Month: December 2016

Improve Chronic Obstructive Pulmonary Diseases (COPD) with Yoga

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By John M. de Castro, Ph.D.

 

 “practicing yoga is one of the best things you can do for the health of your lungs. Yoga will strengthen the muscles of your chest, increase your lung capacity and boost oxygen intake.” – Tania Tarafdar

 

Chronic obstructive pulmonary diseases (COPD) are progressive lung diseases that obstruct airflow. The two main types of COPD are chronic bronchitis and emphysema. COPD is very serious being the third leading cause of death in the United States, over 140,000 deaths per year and the number of people dying from COPD is growing. More than 11 million people have been diagnosed with COPD, but an estimated 24 million may have the disease without even knowing it. COPD causes serious long-term disability and early death. Symptoms develop slowly. Over time, COPD can interfere with the performance of routine tasks and is thus a major cause of disability in the United States. The most common cause of COPD is smoking. But, COPD also occurs with miners and is called black lung disease. COPD is not contagious. Most of the time, treatment can ease symptoms and slow progression.

 

There is no cure for COPD. COPD treatments include lifestyle changes, medicine, bronchodilators, steroids, pulmonary rehabilitation, oxygen therapy, and surgery. They all attempt to relieve symptoms, slow the progress of the disease, improve exercise tolerance, prevent and treat complications, and improve overall health. Yoga practice would seem to be a useful lifestyle change that could improve COPD symptoms as it has been shown to improve exercise tolerance and overall health and includes breathing exercises. Indeed, it has been shown that yoga practice improves the mental and physical health of patients with COPD.

 

In today’s Research News article “Yoga-based pulmonary rehabilitation for the management of dyspnea in coal miners with chronic obstructive pulmonary disease: A randomized controlled trial.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1413254018698520/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5052394/

Ranjita and colleagues studied the effectiveness of yoga practice on Chronic obstructive pulmonary diseases (COPD) by recruiting non-smoking male coal miners with COPD and randomly assigned them to a treatment as usual group or a yoga practice group. Yoga was practiced in 90-minute session, 6 days per week for 12 weeks. Before and after training the participants were measured for exercise tolerance with a walking test, breathing difficulty, blood oxygen levels, pulse rate, and fatigue.

 

They found that the miners who participated in the yoga practice had a significant (24.4%) improvement in breathing, a 25.9% decrease in fatigue, a 19.9% increase in the walking test distance covered, a 1.3% increase in blood oxygen levels, and a 4.3% decrease in resting pulse rate. Hence, yoga practice significantly improved the miners’ lung function, energy level, and physical fitness.

 

These are excellent results and suggest that yoga practice may be a very useful additional treatment for Chronic obstructive pulmonary diseases (COPD). Previous research has shown that yoga practice improved overall health, depression, anxiety in COPD sufferers. Since, yoga practice is a gentle exercise that includes breathing exercises, it seems reasonable that it would have these beneficial effects for COPD sufferers. It would be useful if future research compared yoga practice to other forms of exercise as treatments for COPD. The yoga practice used in this study was exceptionally intensive. Many patients would not be willing to engage in such an intense practice. Future research should also look at whether less intensive yoga practice might be beneficial.

 

So, improve chronic obstructive pulmonary diseases (COPD) with yoga.

 

“A comprehensive yoga program can have a salutary effect on general health and respiratory health and thereby help increase a person’s ability to perform activities of daily living. COPD is known to increase the level of stress, emotional vulnerability, inactivity and muscle wasting. Yoga techniques are particularly suited for promoting relaxation, psycho-emotional stability and exercise tolerance.” – Vijai Sharma

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Ranjita, R., Hankey, A., Nagendra, H. R., & Mohanty, S. (2016). Yoga-based pulmonary rehabilitation for the management of dyspnea in coal miners with chronic obstructive pulmonary disease: A randomized controlled trial. Journal of Ayurveda and Integrative Medicine, 7(3), 158–166. http://doi.org/10.1016/j.jaim.2015.12.001

 

Abstract

Background: Coal mine dust exposure causes chronic airflow limitation in coal miners resulting in dyspnea, fatigue, and eventually chronic obstructive pulmonary disease (COPD). Yoga can alleviate dyspnea in COPD by improving ventilatory mechanics, reducing central neural drive, and partially restoring neuromechanical coupling of the respiratory system.

Objectives: To evaluate the effectiveness of Integrated Approach of Yoga Therapy (IAYT) in the management of dyspnea and fatigue in coal miners with COPD.

Materials and methods: Randomized, waitlist controlled, single-blind clinical trial. Eighty-one coal miners (36–60 years) with stable Stages II and III COPD were recruited. The yoga group received an IAYT module for COPD that included asanas, loosening exercises, breathing practices, pranayama, cyclic meditation, yogic counseling and lectures 90 min/day, 6 days/week for 12 weeks. Measurements of dyspnea and fatigue on the Borg scale, exercise capacity by the 6 min walk test, peripheral capillary oxygen saturation (SpO2%), and pulse rate (PR) using pulse oximetry were made before and after the intervention.

Results: Statistically significant within group reductions in dyspnea (P < 0.001), fatigue (P < 0.001) scores, PR (P < 0.001), and significant improvements in SpO2% (P < 0.001) and 6 min walk distance (P < 0.001) were observed in the yoga group; all except the last were significant compared to controls (P < 0.001).

Conclusions: Findings indicate that IAYT benefits coal miners with COPD, reducing dyspnea; fatigue and PR, and improving functional performance and peripheral capillary SpO2%. Yoga can now be included as an adjunct to conventional therapy for pulmonary rehabilitation programs for COPD patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5052394/

 

Improve Health and Lower Costs with Workplace Mindfulness

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By John M. de Castro, Ph.D.

