Month: June 2017

Reduce Fear of Pain at Work and Musculoskeletal Pain with Mindfulness

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Reduce Fear of Pain at Work and Musculoskeletal Pain with Mindfulness

 

By John M. de Castro, Ph.D.

 

“a regular meditation practice is the best ongoing foundation for working with pain. Mindfulness practice is a wonderful opportunity to do just that. It helps to shift the locus of control from the outside (“this is happening to me and there is nothing I can do about it”) to the inside (“this is happening to me but I can choose how I relate to it”). – Mindful

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have common chronic pain conditions. It has to be kept in mind that pain is an important signal that there is something wrong or that damage is occurring. This signals that some form of action is needed to mitigate the damage. This is an important signal that is ignored at the individual’s peril. So, in dealing with pain, it’s important that pain signals not be blocked or prevented. They need to be perceived. But, methods are needed to mitigate the psychological distress produced by chronic pain.

 

The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the patient’s ability to cope with the pain. Pain involves both physical and psychological issues. The stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. So, reducing the emotional reactions to pain may be helpful in pain management. Mindfulness practices have been shown to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. Indeed, mindfulness practices are effective in treating pain.

 

In today’s Research News article “Ten weeks of physical-cognitive-mindfulness training reduces fear-avoidance beliefs about work-related activity: Randomized controlled trial.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5400305/, Jay and colleagues examine a fear avoidance model of pain where a vicious circle develops creating more pain. The individual when they start to move and feel pain, interpret the pain as potentially damaging and so alter their movements. This is counterproductive and can create more pain, producing more pain avoidance behaviors, producing even more pain, etc. To examine this idea, they recruited female laboratory assistants who were suffering from chronic musculoskeletal pain and randomly assigned them to receive either physical-cognitive-mindfulness training or to follow treatment-as-usual. Therapy consisted of 10 weeks of exercise, cognitive behavioral therapy, and mindfulness training. They were measured before and after training for pain intensity, pain frequency, and leisure time and work related pain fear avoidance.

 

They found that before training, as predicted, there were significant positive relationships between work pain fear avoidance and pain, particularly in the neck and shoulders, such that the greater the pain fear avoidance the greater the pain. They also found that in comparison to the treatment-as-usual control group that the physical-cognitive-mindfulness training group had significant improvements after training of over 50% in pain and in work related pain fear avoidance. Leisure time pain fear avoidance was not related to pain and not affected by the treatment.

 

The results suggest that work related pain fear avoidance is related to musculoskeletal pain intensity and that physical-cognitive-mindfulness training improves both. These relationships, however, are situation specific as leisure time pain fear avoidance  was unrelated. It is unclear if the relationships between pain and pain fear avoidance are causal because of the correlative nature of the relationships. It is also unclear which, or which combinations, of the three components of the treatment was effective in reducing pain and pain fear avoidance. The results, however, are interesting and should be followed up with further research.

 

So, reduce fear of pain at work and musculoskeletal pain with mindfulness.

 

“Chronic pain is frustrating and debilitating. The last thing we want to do is pay more attention to our pain. But that’s the premise behind mindfulness, a highly effective practice for chronic pain (among other concerns).” – Margarita Tartakovsky

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Jay, K., Brandt, M., Jakobsen, M. D., Sundstrup, E., Berthelsen, K. G., schraefel, mc, … Andersen, L. L. (2016). Ten weeks of physical-cognitive-mindfulness training reduces fear-avoidance beliefs about work-related activity: Randomized controlled trial. Medicine, 95(34), e3945. http://doi.org/10.1097/MD.0000000000003945

 

Abstract

People with chronic musculoskeletal pain often experience pain-related fear of movement and avoidance behavior. The Fear-Avoidance model proposes a possible mechanism at least partly explaining the development and maintenance of chronic pain. People who interpret pain during movement as being potentially harmful to the organism may initiate a vicious behavioral cycle by generating pain-related fear of movement accompanied by avoidance behavior and hyper-vigilance.

This study investigates whether an individually adapted multifactorial approach comprised of biopsychosocial elements, with a focus on physical exercise, mindfulness, and education on pain and behavior, can decrease work-related fear-avoidance beliefs.

As part of a large scale 10-week worksite randomized controlled intervention trial focusing on company initiatives to combat work-related musculoskeletal pain and stress, we evaluated fear-avoidance behavior in 112 female laboratory technicians with chronic neck, shoulder, upper back, lower back, elbow, and hand/wrist pain using the Fear-Avoidance Beliefs Questionnaire at baseline, before group allocation, and again at the post intervention follow-up 10 weeks later.

A significant group by time interaction was observed (P < 0.05) for work-related fear-avoidance beliefs. The between-group difference at follow-up was –2.2 (–4.0 to –0.5), corresponding to a small to medium effect size (Cohen’s d = 0.30).

Our study shows that work-related, but not leisure time activity-related, fear-avoidance beliefs, as assessed by the Fear-avoidance Beliefs Questionnaire, can be significantly reduced by 10 weeks of physical-cognitive-mindfulness training in female laboratory technicians with chronic pain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5400305/

Improve Asthma in Children with Tai Chi

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Improve Asthma in Children with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Tai Chi/Qigong is eminently suitable and beneficial for asthma sufferers. As well as being non-exertive their practice teaches correct breathing and posture, which can help eliminate or decrease the severity of attacks. Benefits of Tai Chi for Asthmatics” – Living Chi

 

Asthma is a chronic disease of the lungs that involves a persistent inflammation of the airways. When the inflammation worsens, it makes it more difficult for air to move in and out of the lungs provoking coughing, wheezing, shortness of breath and chest tightness. It is estimated that 300 million people worldwide and 30 million people in the U.S. suffer from asthma and the incidence appears to be growing. In the U.S.it is estimated to cost $60 billion per year in healthcare costs and lost productivity. Asthma is the most common chronic disease in the world among children with about 10% of children suffering from asthma.

 

Asthma is not fatal and those with moderate asthma have an equivalent life expectancy to those that don’t. There is no cure for asthma. So, it is a chronic disease that must be coped with throughout the lifetime. Treatments are aimed at symptomatic relief. Most frequently drugs, anti-inflammatory hormones, and inhalers are used to help control the inflammation. Exercise can be difficult with asthma and may actually precipitate an attack. This can be a problem as maintaining fitness with asthma can be difficult. A gentle form of exercise, Tai Chi, does not require heavy breathing and thus does not provoke asthma. In addition, breathing exercises like those incorporated into Tai Chi practice are known to help control asthma. This suggests that Tai Chi may be a helpful exercise for people with asthma.

