Month: September 2017

Reduce Compulsive Sexual Behavior with Mindfulness

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Reduce Compulsive Sexual Behavior with Mindfulness

 

By John M. de Castro, Ph.D.

 

“ve Sexual Behavior with Mindfulnessfeeling ashamed of one’s sexual desires, interests, fetishes, and so on, only makes one feel more obsessive and compulsive about them, rather than the opposite. . .. Mindfulness practice helps my clients to observe their reactions to themselves in accepting and non-judgmental ways. Also, they learn to catch and become aware of the negative thoughts and emotions that arise that make them feel compelled to act out.” – Michael Aaron

 

Sexual behavior is a very important aspect of human behavior, especially for reproduction. In fact, Sigmund Freud made it a centerpiece of his psychodynamic theory. At its best, it is the glue that holds families and relationships together. But, it is a common source of dysfunction and psychosocial problems. Compulsive sexual behavior “encompasses problems with preoccupation with thoughts surrounding sexual behavior, loss of control over sexual behavior, disturbances in relationships due to sexual behavior, and disturbances in affect (e.g., shame) due to sexual behavior.” It is also called sex addiction and hypersexuality. It is chronic and remarkably common affecting 3% to 17% of the population. In addition, it is associated with substance abuse in around half of people with compulsive sexual behavior.

 

Compulsive sexual behavior is frequently treated with psychotherapy, Cognitive Behavioral, Therapy, or drugs with mixed success. Since, it is also looked at as an addiction and mindfulness treatment has been found to be effective for both sexual dysfunction and for addictions, mindfulness may be affective for individuals with both substance abuse and compulsive sexual behavior. As a first step in evaluation this possibility, the relationship between mindfulness and compulsive sexual behavior needs to be investigated in these individuals.

 

In today’s Research News article “The relationship between mindfulness and compulsive sexual behavior in a sample of men in treatment for substance use disorders.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4996480/, Shorey and colleagues recruited men in a residential treatment center for substance abuse. Upon admission to the facility and after withdrawal from drugs the men completed a battery of tests including measures of mindfulness, alcohol use, drug use, and compulsive sexual behavior, including preoccupation, loss of control, relationship disturbance, and affect (emotional) disturbance.

 

They found that the higher the level of mindfulness that the men had the lower the levels of drug use, alcohol use, and compulsive sexual behavior, including preoccupation, loss of control, relationship disturbance, and affect disturbance. These relationships with compulsive sexual behavior remained significant and negative even when drug and alcohol use were factored in. In contrast, drug use was not related to compulsive sexual behavior, except for a positive relationship with relationship disturbance. So, although there’s high comorbidity between substance abuse and compulsive sexual behavior, they don’t appear to be highly related.

 

These are encouraging results that suggest that mindfulness may be an antidote for compulsive sexual behavior in patients with substance abuse. These results, however, are correlative and so causation cannot be concluded and are only applicable to men. The next step, of course, will be to form a randomized clinical trial of the effects of mindfulness training on compulsive sexual behavior in patients with substance abuse in both men and women to establish the efficacy of mindfulness training as a treatment. It is possible that mindfulness training will be effective for the treatment of both substance abuse and compulsive sexual behavior in both genders.

 

So, reduce compulsive sexual behavior with mindfulness.

 

“findings tentatively support the usefulness of mindfulness in the effective treatment of sex addiction. In addition to helping bring about a reduction in dysfunctional sex-related actions, fantasies and thoughts, mindfulness training may help affected individuals gain improved emotional control, an increased ability to handle stressful situations and improved resistance to any potentially damaging sex-related urges that arise.” – The Ranch

 

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

 

Shorey, R. C., Elmquist, J., Gawrysiak, M. J., Anderson, S., & Stuart, G. L. (2016). The relationship between mindfulness and compulsive sexual behavior in a sample of men in treatment for substance use disorders. Mindfulness, 7(4), 866–873. http://doi.org/10.1007/s12671-016-0525-9

 