 

“Mindfulness is, above all, about being aware and awake rather than operating unconsciously. When you’re consciously present at work, you’re aware of two aspects of your moment-to-moment experience—what’s going on around you and what’s going on within you.” –  Shamash Alidina

 

A healthcare system is only as good as the propensity of people to utilize it. For a number of reasons including procrastination, denial, fear, etc. people often do not go to the doctor even when needed. This can have negative health consequences. On the other hand, using the health care system in a timely manner promotes health by preventing disease or increasing early diagnosis which can reduce the duration and severity of disease. So, counterintuitively, using the healthcare system can actually reduce costs. Hence finding methods to promote the timely and appropriate use of the healthcare system is in everyone’s interest.

 

In the U.S., the majority of health insurance is provided by employers who are responsible for the costs. So, it is in the best interest of employers to promote the health of their employees to reduce costs and improve their bottom line. This is a win-win situation where health promotion in the workplace is good both for the employer and the employee. There have been a number of programs implemented in the workplace that have been tried to improve employee health. A common program is one that promotes a healthy diet and exercise. Less common, but growing in popularity are programs that employ mindfulness training. But, to date there has not been a direct comparison of the two.

 

In today’s Research News article “A healthcare utilization cost comparison between employees receiving a worksite mindfulness or a diet/exercise lifestyle intervention to matched controls 5 years post intervention.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1412011575489431/?type=3&theater

or see summary: Klatt and colleagues recruited faculty and staff who participated in the university’s health care plan which also tracked costs. They were randomly assigned to receive either a diet and exercise education program or a mindfulness training program, or to a no-treatment matched control group. They measured health care costs for the nine months prior to the trainings and for five years after. The mindfulness training was a group based training in mindfulness meditation while the diet and exercise education program worked to improve awareness of health behaviors.

 

They found that both training groups, in comparison to controls, had increased use of the healthcare system as evidenced by an increase in prescription medications but a decreased use of primary care, fewer hospital admissions, and overall lower healthcare costs. The overall savings averaged $4,000 per employee per year. Hence, both mindfulness and diet and exercise training programs resulted in substantially lower healthcare costs that were maintained over a 5-year period. To have such a long-term follow-up is extremely rare but very valuable as it demonstrates that the training programs have enduring consequences.

 

The authors “hypothesize that the results of this study reflect that both of the original interventions raised health awareness, so that participants were more proactive and involved in their health.” It is likely that they did so in different ways. Diet and exercise education did so directly by stressing engaging in health behaviors while mindfulness training did so by raising the individual’s awareness of their body and physical state. If this is true it suggests that combining the two interventions may have an even greater impact on health and healthcare costs.

 

So, improve health and lower costs with workplace mindfulness.

 

“Once you learn mindfulness skills, you can practice them at almost any moment of the day—sitting at your computer, stuck in traffic, even eating. In fact, there has been a . . . growing interest in using the practice of mindfulness in the workplace to provide a buffer against stress.” – Jason Marsh

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Klatt MD, Sieck C, Gascon G, Malarkey W, Huerta T. A healthcare utilization cost comparison between employees receiving a worksite mindfulness or a diet/exercise lifestyle intervention to matched controls 5 years post intervention. Complement Ther Med. 2016 Aug;27:139-44. doi: 10.1016/j.ctim.2016.05.008.

 

Abstract

Objective: To compare healthcare costs and utilization among participants in a study of two active lifestyle interventions implemented in the workplace and designed to foster awareness of and attention to health with a propensity score matched control group.

Design and setting: We retrospectively compared changes in healthcare (HC) utilization among participants in the mindfulness intervention (n = 84) and the diet/exercise intervention (n = 86) to a retrospectively matched control group (n = 258) drawn for this study. The control group was matched from the non-participant population on age, gender, relative risk score, and HC expenditures in the 9 month preceding the study.

Main outcome measures: Measures included number of primary care visits, number and cost of pharmacy prescriptions, number of hospital admissions, and overall healthcare costs tracked for 5 years after the intervention.

Results: Significantly fewer primary care visits (p < .001) for both intervention groups as compared to controls, with a non-significant trend towards lower overall HC utilization (4,300.00 actual dollar differences) and hospital admissions for the intervention groups after five years. Pharmacy costs and number of prescriptions were significantly higher for the two intervention groups compared to controls over the five years (p < 0.05), yet still resulted in less HC utilization costs, potentially indicating greater self-management of care.

Conclusion: This study provides valuable information as to the cost savings and value of providing workplace lifestyle interventions that focus on awareness of one’s body and health. Health economic studies validate the scale of personal and organization health cost savings that such programs can generate.

Lower Stress and Improve Mood with Cancer with Mindfulness

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By John M. de Castro, Ph.D.

 

“Through Mindfulness, you can embrace that staying positive in the face of cancer includes recognizing and validating all the feelings you are experiencing, negative ones included.” – Richard Dicken

 

Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly improving. It is estimated that 15 million adults and children with a history of cancer are alive in the United States today. But, surviving cancer carries with it a number of problems. “Physical, emotional, and financial hardships often persist for years after diagnosis and treatment. Cancer survivors are also at greater risk for developing second cancers and other health conditions.” National Cancer Survivors Day. Unfortunately, most of these residual problems go untreated. Psychologically, cancer survivors frequently suffer from anxiety, depression, mood disturbance, Post-Traumatic Stress Disorder (PTSD), sleep disturbance, fatigue, sexual dysfunction, loss of personal control, impaired quality of life, and psychiatric symptoms which have been found to persist even ten years after remission.

 

So, coping with the emotions and stress of cancer is a challenge and there are no simple treatments for these psychological sequelae of surviving cancer. Mindfulness training, however, may be helpful. It has been shown to improve recovery from cancer and to reduce anxiety and depression in people with a wide variety of conditions. One form of mindfulness training, Mindfulness-Based Stress Reduction (MBSR) was specifically designed to help people cope with stress and emotions. In today’s Research News article “Mindfulness-Based Stress Reduction as a Stress Management Intervention for Cancer Care: A Systematic Review.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1410585555632033/?type=3&theater

or see summary below: Rush and Sharma reviewed the published research literature on the effectiveness of MBSR for the treatment of stress and negative mood in cancer patients (13 articles). They found that the majority of studies indicate that Mindfulness-Based Stress Reduction (MBSR) is significantly effective in improving mood and reducing stress in cancer patients.