 

In today’s Research News article “.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5406730/, Lin and colleagues recruited children with and without a diagnosis of mild, intermittent asthma (average age of 10.5). The children were instructed in Tai Chi for 60 minutes, once a week, for 12 weeks and were requested to practice every day at home assisted by supplied videos. They were measured before and after training for lung function, fractional exhaled nitric oxide (an indicator of airway inflammation), and asthma quality of life. They were compared to a group of similar children who did not practice Tai Chi.

 

They found that the groups that performed Tai Chi showed significant improvements in lung function and decreases in lung inflammation. In addition, the children with asthma showed significant improvements in asthma quality of life, including asthma symptoms, limitations on activity, and emotional function. It should be mentioned that the control children did not engage in any form of exercise, so, it is not clear that Tai Chi has any greater benefits than other exercises. It remains for future research to clarify this issue.

 

It is clear, however, that the gentle exercise of Tai Chi combined with its breathing exercises is of great benefit to children with asthma, improving breathing and their quality of life. The study only investigated children with mild and intermittent asthma. So, it remains for future research to demonstrate if Tai Chi practice is similarly beneficial for more severe cases of asthma. But these results are very encouraging as Tai Chi is gentle, safe, does not provoke asthmatic attacks, is inexpensive to teach, practice can be conveniently maintained at home, and it includes beneficial breathing exercises.

 

So, improve asthma in children with Tai Chi.

 

“Breathing, relaxation and exercise programs, have for many years, been a useful tool in asthma management. The problem is that breathing; relaxation and exercise are often practiced separately, making them a relatively disjointed and limited part of asthma management.” – Living Chi

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Lin, H.-C., Lin, H.-P., Yu, H.-H., Wang, L.-C., Lee, J.-H., Lin, Y.-T., … Chiang, B.-L. (2017). Tai-Chi-Chuan Exercise Improves Pulmonary Function and Decreases Exhaled Nitric Oxide Level in Both Asthmatic and Nonasthmatic Children and Improves Quality of Life in Children with Asthma. Evidence-Based Complementary and Alternative Medicine : eCAM, 2017, 6287642. http://doi.org/10.1155/2017/6287642

 

Abstract

Tai-Chi-Chuan (TCC) is an exercise of low-to-moderate intensity which is suitable for asthmatic patients. The aim of our study is to investigate improvements of the lung function, airway inflammation, and quality of life of asthmatic children after TCC. Participants included sixty-one elementary school students and they were divided into asthmatic (n = 29) and nonasthmatic (n = 32) groups by the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Among them, 20 asthmatic and 18 nonasthmatic children volunteered to participate in a 60-minute TCC exercise weekly for 12 weeks. Baseline and postintervention assessments included forced expiratory volume in one second (FEV1), forced vital capacity (FVC), peak expiratory flow rate (PEFR), fractional exhaled nitric oxide (FeNO) level, and Standardised Pediatric Asthma Quality of Life Questionnaire (PAQLQ(S)). After intervention, the level of FeNO decreased significantly; PEFR and the FEV1/FVC also improved significantly in both asthmatic group and nonasthmatic group after TCC. The asthmatic children also had improved quality of life after TCC. The results indicated that TCC could improve the pulmonary function and decrease airway inflammation in both children with mild asthma and those without asthma. It also improves quality of life in mild asthmatic children. Nevertheless, further studies are required to determine the effect of TCC on children with moderate-to-severe asthma.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5406730/

Mindful Fatherhood

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Mindful Fatherhood

 

By John M. de Castro, Ph.D.

 

“Mindful Fathering is the act of consciously checking into your life as a father. It’s about staying present in your life as a father, observing the dreary, ugly, and painful parts of fathering with acceptance and non-judgement, and honoring those parts with our full attention, just as we honor the wonderful and sublime moments of fatherhood, rather than numbing ourselves out of our lives through substances, technology, or boredom.” – MindfulFathering

 

Fathers’ Day, like Mother’s Day was basically invented and promoted by the greeting card and florist industries. But, even though its origins were crass, the idea took off, because it hit upon a truth; that most of us love our fathers. As a result, Fathers’ Day has become a culturally accepted and encouraged time for the celebration of fatherhood and all that it means. The deep bonds and love that most people feel for their fathers and their fathers for them fuels the celebration of the holiday.

 

The holiday is also popular as everyone has a father, who in turn, has had a father, who has had a father, etc. Many are, or want to be fathers. It has and always will, play an immensely important role in our individual and societal existence. The effectiveness, or lack thereof, of fathering has a major impact on the children that continues throughout their lives. It is such an important role that it seems reasonable to explore what goes into successful fathering and child rearing and what might be of assistance in improving fathering. There has accumulated a tremendous amount of scientific evidence that mindfulness, (“awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally”) can be an important asset for fathers. So, on this day celebrating fatherhood, we’ll explore the role of mindfulness.

 

Mindfulness has been found to be important to becoming a father in the first place. Mindfulness makes the individual more attractive to the opposite sex, it improves sexual relationships, it helps to relieve infertility, and it improves relationships in general. All of which underscores the importance of mindfulness in improving the likelihood that conception will occur and that the infant will be born into a supportive social context. Mindfulness continues after birth to be of assistance as it improves caregiving and parenting, even in the case where the child has developmental disabilities. Mindfulness not only helps the parents deal with the stresses of childrearing, but developing mindfulness in the child can be of great assistance to helping the kids develop emotionally and cognitively, develop high level thinking, develop healthy self-concepts, develop socially, deal with stress, and cope with trauma and childhood depression. It even improves the child’s psychosocial development and academic performance and grades in school. In addition, it seems to be able to assist children through the troubled times of adolescence.

 

Fathering does not occur in a vacuum. It’s been said that “It takes a village” to rear a child. Indeed, fatherhood is embedded in a community. There are many people who are either directly or indirectly involved, from the mother, to the extended family, the community, the medical profession, teachers, clergy, social workers, childcare workers, and even the government. So relationships become an essential part of fathering from conception, to birth, and family and social life. Mindfulness is important to the father in developing and promoting these social connections that are so important for the child’s development. Mindful people generally connect better and are better liked by others, making them socially much more effective.