Abstract

Substance use disorders (SUDs) are a serious worldwide problem. Despite years of research on the treatment of SUDs, relapse remains high. One factor that may complicate SUDs treatment for some patients is compulsive sexual behavior. Factors that are related to both SUDs and compulsive sexual behavior could be targeted in SUDs treatment. In the current study, we examined dispositional mindfulness, a protective factor for a range of mental health problems, and its relationship to compulsive sexual behavior in a SUDs treatment sample. This is the first study to examine this relationship in a SUDs sample. Medical records from men in residential SUDs treatment were reviewed for the current study (N = 271). Upon admission to treatment, men completed self-report measures on alcohol and drug use, dispositional mindfulness, and compulsive sexual behavior. Bivariate correlations demonstrated dispositional mindfulness to be negatively associated with a variety of indicators of compulsive sexual behavior. After controlling for alcohol and drug use and problems in hierarchical regression analyses, which were both associated with compulsive sexual behaviors, dispositional mindfulness remained negatively associated with all of the compulsive sexual behavior indicators. Our results provide the first empirical association between dispositional mindfulness and compulsive sexual behavior in a SUDs sample. Although continued research is needed in this area, our findings suggest that it may be beneficial for SUDs treatment to incorporate mindfulness-based interventions for individuals with comorbid compulsive sexual behavior.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4996480/

Improve Workaholism with Meditation

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Improve Workaholism with Meditation

 

By John M. de Castro, Ph.D.

 

“mindfulness is most impactful when it is a way of being that is seamlessly interwoven into daily life, rather than simply a standalone practice. Although it may seem difficult to abandon our attachment to electronic devices and ditch the urge to work nonstop, the space that we create for living, loving, and interacting with the world is by far worth the effort.” – Grace Bullock

 

In western culture working hard is encouraged. But, it should not become an addiction. Work, like many good things can be overdone and become damaging to productivity and the individual’s psychological and physical health and well-being. We refer to work addiction as workaholism. It has been estimated that over 10 million Americans work in excess of 60 hours per week and even though the average American receives 13 paid vacation days per year over a third do not take a single day of vacation and when they do, 30% report feeling constantly worried about work while on vacation. Most bring laptops and cell phones with them to work while on vacation. Workaholics say that they have to rush through their day to accomplish all that they want to and at the end of the day they feel that they didn’t accomplish all that they could. This overwork spills over into family life where workaholic marriages are much more likely than average to fail, with a 55% divorce rate.

 

The treatments for workaholism generally resemble treatments for other addictions. Mindfulness training has been shown to be helpful in treating addition and preventing relapse. Mindfulness has also been shown to be effective for treating and preventing burnout at work. But, to my knowledge there have not been published research studies on the application of mindfulness training for the treatment of workaholism. This was, however, addressed in today’s Research News article “Meditation awareness training for the treatment of workaholism: A controlled trial.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5520118/, Van Gordon and colleagues recruited full-time male and female workers (mean age of 39 years) who scored high on a workaholism scale and created meditation training and wait-list control groups matched on sex, age, education level, salary, and employment type. The meditation training consisted of 2-hour meditation workshops once a week for 8 weeks and guided meditation CDs to continue practice at home. They were measured before and after training for workaholism, job satisfaction, work performance, anxiety, depression, stress, and hours of work per week both at work and at home.

 

They found that the meditation group, compared to baseline and to the wait-list control group, showed significant reductions in workaholism, hours worked per week, anxiety, depression, and stress and increases in job satisfaction. Hence, the meditation practice produced significant relief of workaholism. In addition, job performance was unchanged even though they worked fewer hours. These results suggest that a randomized controlled clinical trial is warranted with an active control group and perhaps a comparison of different therapies. They also

suggest that meditation practice is an effective treatment for workaholism.

 

So, improve workaholism with meditation.

 

“It is possible to move through the drama of our lives without believing so earnestly in the character that we play. That we take ourselves so seriously, that we are so absurdly important in our own minds, is a problem for us. We feel justified in being annoyed with everything. We feel justified in denigrating ourselves or in feeling that we are more clever than other people. Self-importance hurts us, limiting us to the narrow world of our likes and dislikes. We end up bored to death with ourselves and our world. We end up never satisfied.”
― Pema Chödrön

 

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

 

William Van Gordon, Edo Shonin, Thomas J. Dunn, Javier Garcia-Campayo, Marcelo M. P. Demarzo, Mark D. Griffiths. Meditation awareness training for the treatment of workaholism: A controlled trial. J Behav Addict. 2017 Jun; 6(2): 212–220. Published online 2017 Apr 19. doi: 10.1556/2006.6.2017.021

 

Abstract

Background and aims

Workaholism is a form of behavioral addiction that can lead to reduced life and job satisfaction, anxiety, depression, burnout, work–family conflict, and impaired productivity. Given the number of people affected, there is a need for more targeted workaholism treatments. Findings from previous case studies successfully utilizing second-generation mindfulness-based interventions (SG-MBIs) for treating behavioral addiction suggest that SG-MBIs may be suitable for treating workaholism. This study conducted a controlled trial to investigate the effects of an SG-MBI known as meditation awareness training (MAT) on workaholism.