 

Hence, the published research literature indicates that MBSR is a safe and effective treatment for the psychological issues consequent upon cancer diagnosis and treatment. MBSR contains a number of components including meditation, yoga, and body scan. The literature does not isolate which components or which combination of components are necessary for MBSR’s effectiveness. The literature also does not identify what changes produced by this practice underlie its reduction in stress responses and improves mood. But, it can be speculated that the focus on the present moment is crucial. Ruminations about the past and worries about the future can by themselves impair mood and increase stress in cancer patients. So, it is possible that the focus on present moment awareness in MBSR is the crucial process, allowing the patients to focus on their present problems without amplifying them through worry and rumination. These are important questions for future research.

 

MBSR reduces both the physiological and psychological responses to stress. Since stress can exacerbate all of the symptoms of cancer treatment and can reduce the body’s ability to cope with the disease, improvement in the stress response is extremely important to enduring and recovering from cancer and its treatment. In addition, a positive mood can help the individual relax and cope with the difficulties of cancer treatment. So, the reduction in stress and the improvement in mood produced by MBSR likely improves the prognosis for cancer patients and may lead to a greater likelihood of remission and even survival.

 

So, lower stress and improve mood with cancer with mindfulness.

 

“meditation can help to relieve particular symptoms and improve quality of life for people with cancer. Research has shown that it can improve your mood, improve your ability to concentrate, reduce severe depression and anxiety, and boost the immune system.” – Cancer Research UK
CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Rush SE, Sharma M. Mindfulness-Based Stress Reduction as a Stress Management Intervention for Cancer Care: A Systematic Review. J Evid Based Complementary Altern Med. 2016 Aug 3. pii: 2156587216661467. [Epub ahead of print]

 

Abstract

Cancer is acknowledged as a source of stress for many individuals, often leading to suffering, which can be long-lasting. Mindfulness-based stress reduction offers an effective way of reducing stress among cancer patients by combining mindfulness meditation and yoga in an 8-week training program. The purpose of this study was to inspect studies from October 2009 to November 2015 and examine whether mindfulness-based stress reduction can be utilized as a viable method for managing stress among cancer patients. A systematic search from Medline, CINAHL, and Alt HealthWatch databases was conducted for quantitative articles involving mindfulness-based stress reduction interventions targeting cancer patients. A total of 13 articles met the inclusion criteria. Of these 13 studies, 9 demonstrated positive changes in either psychological or physiological outcomes related to anxiety and/or stress, with 4 describing mixed results. Despite the limitations, mindfulness-based stress reduction appears to be promising for stress management among cancer patients.

 

Cost Effectively Treat Recurrent Depression with Mindfulness

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By John M. de Castro, Ph.D.

 

“Depression is not only the most common mental illness, it’s also one of the most tenacious. Up to 80 percent of people who experience a major depressive episode may relapse. Drugs may lose their effectiveness over time, if they work at all. But a growing body of research is pointing to an intervention that appears to help prevent relapse by altering thought patterns without side effects: mindfulness-based cognitive therapy, or MBCT”. – Stacy Lu

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. It is also generally episodic, coming and going. Some people only have a single episode but most have multiple reoccurrences of depression.  Depression can be difficult to treat and usually treated with anti-depressive medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But, drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression.

 

Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can be applied when the typical treatments fail. Mindfulness training is another alternative treatment for depression. It has been shown to be an effective treatment for depression and is also effective for the prevention of its recurrence. Mindfulness Based Cognitive Therapy (MBCT) was specifically developed to treat depression and can be effective even in the cases where drugs fail. Hence, MBCT is a promising alternative treatment. As such, it is important to further investigate its effectiveness. But, costs are also important, so determining the cost-effective of MBCT is also very important.

 

In today’s Research News article “Mindfulness-based cognitive therapy for recurrent major depression: A ‘best buy’ for health care?” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1408935652463690/?type=3&theater

or see summary below, Shawyer and colleagues recruited adults who were in remission from verified Major Depressive Disorder and engaged them in a continuous self-monitoring of depression. They were then randomly assigned them to either receive no-treatment or 8 weeks of 2 hour, once a week, Mindfulness-Based Cognitive Therapy (MBCT) with once a month optional booster sessions for 3 months. They measured days depressed, patient quality of life, and the economic costs of disability and treatment, before and after treatment and 14 and 24 months later.

 

They found that over the two years of the study that the patients receiving MBCT had significantly fewer days (44%) with depression than control patients regardless of whether treatment was performed in primary or secondary care facilities. This resulted in major cost savings, with the yearly costs for mental health treatment for the MBCT treated patients 32% lower and overall health care costs 24% lower than control patients. Hence, Mindfulness-Based Cognitive Therapy (MBCT) was found to be not only an effective treatment for reoccurrence of major depression, but also a cost-effective treatment.

 

MBCT uses mindfulness training and cognitive training to allow the patients to reprogram their thought patterns and how they interpret experiences, recognizing that their thoughts are only, just that, thoughts and not reflective of their selves. They learn to experience their emotions but adaptively react to them, seeing them as simply experiences that come and go. The results of today’s Research News study demonstrates, as have a number of other studies, that this approach is effective for the treatment of recurrent depression. But, in today’s cost conscious medical environment, the study, importantly, demonstrated that MBCT also reduces health care costs. Hence, MBCT improves major depression cost-effectively.

 

So, cost effectively treat recurrent depression with mindfulness.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

“Through mindfulness, individuals start to see their thoughts as less powerful. These distorted thoughts – such as “I always make mistakes” or “I’m a horrible person” – start to hold less weight. We ‘experience’ thoughts and other sensations, but we aren’t carried away by them. We just watch them come and go.” – William Marchand

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Frances Shawyer, Joanne C Enticott, Mehmet Özmen, Brett Inder,and Graham N Meadows Mindfulness-based cognitive therapy for recurrent major depression: A ‘best buy’ for health care? Aust N Z J Psychiatry, October 2016; vol. 50, 10: pp. 1001-1013., first published on April 19, 2016

 

Abstract

Objective: While mindfulness-based cognitive therapy is effective in reducing depressive relapse/recurrence, relatively little is known about its health economic properties. We describe the health economic properties of mindfulness-based cognitive therapy in relation to its impact on depressive relapse/recurrence over 2 years of follow-up.

