Month: June 2017

Produce Lasting Improvement in Post-Traumatic Stress Disorder (PTSD) with Yoga

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Produce Lasting Improvement in Post-Traumatic Stress Disorder (PTSD) with Yoga

 

By John M. de Castro, Ph.D.

 

“Knowledge of yoga can help relieve us, direct us and give clarity of mind. It is the ultimate self-help. The first step in yoga practice is to link the mind and body through the breath, bringing awareness to what is happening in the moment. Intense feelings and thoughts can be experienced and reduced in intensity as the mind becomes more still and calm and the body allows the sensations to pass. With repeated practice and guidance, a yoga practice can bring long term relief and a fresh perspective on life for PTSD sufferers.” – Art of Living

 

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 negative changes in beliefs and feelings 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. There are a number of therapies that have been developed to treat PTSD. One of which, mindfulness training has been found to be particularly effective. In today’s Research News article “Yoga for Adult Women with Chronic PTSD: A Long-Term Follow-Up Study.” (See summary below), Rhodes and colleagues examine the ability of yoga practice to treat the symptoms of Post-Traumatic Stress Disorder (PTSD) in women who had persistent symptoms that didn’t respond to treatment. They demonstrated in a prior study that yoga practice produces significant reductions in PTSD symptom severity and PTSD diagnosis and decreases in engagement in negative tension reduction activities (e.g., self-injury), and greater reductions in dissociative and depressive symptoms. In the present study, they performed a long-term follow-up by measuring the participants 1.5 years later for PTSD symptoms, dissociative experiences, depression, engagement in negative tension reduction activities (e.g., self-injury), and stressful life events.

 

They found that 1.5 years after the completion of the study the differences between the yoga and control groups were no longer present. They found that 88% of the women in the yoga practice group continued to practice. After completion of the control condition, the participants were offered training in yoga and 44% chose it. All of these women continued practice later. They found, however, that the higher the frequency of yoga practice at follow-up the lower the levels of depression and PTSD symptom severity and the lower the likelihood of a PTSD diagnosis.

 

These are encouraging results that suggest that yoga practice is an effective treatment for PTSD for women and if the practice continues, the benefits continue for at least a year and a half. But, if the practice is discontinued, the benefits will regress. These results are particularly encouraging as these women were the most difficult and intransigent cases that didn’t respond to other treatments. Yet, they responded to yoga practice. These results suggest that yoga practice should be studied to treat PTSD in men. They further suggest that yoga practice should be incorporated into the treatment package to treat PTSD in women.

 

So, produce lasting improvement in post traumatic stress disorder (PTSD) in women with yoga.

 

“The goal of treatment should be to resolve this disconnect. “If we can help our patients tolerate their own bodily sensations, they’ll be able to process the trauma themselves. . . patients, particularly those suffering from treatment-resistant PTSD, yoga has proved an especially good way to do this.” – Jeneen Interlandi

 

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

Rhodes, A., Spinazzola, J., & van der Kolk, B. (2016). Yoga for Adult Women with Chronic PTSD: A Long-Term Follow-Up Study. Journal Of Alternative & Complementary Medicine, 22(3), 189-196. doi:10.1089/acm.2014.0407

 

Abstract:

Introduction: Yoga-the integrative practice of physical postures and movement, breath exercises, and mindfulness-may serve as a useful adjunctive component of trauma-focused treatment to build skills in tolerating and modulating physiologic and affective states that have become dysregulated by trauma exposure. A previous randomized controlled study was carried out among 60 women with chronic, treatment-resistant post-traumatic stress disorder (PTSD) and associated mental health problems stemming from prolonged or multiple trauma exposures. After 10 sessions of yoga, participants exhibited statistically significant decreases in PTSD symptom severity and greater likelihood of loss of PTSD diagnosis, significant decreases in engagement in negative tension reduction activities (e.g., self-injury), and greater reductions in dissociative and depressive symptoms when compared with the control (a seminar in women’s health). The current study is a long-term follow-up assessment of participants who completed this randomized controlled trial. Methods: Participants from the randomized controlled trial were invited to participate in long-term follow-up assessments approximately 1.5 years after study completion to assess whether the initial intervention and/or yoga practice after treatment was associated with additional changes. Forty-nine women completed the long-term follow-up interviews. Hierarchical regression analysis was used to examine whether treatment group status in the original study and frequency of yoga practice after the study predicted greater changes in symptoms and PTSD diagnosis. Results: Group assignment in the original randomized study was not a significant predictor of longer-term outcomes. However, frequency of continuing yoga practice significantly predicted greater decreases in PTSD symptom severity and depression symptom severity, as well as a greater likelihood of a loss of PTSD diagnosis. Conclusions: Yoga appears to be a useful treatment modality; the greatest long-term benefits are derived from more frequent yoga practice.

Improve Sleep Problems in Adolescents with Mindfulness

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Improve Sleep Problems in Adolescents with Mindfulness

 

By John M. de Castro, Ph.D.

 

“By taking this mindful attitude, sleep is facilitated by simply being aware of the moment-to-moment experience of relaxing into the bed, without judging or being critical of that experience, so that the mind can gently slip into sleep.“ – John Cline

 

Modern society has become more around-the-clock and more complex producing considerable pressure and stress on the individual. The advent of the internet and smart phones has exacerbated the problem. This stress may be amplified for adolescents. Adolescence can be a difficult time, fraught with challenges. During this time, the child transitions to young adulthood; including the development of intellectual, psychological, physical, and social abilities and characteristics. There are so many changes occurring during this time that the child can feel stressed and overwhelmed and unable to cope with all that is required.