Methods

Male and female adults suffering from workaholism (n = 73) were allocated to MAT or a waiting-list control group. Assessments were performed at pre-, post-, and 3-month follow-up phases.

Results

MAT participants demonstrated significant and sustained improvements over control-group participants in workaholism symptomatology, job satisfaction, work engagement, work duration, and psychological distress. Furthermore, compared to the control group, MAT participants demonstrated a significant reduction in hours spent working but without a decline in job performance.

Discussion and conclusions

MAT may be a suitable intervention for treating workaholism. Further controlled intervention studies investigating the effects of SG-MBIs on workaholism are warranted.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5520118/

Change the Brain with Mindfulness

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Change the Brain with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The picture we have is that mindfulness practice increases one’s ability to recruit higher order, pre-frontal cortex regions in order to down-regulate lower-order brain activity. In other words, our more primal responses to stress seem to be superseded by more thoughtful ones.” – Tom Ireland

 

There has accumulated a large amount of research demonstrating that meditation has significant benefits for psychological, physical, and spiritual wellbeing. Its positive effects are so widespread that it is difficult to find any other treatment of any kind with such broad beneficial effects on everything from mood and happiness to severe mental and physical illnesses. This raises the question of how meditation could do this. One possibility is that mindfulness practice results in beneficial changes in the nervous system.

 

The nervous system is a dynamic entity, constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. These changes in the brain are called neuroplasticity. Over the last decade neuroscience has been studying the effects of contemplative practices on the brain and has identified neuroplastic changes in widespread areas. In other words, mindfulness practice appears to mold and change the brain, producing psychological, physical, and spiritual benefits.

 

The results of the research concerning the changes in the brain that occur with mindfulness practice have not presented a consistent picture. One issue may be the way that mindfulness is measured. This issue was explored in today’s Research News article “A distinction between two instruments measuring dispositional mindfulness and the correlations between those measurements and the neuroanatomical structure.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5524689/, Zhuang and colleagues compared Magnetic Resonance Images (MRIs), depression, and emotion regulation, between college students who had been measured for mindfulness with Mindful Attention Awareness Scale (MAAS) to those measured with the Five Factor Mindfulness Questionnaire (FFMQ).

 

They found that higher MAAS scores and FFMQ Describing, Acting with Awareness, and Non-judging scores the lower levels of depression. In addition, higher FFMQ Describing scores were significantly associated with higher emotion regulation. In regard to the brain scans they found that the higher the MAAS score the greater the size of the Precuneus area of the cortex. Mediation analysis demonstrated that the higher the volume of the precuneus cortical region the higher the MAAS score which in turn was associated with lower depression. So, mindfulness as measured by the MAAS was associated greater volume of the precuneus and was responsible for the relationship of the Precuneus volume with depression.

 

In regard to mindfulness measured with the FFMQ and the brain scans they found that the larger the size of the Superior Prefrontal Cortex, the higher the Describing and Non-judging facets and the lower the Non-reacting facet. In addition, the larger the size of the dorsolateral prefrontal cortex and the inferior parietal cortex the higher the Describing FFMQ facet. Mediation analysis demonstrated that the higher the volume of the Superior Prefrontal Cortex the higher the Describing FFMQ facet which in turn predicted higher emotion regulation. So, mindfulness as measured with the Describing FFMQ facet was associated greater size of the Superior Prefrontal Cortex and was responsible for the relationship of the Superior Prefrontal Cortex size with emotion regulation.

 

These results are interesting and suggest that the kind of relationship observed between changes in the brain and mindfulness is affected by the way mindfulness is measured. This could account for some of the conflicting findings in the published research. Also, since the Precuneus is associated with awareness of self, the results suggest that mindfulness as measured by the MAAS mainly measures self-awareness while since the inferior parietal cortex is also associated with awareness of self, the results suggest that mindfulness as measured by the Describing FFMQ facet also measures self-awareness. But the FFMQ mindfulness measure goes further and also documents other abilities. Since, the Prefrontal cortex is associated with attention control and emotion regulation, the results suggest that mindfulness as measured by the Describing and Non-reacting FFMQ facets also measure attention control and emotion regulation.