Method: Non-depressed adults with a history of three or more major depressive episodes were randomised to mindfulness-based cognitive therapy + depressive relapse active monitoring (n = 101) or control (depressive relapse active monitoring alone) (n = 102) and followed up for 2 years. Structured self-report instruments for service use and absenteeism provided cost data items for health economic analyses. Treatment utility, expressed as disability-adjusted life years, was calculated by adjusting the number of days an individual was depressed by the relevant International Classification of Diseases 12-month severity of depression disability weight from the Global Burden of Disease 2010. Intention-to-treat analysis assessed the incremental cost–utility ratios of the interventions across mental health care, all of health-care and whole-of-society perspectives. Per protocol and site of usual care subgroup analyses were also conducted. Probabilistic uncertainty analysis was completed using cost–utility acceptability curves.

Results: Mindfulness-based cognitive therapy participants had significantly less major depressive episode days compared to controls, as supported by the differential distributions of major depressive episode days (modelled as Poisson, p < 0.001). Average major depressive episode days were consistently less in the mindfulness-based cognitive therapy group compared to controls, e.g., 31 and 55 days, respectively. From a whole-of-society perspective, analyses of patients receiving usual care from all sectors of the health-care system demonstrated dominance (reduced costs, demonstrable health gains). From a mental health-care perspective, the incremental gain per disability-adjusted life year for mindfulness-based cognitive therapy was AUD83,744 net benefit, with an overall annual cost saving of AUD143,511 for people in specialist care.

Conclusion: Mindfulness-based cognitive therapy demonstrated very good health economic properties lending weight to the consideration of mindfulness-based cognitive therapy provision as a good buy within health-care delivery.

http://anp.sagepub.com.ezproxy.shsu.edu/content/50/10/1001.full

Improve the Brain’s Regulation of Emotions in PTSD with Mindfulness

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By John M. de Castro, Ph.D.

 

“Mindfulness can help people train themselves to get unstuck from a vicious cycle of negative thinking, often a cornerstone of trauma.” – Jennifer Wolkin

 

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime. But, only a fraction will develop Post-Traumatic Stress Disorder (PTSD). But this still results in a frightening number of people with 7%-8% of the population developing PTSD at some point in their life. For military personnel, it’s much more likely for PTSD to develop with about 11%-20% of those who have served in a war zone developing PTSD.

 

PTSD involves a number of troubling symptoms including reliving the event with the same fear and horror in nightmares or with a flashback. PTSD sufferers avoid situations that remind them of the event this may include crowds, driving, movies, etc. and may avoid seeking help because it keeps them from having to think or talk about the event. They often experience emotional numbing including difficulty experiencing positive or loving feelings toward other people, avoiding relationships, memory difficulties, or see the world as dangerous and no one can be trusted. Sufferers may feel hyperarousal, feeling keyed up and jittery, or always alert and on the lookout for danger. They may experience sudden anger or irritability, may have a hard time sleeping or concentrating, may be startled by a loud noise or surprise. Obviously, these are troubling symptoms that need to be addressed.

 

It is clear that a key problem with PTSD sufferers is a difficulty with regulating emotions. So, a technique, like mindfulness training, that improves emotion regulation may be beneficial. Indeed, mindfulness training has been found to be particularly effective for PTSD. Hence, it is important to further investigate mindfulness relationships to emotion regulation in PTSD sufferers in order to optimize treatment. In today’s Research News article “A Pilot Study of Mindfulness-Based Exposure Therapy in OEF/OIF Combat Veterans with PTSD: Altered Medial Frontal Cortex and Amygdala Responses in Social–Emotional Processing.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1407398169284105/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5028840/

King and colleagues recruited combat veterans with PTSD and examined the effects of mindfulness training on the brain’s processing of emotional stimuli in veterans with PTSD. The veterans were randomly assigned to receive either 16-weeks of, 2-hour sessions, once a week, of group psychotherapy or Mindfulness-Based Exposure Therapy (MBET). MBET involved mindfulness training, self-compassion training, psycho-education, and mindfulness prolonged exposure therapy. Their brains were scanned with functional Magnetic Imaging (f-MRI) 2-weeks before and 2-weeks after training while they were presented with faces expressing either neutral, angry, or fearful emotions.

 

They found that Mindfulness-Based Exposure Therapy (MBET) produced a marked significant reduction in PTSD symptom severity that was greater than that produced by group therapy. They found that regardless of therapy type that relief of PTSD symptoms was associated with increased activation of the dorsal prefrontal cortex which is usually under active in PTSD sufferers. They also found increased activation in brain areas associated with emotion regulation, the medial prefrontal cortex and the rostral anterior cingulate cortex. In addition, the MBET trained veterans showed greater increases in amygdala and fusiform gyrus responses to angry faces, as well as increased response in medial prefrontal cortex to fearful faces. These responses suggest that the mindfulness training resulted in the veterans’ brains being more engaged in processing threatening stimuli.

 

These findings suggest that mindfulness training improves PTSD symptoms by improving the brain’s ability to process emotional stimuli. By paying greater attention to these stimuli they become better at regulating their emotional responses to them. Since, PTSD involves problems with emotions, the improved emotion regulation would be particularly beneficial to the veterans allowing them to better cope with the emotions produced in response to their memories or environmental stimuli.

 

So, improve the brain’s regulation of emotions in PTSD with mindfulness.