 

The resultant stress can impair sleep. It is estimated that 14% of adolescents experience insomnia and 5.3% meet the diagnostic criteria for a sleep disorder. Insomnia is more than just an irritant. Sleep deprivation is associated with decreased alertness and a consequent reduction in performance of even simple tasks, decreased quality of life, increased difficulties with memory and problem solving, and increased likelihood of accidental injury including automobile accidents. It also can lead to anxiety about sleep itself. This is stressful and can produce even more anxiety about being able to sleep. About 4% of Americans revert to sleeping pills. But, these do not always produce high quality sleep and can have problematic side effects, including potential addiction. So, there is a need to find better methods to treat insomnia. Contemplative practices have been reported to improve sleep amount and quality and help with insomnia. The importance of insomnia underscores the need to further investigate safe and effective alternatives to drugs for adolescents.

 

In today’s Research News article “The SENSE Study: Treatment mechanisms of a cognitive behavioral and mindfulness-based group sleep improvement intervention for at-risk adolescents.” (See summary below) Blake and colleagues recruited adolescents (mean age 14.5 years) from schools who had clinically significant anxiety and sleep disorder. They randomly assigned them to receive either 7 weekly 90-minute group sessions of a mindfulness-based sleep improvement program or study skills education. The sleep improvement intervention employs a cognitive behavioral approach, incorporating sleep education, sleep hygiene, stimulus control, and cognitive restructuring, with added mindfulness, savoring, and anxiety specific components. Participants were encouraged to continue practice at home. The adolescents were measured before and after treatment for sleep (actiwatch and self-report), anxiety, and pre-sleep arousal.

 

They found that after the intervention, in comparison to the study skills education group, the mindfulness-based sleep improvement group had significantly improved sleep, measured objectively with actiwatch or subjectively with self-report, better sleep hygiene awareness, lower anxiety, pre-sleep somatic arousal, and less pre-sleep cognitive arousal. Using a sophisticated statistical technique, they found that the improvements in sleep and anxiety were produced as a result of the improvements in pre-sleep somatic arousal, and pre-sleep cognitive arousal.

 

These are exciting results, particularly as the effect sizes were moderate to large and anxiety and sleep disruption are so prevalent in adolescents. This suggests that the mindfulness-based group sleep improvement intervention produces big improvements in a significant problem for adolescents. They further suggest that these improvements were mediated by improvements in pre-sleep arousal levels. So, the mindfulness-based group sleep improvement intervention appears to relax the adolescents so that they can sleep better. Mindfulness training has been shown to reduce the physiological and psychological responses to stress, reduce anxiety levels, and improve emotion regulation. So, these effects on arousal are not unexpected. But, the findings clearly suggest that improvements in mindfulness are very important to reduce anxiety and improve sleep in adolescents.

 

So, improve sleep problems in adolescents with mindfulness

 

“Mindfulness delivered improvements to sleep—including reduced insomnia, improved sleep quality, increased sleep time, and better sleep efficiency—that were comparable to sleep medication.” – Michael Breus

 

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

Matthew Blake, Orli Schwartz, Joanna M. Waloszek, Monika Raniti, Julian G. Simmons, Greg Murray, Laura Blake, M.Teach., Ronald E. Dahl, M.D., Richard Bootzin, Dana L. McMakin, Paul Dudgeon, John Trinder, Nicholas B. Allen. The SENSE Study: Treatment mechanisms of a cognitive behavioral and mindfulness-based group sleep improvement intervention for at-risk adolescents. Sleep 2017 zsx061. doi: 10.1093/sleep/zsx061

 

Abstract

OBJECTIVE:

The aim of this study was to test whether a cognitive-behavioral and mindfulness-based sleep intervention could improve sleep and anxiety on school nights in a group of at-risk adolescents. We also examined whether benefits to sleep and anxiety would be mediated by improvements in sleep hygiene awareness and pre-sleep hyperarousal.

METHOD:

Secondary analysis of a randomized controlled trial conducted with 123 adolescent participants (Female=60%; Mean Age=14.48) who had high levels of sleep problems and anxiety symptoms. Participants were randomized into a sleep improvement intervention (n=63) or active control ‘study skills’ intervention (n=60). Pre-and-post intervention, participants completed the Pittsburgh Sleep Quality Index (PSQI), Spence Children’s Anxiety Scale (SCAS), Sleep Beliefs Scale (SBS), and Pre-Sleep Hyperarousal Scale (PSAS), and wore an actiwatch and completed a sleep diary for five school nights.

RESULTS:

The sleep intervention condition was associated with significantly greater improvements in actigraphy-measured sleep onset latency (SOLobj), sleep diary measured sleep efficiency (SEsubj), PSQI, SCAS, SBS, and PSAS, with medium-large effect sizes. Improvements in the PSQI and SCAS were specifically mediated by the measured improvements in PSAS that resulted from the intervention. Improvements in SOLobj and SEsubj were not specifically related to improvements in any of the putative treatment mechanisms.