 

Clearly, mindfulness is associated with different sizes of areas in the brain’s cortical regions. But, even though the brain is different with mindfulness, the types of differences observed depends upon how mindfulness is measured. The Five Factor Mindfulness Questionnaire (FFMQ) measure appears to be superior to the Mindful Attention Awareness Scale (MAAS) as it breaks mindfulness down into component parts providing greater refinement in observed brain changes. These results will be helpful in future research unravelling the relationship of mindfulness to the characteristics of the nervous system.

 

“The practice of mindfulness can train our brains to have a new default. Instead of automatically falling into the stream of past or future rumination that ignites the depression loop, mindfulness draws our attention to the present moment. As we practice mindfulness, we actually start wiring neurons that balance the brain in a way that is naturally an antidepressant. “ – Debbie Hampton

 

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

 

Zhuang, K., Bi, M., Li, Y., Xia, Y., Guo, X., Chen, Q., … Qiu, J. (2017). A distinction between two instruments measuring dispositional mindfulness and the correlations between those measurements and the neuroanatomical structure. Scientific Reports, 7, 6252. http://doi.org/10.1038/s41598-017-06599-w

 

Abstract

The most widely used measurements of mindfulness are the Mindful Attention Awareness Scale (MAAS) and the Five Facet Mindfulness Questionnaire (FFMQ). However, controversies exist regarding the application of these scales. Additionally, the neural mechanisms of dispositional mindfulness have become a topic of interest. In the current study, we used surface-based methodology to identify the brain regions underlying individual differences in dispositional mindfulness in a large non-clinical sample and compared the two instruments for measuring the dispositional mindfulness. The results indicated that the MAAS scores were significantly associated with increased grey matter volumes in the right precuneus and the significant association between the precuneus and depression symptomatology was mediated by MAAS scores. Regarding the FFMQ, the Describing, Nonjudging, and Nonreactivity facets were selectively associated with the cortical volume, thickness and surface area of multiple prefrontal regions as well as the inferior parietal lobule. Importantly, Describing mediated the association between the dorsolateral PFC volume and the cognitive reappraisal strategies of emotion regulation. These results suggested that the MAAS were mainly associated with self-awareness, while the FFMQ facets were selectively involved in emotion regulation, attention control and self-awareness. Therefore, this study characterized the differences in inter-individual variability between the two typical measurements of dispositional mindfulness and the correlations between those measurements and imaging analyses.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5524689/

Add Home Practice to Mindfulness Training for Maximum Benefit

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Add Home Practice to Mindfulness Training for Maximum Benefit

 

By John M. de Castro, Ph.D.

 

“This is the clearest evidence we have that mindfulness-home practice can make a difference. This is a big source of debate because there are many components at play in a MBSR or MBCT course.“ – Christine Parsons

 

Mindfulness practices have been demonstrated to produce significant benefits for the practitioners’ health and well-being. Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) are specified practices that have proven track records over many years of effectiveness. They are both complex containing discussions, meditation, body scans, and yoga practices. Each is an 8-week program with participants only meeting for instruction once a week. They both rely on the participants practicing the techniques at home daily. There is, however, very little information regarding compliance with the home practice, to what extent do the participants fully comply with the instructions to practice at home, and what effects that may have on the effectiveness of the programs.

 

In today’s Research News article “Home practice in Mindfulness-Based Cognitive Therapy and Mindfulness-Based Stress Reduction: A systematic review and meta-analysis of participants’ mindfulness practice and its association with outcomes.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501725/, Parsons and colleagues review, summarize, and perform a meta-analysis of adherence to home practice requirements during 8 weeks of mindfulness training. They found 49 research articles employing Mindfulness-Based Stress Reduction (MBSR) or Mindfulness-Based Cognitive Therapy (MBCT) which required home practice.

 

They found that the studies reported that participants performed about 64% of the required home practice. That translated into an average of 29 minutes per day of the required 45 minutes. This level of compliance was found to be true regardless of whether clinical or non-clinical samples were used, or whether the primary outcomes were psychological or physical, or between MBSR or MBCT programs. They also found that there was a small, albeit significant, relationship between the amount of home practice and the magnitude of the benefits from the treatment, such that the greater the amount of home practice, the greater the benefit.