 

“Mindfulness can help people cope with and manage their trauma memories, explore their patterns of avoidance when confronting reminders of their trauma, and better understand their reactions to their symptoms. It helps them feel more grounded, and to notice that even very painful memories have a beginning, a middle and an end — that they can become manageable and feel safer. It’s hard work, but it can pay off.” – Anthony King

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

King, A. P., Block, S. R., Sripada, R. K., Rauch, S. A. M., Porter, K. E., Favorite, T. K., … Liberzon, I. (2016). A Pilot Study of Mindfulness-Based Exposure Therapy in OEF/OIF Combat Veterans with PTSD: Altered Medial Frontal Cortex and Amygdala Responses in Social–Emotional Processing. Frontiers in Psychiatry, 7, 154. http://doi.org/10.3389/fpsyt.2016.00154

 

Abstract

Combat-related posttraumatic stress disorder (PTSD) is common among returning veterans, and is a serious and debilitating disorder. While highly effective treatments involving trauma exposure exist, difficulties with engagement and early drop may lead to sub-optimal outcomes. Mindfulness training may provide a method for increasing emotional regulation skills that may improve engagement in trauma-focused therapy. Here, we examine potential neural correlates of mindfulness training and in vivo exposure (non-trauma focused) using a novel group therapy [mindfulness-based exposure therapy (MBET)] in Afghanistan (OEF) or Iraq (OIF) combat veterans with PTSD. OEF/OIF combat veterans with PTSD (N = 23) were treated with MBET (N = 14) or a comparison group therapy [Present-centered group therapy (PCGT), N = 9]. PTSD symptoms were assessed at pre- and post-therapy with Clinician Administered PTSD scale. Functional neuroimaging (3-T fMRI) before and after therapy examined responses to emotional faces (angry, fearful, and neutral faces). Patients treated with MBET had reduced PTSD symptoms (effect size d = 0.92) but effect was not significantly different from PCGT (d = 0.43). Improvement in PTSD symptoms from pre- to post-treatment in both treatment groups was correlated with increased activity in rostral anterior cingulate cortex, dorsal medial prefrontal cortex (mPFC), and left amygdala. The MBET group showed greater increases in amygdala and fusiform gyrus responses to Angry faces, as well as increased response in left mPFC to Fearful faces. These preliminary findings provide intriguing evidence that MBET group therapy for PTSD may lead to changes in neural processing of social–emotional threat related to symptom reduction.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5028840/

 

Improve Caregiving for People with Intellectual Disabilities with Mindfulness

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By John M. de Castro, Ph.D.

 

“mindfulness – or intentionally paying attention to the present moment with nonjudgment – turns out to be equally as beneficial for those of us who are caregivers as it is for those of us who need caregiving. A mindfulness practice can improve not only our experiences of caregiving, but also the ways in which we (re)act as caregivers.” – Jennie Crooks

 

Caring for children and adults with intellectual and developmental disabilities can be difficult. Developmental disabilities are a group of conditions due to an impairment in physical, learning, language, or behavior areas. These conditions begin during the developmental period, may impact day-to-day functioning, and usually last throughout a person’s lifetime. Recent estimates in the United States show that about one in six, or about 15%, of children aged 3 through 17 years have one or more developmental disabilities.

 

Today, most people with intellectual and developmental disabilities live with their families. This places many stresses on the caregivers and their families and stretches their financial resources. Due to these issues, people with severe cases of intellectual and developmental disabilities are often cared for in community and group homes. The staff of these homes, like family caregivers are under high levels of stress for many reasons including that many individuals with intellectual and developmental disabilities are highly aggressive and at time combative.  They sometimes require physical restraint and can cause injuries to the caregiver and to other patients. In addition, the high levels of stress and injury results in many staff leaving.

 

It should be clear that there is a need for methods to reduce the stress, injuries, and burnout of caregivers in community and group homes. Mindfulness training has been found to be helpful for caregivers in the home setting. So, it would be reasonable to expect that mindfulness training may also be helpful for caregivers in community and group homes. In today’s Research News article “Effectiveness of Caregiver Training in Mindfulness-Based Positive Behavior Support (MBPBS) vs. Training-as-Usual (TAU): A Randomized Controlled Trial.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1405689346121654/?type=3&theater

or see summary below or view the full text of the study at:

http://journal.frontiersin.org/article/10.3389/fpsyg.2016.01549/full?utm_source=newsletter&utm_medium=email&utm_campaign=Psychology-w43-2016

Singh and colleagues recruited caregivers of individuals with intellectual and developmental disabilities in a large institutional setting. They were randomly assigned to receive either a Mindfulness-Based Positive Behavior Support (MBPBS) program or the usual training program offered in the facility (Training as Usual; TAU). “The standard 7-day MBPBS protocol was presented in three parts, spread over a 10-week period.” Before and after training they measured patients’ aggressive events, such as hitting, biting, scratching, punching, kicking, slapping, or destroying property, and emergency medications dispensed, the staff’s stress and turnover, and the institutional costs.

 

They found that the staff receiving MBPBS had a significantly greater reduction in stress levels (36%) and had fewer resignations than those receiving TAU (9%). The mindfulness training also produced a significant reduction in the number of aggressive events, emergency medications dispensed, and the need for physical restraints. For the institution, MBPBS training reduced the need for staff, the number of days lost due to injury, and medical and physical rehabilitation therapy services for injured staff and thus saved the facility significant funds.

 

These are exciting findings. Mindfulness training improved the environment and staff stress and reduced costs. That’s quite remarkable given that this is one of the most costly and difficult caregiving challenges there is. It is unclear how improving the mindfulness of the caregivers produced such a marked improvement in the behaviors of the individuals with intellectual and developmental disabilities. Perhaps, being more mindful facilitates the quality of the interactions, calming the patients. As the authors state “We suspect that disciplined meditation practice enables the caregivers to gradually change their relationship to their perceived mental and emotional experiences that arise when providing care to the individuals. . . this mindset enables them to avoid reacting to the challenging behaviors of the individuals based on their premature cognitive commitment to control aggressive behavior through physical restraints and stat medications.”

