By John M. de Castro, Ph.D.
“Mindfulness also allows us to become more aware of the stream of thoughts and feelings that we experience and to see how we can become entangled in that stream in ways that are not helpful. This lets us stand back from our thoughts and start to see their patterns. Gradually, we can train ourselves to notice when our thoughts are taking over and realise that thoughts are simply ‘mental events’ that do not have to control us.” – Mark Williams
Schizophrenia is the most common form of psychosis. It effects about 1% of the population worldwide. It appears to be highly heritable and involves changes in the brain. It is characterized by positive symptoms such as hallucinations; seeing and, in some cases, feeling, smelling or tasting things that aren’t there, or delusions; unshakable beliefs that, when examined rationally, are obviously untrue. It is also characterized by negative symptoms involving a reduced ability to function normally, neglect of personal hygiene, lack of emotion, blank facial expressions, speaking in a monotone, loss of interest in everyday activities, social withdrawal, and an inability to experience pleasure. The symptoms usually do not appear until late adolescence or early adulthood.
Schizophrenia is very difficult to treat with psychotherapy and is usually treated with antipsychotic drugs. These drugs, however, are not always effective, sometimes lose effectiveness, and can have some difficult side effects. Hence, there is a need for safe and effective alternative treatments for psychotic disorders. Mindfulness training has been shown to be beneficial for a variety of mental health problems, including anxiety, depression, Antisocial Personality Disorder, Borderline personality disorder, impulsivity, obsessive compulsive disorder, phobias, post-traumatic stress disorder, sexual dysfunction, and suicidality. It also appears to be helpful with psychosis. Hence, there is a need to further investigate the potential of mindfulness as a treatment for schizophrenia. This needs to begin with studying the relationships of mindfulness to the positive and negative symptoms of schizophrenia.
In today’s Research News article “Mindfulness in schizophrenia: Associations with self-reported motivation, emotion regulation, dysfunctional attitudes, and negative symptoms.” See:
or see summary below or view the full text of the study at:
Tabak, Horan, and Green recruited outpatients with schizophrenia who were being treated with drugs and non-schizophrenic individuals as controls. They measured the demographic characteristics of the participants, mindfulness, behavioral inhibition and activation, emotion regulation, and dysfunctional attitudes. They found, as expected, that people with schizophrenia were significantly lower in mindfulness than controls, including lower scores on the describing, acting with awareness, and nonjudging facets of mindfulness. In patients, but not controls, higher levels of mindfulness were associated with higher levels of the reappraisal aspect of emotion regulation and lower levels of the defeatist beliefs dysfunctional attitude.
These are encouraging findings that should be viewed as a good first step. Mindfulness is low in patients with schizophrenia. As such, building mindfulness may be a useful treatment. The findings also suggest that mindfulness training in these patients might help to counteract the negative symptoms of schizophrenia by building the ability to regulate emotions and the positive symptoms by reducing dysfunctional, defeatist, attitudes. These findings, though, must be interpreted carefully as these are correlational findings and cannot be used to prove a causal connection. In addition, the patients were receiving drugs and the extent to which low mindfulness may be due to drug effects cannot be determined.
Nevertheless, mindfulness training may help to improve schizophrenia.
“Mindfulness is not something we can simply ‘plug into’ to fix ourselves, it’s a fundamentally different way of approaching our difficulties and our lives, and is a practice that takes time to develop. Eight-week courses run by appropriately trained providers are the perfect opportunity to develop understanding and practise this approach.” – Sarah Maynard
CMCS – Center for Mindfulness and Contemplative Studies
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Tabak, N. T., Horan, W. P., & Green, M. F. (2015). Mindfulness in schizophrenia: Associations with self-reported motivation, emotion regulation, dysfunctional attitudes, and negative symptoms. Schizophrenia Research,168(0), 537–542. http://doi.org/10.1016/j.schres.2015.07.030
Mindfulness-based interventions are gaining empirical support as alternative or adjunctive treatments for a variety of mental health conditions, including anxiety, depression, and substance use disorders. Emerging evidence now suggests that mindfulness-based treatments may also improve clinical features of schizophrenia, including negative symptoms. However, no research has examined the construct of mindfulness and its correlates in schizophrenia. In this study, we examined self-reported mindfulness in patients (n=35) and controls (n=25) using the Five-Facet Mindfulness Questionnaire. We examined correlations among mindfulness, negative symptoms, and psychological constructs associated with negative symptoms and adaptive functioning, including motivation, emotion regulation, and dysfunctional attitudes. As hypothesized, patients endorsed lower levels of mindfulness than controls. In patients, mindfulness was unrelated to negative symptoms, but it was associated with more adaptive emotion regulation (greater reappraisal) and beliefs (lower dysfunctional attitudes). Some facets of mindfulness were also associated with self-reported motivation (behavioral activation and inhibition). These patterns of correlations were similar in patients and controls. Findings from this initial study suggest that schizophrenia patients may benefit from mindfulness-based interventions because they (a) have lower self-reported mindfulness than controls and (b) demonstrate strong relationships between mindfulness and psychological constructs related to adaptive functioning.