 

Why would mindfulness be such an important component of fatherhood? There are a number of reasons that mindfulness helps. It reduces the psychological and physical effects of stress on the father and let’s face it, raising children can be quite stressful. Mindfulness helps the father maintain his health and well-being, and to recover quicker should he become ill. Mindfulness also improves emotion regulation making the father better able to be in touch with his emotions yet react to them adaptively and effectively. This skill is needed as children are capable of learning how to push all the parents buttons and reacting well is essential to dealing successfully with the child.

 

With the increasing frequency of divorce and single parent households, the first and most important function of a father is simply to be present for their child. This may take the form of a traditional family, but may also be as the primary custodian, or only during delineated visitations, or there may be shared responsibility with separate households, or as a step-parent. The mindful father takes this role and his responsibilities to the child very seriously and regardless of the living arrangements invests time and resources in the child. Regardless of the circumstances being mindfully involved in the child’s life is crucial. But being present doesn’t just mean being physically present hanging around. Probably the most important thing a father can do is to simply be present with the child, devoting singular attention to the child. It means attending to the children emotionally, listening carefully, and being caring and compassionate.

 

The essential capacity developed in mindfulness training is paying much greater attention to what’s occurring in the present moment. This can be of immense help to the father. It makes him better attuned to his child’s and to his own needs. It reduces rumination and recriminations about past mistakes. It tends to diminish the worry and anxiety about the future. It helps him to focus on what needs to be done now, making him much more effective. And it helps him to experience the joys of fatherhood to their fullest. In general, by focusing on now, he is tuned into the only time that matters for himself or his child, improving his relationship with reality, dealing with its problems and relishing its wonders.

 

This is where mindfulness comes in. Mindfulness training promotes paying close attention to what is happening in the present moment. So, when interacting with their children a mindful father is truly present for them and not thinking about other things. Mindfulness promotes careful attentive listening. One of the most important things a child wants is to be truly heard. That is the gift of a mindful father. Mindfulness also promotes compassion, being aware of the emotional state of another. This is also important for a child. Childhood can be difficult and being in touch with a child’s moods is an important part of effective fathering. Mindfulness also develops the ability to closely observe without judging the child. This is immensely important for the development of the child’s self-concept and for the flowering of experimentation and creativity. Yes, children need direction, but too much judging can cause harm. So, observing the child with non-judgmental awareness is important for children flourishing.

 

Hence, mindfulness can make fathering better, both for the father, and the child. So, on this important day of celebration of fathers, let’s adopt mindfulness and make it a part of our relationship with our fathers and our children. Most of us love our fathers but we love mindful fathers even more especially when we ourselves are mindful.

 

“But mindfulness is really about being the best parent you can be. When we are mindful, we think about what we are doing and why we are doing it.  If we are grounded in principles, it is easier to be more aware of what is happening at the moment and to be more observant.  Connecting with the deep reasons why we chose to be a parent can help us see what is going on in a clearer light.” – Wayne Parker

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

Women Benefit More than Men from Mindfulness

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Women Benefit More than Men from Mindfulness

 

By John M. de Castro, Ph.D.

 

“For people that tend to be willing to confront or expose themselves or turn toward the difficult, mindfulness is made for helping that process. For people who have been largely turning their attention away from the difficult, to suddenly bring all their attention to their difficulties can be somewhat counterproductive. While facing one’s difficulties and feeling one’s emotions may seem to be universally beneficial, it does not take into account that there may be different cultural expectations for men and women around emotionality.” – Willoughby Britton

 

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, suicidality and even with psychosis. It also improves the psychological well-being of healthy people. Interestingly, there appears to be differences between men and women in the occurrence of various mental illnesses. Women have a much higher incidence of emotional issues than men such as anxiety and depression. On the other hand, men are more likely to have conduct disorders and substance abuse.

 

One of the ways that mindfulness appears to work to improve mental health is by improving emotion regulation. This increases the individual’s ability to fully experience emotions but react to and cope with them adaptively, in other words, not to be carried away by them. Since women are more likely to have emotional issues than men, and mindfulness is particularly effective in improving emotion regulation, it would seem reasonable to hypothesize that mindfulness would have greater psychological benefits for women than for men.

 

In today’s Research News article “Women Benefit More Than Men in Response to College-based Meditation Training.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5397480/, Rojiana and colleagues recruited male and female university students and trained them for 12 weeks, 3 times per week for 1 hour, in focused and open monitoring meditation. They completed measurements before and after training of mindfulness, positive and negative emotions, and self-compassion. They then compared the effectiveness of the meditation training for men and women.

 

They found that after training both men and women improved in mindfulness and self -compassion, but women had greater improvements than men in mindfulness and the mindfulness facets of observing, describing, non-judging, and non-reacting. Women also showed greater decreases in negative emotions. For women, it was found that the greater the increase in mindfulness, the greater the decrease in negative emotions. Hence, they found that women tended to benefit more from the meditation training that the men.

 

These are interesting results that suggest that women respond to meditation training with greater improvements in emotions and mindfulness than men. This may well have occurred due to the facts that mindfulness is known to improve emotion regulation and women have greater problems with emotion regulation and thereby benefit more. The greater improvements in mindfulness in women are interesting and may be due to the fact that the women were lower in mindfulness, particularly non-reactivity, to begin with. The meditation simply increased their levels of mindfulness to those of the men. This suggests that women have a greater tendency to react emotionally and that mindfulness training by decreasing this reactivity has greater benefits for women.

 

The results might have been different had the study measured behavioral conduct and externalizing behaviors rather than emotions. In a sense, the study played right to the issues than most trouble women and didn’t measure those that are more characteristic of males. Had they measured these factors perhaps they would have seen greater improvement in men rather than women. Regardless, women appear to benefit more emotionally from mindfulness training than men.

 

“When thrown by their feelings, men tend to “externalize” their emotions by doing things like working out, playing video games or otherwise interacting with their outer worlds. Women tend to “internalize” by analyzing and ruminating over their emotional states, psychologists say. While many men go outward — and one might argue, distract themselves from their internal world — women go inward.” – Drake Baer

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Rojiani, R., Santoyo, J. F., Rahrig, H., Roth, H. D., & Britton, W. B. (2017). Women Benefit More Than Men in Response to College-based Meditation Training. Frontiers in Psychology, 8, 551. http://doi.org/10.3389/fpsyg.2017.00551

 

Abstract

Objectives: While recent literature has shown that mindfulness training has positive effects on treating anxiety and depression, there has been virtually no research investigating whether effects differ across genders—despite the fact that men and women differ in clinically significant ways. The current study investigated whether college-based meditation training had different effects on negative affect for men and women.