 

So, improve caregiving for people with intellectual disabilities with mindfulness

 

“Learning to quell distress and anxiety is especially important for parents of children with development disabilities because it’s often a lifetime caregiving commitment.” – Elisabeth M. Dykens

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Singh NN, Lancioni GE, Karazsia BT, Chan J and Winton ASW (2016) Effectiveness of Caregiver Training in Mindfulness-Based Positive Behavior Support (MBPBS) vs. Training-as-Usual (TAU): A Randomized Controlled Trial. Front. Psychol. 7:1549. doi: 10.3389/fpsyg.2016.01549

 

Caregivers of individuals with intellectual and developmental disabilities (IDD) often end up having their medical and psychological well-being compromised due to the stressful nature of caregiving, especially when those in their care engage in aggressive behavior. In this study, we provided caregivers with mindfulness-based training to enable them to better manage their psychological well-being and, through this, to also enhance specific indices of quality of life of the individuals in their care. Thus, the aim of the present study was to evaluate in a randomized controlled trial (RCT) the comparative effectiveness of Mindfulness-Based Positive Behavior Support (MBPBS) and Training-as-Usual (TAU) for caregivers in a congregate care facility for individuals with severe and profound IDD. The comparative effects of the two training conditions were assessed in terms of caregiver variables care recipient variable (number of aggressive events), and agency variables Results showed that MBPBS was significantly more effective than TAU in enabling the caregivers to manage their perceived psychological stress, and to reduce the use of physical restraints and stat medications for aggressive behavior of the individuals in their care. In addition, there were significant reductions in aggressive events by the individuals in their care, 1:1 staffing of individuals with aggressive behavior, and staff turnover. Furthermore, the MBPBS training was significantly more cost-effective than the TAU training. If replicated in future RCT studies, MBPBS may provide an effective means of enhancing socially acceptable bidirectional engagement of caregivers and care recipients within a person-centered context.

http://journal.frontiersin.org/article/10.3389/fpsyg.2016.01549/full?utm_source=newsletter&utm_medium=email&utm_campaign=Psychology-w43-2016

 

Happiness is Just a Spin Away

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By John M. de Castro, Ph.D.

 

 “We tend to forget that happiness doesn’t come as a result of getting something we don’t have, but rather of recognizing and appreciating what we do have.” – Frederick Keonig

 

We were recently driving through Louisiana and passed a billboard advertising a casino with the headline “Happiness is just a spin away.” For the gambler, this is the lure. Each win is a rush of happiness. Unfortunately, it’s short-lived. The next burst of happiness is now right in front of the gambler if they just continue spinning. From a psychological standpoint this is a perfect example of the power of intermittent reinforcement. When a reward is contingent upon an action, in this case pulling the lever on a slot machine, but the dispensing of the reward is not predictable, with the number of pulls needed to produce the reward not predictable, it produces a very potent form of conditioning. It is why gambling is so addictive. The brief rush of a win strongly conditions the lever pulling to get the next rush.

 

I was struck by how well the sign, “Happiness is just a spin away,” captured the western ideas of happiness and how to obtain it. It is a perpetual cycle of reward producing brief happiness followed by the loss of happiness followed by more action to produce another brief happiness. This is what psychologists term the hedonic treadmill. On the face of it, it sounds silly. We would never do that. But, if we look honestly and carefully at our lives we will see that most of it is spent on the hedonic treadmill. We work to purchase a new car and get a rush of happiness, but after a while it fades. So, we pursue a new love interest, and get a rush of happiness, but after a while it fades. So we work to purchase a new home and get a rush of happiness, but after a while it fades. So, we look for a new job and get a rush of happiness, but after a while it fades. And on and on it goes, on the treadmill, pursuing the ephemeral happiness that we can never seem to be able to keep a hold of. So, we spin the wheel again.

 

Humans consider themselves smart people. But, it never seems to occur to most people that there may be something wrong with their idea of how to obtain happiness. After spending the majority of our lives failing to obtain the lasting happiness that we seek, you’d think that we’d catch on that what we’re doing isn’t working, hasn’t ever worked, and there’s no reason to believe that it ever will work. But working against that recognition is a society and a culture that is determined to keep us on the hedonic treadmill. The western consumer culture requires that we keep seeking happiness in things. If we didn’t, the economy might collapse. It is virtually impossible to escape the advertising messages that pervade our everyday lives. Each holds out the promise of happiness if we just use this toothpaste, take this drug, drive this car, see this movie, go to this concert, buy this gadget, etc. The barrage of messages is all geared to keeping us on the treadmill. If there is a crack, a glimmer of vision that something might be wrong, the messaging distracts us by bombarding us with the idea that “happiness is just a spin away.”

 

So, what are we to do? Give up the search for happiness? No, that is a waste of time. We are born with a biological program to seek happiness and to deny it is to fight against our biological nature. So, trying to not seek happiness is as futile as to pursue it on the hedonic treadmill. Fortunately, there is an answer. One so simple, that few see it. It’s right in front of us hidden in our delusions of what makes us happy. It is so simple that we can’t believe that that could be the answer. It is so contrary to the cultural messaging that we can’t trust that it could work even if we saw it. It’s simply to accept what is, enjoy what we have, and be in the present moment.

 

If we adopt the belief that happiness is right here, right now, if we only allow ourselves to accept it, then we will begin to look at our existence differently. We don’t need to search somewhere else. We don’t need to wait to another time. All we need to do is look closely, without judgment at our present experience. We have become so used to it that we can no longer see it. But, what is here in the present moment is actually wondrous and miraculous. Each breath is a miracle. The energy and life just bubbling in and through our bodies is amazing. How can we not be happy when we realize the mystery of our existence and what a gift this precious moment is. We’ve experienced so many similar moments, are so accustomed to them, that it’s difficult to break through and see the wonder in each one. But, just concentrate, if only occasionally, on fully experiencing what is transpiring right now. It just might change your life.