 

Hence, the published research literature suggests that participants in both MBSR and MBCT programs perform on average about 2/3rds of the required home practice and that the better the compliance with the home practice requirement the better the outcomes. This is actually surprising good levels of compliance. Unfortunately, most of the studies used self-reports of home practice and the participants may have felt compelled to report better compliance than what they actually did. Nevertheless, the research suggests that home practice is a beneficial component of the practices. It is possible that this is true because it brings the practice into the everyday environment of the participants, away from the artificiality of the clinic. This may help to more readily transfer what is learned from the clinic to the real world and thereby heighten the impact of the practices.

 

So, add home practice to mindfulness training for maximum benefit.

 

“home practice helps generate meaningful change in dispositional mindfulness, which is purportedly a key mechanism of action in mindfulness-based interventions.” – Dawn Epstein

 

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

 

Parsons, C. E., Crane, C., Parsons, L. J., Fjorback, L. O., & Kuyken, W. (2017). Home practice in Mindfulness-Based Cognitive Therapy and Mindfulness-Based Stress Reduction: A systematic review and meta-analysis of participants’ mindfulness practice and its association with outcomes. Behaviour Research and Therapy, 95, 29–41. http://doi.org/10.1016/j.brat.2017.05.004

 

Abstract

Mindfulness-Based Cognitive Therapy (MBCT) and Mindfulness-Based Stress Reduction (MBSR) emphasize the importance of mindfulness practice at home as an integral part of the program. However, the extent to which participants complete their assigned practice is not yet clear, nor is it clear whether this practice is associated with positive outcomes.

For this systematic review and meta-analysis, searches were performed using Scopus and PubMed for studies published through to the end of 2015, reporting on formal home practice of mindfulness by MBSR or MBCT participants.

Across 43 studies (N = 1427), the pooled estimate for participants’ home practice was 64% of the assigned amount, equating to about 30 minutes per day, six days per week [95% CI 60–69%]. There was substantial heterogeneity associated with this estimate. Across 28 studies (N = 898), there was a small but significant association between participants’ self-reported home practice and intervention outcomes (r = 0·26, 95% CI 0·19,–0·34).

MBSR and MBCT participants report completing substantial formal mindfulness practice at home over the eight-week intervention, albeit less than assigned amounts. There is a small but significant association between the extent of formal practice and positive intervention outcomes for a wide range of participants.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501725/

Reduce Depression and Anxiety Around Pregnancy with Mindfulness

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Reduce Depression and Anxiety Around Pregnancy with Mindfulness

 

By John M. de Castro, Ph.D.

 

“By learning mindfulness skills as part of their childbirth education, expectant mothers can reappraise the impending birth as something they can handle instead of viewing it as something to fear.” – Larissa Duncan

 

The perinatal period, from the onset of pregnancy to the end of the infants first year, is a time of intense physiological and psychological change in both the mother and the infant. Anxiety, depression, and fear are quite common during pregnancy. More than 20 percent of pregnant women have an anxiety disorder, depressive symptoms, or both during pregnancy. A debilitating childbirth fear has been estimated to affect about 6% or pregnant women and 13% are sufficiently afraid to postpone pregnancy. It is difficult to deal with these emotions under the best of conditions but in combinations with the stresses of pregnancy can turn what could be a joyous experience of creating a human life into a horrible worrisome, torment.

 

The psychological health of pregnant women has consequences for fetal development, birthing, and consequently, child outcomes. Depression during pregnancy is associated with premature delivery and low birth weight. Childbirth fear is associated with “low childbirth self-efficacy, greater use of pain medication during labor, more unwanted obstetric interventions in labor, as well as increased risk of postpartum depression.” Hence, it is clear that there is a need for methods to treat childbirth fear, depression, and anxiety during pregnancy. Since the fetus can be negatively impacted by drugs, it would be preferable to find a treatment that did not require drugs. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy. So, it would make sense to study the effects of mindfulness training during the perinatal period.

 

In today’s Research News article “The Effectiveness of Mindfulness-Based Interventions on Maternal Perinatal Mental Health Outcomes: a Systematic Review.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506176/, Shi & MacBeth reviewed the published research literature on the effectiveness of mindfulness training on the emotional states of women in the perinatal period. They found 18 published studies that employed Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), or mindful yoga as the treatment for anxiety and depression during the perinatal period.