Methods: Seventy-seven university students (36 women, age = 20.7 ± 3.0 years) participated in 12-week courses with meditation training components. They completed self-report questionnaires of affect, mindfulness, and self-compassion before and after the course.

Results: Compared to men, women showed greater decreases in negative affect and greater increases on scales measuring mindfulness and self-compassion. Women’s improvements in negative affect were correlated to improvements in measures of both mindfulness skills and self-compassion. In contrast, men showed non-significant increases in negative affect, and changes in affect were only correlated with ability to describe emotions, not any measures of experiential or self-acceptance.

Conclusion: These findings suggest that women may have more favorable responses than men to school-based mindfulness training, and that the effectiveness of mindfulness-based interventions may be maximized by gender-specific modifications.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5397480/

Spring Back from Stress with Mindfulness

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Spring Back from Stress with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Among healthcare professionals, mindfulness training can reduce psychological and physiologic stress, emotional distress, and burnout while improving empathy, job satisfaction, and sense of well-being.” – Lois Howland

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. It is estimated that over 45% of healthcare workers experience burnout. Currently, over a third of healthcare workers report that they are looking for a new job. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout it is a threat to the healthcare providers and their patients. In fact, it is a threat to the entire healthcare system as it contributes to the shortage of doctors and nurses.

 

Preventing burnout has to be a priority. But, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout, so it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, and improving sleep.

 

Working early in healthcare careers to improve resilience could work to prevent burnout. So, it makes sense to investigate how mindfulness training during healthcare education may promote resilience and lower the likelihood of future burnout in healthcare workers. In today’s Research News article “Correlates and Predictors of Resilience among Baccalaureate Nursing Students.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5376833/, Mathad and colleagues recruited nursing students who completed measures of mindfulness, resilience, empathy and perseverative thinking.

 

They found that the higher the levels of mindfulness the higher the levels of resilience even in a multiple regression model considering the other measures. They also found that higher levels of resilience were, in turn, associated with higher levels of empathy and lower levels of repeated negative thinking and unproductive negative thinking. This is a correlative study so causation cannot be determined. But, the findings fit with previous research where mindfulness was manipulated through training and caused an increase in resilience. So, it is reasonable to conclude that the current findings were probably due to mindfulness improving resilience.

 

Hence, it appears that mindfulness increases resilience and this in turn reduces negative thinking and improves empathy. This all suggests that mindfulness would tend to protect healthcare providers from the effects of stress, making the individuals more resilient and less likely to experience burnout.

 

So, spring back from stress with mindfulness.

 

“By being in the present moment we help ourselves as health care providers to moderate the challenges of stress, even having the opportunity to transform previously overwhelming situations into ones of challenge and mastery. This presence also helps us to be better clinicians. We are more present, more available, and better able to access empathy, compassion, and caring skills.” – Arnie Kozak

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Mathad, M. D., Pradhan, B., & Rajesh, S. K. (2017). Correlates and Predictors of Resilience among Baccalaureate Nursing Students. Journal of Clinical and Diagnostic Research : JCDR, 11(2), JC05–JC08. http://doi.org/10.7860/JCDR/2017/24442.9352

 

Abstract

Introduction

A growing body of literature recognizes the importance of resilience in the nursing profession. Both mindfulness and resilience aid in handling stress, stress increases the risk of rumination and/or worry especially in females and they are more empathetic than other healthcare students.

Aim

To identify correlates and predictors of the resilience among nursing students.

Materials and Methods

This is a descriptive correlation study and we have recruited 194 participants (1-4th year B.Sc Nursing) from Government College of Nursing and NIMHANS College of Nursing in Bangalore, India. The following instruments were used to collect the data, Freiburg Mindfulness Inventory (FMI), Toronto Empathy Questionnaire (TEQ), Perseverative Thinking Questionnaire (PTQ) and Connor–Davidson Resilience Scale (CD-RISC). Data was analysed using Pearson’s correlation test and multiple regression analysis.

Results

Resilience is significantly correlated with mindfulness, perseverative thinking and empathy in nursing students. Based on regression analysis this model accounted for almost 33% of variance in resilience. This result is of interest as mindfulness alone explained 23% of the variance and unproductive Repeated Negative Thinking (RNT) and RNT consuming mental capacity predicted 8% and 2% respectively.

Conclusion

These results support the importance of resilience and mindfulness in nursing students. Hence, resilience and/or mindfulness enhancing interventions should be inculcated in nursing education.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5376833/

Improve Major Depression with Yoga

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Improve Major Depression with Yoga

 

By John M. de Castro, Ph.D.

 

“Yoga gives us an active role in healing. And by slowing down mental chatter through breath work, it helps facilitate self-acceptance. In other words, through practicing yoga, we become quieter and more grounded. Yoga can help perfectionists as well as those who tend to be self-critical or lack self-confidence,” – Janeen Dr. Locker

 

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. It is 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. Even after remission some symptoms of depression may still be present (residual symptoms).

 

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 relieve the suffering. Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail.  Another effective alternative treatment is exercise. But it is difficult to get depressed people, who lack energy, to engage in regular exercise. Yoga is a contemplative practice that is both a mindfulness practice and an exercise. It has been shown to be effective in the treatment of depression and even yogic breathing alone has been found to be effective. So, the combination of yoga practice with breathing exercises should be particularly effective.

 

In today’s Research News article “Treatment of Major Depressive Disorder with Iyengar Yoga and Coherent Breathing: A Randomized Controlled Dosing Study.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5359682/, Streeter and colleagues examine the amount of yoga practice needed to treat depression. They recruited adult patients with major depressive disorder and randomly assigned them to receive either a low or a high dose of Iyengar yoga practice combined with a coherent breathing exercise. Treatment occurred over 12 weeks. The 90-minute practice consisted of 60 minutes of yoga, 10 minutes of relaxation and 20 minutes of breathing exercise. In the low dose condition, there were two 90-minute yoga sessions and 3 60-minute home practices per week for a total of 6 hours of practice per week. In the high dose condition, there were three 90-minute yoga sessions and 4 60-minute home practices per week for a total of 8.5 hours of practice per week. The participants were measured before and after training and during training at weeks 4 and 8 for the presence of mental illness and depression.