 

Just take a look around. Listen to the bird chirp and wonder at the experience of hearing and the sheer beauty of the singing. Look at the tree where the bird is perched and enjoy its uniqueness. There has never been and never will be one just like it. See its beautiful nuanced colors from the myriad shades of brown of the bark to the shimmering green of its leaves in the sunlight. Look at its roots and be amazed by its stability and strength, at their ability to remove nutrients and water from the ground and move them a 100 feet into the air. Look at its leaves wonder at their ability to use the sun’s energy to create complex molecules and energy from the nutrients. Now look at the person standing under the tree and witness their uniqueness. Marvel at their ability to simply stand or walk and what an amazing feat of balance, dexterity, coordination, and strength it is. Look in their eyes and realize the consciousness that is looking through them and seeing you. Observe their happiness, sadness, joy, fear, etc. and recognize how much just like you they are. Relish the fact that you are not alone. This could go on and on. There is so much right in front of you in this present moment to keep you entertained and awed for days on end.

 

The ultimate reward for making the effort to deeply experience the present moment is the happiness which will grow. Not the ephemeral happiness or the momentary highs of the hedonic treadmill, but an enduring, satisfying, mellow happiness that can be re-invoked at will. Happiness is not “a spin away.” It is always present and accessible in the present. So, get off the treadmill and discover the happiness that has always been present inside you. You only need to stop the seeking elsewhere and just be in the present. Happiness is not somewhere else at some other time. It is here all of the time for the picking. You just have to stop waiting for the results of the “spin” and simply enjoy “spinning.”

 

“There is only one cause of unhappiness: the false beliefs you have in your head, beliefs so widespread, so commonly held, that it never occurs to you to question them.” – Anthony de Mello

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are  also available on Google+ https://plus.google.com/106784388191201299496/posts

Improve Schizophrenia with Mindfulness

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mindfulness-schizophrenia2-tabak

 

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:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1402675313089724/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4591204/

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

 

This and other Contemplative Studies posts are available at the Contemplative Studies Blog http://contemplative-studies.org/wp/

They are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

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

 

Abstract

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.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4591204/

Improve the Physical Discomfort from Cancer Treatment with Yoga

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yoga-cancer2-peppone

 

By John M. de Castro, Ph.D.

 

“Cancer patients who practice yoga as therapy during their treatment often refer to their yoga practice as a life-saver. No matter how sick from treatments and no matter how little energy, many find that the one thing that would bring relief were a gentle set of therapeutic yoga poses geared for cancer patients.” – Yoga U

 

About 12.5% of women in the U.S. develop invasive breast cancer over their lifetimes and every year about 40,000 women die. Indeed, more women in the U.S. die from breast cancer than from any other cancer, besides lung cancer. Breast cancer diagnosis, however, is not a death sentence. It is encouraging that the death rates have been decreasing for decades from improved detection and treatment of breast cancer. Five-year survival rates are now at around 95%.

 

The improved survival rates mean that more women are now living with cancer. Surviving cancer, however, carries with it a number of problems. “Physical, emotional, and financial hardships often persist for years after diagnosis and treatment. Cancer survivors are also at greater risk for developing second cancers and other health conditions.” (National Cancer Survivors Day). In addition, breast cancer survivors can have to deal with the consequences of chemotherapy, and often experience increased fatigue, pain, and bone loss, reduced fertility, difficulty with weight maintenance, damage to the lymphatic system, heightened fear of reoccurrence, and an alteration of their body image.

 

Treatments often involve aromatase inhibitor therapy which have been shown to be beneficial for survival and reduced rates of reoccurrence, but produce problematic side effects such as joint pain and stiffness, bone loss, and menopausal symptoms. This can lead to patients not adhering to, or even discontinuing treatments. So there is a need for safe and effective treatment for these side effects. Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual psychological symptoms and improve cognitive function. Indeed, yoga practice has been found to improve sleep quality and memory, reduce the side effects from chemotherapy and improve the quality of life in cancer survivors. So, it makes sense to see if yoga can help to improve the side effects of aromatase inhibitor therapy in breast cancer survivors.

 

In today’s Research News article “The effect of YOCAS©® yoga for musculoskeletal symptoms among breast cancer survivors on hormonal therapy. Breast Cancer Research and Treatment.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1401246889899233/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4467273/

Peppone and colleagues recruited breast cancer survivors who were receiving aromatase inhibitor therapy and randomly assigned them to either participate in a twice a week, 75-minute session, 4-week community based yoga training or to receive treatment as usual. Participants were measured for musculoskeletal symptoms both before and after treatment. They found that the yoga treatment group relative to controls improved significantly on almost all measured dimensions of musculoskeletal symptoms, including pain, illness, time in bed, fatigue, muscle aches, arm weakness, sluggishness, and physical ability.

 

These results are very encouraging and suggest that yoga practice may be a safe and effective treatment for the musculoskeletal side effects of aromatase inhibitor therapy for breast cancer survivors. This is important not just for the comfort of the patients, but for their compliance with treatment and ultimate survival. This adds to the long list of beneficial effects of yoga practice. It would be expected that these women would not only have improved side effects but also receive a myriad of other physical and psychological benefits from the yoga practice.

 

So, improve the physical discomfort from cancer treatment with yoga.

 

“one of the main reasons that people with cancer use yoga is because it makes them feel good. Yoga teachers promote it as a natural way to help you relax and cope with stress, anxiety and depression. Generally, it can help to lift your mood and enhance well being. Some people with cancer who have used yoga say that it helps calm their mind so that they can cope better with their cancer and its treatment. Others say that it helps to reduce symptoms and side effects such as pain, tiredness, sleep problems and depression. Yoga can sometimes help you to move around more quickly and easily after surgery for cancer.” Cancer Research UK
CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are available at the Contemplative Studies Blog http://contemplative-studies.org/wp/

They are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Peppone, L. J., Janelsins, M. C., Kamen, C., Mohile, S. G., Sprod, L. K., Gewandter, J. S., … Mustian, K. M. (2015). The effect of YOCAS©® yoga for musculoskeletal symptoms among breast cancer survivors on hormonal therapy. Breast Cancer Research and Treatment, 150(3), 597–604. http://doi.org/10.1007/s10549-015-3351-1

 