 

They found that the research indicated that mindfulness-based treatments were particularly effective for anxiety and to a lesser extent for depression and its recurrence. The treatments were reported to be safe, with no appreciable negative side effects, and acceptable, with low drop out rates. They note that there is a need for more highly controlled randomized controlled trials that include active control conditions in the future.

 

The results from the summarized 18 studies suggest that mindfulness based interventions are safe and effective treatment for perinatal anxiety and depression. Mindfulness practices have been shown to increase the focus on the present moment. Anxiety tends to revolve around the future while depression appears to revolve around the past. By focusing the individual on what is occurring in the present moment mindfulness training appears to decrease thinking about the past or the future and may thereby reduce anxiety and depression. Mindfulness training has also been shown to reduce the physiological and psychological responses to stress. The reduction in stress responses during the high stress perinatal period may also contribute to the women’s improved mood.

 

So, reduce depression and anxiety around pregnancy with mindfulness.

 

“Since mindfulness has a lot to do with being in touch with the sensations in your body, and being aware, new moms are in a prime state to learn it! In fact, pregnancy and early motherhood, nursing and sleep disturbance, weight gain and weight loss-these all in some way force you to be in your body. For those of us who live most of our lives above our necks, this can actually be a great blessing.” – Cassandra Vieten

 

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

 

Shi, Z., & MacBeth, A. (2017). The Effectiveness of Mindfulness-Based Interventions on Maternal Perinatal Mental Health Outcomes: a Systematic Review. Mindfulness, 8(4), 823–847. http://doi.org/10.1007/s12671-016-0673-y

 

Presenting with common mental health difficulties, particularly depression and anxiety, there is also preliminary evidence that mindfulness-based interventions (MBIs) including mindfulness-based cognitive therapy (MBCT), mindfulness-based stress reduction (MBSR) and integrated mindfulness yoga practices may also be effective in reducing common mental health difficulties during pregnancy. We systematically reviewed and synthesized the current literature on the effectiveness of MBIs in reducing severity of perinatal anxiety and depression. Databases including PubMed, Cochrane Library, IndMED and PsychoInfo were searched for relevant studies. Manual searches were conducted in relevant articles and Google Scholar. Seventeen cohorts representing 18 studies were included. Pre-post effect sizes were reported for both treatment and control groups. Seven randomized controlled trials (RCTs), two non-randomized controlled trials and nine treatment evaluations were included. Maternal participation in an MBI was associated with reductions in perinatal anxiety of moderate to large magnitude. Results for the effect of MBIs on depression were less consistent, with pre-post treatment reductions of moderate magnitude, but no significant differences in depression scores when MBI was compared with a control group. There was some evidence that MBIs were associated with increased mindfulness. Risk of bias in studies was variable. Our review offers preliminary evidence for the effectiveness of MBIs in reducing perinatal anxiety, with more equivocal findings with regard to perinatal depressive symptoms. Further methodologically rigorous evaluation using RCTs and longer follow-up periods are recommended.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506176/

Improve Immune Response and Sleep to Breast Cancer with Yoga

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Improve Immune Response and Sleep to Breast Cancer with Yoga

 

By John M. de Castro, Ph.D.

 

“I’m convinced that yoga made all the difference in my treatment. The breathing was the thing that always came back for me—keeping the fear and panic down. I was in a PET scan machine for an hour. You just lie there and think terrible thoughts. I found my breathing. That was the most valuable thing.” –  Debra Campagna

 

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 always a death sentence. 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). Also, breast cancer survivors can have to deal with a heightened fear of reoccurrence. This is particularly true with metastatic cancer. Additionally, cancer survivors frequently suffer from anxiety, depression, mood disturbance, Post-Traumatic Stress Disorder (PTSD), sleep disturbance, fatigue, sexual dysfunction, loss of personal control, impaired quality of life, an alteration of their body image, and psychiatric symptoms which have been found to persist even ten years after remission. So, safe and effective treatments for the symptoms in breast cancer and the physical and psychological effects of the treatments are needed.

 

Mindfulness training has been shown to help with general cancer recovery and breast cancer recovery. Mindfulness helps to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. The mindfulness practice of Yoga has also been shown to be helpful with the residual symptoms and the psychological and physical ability to deal with cancer treatment. So, it’s reasonable to further explore the potential benefits of yoga practice for women during and after treatment.