 

They found that as practice continued over the 12 weeks there were systematic significant decreases in depression. But, there were no significant differences between the low and high dose groups. There were no adverse events other than mild muscle soreness. Hence, they found that yoga practice was safe and effective, producing clinically significant reductions in depression regardless of dose. There wasn’t a control condition, so it might be argued that the results were due to confounding conditions. But, the fact that previous research with appropriate controls demonstrated that yoga practice reduces depression makes it highly likely that the reduced depression in the current study was produced by the yoga practice.

 

It is interesting that there was no difference between the dosing conditions. It might be argued, however, 6 hours of practice per week for 12 weeks is not a low dose. It is possible that this extensive of a practice is all that is necessary to produce maximal effectiveness. It would be useful if future research employed a range of doses including some much smaller than the current low dose. It would also be important to follow-up the results to investigate the long-term effectiveness of the yoga treatment. Regardless, the present study and previous research make it abundantly clear that yoga practice is a safe and effective treatment for major depression.

 

So, improve major depression with yoga.

 

“Some people who haven’t responded to traditional treatments might do well with yoga, because unlike antidepressant drugs, yoga and deep breathing target the autonomic nervous system. If your autonomic nervous system is balanced out, then the rest of the brain works better,” – Chris Streeter

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Streeter, C. C., Gerbarg, P. L., Whitfield, T. H., Owen, L., Johnston, J., Silveri, M. M., … Jensen, J. E. (2017). Treatment of Major Depressive Disorder with Iyengar Yoga and Coherent Breathing: A Randomized Controlled Dosing Study. Journal of Alternative and Complementary Medicine, 23(3), 201–207. http://doi.org/10.1089/acm.2016.0140

 

Abstract

Objectives: The aims of this study were to assess the effects of an intervention of Iyengar yoga and coherent breathing at five breaths per minute on depressive symptoms and to determine optimal intervention yoga dosing for future studies in individuals with major depressive disorder (MDD).

Methods: Subjects were randomized to the high-dose group (HDG) or low-dose group (LDG) for a 12-week intervention of three or two intervention classes per week, respectively. Eligible subjects were 18–64 years old with MDD, had baseline Beck Depression Inventory-II (BDI-II) scores ≥14, and were either on no antidepressant medications or on a stable dose of antidepressants for ≥3 months. The intervention included 90-min classes plus homework. Outcome measures were BDI-II scores and intervention compliance.

Results: Fifteen HDG (Mage = 38.4 ± 15.1 years) and 15 LDG (Mage = 34.7 ± 10.4 years) subjects completed the intervention. BDI-II scores at screening and compliance did not differ between groups (p = 0.26). BDI-II scores declined significantly from screening (24.6 ± 1.7) to week 12 (6.0 ± 3.8) for the HDG (–18.6 ± 6.6; p < 0.001), and from screening (27.7 ± 2.1) to week 12 (10.1 ± 7.9) in the LDG (–17.7 ± 9.3; p < 0.001). There were no significant differences between groups, based on response (i.e., >50% decrease in BDI-II scores; p = 0.65) for the HDG (13/15 subjects) and LDG (11/15 subjects) or remission (i.e., number of subjects with BDI-II scores <14; p = 1.00) for the HDG (14/15 subjects) and LDG (13/15 subjects) after the 12-week intervention, although a greater number of subjects in the HDG had 12-week BDI-II scores ≤10 (p = 0.04).

Conclusion: During this 12-week intervention of yoga plus coherent breathing, depressive symptoms declined significantly in patients with MDD in both the HDG and LDG. Both groups showed comparable compliance and clinical improvements, with more subjects in the HDG exhibiting BDI-II scores ≤10 at week 12.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5359682/

Improve Social Anxiety Disorder with Mindfulness

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Improve Social Anxiety Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“regular and consistent mindfulness meditation will help to strengthen your ability to overcome the initial problems that you experience. If you are suffering with the symptoms of social anxiety disorder (SAD), regular practice will eventually improve your self-concept and ability to handle negative emotions. You will also learn how to better respond to troubling thoughts and treat yourself with more compassion.” – Arlin Cuncic

 

It is a common human phenomenon that being in a social situation can be stressful and anxiety producing. This is particularly true when asked to perform in a social context such as giving a speech. Most people can deal with the anxiety and can become quite comfortable. But many do not cope well and the anxiety is overwhelming, causing the individual to withdraw. Social Anxiety Disorder (SAD) is characterized by a persistent, intense, and chronic fear of being watched and judged by others and feeling embarrassed or humiliated by their actions. This fear may be so severe that it interferes with work, school, and other activities and may negatively affect the person’s ability to form relationships.

 

SAD is the most common form of anxiety disorder and it is widespread, occurring in about 7% of the U.S. population. It has a typical onset in late childhood or young adulthood, prior to the age of 25. Hence, it is particularly widespread among young adults. Anxiety disorders have generally been treated with drugs. It has been estimated that 11% of women in the U.S. are taking anti-anxiety medications. But, there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for SAD. Although, these therapies can be effective they are costly and only available to a small numbers of sufferers. In addition, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments.

 

Recently, it has been found that mindfulness training can be effective for anxiety disorders including Social Anxiety Disorder (SAD). Mindfulness-Based Stress Reduction (MBSR) contains three mindfulness trainings, meditation, body scan, and yoga, and has been shown to be effective in treating anxiety disorders. So, it would be reasonable to expect that MBSR training would improve the symptoms of Social Anxiety Disorder (SAD) in young adults.

 

In today’s Research News article “An open trial of mindfulness-based stress reduction for young adults with social anxiety disorder.” (See summary below), Hjeltnes and colleagues perform a pilot study of the effectiveness of a Mindfulness-Based Stress Reduction (MBSR) program for the treatment of Social Anxiety Disorder (SAD) in young adults. They recruited university students, aged 19 to 25 years, who suffered from SAD. The students participated in a standard 8-week MBSR program. They were assessed at the beginning, midway, and at the end of the program for social anxiety, global psychological distress, mindfulness, self-compassion, and self-esteem.