Abstract

Up to 50 % of breast cancer survivors on aromatase inhibitor therapy report musculoskeletal symptoms such as joint and muscle pain, significantly impacting treatment adherence and discontinuation rates. We conducted a secondary data analysis of a nationwide, multisite, phase II/III randomized, controlled, clinical trial examining the efficacy of yoga for improving musculoskeletal symptoms among breast cancer survivors currently receiving hormone therapy (aromatase inhibitors [AI] or tamoxifen [TAM]). Breast cancer survivors currently receiving AI (N = 95) or TAM (N = 72) with no participation in yoga during the previous 3 months were randomized into 2 arms: (1) standard care monitoring and (2) standard care plus the 4-week yoga intervention (2×/week; 75 min/session) and included in this analysis. The yoga intervention utilized the UR Yoga for Cancer Survivors (YOCAS©®) program consisting of breathing exercises, 18 gentle Hatha and restorative yoga postures, and meditation. Musculoskeletal symptoms were assessed pre- and post-intervention. At baseline, AI users reported higher levels of general pain, muscle aches, and total physical discomfort than TAM users (all P ≤ 0.05). Among all breast cancer survivors on hormonal therapy, participants in the yoga group demonstrated greater reductions in musculoskeletal symptoms such as general pain, muscle aches and total physical discomfort from pre-to post-intervention than the control group (all P ≤ 0.05). The severity of musculoskeletal symptoms was higher for AI users compared to TAM users. Among breast cancer survivors on hormone therapy, the brief community-based YOCAS©® intervention significantly reduced general pain, muscle aches, and physical discomfort.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4467273/

 

Reduce Brain Induced Mind Wandering with Meditation

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By John M. de Castro, Ph.D.

 

“Our minds wander, on average 50 percent of the time. The exact rate varies enormously. . . . Noticing where your mind has gone – checking your twitter feed instead of working on that report – gives you the chance for a second thought: “my mind has wandered off again.” That very thought disengages your brain from where it has wandered and activates brain circuits that can help your attention get unstuck and return to the work at hand.” – Daniel Goleman

 

We spend a tremendous amount of our time with our minds wandering and not on the task or the environment at hand. We daydream, plan for the future, review the past, ruminate on our failures, exalt in our successes. In fact, we spend almost half of our waking hours off task with our mind wandering. You’d think that if we spend so much time doing this it must be enjoyable. But, in fact research has shown that when our mind is wandering we are actually unhappier than when we are paying attention to what is at hand.

 

A system of the brain known as the Default Mode Network (DMN) becomes active during wind wandering and relatively quiet during focused on task behavior. It is involved when we are engaged in internally focused tasks such as recalling deeply personal memories, daydreaming, sleeping, imagining the future and trying to take the perspective of others. The DMN involves neural structures including the medial prefrontal cortex, anterior and posterior cingulate cortices, precuneus, inferior parietal cortex, and lateral temporal cortex. These areas of the DMN are functionally connected, such that they are simultaneously active during mind wandering.

 

Meditation is known to reduce the size and activity of the Default Mode Network (DMN) through a process known as neuroplasticity where the size and connectivity of neural structures are modified by experience. In addition, meditation appears to decrease the functional connectivity of these structures.  The research underlying these conclusions, however, suffer from a flaw in that meditation is compared to rest or to non-meditators. It is possible that any active mental task could also have the same effects on the DMN. There is thus a need to investigate the differences between the effects of meditation and other active mental activities on the activity of the DMN.

 

In today’s Research News article “Meditation leads to reduced default mode network activity beyond an active task.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1399745846716004/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4529365/

Garrison and colleagues recruited experienced meditators and non-meditators and scanned their brains (functional Magnetic Imaging, fMRI) while they either followed meditation instructions or an active mental task, making decisions as to whether adjectives applied to the self or to case. As expected the meditators reported less mind wandering during meditation. Importantly, they found that the meditators had significantly lower activity in the Default Mode Network (DMN) than the controls during the meditations but not during the active task.

 

These findings are important in that they demonstrate that the reduction in the DMN activity is not due to just any active mental task but specifically to meditation. The results also replicate the finding that meditation lowers mind wandering and the activity of the DMN. Hence meditation in particular appears to have the ability to reduce mind wandering, improving focus, by decreasing the activity of the brain system responsible for mind wandering.

 

So, reduce brain induced mind wandering with meditation.

 

“new knowledge about the default mode network and the self-reflecting thoughts that it stimulates may facilitate our understanding of how we function in our daily lives. We are more than intellect or the motor control of arms and legs, which is often the focus of brain researchers. Perhaps it may at times be good to know that our brain actually gives us room for our spontaneous thoughts and the associations and emotions that may at first seem a bit weird.” – Marcus Raichle

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Garrison, K. A., Zeffiro, T. A., Scheinost, D., Constable, R. T., & Brewer, J. A. (2015). Meditation leads to reduced default mode network activity beyond an active task. Cognitive, Affective & Behavioral Neuroscience, 15(3), 712–720. http://doi.org/10.3758/s13415-015-0358-3

 

Abstract

Meditation has been associated with relatively reduced activity in the default mode network, a brain network implicated in self-related thinking and mind wandering. However, previous imaging studies have typically compared meditation to rest despite other studies reporting differences in brain activation patterns between meditators and controls at rest. Moreover, rest is associated with a range of brain activation patterns across individuals that has only recently begun to be better characterized. Therefore, this study compared meditation to another active cognitive task, both to replicate findings that meditation is associated with relatively reduced default mode network activity, and to extend these findings by testing whether default mode activity was reduced during meditation beyond the typical reductions observed during effortful tasks. In addition, prior studies have used small groups, whereas the current study tested these hypotheses in a larger group. Results indicate that meditation is associated with reduced activations in the default mode network relative to an active task in meditators compared to controls. Regions of the default mode showing a group by task interaction include the posterior cingulate/precuneus and anterior cingulate cortex. These findings replicate and extend prior work indicating that suppression of default mode processing may represent a central neural process in long-term meditation, and suggest that meditation leads to relatively reduced default mode processing beyond that observed during another active cognitive task.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4529365/