CONCLUSION:

This study provides evidence that pre-sleep arousal but not sleep hygiene awareness is important for adolescents’ perceived sleep quality, and could be a target for new treatments of adolescent sleep problems.

https://www.ncbi.nlm.nih.gov/pubmed/28431122

Improve Attention Deficit Hyperactivity Disorder (ADHD) with Mind-Body Practices

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Improve Attention Deficit Hyperactivity Disorder (ADHD) with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

“mindfulness practice can help us pay attention better, resist distractions, be less impulsive, remember what we are doing in the moment, and regulate our own emotions, it is helpful whether we have ADHD or not. But it holds special interest for those with ADHD.” – Casey Dixon

 

Attention Deficit Hyperactivity Disorder (ADHD) is currently epidemic in the US. Roughly 6.4 million American children have been diagnosed with ADHD and 6.4% of American children are being treated with medication. There has been a 42% increase in the diagnoses of ADHD in the last 8 years. This increase in diagnoses probably represents an increase in awareness and willingness to diagnose ADHD rather than an increase in cases of ADHD. “Many children who like to run and jump may be high-energy. But that doesn’t mean they are hyperactive. To count as ADHD, symptoms have to be on the extreme side and have to cause problems in the child’s life. Also, they have to have been doing this for at least 6 months.” – WebMD

 

What can be done about this huge problem that is affecting such a large proportion of American children and adults? The most common treatment is drugs, like methylphenidate, Ritalin, which helps reduce symptoms in about 30% of the people with ADHD. Unfortunately, the effectiveness of the drugs appears to be markedly reduced after the first year. In addition, the drugs often have troublesome side effects, including nervousness agitation, anxiety, irritability, sleep and appetite problems, head and stomach aches, nausea, dizziness, and heart palpitations. They can also be addictive and can readily be abused. If that’s not enough using drugs that alter the brain in children during the time of brain development is fraught with long-term risks. So, drugs, at present, do not appear to be a good solution, only affecting some, only for a short time, and with unwanted side effects.  Is there a better way?

 

There are indications that mind-body training may be a more effective treatment for ADHD. It makes sense that it should be, as the skills and abilities strengthened by mind-body training are identical to those that are defective in ADHD, attention, impulse control, executive function, emotion control, and mood improvement. Mind-body practices include meditation, tai chi, qigong, yoga , etc. Movement based mind-body practices would appear to be particularly appropriate as they are also exercise and as such an outlet for some of the excess energy.

 

In today’s Research News article “Mind–Body Therapy for Children with Attention-Deficit/Hyperactivity Disorder.” See summary below or view the full text of the study at: http://www.mdpi.com/2227-9067/4/5/31/htm

Herbert and Esparham review and summarize the published research literature on the effectiveness of mind-body practices for the treatment of Attention Deficit Hyperactivity Disorder (ADHD).

 

They report that in general movement based mind-body practices are effective for children with ADHD.  The research suggests that yoga practice improves attention, executive function, sleep patterns, produces less anxiety, more ability to focus at school, and less conflicts in children. The ancient Chinese slow movement practice of Tai Chi also appears to help with ADHD, producing significantly decreased anxiety, daydreaming, inappropriate emotions, and hyperactivity, and improved conduct. Meditation practice also appears to be effective for the symptoms of ADHD. The research indicates that mindfulness meditation practice appears to reduce ADHD symptoms and internalization, and improve attention and thinking. The research suggests that meditation practice acts by producing changes to the brains of children with ADHD.

 

These are exciting findings that suggest that mind-body practices are effective treatments for ADHD in children. This is particularly heartening as these mind-body practices are safe, and unlike drugs, have no significant side effects. They are also inexpensive treatments in comparison to active therapies and drugs. They are also convenient for the children to practice when time is available at home or school. Families and teachers can access online or purchase videos as resources to guide the practices. In addition, there are indications that these practices produce relatively permanent beneficial changes in the children’s brains, suggesting lasting benefits.

 

So, improve attention deficit hyperactivity disorder (ADHD) with mind-body practices.

 

“Mindfulness meditation for people with ADHD? It may seem like a stretch, since difficulty with mindfulness is the very challenge for those with attention deficit hyperactivity disorder. And yet recent research shows that mindfulness training can be adapted for this condition and that it can improve concentration.”  – Lynda McCullough

 

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

Herbert, A.; Esparham, A. Mind–Body Therapy for Children with Attention-Deficit/Hyperactivity Disorder. Children 2017, 4, 31. doi:10.3390/children4050031

 

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is pervasive among the pediatric population and new treatments with minimal adverse effects are necessary to be studied. The purpose of this article is to review current research studying mind-body therapies for treatment of children diagnosed with ADHD. Literature was reviewed pertaining to the effectiveness of movement-based therapies and mindfulness/meditation-based therapies for ADHD. Many positive effects of yoga, Tai Chi, physical activity, and meditation may significantly improve symptoms of ADHD among children.

http://www.mdpi.com/2227-9067/4/5/31/htm

Decrease Alcohol Intake and Related Consequences in Teens with Mindfulness

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Decrease Alcohol Intake and Related Consequences in Teens with Mindfulness

By John M. de Castro, Ph.D.

 

“Mindfulness also helps people learn to relate to discomfort differently. When an uncomfortable feeling like a craving or anxiety arises, people . . . are able to recognize their discomfort, and observe it with presence and compassion, instead of automatically reaching for a drug to make it go away.” – Sarah  Bowen

 

Alcohol abuse often develops during adolescence and especially at college. Four out of five college students drink alcohol and about half of those consume alcohol through binge drinking. About 25% of college students report academic consequences of their drinking including missing class, falling behind, doing poorly on exams or papers, and receiving lower grades overall. More than 150,000 students develop an alcohol-related health problem. This drinking has widespread consequence for not only the students but also the college communities, and families. More than 690,000 students are assaulted by another student who has been drinking. More than 97,000 students are victims of alcohol-related sexual assault or date rape. 599,000 students receive unintentional injuries while under the influence of alcohol. Significantly, 1,825 college students die each year from alcohol-related unintentional injuries and between 1.2% and 1.5% of students indicate that they tried to commit suicide within the past year due to drinking or drug use.