 

They found that the MBSR program produced a large clinically significant reduction in social anxiety and global psychological distress. They also found significant increases in mindfulness, particularly in the non-judging and non-reacting facets of mindfulness, self-esteem, self-compassion, self-kindness, and common humanity. These results are impressive, but, it needs to be recognized that this was an uncontrolled pilot trial and as such the results could have been due to a number of contaminating factors including placebo effects, experimenter bias, attention effects etc. It remains for a randomized controlled clinical trial to verify these findings. But the magnitudes of the effects are impressive and the fact that MBSR has been demonstrated in controlled trials to reduce anxiety, makes it more likely that the MBSR program was responsible.

 

Anxiety is a fear of potential future negative events. It is dependent upon future oriented thought processes. Mindfulness training may counteract this by focusing the individual on the present moment. Since, there are no negative events there in the present moment, anxiety dissipates. In addition, mindfulness training improves the individual’s ability to see the negative future projections as they arise in the mind and recognize that they are not based in present reality. This can lead to reduced anxiety and better performance at school, work and other activities and improve the person’s ability to form relationships.

 

So, improve social anxiety disorder with mindfulness.

 

“When you develop a mindfulness-based relationship with your inner emotions, your anxiety and fear, you set up a completely different inner environment that greatly facilitates transformation, resolution and healing of the emotional constructs of anxiety and fear. The simple fact is that reactivity inhibits change, while mindfulness promotes change and healing.” – Peter Strong

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Aslak Hjeltnes, Helge Molde, Elisabeth Schanche, Jon Vøllestad, Julie Lillebostad Svendsen, Christian Moltu and Per-Einar Binder. An open trial of mindfulness-based stress reduction for young adults with social anxiety disorder. Scandinavian Journal of Psychology, Volume 58, Issue 1, February 2017, Pages: 80–90, DOI: 10.1111/sjop.12342.

 

Abstract

The present study investigated mindfulness-based stress reduction (MBSR) for young adults with a social anxiety disorder (SAD) in an open trial. Fifty-three young adults in a higher education setting underwent a standard eight-week MBSR program. Eight participants (15%) did not complete the program. Participants reported significant reductions in SAD symptoms and global psychological distress, as well as increases in mindfulness, self-compassion, and self-esteem. Using intention-to-treat (ITT) analyses, effect sizes ranged from large to moderate for SAD symptoms (Cohen’s d = 0.80) and global psychological distress (d = 0.61). Completer analyses yielded large effect sizes for SAD symptoms (d = 0.96) and global psychological distress (d = 0.81). The largest effect sizes were found for self-compassion (d = 1.49) and mindfulness (d = 1.35). Two thirds of the participants who were in the clinical range at pretreatment reported either clinically significant change (37%) or reliable improvement (31%) on SAD symptoms after completing the MBSR program, and almost two thirds reported either clinically significant change (37%) or reliable improvement (26%) on global psychological distress. MBSR may be a beneficial intervention for young adults in higher education with SAD, and there is a need for more research on mindfulness and acceptance-based interventions for SAD.

Improve Internet Gaming Disorder with Mindfulness

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Improve Internet Gaming Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The conclusion to draw here is that though substances like cocaine are very effective at triggering changes in the brain that lead to addictive behavior and urges, they are not the only possible triggers: just about any deeply pleasurable activity — sex, eating, Internet use — has the potential to become addictive and destructive.” – Howard Markel

 

There are many addictions, from exercise, to alcohol, to sex, to drugs, to gambling, to cigarettes. There are a number of differences produced by the specific nature of each addiction. But, there are also some general features. The core components of addiction include an enhanced incentive for the activity or substance (craving), impaired self-control (impulsivity and compulsivity), emotional dysregulation (negative mood) and increased reactivity to stress. Mindfulness training has been shown to be helpful with each of these components, decreasing cravings, impulsiveness, and psychological and physiological responses to stress, and increasing emotion regulation.  It is no wonder then that mindfulness training has been found to be effective for the treatment of a variety of addictions.

 

Video game addictions are very common. It is estimated that 72% of American households play some form of video games, with the average use of 20 hours per week. About 9% show signs of addiction to video games while 4% were classified as extreme players who played 50 hours per week or more. The consequences of video game addiction range from “impaired physical health, such as being overweight or obese due to lack of physical activity, sleep disorders, and heightened risk for seizures, depressive and somatic symptoms, social anxiety, and attention-deficit/hyperactivity disorder, substance misuse, driving while playing video games, suicidal ideation, hostility, violence, loss of relationships and employment, and financial debt.”

 

There is thus a need to find safe and effective treatments for gaming addiction that not only help stop the addiction but also prevent relapse.  In today’s Research News article “Mindfulness-Oriented Recovery Enhancement for Internet Gaming Disorder in U.S. Adults: A Stage I Randomized Controlled Trial.” (See summary below) Li and colleagues study the ability of mindfulness practices to treat gaming addiction. They recruited adults who met the requirements for clinical diagnosis of Internet Gaming Disorder and randomly assigned them to 8 weekly 2-hour group sessions of a support group or of Mindfulness-Oriented Enhancement (MORE). The treatment integrates training in mindfulness, cognitive reappraisal skills, and savoring natural rewards. MORE is designed to modify automatic behavioral habits and pleasure dysregulation associated with addictive behaviors. The participants are requested to continue mindfulness practices at home. The participants were measured before and after the 8-week treatment period and were followed-up 3-months later for internet gaming addiction, craving, maladaptive thoughts, mental distress, coping strategies, and mindfulness.

 

They found that both groups showed improvement in internet gaming addiction measures, but the Mindfulness-Oriented Enhancement (MORE) group showed significantly greater improvement than the support group, particularly at the 3-month follow-up. They also found that both groups showed reductions in craving, distraction, catastrophizing, loneliness, and depression, and improved impulse control, acceptance and socialization, but the MORE group showed significantly greater improvement than the support group in craving, loneliness, and depression, particularly at the 3-month follow-up.

 

These exciting results suggest that both a support group and a mindfulness based addition treatment program produced significant improvements in internet gaming addiction. But, the mindfulness treatment produced superior results for improving internet gaming along with reducing cravings for gaming, and improving mood. This was true particularly at the 3-month follow-up suggesting that the mindfulness based addition treatment program produces more long-lasting benefits. This further suggests that MORE may also be superior at preventing relapse.

