation. We also found lower COMT gene expression levels in female in comparison to male participants (F=5.366, p=0.024) in the sample as a whole. COMT gene expression down-regulation of male OCD patients relative to male controls is 38%, and that of female OCD patients relative to female controls is 27%. These results suggest that COMT gene expression down-regulation might play an important role in the development of OCD and that there may be gender differences in this alteration.
View details for DOI 10.1016/j.janxdis.2009.02.004
View details for Web of Science ID 000265657700014
View details for PubMedID 19269131
Impact of in-home behavioral management versus telephone support to reduce depressive symptoms and perceived stress in Chinese caregivers: Results of a pilot study
AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY
2007; 15 (5): 425-434
Recent work has shown that Chinese Americans caring for a family member with dementia experience considerable psychological distress. However, few studies evaluate treatments for them. This study evaluated the efficacy of in-home intervention, based on cognitive behavior therapy principles, to relieve stress and depression in female Chinese American caregivers (CGs).Fifty-five CGs who met inclusion criteria were randomly assigned to a telephone support condition (TSC) or to an in-home behavioral management program (IHBMP) for 4 months. In the TSC, biweekly calls were made and relevant material was mailed. In the IHBMP, specific psychological skills were taught to deal with caregiving stress. CGs were assessed before and after treatment. Outcome measures evaluated overall perceived stress, caregiving-specific stress, and depressive symptoms.CGs in IHBMP were less bothered by caregiving-specific stressors and had lower depression levels than CGs in TSC. There was no difference in overall stress. CGs with low baseline level of self-efficacy for obtaining respite benefited from IHBMP, but showed little improvement in the TSC. CGs with higher self-efficacy benefited from both treatments.This intervention is promising and warrants replication in future studies. Additional research is needed to evaluate longer-term effects and to identify individual differences associated with improvement.
View details for Web of Science ID 000246299600008
View details for PubMedID 17463192
Recruiting Chinese Americans for dementia caregiver intervention research: Suggestions for success
AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY
2006; 14 (8): 676-683
The purpose of this study was to compare the relative effectiveness of three recruitment modalities for enrolling Chinese-American and white family caregivers into research studies to evaluate intervention strategies.A total of 116 Chinese Americans and 134 whites were screened for eligibility to participate in one of two clinical intervention trials. Participants were recruited using: 1) media sources; 2) nonprofessional referral sources; or 3) professional referrals. Each participant was asked an open-ended question about how they became aware of the programs offered.A smaller proportion of Chinese Americans (39%) than whites (50%) who responded to recruiting strategies actually enrolled as subjects. There was a significant interaction between ethnicity and recruitment strategy. Chinese-American caregivers who were recruited by nonprofessional sources were less likely to enroll in the intervention studies than those who were recruited through media sources or professional referrals. Whites, on the other hand, were more likely to be recruited through nonprofessional sources than the other two.A consumer-oriented approach, which included direct face-to-face contact with key community leaders, generated the highest number of Chinese-American participants. Culture-specific factors such as trust-building with social service agencies, demonstrating genuine commitment to the well-being of the target community, and linguistic and ethnic matching between research staff and potential participants appear helpful to successful research recruitment in this rapidly increasing segment of dementia caregivers.
View details for Web of Science ID 000239205500006
View details for PubMedID 16861372
The effect of bereavement due to suicide on survivors'depression: A study of Chinese samples
OMEGA-JOURNAL OF DEATH AND DYING
2005; 51 (3): 217–27
The affective effect of suicide on people around is assessed with the Center for Epidemiologic Studies Depression Scale (CES-D), and some correlates are examined to identify characteristics of the bereaved individuals who score high on depression. We used the informants of 66 suicides as subjects for study and the informants of 66 living people as the control group. For each suicide and living person, we interviewed two informants: one family member and one friend. Data collection was accomplished in China in the summer of 2003. Results indicate that the bereaved people (informants of the suicides) are more likely to experience depression than those people in the control group. The closer the relationship to the suicide, the higher the degree of depression. While the survivor's education and income are negatively correlated with his or her depression level, neither age nor gender is a predictor of depression in the sample. Given the strong relationship between suicide and depression, the bereaved survivors of suicide could be a high risk group of suicide. Further and larger study is warranted to investigate more details of the high risk group so as to recommend prevention measures.