 

These facts are sobering and clearly highlight the need to explore methods to control excessive alcohol intake. Students often use protective behavioral strategies to increase self-control while drinking and help reduce negative alcohol-related consequences, these include adding extra ice to the drink, avoiding taking shots, or trying to out-drink companions. These strategies, when employed appear to be successful in helping to control drinking and its consequences. Another potential method to control alcohol intake and its consequences is mindfulness as it has been shown to assist in the control of alcohol intake and in recovery from alcohol addiction .

 

So, it would make sense to further explore the relationship of mindfulness and protective behavioral strategies on alcohol intake and its negative consequences in college students. In today’s Research News article “Trait mindfulness and protective strategies for alcohol use: Implications for college student drinking.” (See summary below), Brett and colleagues recruited male and female college students who we 18 years of age or older and reported recent alcohol use. The students completed on-line measurements for mindfulness, alcohol use, protective behavioral strategies, and alcohol related consequences.

 

The researchers found that higher levels of mindfulness were associated with higher levels of protective behavioral strategies which, in turn, were associated with lower levels of alcohol intake by the students. High levels of mindfulness were also associated with higher levels of protective behavioral strategies which, in turn, were associated with lower levels of alcohol related consequences, with a small but significant negative direct relationship of mindfulness on alcohol related consequences. They also found that the relationship between protective behavioral strategies and lower alcohol related consequences was greatest in students with low levels of mindfulness.

 

These results suggest that mindfulness is primarily associated with lower alcohol intake and lower alcohol related consequences indirectly by promoting protective behavioral strategies. So mindful students were more likely to engage in strategies such as adding extra ice to the drink, avoiding taking shots, or trying to out-drink companions and this, in turn, produced lower level of negative consequences produced by the alcohol intake.

 

It should be kept in mind that these results are correlational and as such causation cannot be determined. It remains for future research to manipulate mindfulness and determine if protective behavioral strategies are increased and negative alcohol related consequences and alcohol intake are reduced. Prior research, however, has shown that mindfulness training reduces alcohol consumption. This, taken together with the current results suggest that mindfulness may be responsible for eliciting engagement in protective strategies dampening alcohol intake and the negative consequences of excessive intake.

 

So, decrease alcohol intake and related consequences in teens with mindfulness.

 

“teaching teens about the brain and how mindfulness affects it can help create an understanding and desire to practice. Mindfulness also helps with impulse control, a concept with which many teenagers struggle.” – Courtney Howard

 

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

Brett EI, Leffingwell TR, Leavens EL. Trait mindfulness and protective strategies for alcohol use: Implications for college student drinking. Addict Behav. 2017 Apr 8;73:16-21. doi: 10.1016/j.addbeh.2017.04.011

 

Highlights

  • The current study examined PBS and mindfulness as they relate to alcohol outcomes.
  • PBS mediated the relationship between mindfulness and alcohol outcomes.
  • Mindfulness moderated the relationship between PBS use and alcohol consequences.
  • Interventions targeting those low in mindfulness may be effective in reducing consequences.

Abstract

Introduction

The use of Protective Behavioral Strategies (PBS) has been strongly linked with decreased experience of alcohol-related consequences, making them a potential target for intervention. Additionally, mindfulness is associated with decreased experience of alcohol-related consequences. The purpose of the current study was to evaluate a model of PBS as a mediator of the effect of mindfulness on alcohol-related consequences. Additionally, mindfulness as a moderator of the relationship between PBS and alcohol use and consequences was examined.

Methods

College students (N = 239) at a large South Central university completed self-report measures of demographics, alcohol use and consequences, use of PBS, and trait mindfulness.

Results

Results indicated that both higher levels of mindfulness and using more PBS predicted decreased alcohol-related consequences and consumption, with PBS mediating both relationships (p < 0.01). Those with higher levels of mindfulness were more likely to use PBS, with individuals using more PBS experiencing fewer alcohol-related consequences and consuming fewer drinks per week. Mindfulness moderated the relationship between PBS and consequences, with a significantly stronger negative relationship for those with lower levels of mindfulness.

Conclusions

Individuals who are higher in trait mindfulness are more likely to use PBS, which leads to a decrease in the experience of alcohol-related consequences. Furthermore, for individuals lower in mindfulness, low PBS use may lead to increased experience of alcohol consequences. Interventions that incorporate PBS may be most beneficial for students who are low in mindfulness and unlikely to engage in drinking control strategies.

Improve Veteran Health with In-Person and Telehealth Yoga

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Improve Veteran Health with In-Person and Telehealth Yoga

 

By John M. de Castro, Ph.D.

 

“The fact that veterans are embracing yoga and realizing its benefits speaks directly to the stigmas attached to both yoga and PTSD. Veterans practicing yoga illuminate the value of the practice for any person, from any walk of life, not just “new-age hippies.” It also demonstrates that suffering trauma that affects our mental health does not break us or make us any less human.” – Dana Santas

 

Mindfulness training has been shown through extensive research to be effective in improving the physical and psychological condition of otherwise healthy people and also treating the physical and psychological issues of people with illnesses and particularly with the physical and psychological reactions to stress. Techniques such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) as well as Yoga practice and Tai Chi or Qigong practice have been demonstrated to be particularly effective. This has led to an increasing adoption of these mindfulness techniques for the health and well-being of both healthy and ill individuals.