 

The results add to the list of addictions that can be successfully treated with mindfulness practices. With the number of people engaged in internet gaming and the huge number who become addicted, it is heartening to see that a mindfulness based addition treatment program can be safe and effective, relieving addiction and cravings and improving mood.

 

So, improve internet gaming disorder with mindfulness.

 

“mindfulness can play an important role in ameliorating problem gambling symptomatology.” – Mark Griffiths

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Li, W., Garland, E. L., McGovern, P., O’Brien, J. E., Tronnier, C., & Howard, M. O. (2017, April 24). Mindfulness-Oriented Recovery Enhancement for Internet Gaming Disorder in U.S. Adults: A Stage I Randomized Controlled Trial. Psychology of Addictive Behaviors. Advance online publication. http://dx.doi.org/10.1037/adb0000269

 

Abstract

Empirical studies have identified increasing rates of Internet gaming disorder (IGD) and associated adverse consequences. However, very few evidence-based interventions have been evaluated for IGD or problematic video gaming behaviors. This study evaluated Mindfulness-Oriented Recovery Enhancement (MORE) as a treatment for IGD. Thirty adults (Mage 25.0, SD 5.4) with IGD or problematic video gaming behaviors were randomized to 8 weeks of group-based MORE or 8 weeks of a support group (SG) control condition. Outcome measures were administered at pre- and posttreatment and 3-months following treatment completion using self-report instruments. Linear mixed models were used for outcome analyses. MORE participants had significantly greater reductions in the number of Diagnostic and Statistical Manual of Mental Disorders–5 IGD criteria they met, craving for video gaming, and maladaptive cognitions associated with gaming than SG participants, and therapeutic benefits were maintained at 3-month follow-up. MORE is a promising treatment approach for IGD.

Relieve Chronic Fatigue with Tai Chi

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Relieve Chronic Fatigue with Tai Chi

 

By John M. de Castro, Ph.D.

 

“T’ai chi is a wonderfully gentle form of movement and exercise that can be appropriate to all levels of physical ability. It can also result in increased energy levels which are particularly noticeable if your energy levels are low in the first place.” – ME/CFS Self-Help Guru

 

Chronic Fatigue Syndrome (CFS) occurs in about 0.2% of the population. It produces a profound, prolonged, and debilitating tiredness. When severe, it can produce a chronic and extreme tiredness, so severe that sufferers can become bed-bound or need to use a wheel-chair. It produces muscle pain, brain fog and dizziness, poor memory, disturbed sleep and trouble with digestion. But, deep fatigue can also be produced by a myriad of conditions including diseases and their treatment, including cancer, multiple sclerosis, rheumatoid arthritis, insomnia, and chronic obstructive pulmonary disease (COPD). Fatigue is also associated with aging. Fatigue is widespread. Some form of chronic fatigue has been reported by about 10% of the population. Unfortunately, there are no known cures. The usual treatments for fatigue are targeted at symptom relief and include exercise and drugs.

 

Mindfulness has been shown to reduce fatigue due to a number of conditions. The mindfulness practice of Yoga is also includes exercise and it has been shown to be an effective treatment for the symptoms of Chronic Fatigue Syndrome / Myalgic encephalomyelitis (CFS/ME). Tai Chi is an ancient Chinese practice involving mindfulness and gentle movements. It is easy to learn, safe, and gentle. So, it may be more appropriate for patients who lack the energy to engage in more vigorous exercise, particularly those who are ill with other serious conditions. In today’s Research News article “Does Tai Chi relieve fatigue? A systematic review and meta-analysis of randomized controlled trials.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5381792/ Xiang and colleagues review the published research literature on the effects of Tai Chi on patients with chronic fatigue and perform a meta-analysis. They found 10 published randomized controlled trials.

 

They reported that Tai Chi practice produced a significant reduction in fatigue in the patients. They found that this was true for patients with cancer, multiple sclerosis, and age related fatigue. Fatigue was found to be significantly reduced when Tai Chi practice was conducted for both greater than and less than 3 months, for greater than and less than 60 minutes per practice, and for greater than and less than 5 times per week, although greater than 5 times per week was more effective. Tai Chi practice was also found to produce significant improvements in vitality, sleep, and depression. There were no adverse events reported in any of the studies.

 

The published research strongly suggests that the practice of Tai Chi is an effective treatment for chronic fatigue, relieving fatigue and also improving vitality, sleep, and depression. This ancient gentle practice is completely safe, can be used with the elderly and sickly, is inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, it can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Hence, Tai Chi would appear to be an excellent treatment for sickly individuals, including the elderly.

 

So, relieve chronic fatigue with Tai Chi.

 

“While being ill reduces activity levels and can produce deconditioning, fatigue, pain, stiffness, anxiety, and depression, exercising can help you reverse that downward spiral by increasing your levels of fitness; reducing fatigue, pain, and stiffness; and improving mood.” – Johannes Starke

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Xiang, Y., Lu, L., Chen, X., & Wen, Z. (2017). Does Tai Chi relieve fatigue? A systematic review and meta-analysis of randomized controlled trials. PLoS ONE, 12(4), e0174872. http://doi.org/10.1371/journal.pone.0174872

 

Abstract

Background

Fatigue is not only a familiar symptom in our daily lives, but also a common ailment that affects all of our bodily systems. Several randomized controlled trials (RCTs) have proven Tai Chi to be beneficial for patients suffering from fatigue, however conclusive evidence is still lacking. A systematic review and meta-analysis was performed on all RCTs reporting the effects of Tai Chi for fatigue.

Methods

In the end of April 2016, seven electronic databases were searched for RCTs involving Tai Chi for fatigue. The search terms mainly included Tai Chi, Tai-ji, Taiji, fatigue, tiredness, weary, weak, and the search was conducted without language restrictions. Methodological quality was assessed using the Cochrane Risk of Bias tool. RevMan 5.3 software was used for meta-analysis. Publication bias was estimated with a funnel plot and Egger’s test. We also assessed the quality of evidence with the GRADE system.