View details for DOI 10.2190/496B-Q1WQ-K9TJ-518E
View details for Web of Science ID 000233981100003
View details for PubMedID 20814566
View details for PubMedCentralID PMC2931588
Myozenin: An alpha-actinin- and gamma-filamin-binding protein of skeletal muscle Z lines
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
2001; 98 (4): 1595–1600
To better understand the structure and function of Z lines, we used sarcomeric isoforms of alpha-actinin and gamma-filamin to screen a human skeletal muscle cDNA library for interacting proteins by using the yeast two-hybrid system. Here we describe myozenin (MYOZ), an alpha-actinin- and gamma-filamin-binding Z line protein expressed predominantly in skeletal muscle. Myozenin is predicted to be a 32-kDa, globular protein with a central glycine-rich domain flanked by alpha-helical regions with no strong homologies to any known genes. The MYOZ gene has six exons and maps to human chromosome 10q22.1-q22.2. Northern blot analysis demonstrated that this transcript is expressed primarily in skeletal muscle with significantly lower levels of expression in several other tissues. Antimyozenin antisera stain skeletal muscle in a sarcomeric pattern indistinguishable from that seen by using antibodies for alpha-actinin, and immunogold electron microscopy confirms localization specifically to Z lines. Thus, myozenin is a skeletal muscle Z line protein that may be a good candidate gene for limb-girdle muscular dystrophy or other neuromuscular disorders.
View details for DOI 10.1073/pnas.041609698
View details for Web of Science ID 000166949200053
View details for PubMedID 11171996
View details for PubMedCentralID PMC29302
Mutations in ACTN4, encoding alpha-actinin-4, cause familial focal segmental glomerulosclerosis
2000; 24 (3): 251–56
Focal and segmental glomerulosclerosis (FSGS) is a common, non-specific renal lesion. Although it is often secondary to other disorders, including HIV infection, obesity, hypertension and diabetes, FSGS also appears as an isolated, idiopathic condition. FSGS is characterized by increased urinary protein excretion and decreasing kidney function. Often, renal insufficiency in affected patients progresses to end-stage renal failure, a highly morbid state requiring either dialysis therapy or kidney transplantation. Here we present evidence implicating mutations in the gene encoding alpha-actinin-4 (ACTN4; ref. 2), an actin-filament crosslinking protein, as the cause of disease in three families with an autosomal dominant form of FSGS. In vitro, mutant alpha-actinin-4 binds filamentous actin (F-actin) more strongly than does wild-type alpha-actinin-4. Regulation of the actin cytoskeleton of glomerular podocytes may be altered in this group of patients. Our results have implications for understanding the role of the cytoskeleton in the pathophysiology of kidney disease and may lead to a better understanding of the genetic basis of susceptibility to kidney damage.
View details for DOI 10.1038/73456
View details for Web of Science ID 000085590600014
View details for PubMedID 10700177
Human skeletal muscle-specific alpha-actinin-2 and -3 isoforms form homodimers and heterodimers in vitro and in vivo
BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS
1998; 248 (1): 134–39
Alpha-actinins belong to a family of actin-binding and crosslinking proteins and are expressed in many different cell types. Multiple isoforms of alpha-actinin are found in humans and are encoded by at least four distinct genes. Human skeletal muscle contains two sarcomeric isoforms, alpha-actinin-2 and -3. Previous studies have shown that the alpha-actinins function as anti-parallel homodimers but the question of heterodimer formation between two different isoforms expressed in the same cell type has not been explored. To address this issue, we expressed both alpha-actinin-2 and -3 in vitro and were able to detect their interaction by both blot overlay and co-immunoprecipitation methods. We were also able to demonstrate the presence of heterodimers in vivo in human skeletal muscle and in COS-1 cells transiently transfected with both isoforms. Our results clearly demonstrate the potential for alpha-actinin isoforms to form heterodimers which might have unique functional characteristics.
View details for DOI 10.1006/bbrc.1998.8920
View details for Web of Science ID 000074758800025
View details for PubMedID 9675099