 

The vast majority of the mindfulness training techniques, adopted so far, however, require a certified trained therapist. This produces costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules. As a result, there has been attempts to develop alternative distance education approaches such as on-line mindfulness training programs and videoconferencing. These have tremendous advantages in decreasing costs and making training schedules much more flexible. But, the question arises as to whether these programs are as effective as their traditional counterparts. Many believe that the presence of a therapist is a crucial component to the success of the programs and the lack of an active therapist physically present in on-line or videoconferencing programs may greatly reduce their effectiveness. It is not known if yoga practice can be successfully delivered through distance videoconferencing programs.

 

In today’s Research News article “Results from a clinical yoga program for veterans: yoga via telehealth provides comparable satisfaction and health improvements to in-person yoga.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5381127/

Schulz-Heik and colleagues compared the effectiveness of yoga classes provided to veterans with a wide variety of physical and mental health problems. The classes were either in-person or the same class delivered via videoconferencing to a remote site. The classes were offered 13 times per week. The participants were free to attend whichever classes and how many they wanted on their own schedules. All participants who attended any classes during a two-week period were asked to complete a questionnaire on their satisfaction with the classes, global health, and 16 different health symptoms. Satisfaction with classes was demonstrated as 82% rated them excellent and 98% stated that they enjoyed the classes and 98% would recommend them to a friend.

 

They found that the veterans reported significant improvement in a wide range of physical and mental health symptoms, including overall pain, back pain, headache, upset stomach, sleep problems, energy level, irritability, concentration, anger, depression, anxiety, jumpiness, disturbing memories, and other symptoms. Importantly, the in-person and videoconferencing programs demonstrated equal improvements with no significant differences found between them.

 

These are very interesting results but must be interpreted with caution. There was no active control condition. So, the reported benefits might be due to placebo effects, experimenter bias, demand characteristics, etc. The results though are similar to those reported for yoga practice in randomized controlled trials and it is reasonable to conclude that the current yoga program produced similar benefits. Regardless, it is striking that the videoconferencing program was equally effective as the in-person program. This is important as it suggests that inexpensive mindfulness training can be offered to widespread audiences. In addition, videoconferencing training is convenient for the participants, as they do not have to go to a practitioners site on a particular schedule. This, in turn, allows for the application of yoga training for the prevention and treatment of psychological and physical disorders with busy people, low income people, and even people in remote locations, thus greatly expanding the numbers of people who can benefit.

 

“yoga is being increasingly embraced by Veterans Affairs and the military looking to move veterans off addictive painkillers and offer them alternative treatments for pain.” – Emily Wax-Thibodeaux

 

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

Schulz-Heik, R. J., Meyer, H., Mahoney, L., Stanton, M. V., Cho, R. H., Moore-Downing, D. P., … Bayley, P. J. (2017). Results from a clinical yoga program for veterans: yoga via telehealth provides comparable satisfaction and health improvements to in-person yoga. BMC Complementary and Alternative Medicine, 17, 198. http://doi.org/10.1186/s12906-017-1705-4

 

Abstract

Background

Yoga is increasingly popular, though little data regarding its implementation in healthcare settings is available. Similarly, telehealth is being utilized more frequently to increase access to healthcare; however we know of no research on the acceptability or effectiveness of yoga delivered through telehealth. Therefore, we evaluated the feasibility, acceptability, and patient-reported effectiveness of a clinical yoga program at a Veterans Affairs Medical Center and assessed whether these outcomes differed between those participating in-person and those participating via telehealth.

Methods

Veterans who attended a yoga class at the VA Palo Alto Health Care System were invited to complete an anonymous program evaluation survey.

Results

64 Veterans completed the survey. Participants reported high satisfaction with the classes and the instructors. More than 80% of participants who endorsed a problem with pain, energy level, depression, or anxiety reported improvement in these symptoms. Those who participated via telehealth did not differ from those who participated in-person in any measure of satisfaction, overall improvement (p = .40), or improvement in any of 16 specific health problems.

Conclusions

Delivering yoga to a wide range of patients within a healthcare setting appears to be feasible and acceptable, both when delivered in-person and via telehealth. Patients in this clinical yoga program reported high levels of satisfaction and improvement in multiple problem areas. This preliminary evidence for the effectiveness of a clinical yoga program complements prior evidence for the efficacy of yoga and supports the use of yoga in healthcare settings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5381127/

Improve Mood with Religion and Spirituality

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Improve Mood with Religion and Spirituality

 

By John M. de Castro, Ph.D.

 

“my Church serves as a safe haven where I can thank God, or ask for grace, strength and guidance to face the tribulations of daily life. There’s peace and contentment in this.” – Joseph Wegmann

 

Psychological well-being is sometimes thought of as a lack of mental illness. But, it is more than just a lack of something. It is a positive set of characteristics that lead to happy, well-adjusted life. These include the ability to be aware of and accept one’s strengths and weaknesses, to have goals that give meaning to life, to truly believe that your potential capabilities are going to be realized, to have close and valuable relations with others, the ability to effectively manage life issues especially daily issues, and the ability to follow personal principles even when opposed to society.

 

Religion and spirituality have been promulgated as solutions to the challenges of life both in a transcendent sense and in a practical sense. What evidence is there that these claims are in fact true? The transcendent claims are untestable with the scientific method. But, the practical claims are amenable to scientific analysis. There have been a number of studies of the influence of religiosity and spirituality on the physical and psychological well-being of practitioners mostly showing positive benefits, with spirituality encouraging personal growth and mental health.