Results

Ten trials (n = 689) were included, and there was a high risk of bias in the blinding. Two trials were determined to have had low methodological quality. Tai Chi was found to have improved fatigue more than conventional therapy (standardized mean difference (SMD): -0.45, 95% confidence interval (CI): -0.70, -0.20) overall, and have positive effects in cancer-related fatigue (SMD:-0.38, 95% CI: -0.65, -0.11). Tai Chi was also more effective on vitality (SMD: 0.63, 95% CI: 0.20, 1.07), sleep (SMD: -0.32, 95% CI: -0.61, -0.04) and depression (SMD: -0.58, 95% CI: -1.04, -0.11). However, no significant difference was found in multiple sclerosis-related fatigue (SMD: -0.77, 95% CI: -1.76, 0.22) and age-related fatigue (SMD: -0.77, 95% CI: -1.78, 0.24). No adverse events were reported among the included studies. The quality of evidence was moderate in the GRADE system.

Conclusions

The results suggest that Tai Chi could be an effective alternative and /or complementary approach to existing therapies for people with fatigue. However, the quality of the evidence was only moderate and may have the potential for bias. There is still absence of adverse events data to evaluate the safety of Tai Chi. Further multi-center RCTs with large sample sizes and high methodological quality, especially carefully blinded design, should be conducted in future research.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5381792/

Improve Mental and Physical Health in Women with Breast Cancer with Mindfulness

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Improve Mental and Physical Health in Women with Breast Cancer with Mindfulness

 

By John M. de Castro, Ph.D.

 

“What I’ve come to understand as a newly inaugurated breast cancer survivor is this: allowing a greater good to open up through me is more beneficial than expecting life to meet my personal demands. It is healthier for me to let go of my need for control in order to walk mindfully in the way of gratitude. And while my destiny will unfold with every step I take, the truth will manifest itself in time.” – Kimberly Holman

 

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 a heightened fear of reoccurrence, and an alteration of their body image.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression.. Indeed, yoga practice has been found to improve sleep quality and memory, reduce the side effects from chemotherapy, relieve neuromuscular symptoms, and improve the quality of life in cancer survivors. Also, Tai Chi or Qigong practice has been shown to improve quality of life, reduce fatigue, and lower blood pressure and cortisol levels. Mindfulness-Based Stress Reduction (MBSR) combines meditation, yoga, and body scan meditation practices. As such, it should be an excellent treatment for the physical and psychological problems of women with breast cancer.

 

In today’s Research News article “Mindfulness and its efficacy for psychological and biological responses in women with breast cancer.” (See summary below), Sarenmalm and colleagues performed a randomized controlled clinical trial of the effectiveness of Mindfulness-Based Stress Reduction (MBSR) for the treatment of the physical and psychological problems of women with breast cancer. They recruited breast cancer patients who had completed “adjuvant chemotherapy and/or radiation therapy, with or without endocrine therapy.” Participants were randomly assigned to receive MBSR treatment for 8-weeks either instructor led or self-taught or no treatment. Measurements were taken before and after treatment and 1 month and 3 months later of depression, physical and psychological symptoms, health status, coping capacity, mindfulness, personal growth, and plasma measures of immune system and inflammatory system function.

 

They found that MBSR taught by an instructor produced significant benefits relative to the self-taught MBSR and no treatment groups. In particular, instructor led MBSR significantly reduced depression, psychological symptoms, physical symptoms, total symptom burden, and improved vitality, physical functioning, mental health, and general health. In addition, MBSR was found to significantly improve coping capacity, post-traumatic growth, and mindfulness, particularly non-reactivity, and the immune response.

 

These are remarkable, striking, and very significant findings. Women with breast cancer had clinically significant improvements in their mental and physical health as a result of participation in an instructor MBSR training. It is interesting that self-taught MBSR did not have the same significant benefits, underscoring the need for professional leadership of the MBSR group. The self-taught MBSR group was an excellent active control group. The strength of this control condition makes the results all the more important as it suggests that placebo effects were not responsible for the benefits.

 

The results make it clear that instructor led Mindfulness-Based Stress Reduction (MBSR) should be prescribed for the treatment of the physical and psychological problems of women with breast cancer.

 

“Women who had the most stress . . . benefited the most from the Mindfulness-Based Stress-Reduction for Breast Cancer program. The results of this study echo results from other small studies showing that mindfulness-based meditation can help ease the stress, anxiety, fear, and depression that often come along with a breast cancer diagnosis and treatment.” – BreastCancer.org

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Kenne Sarenmalm, E., Mårtensson, L. B., Andersson, B. A., Karlsson, P. and Bergh, I. (2017), Mindfulness and its efficacy for psychological and biological responses in women with breast cancer. Cancer Med. doi:10.1002/cam4.1052

 

Abstract

Many breast cancer survivors have to deal with a variety of psychological and physiological sequelae including impaired immune responses. The primary purpose of this randomized controlled trial was to determine the efficacy of a mindfulness-based stress reduction (MBSR) intervention for mood disorders in women with breast cancer. Secondary outcomes were symptom experience, health status, coping capacity, mindfulness, posttraumatic growth, and immune status. This RTC assigned 166 women with breast cancer to one of three groups: MBSR (8 weekly group sessions of MBSR), active controls (self-instructing MBSR) and non-MBSR. The primary outcome measure was the Hospital Anxiety and Depression Scale. Secondary outcome measures were: Memorial Symptom Assessment Scale, SF-36, Sense of Coherence, Five Facets of Mindfulness Questionnaire, and Posttraumatic Growth Index. Blood samples were analyzed using flow cytometry for NK-cell activity (FANKIA) and lymphocyte phenotyping; concentrations of cytokines were determined in sera using commercial high sensitivity IL-6 and IL-8 ELISA (enzyme-linked immunosorbent assay) kits. Results provide evidence for beneficial effects of MBSR on psychological and biological responses. Women in the MBSR group experienced significant improvements in depression scores, with a mean pre-MBSR HAD-score of 4.3 and post-MBSR score of 3.3 (P = 0.001), and compared to non-MBSR (P = 0.015). Significant improvements on scores for distress, symptom burden, and mental health were also observed. Furthermore, MBSR facilitated coping capacity as well as mindfulness and posttraumatic growth. Significant benefits in immune response within the MBSR group and between groups were observed. MBSR have potential for alleviating depression, symptom experience, and for enhancing coping capacity, mindfulness and posttraumatic growth, which may improve breast cancer survivorship. MBSR also led to beneficial effect on immune function; the clinical implications of this finding merit further research.

http://onlinelibrary.wiley.com.ezproxy.shsu.edu/doi/10.1002/cam4.1052/full