 

In today’s Research News article, Use of Daily Phone Diary to study religiosity and mood: Convergent validity See summary below or view the full text of the study at:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5360558/, Szczesniak and colleagues studied the relationships between spiritual / religious practice and thee individual’s mood. Adult participants completed measures of depression, religiosity, and spiritual coping and were asked to recall events, lasting more than 5 minutes, that happened over the prior 24 hours and their mood associated with each event on a 7-point scale from negative to positive.

 

They found that during religious / spiritual activities there was a high probability of improved mood. This improvement was greater in females than in males and in Protestants and Catholics than in non-denominational Christians. In addition, this mood improvement after participation in religious / spiritual activities was highly likely to be maintained for the remainder of the 24-hour recording period. These results suggest that engaging in religious / spiritual activities is associated with more positive emotions and this improved mood continues afterward. This emotional improvement may, at least in part, be responsible for the positive mental health benefits of spirituality and religiosity.

 

So, improve mood with religion and spirituality.

 

“If you want to feel peaceful, loving, and joyful, surround yourself with as many uplifting people and things as possible, Fishel says. “We are all energetic beings. We become what we eat, what we watch, the people we surround ourselves with.”” – Claudia Pinto

 

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

 

Szczesniak, R. D., Zou, Y., Dimitriou, S. M., Quittner, A. L., & Grossoehme, D. H. (2017). Use of Daily Phone Diary to study religiosity and mood: Convergent validity. Journal of Health Care Chaplaincy, 23(2), 67–85. http://doi.org/10.1080/08854726.2016.1253955

 

Abstract

Studies of religious/spiritual behavior frequently rely on self-reported questionnaire data, which is susceptible to bias. The Daily Phone Diary (DPD) was developed to minimize bias in reporting activities and behavior across a 24-hour period. A cross-sectional study of 126 parents of children with cystic fibrosis was used to establish the validity of the DPD to study religious/spiritual behaviors. Longitudinal models were used to determine the odds of improved mood during religious/spiritual activities. Convergent validity was found. Participants had increased odds of improved mood during religious/spiritual activities compared to non-religious/spiritual activities. Associations with gender and religious affiliations were found. The DPD is a valid tool for studying religious/spiritual activities and opens novel avenues for chaplaincy research and the development of chaplaincy interventions incorporating these findings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5360558/

Mindfulness is Associated with Improved Athletic Psychology in Elite Athletes

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Mindfulness is Associated with Improved Athletic Psychology in Elite Athletes

 

By John M. de Castro, Ph.D.

 

“Meditation is becoming popular for many reasons, especially related to health. Athletes are also taking up the practice more and more because research has shown that meditation can be used as a tool to manage pain, decrease anxiety and improve focus.” – Kris Eiring

 

Athletic performance requires the harmony of mind and body. Excellence is in part physical and in part psychological. Without inheriting an athletic body and without many hours of training the individual will never reach an elite level. But, once there, the difference between winning and losing is psychological. That is why an entire profession of Sports Psychology has developed. “In sport psychology, competitive athletes are taught psychological strategies to better cope with a number of demanding challenges related to psychological functioning.” They use a number of techniques to enhance performance including anxiety or energy management, attention and concentration control (focusing), communication, goal setting, imagery, visualization, mental practice, self-talk, controlling negative emotions, team building, time management/organization.

 

Mindfulness training has been shown to enhance a number of the characteristics that are taught by Sports Psychologists. Mindfulness training improves attention and concentration and emotion regulation and reduces anxiety and worry and rumination, and the physiological and psychological responses to stress. As a result, mindfulness training, including meditation and yoga practices, have been employed by elite athletes and even by entire teams to enhance their performance. There have been, however, very few empirical tests of the efficacy of mindfulness training to enhance elite athletes’ performance or the mechanism of action.

 

In today’s Research News article “Mindfulness Mechanisms in Sports: Mediating Effects of Rumination and Emotion Regulation on Sport-Specific Coping.” (See summary below), Josefsson and colleagues examined the relationship of mindfulness effects on rumination and emotion regulation on athletic performance. They recruited a large sample of elite High School athletes from a variety of sports and requested that they complete measures of mindfulness, rumination, emotion regulation, and athletic coping skills. They analyzed the obtained data with correlation techniques and a sophisticated statistical technique called path analysis.

 

They found that, as has previous studies, that the higher the levels of mindfulness of the athletes the lower the levels of rumination and the higher the levels of emotion regulation. They also found with path analysis that mindfulness levels were associated with better athletic coping skills in two ways, directly and indirectly through mindfulness’ relationships with rumination and emotion regulation. In other words, the higher the levels of mindfulness the better the athletic coping skills. This occurred by a direct relationship of mindfulness on athletic coping skills and also due to the mindfulness’ association with lower rumination and improved emotion regulation and their relationships with improved athletic coping skills.

 

This study was correlational and causation cannot be determined. But the results suggest that mindfulness is an important asset for the elite athlete. They further suggest that mindfulness may enhance athletic performance by improving the athletes ability to cope with their emotions and by decreasing worry and rumination. It remains for future studies to actively train athletes in mindfulness skills and determine if emotion regulation, rumination, athletic coping skills, and athletic performance are enhanced. Regardless, it is clear that mindfulness skills help and athlete cope with the psychological demands of elite athletic performance.

 

“The application of mindfulness to sport performance has recently become a popular research endeavor. By enhancing current moment awareness, a critical component of peak sport performance, some research has suggested that mindfulness exercises can help to generate “flow”, or a state of complete focus on the task or event at hand . . . mindfulness-based interventions for sports are effective because they help athletes direct their attention to the current athletic task, while minimizing external distractions.” – Mitch Plemmons

 

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

Torbjörn Josefsson, Andreas Ivarsson, Magnus Lindwall, Henrik Gustafsson, Andreas Stenling, Jan Böröy, Emil Mattsson, Jakob Carnebratt, Simon Sevholt, Emil Falkevik. Mindfulness Mechanisms in Sports: Mediating Effects of Rumination and Emotion Regulation on Sport-Specific Coping. Mindfulness (2017). doi:10.1007/s12671-017-0711-4

 

Abstract

The main objective of the project was to examine a proposed theoretical model of mindfulness mechanisms in sports. We conducted two studies (the first study using a cross-sectional design and the second a longitudinal design) to investigate if rumination and emotion regulation mediate the relation between dispositional mindfulness and sport-specific coping. Two hundred and forty-two young elite athletes, drawn from various sports, were recruited for the cross-sectional study. For the longitudinal study, 65 elite athletes were recruited. All analyses were performed using Bayesian statistics. The path analyses showed credible indirect effects of dispositional mindfulness on coping via rumination and emotion regulation in both the cross-sectional study and the longitudinal study. Additionally, the results in both studies showed credible direct effects of dispositional mindfulness on rumination and emotion regulation. Further, credible direct effects of emotion regulation as well as rumination on coping were also found in both studies. Our findings support the theoretical model, indicating that rumination and emotion regulation function as essential mechanisms in the relation between dispositional mindfulness and sport-specific coping skills. Increased dispositional mindfulness in competitive athletes (i.e. by practicing mindfulness) may lead to reductions in rumination, as well as an improved capacity to regulate negative emotions. By doing so, athletes may improve their sport-related coping skills, and thereby enhance athletic performance.

Reduce Sensitivity to Rejection with Non-Judging Mindfulness

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Reduce Sensitivity to Rejection with Non-Judging Mindfulness

 

By John M. de Castro, Ph.D.

 

“Simply acknowledging that rejection will hurt, whatever we do, can in itself be a relief. Much of our suffering comes from wishing that our experience was different to how it currently is. But mindfulness helps us to see and accept this moment, however we happen to find it, even if our moment is filled with feelings of unworthiness. The trick is to remember that unworthiness is a transitory feeling, never an absolute truth about us.” – The Mindfulness Project

 

Being rejected socially is a painful but common experience. Our sensitivity to rejection probably evolved to help maintain group cohesion which was essential during early human evolutionary development. So, it is normal and natural. But, being overly sensitive to rejection can be maladaptive not just to the individual but also to the group as it can accentuate withdrawal. Indeed, high sensitivity to rejection is characteristic of a number of mental illnesses including borderline personality disorder, avoidant personality disorder, depression, and social anxiety.

 

Mindfulness makes us more aware of ourselves and our emotions and improves our ability to cope with these emotions. As such, it may help with coping with rejection. Indeed, mindfulness has been shown to improve social relationships, including romantic relationships, and reduce our dependence on other people. Mindfulness has also been shown to improve the mental illnesses that are characterized by high levels of rejection sensitivity, including borderline personality disorder, depression, and social anxiety. So, it makes sense to hypothesize that mindfulness may be an antidote to high sensitivity to rejection.

 

In today’s Research News article “Dispositional mindfulness and rejection sensitivity: The critical role of nonjudgment.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4809056/

Peters and colleagues examine the relationship of mindfulness to rejection sensitivity. They recruited college students and required them to complete online measures of five different facets of mindfulness, rejection sensitivity, and positive and negative emotions. They then preformed statistical analysis to determine the relationships between these variables.

 

They found that the mindfulness facets of acting with awareness, nonjudging, nonreactivity, and describing were all significantly negatively related to rejection sensitivity and negative emotions. When these mindfulness facets were included simultaneously in a multiple regression the mindfulness facets of acting with awareness, nonjudging, and nonreactivity remained as significant predictors of low rejection sensitivity, but nonjudging was by far the strongest predictor. In addition, nonjudging was found to moderate the relationship between rejection sensitivity and negative emotions, suggesting that nonjudging may protect the individual from the bad feelings produced by rejection.

 

It needs to be kept in mind that this study was correlational and thereby cannot determine causal connections. It is equally likely that rejection sensitivity interferes with mindfulness as that mindfulness reduces rejection sensitivity. Nevertheless, the results confirm the relationship between high levels of mindfulness, especially nonjudging and low levels of sensitivity to rejection. This relationship may occur by nonjudging protecting the individual from the negative emotions resulting from rejection. Judging experience can make it seem worse than it is and amplify the emotional consequences of the experience. So, by not judging an experience of rejection, the individual may be better able to keep the emotions elicited at a more normal and natural level.

 

So, reduce sensitivity to rejection with non-judging mindfulness.

 

“Rejections aren’t the end of the world but sometimes we can react as if they are. Being turned away from one opportunity makes you available for another. Ultimately, I encourage people not to take things so seriously. If that reaction arises, mindfulness practice can help people to back away from it and keep things in perspective.” – 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

Peters, J. R., Eisenlohr-Moul, T. A., & Smart, L. M. (2016). Dispositional mindfulness and rejection sensitivity: The critical role of nonjudgment. Personality and Individual Differences, 93, 125–129. http://doi.org/10.1016/j.paid.2015.06.029

 

Highlights

  • Examined relationships between facets of mindfulness and rejection sensitivity (RS)
  • RS was negatively associated with multiple mindfulness facets, especially nonjudging
  • Increased nonjudging reduced the association between RS and trait negative affect
  • Mindfulness, specifically nonjudging, may be protective against RS and its effects

Abstract

The pain of rejection is a crucial component of normal social functioning; however, heightened sensitivity to rejection can be impairing in numerous ways. Mindfulness-based interventions have been effective with several populations characterized by elevated sensitivity to rejection; however, the relationship between mindfulness and rejection sensitivity has been largely unstudied. The present study examines associations between rejection sensitivity and multiple dimensions of dispositional mindfulness, with the hypothesis that a nonjudgmental orientation to inner experiences would be both associated with decreased rejection sensitivity and attenuate the impact of sensitivity to rejection on general negative affect. A cross-sectional sample of undergraduates (n = 451) completed self-report measures of rejection sensitivity, dispositional mindfulness, and trait-level negative affect. Significant zero-order correlations and independent effects were observed between most facets of dispositional mindfulness and rejection sensitivity, with nonjudging demonstrating the largest effects. As predicted, rejection sensitivity was associated with negative affectivity for people low in nonjudging (β = .27, t = 5.12, p < .001) but not for people high in nonjudging (β = .06, t = .99, p = .324). These findings provide preliminary support for mindfulness, specifically the nonjudging dimension, as a protective factor against rejection sensitivity and its effects on affect.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4809056/

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 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 and usually treated with anti-depressive medication. But, of patients treated initially with antidepressant drugs only about a third attained remission of the depression. After repeated and varied treatments including antidepressant drugs, therapy, exercise etc. only about two thirds of patients attained remission. Also, many patients who achieve remission have relapses and recurrences of the depression. In addition, antidepressant drugs often have troubling side effects and can lose effectiveness over time.

 

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. 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. Aerobic exercise has also been found to relieve depression. Yoga practice in many ways is ideal as it is both a mindfulness practice and an exercise and it can be practiced in groups or individually at home. It has also been shown to reduce depression.

 

In today’s Research News article “Treating major depression with yoga: A prospective, randomized, controlled pilot trial.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5354384/

Prathikanti and colleagues recruited patients with mild to moderate major depression who were not currently taking anti-depressive medications and randomly assigned them to receive 8 weeks of either 90 minutes twice weekly of Hatha yoga practice or a wait list control that received 90 minutes twice weekly of education on the history of yoga. The participants were measured before during, and after treatment for depression, cognitive ability, psychiatric symptoms, self-efficacy, and self-esteem. They found that the yoga group had a significantly greater decline in depression and increase in self-esteem than the education control group and 60% of the yoga group, compared to 10% of the education group, achieved clinical remission of depression. No adverse effects were reported.

 

The results of this randomized controlled clinical trial suggest that yoga practice is safe and effective in relieving depression when used as the sole treatment. The fact that 60% of the yoga practice participants achieved clinically significant remission of their depression is particularly heartening. Unfortunately, this was a pilot study and no follow up measurements were taken, so it cannot be determined whether the effects endure. Regardless, it appears that yoga can be successfully applied as a monotherapy for mild to moderate major depression.

 

So, improve major depression with yoga.

 

“Available reviews of a wide range of yoga practices suggest they can reduce the impact of exaggerated stress responses and may be helpful for both anxiety and depression. In this respect, yoga functions like other self-soothing techniques, such as meditation, relaxation, exercise, or even socializing with friends.” – Harvard Mental Health Letter

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

Prathikanti, S., Rivera, R., Cochran, A., Tungol, J. G., Fayazmanesh, N., & Weinmann, E. (2017). Treating major depression with yoga: A prospective, randomized, controlled pilot trial. PLoS ONE, 12(3), e0173869. http://doi.org/10.1371/journal.pone.0173869

 

Abstract

Background

Conventional pharmacotherapies and psychotherapies for major depression are associated with limited adherence to care and relatively low remission rates. Yoga may offer an alternative treatment option, but rigorous studies are few. This randomized controlled trial with blinded outcome assessors examined an 8-week hatha yoga intervention as mono-therapy for mild-to-moderate major depression.

Methods

Investigators recruited 38 adults in San Francisco meeting criteria for major depression of mild-to-moderate severity, per structured psychiatric interview and scores of 14–28 on Beck Depression Inventory-II (BDI). At screening, individuals engaged in psychotherapy, antidepressant pharmacotherapy, herbal or nutraceutical mood therapies, or mind-body practices were excluded. Participants were 68% female, with mean age 43.4 years (SD = 14.8, range = 22–72), and mean BDI score 22.4 (SD = 4.5). Twenty participants were randomized to 90-minute hatha yoga practice groups twice weekly for 8 weeks. Eighteen participants were randomized to 90-minute attention control education groups twice weekly for 8 weeks. Certified yoga instructors delivered both interventions at a university clinic. Primary outcome was depression severity, measured by BDI scores every 2 weeks from baseline to 8 weeks. Secondary outcomes were self-efficacy and self-esteem, measured by scores on the General Self-Efficacy Scale (GSES) and Rosenberg Self-Esteem Scale (RSES) at baseline and at 8 weeks.

Results

In intent-to-treat analysis, yoga participants exhibited significantly greater 8-week decline in BDI scores than controls (p-value = 0.034). In sub-analyses of participants completing final 8-week measures, yoga participants were more likely to achieve remission, defined per final BDI score ≤ 9 (p-value = 0.018). Effect size of yoga in reducing BDI scores was large, per Cohen’s d = -0.96 [95%CI, -1.81 to -0.12]. Intervention groups did not differ significantly in 8-week change scores for either the GSES or RSES.

Conclusion

In adults with mild-to-moderate major depression, an 8-week hatha yoga intervention resulted in statistically and clinically significant reductions in depression severity.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5354384/