 

In today’s Research News article “Effect of Yoga on Sleep Quality and Neuroendocrine Immune Response in Metastatic Breast Cancer Patients.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5545949/, Rao and colleagues recruited women with advanced metastatic breast cancer. They received treatment as usual and were randomly assigned to receive either education and supportive counseling or an integrated yoga program for 12 weeks consisting of 60-min sessions twice a week combined with home practice of relaxation, breathing exercises, postures, and meditation. They were measured before and after treatment for sleep disturbance, salivary cortisol, and natural killer cells in the blood.

 

They found that after treatment the yoga practice group had significant improvements in sleep including sleep quality and reductions in insomnia and sleep distress. There was also a decrease in salivary cortisol levels in the morning indicating a less stressful sleep. Importantly, they found that yoga practice produced a significant increase in natural killer cells in the blood. There were no adverse effects observed and adherence to the protocol was high at 80%.

 

It would have been better if the control group had performed some other form of exercise to determine if it was yoga practice per se or simply exercise was responsible for the results. In addition, since the integrated yoga program contained multiple components it is impossible to differentiate which or which combination of components was effective. Nevertheless, these are impressive and exciting results that integrated yoga practice can have such profound positive effects on women with advanced metastatic breast cancer.

 

The results suggest that yoga practice improves sleep and the ability of the immune system to fight the cancer. The importance of adequate, high quality sleep for women fighting cancer cannot be overemphasized. High sleep quality is related to reductions in stress and inflammation which in turn is related to improved ability to fight the cancer. The present findings suggest that yoga is a safe and effective practice with clear physical and psychological benefits aiding in the fight against advanced metastatic breast cancer.

 

So, improve immune response and sleep to breast cancer with yoga.

 

“For women with breast cancer, research shows those who practice yoga may also have less stress and fatigue, and better quality of life.” – American Cancer Society

 

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

 

Rao, R. M., Vadiraja, H., Nagaratna, R., Gopinath, K. S., Patil, S., Diwakar, R. B., … Nagendra, H. (2017). Effect of Yoga on Sleep Quality and Neuroendocrine Immune Response in Metastatic Breast Cancer Patients. Indian Journal of Palliative Care, 23(3), 253–260. http://doi.org/10.4103/IJPC.IJPC_102_17

 

Abstract

Background:

Studies have shown that distress and accompanying neuroendocrine stress responses as important predictor of survival in advanced breast cancer patients. Some psychotherapeutic intervention studies have shown have modulation of neuroendocrine-immune responses in advanced breast cancer patients. In this study, we evaluate the effects of yoga on perceived stress, sleep, diurnal cortisol, and natural killer (NK) cell counts in patients with metastatic cancer.

Methods:

In this study, 91 patients with metastatic breast cancer who satisfied selection criteria and consented to participate were recruited and randomized to receive “integrated yoga based stress reduction program” (n = 45) or standard “education and supportive therapy sessions” (n = 46) over a 3 month period. Psychometric assessments for sleep quality were done before and after intervention. Blood draws for NK cell counts were collected before and after the intervention. Saliva samples were collected for three consecutive days before and after intervention. Data were analyzed using the analysis of covariance on postmeasures using respective baseline measure as a covariate.

Results:

There was a significant decrease in scales of symptom distress (P < 0.001), sleep parameters (P = 0.02), and improvement in quality of sleep (P = 0.001) and Insomnia Rating Scale sleep score (P = 0.001) following intervention. There was a decrease in morning waking cortisol in yoga group (P = 0.003) alone following intervention. There was a significant improvement in NK cell percent (P = 0.03) following intervention in yoga group compared to control group.

Conclusion:

The results suggest modulation of neuroendocrine responses and improvement in sleep in patients with advanced breast cancer following yoga intervention.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5545949/

Mindful Loneliness

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Mindful Loneliness

 

By John M. de Castro, Ph.D.

 

“We always tell people to quit smoking for health reasons, but rarely do we think about loneliness in the same way. We know that loneliness is a major risk factor for health problems and mortality in older adults. This research suggests that mindfulness meditation training is a promising intervention for improving the health of older adults.” – David Creswell

Humans are social creatures. We’ve been able to dominate our planet, not due to any particular physical prowess, but by our working together for the common good. This need for others is deeply embedded in our DNA. In fact, we are generally happiest when we’re with family and friends. Conversely, being without close social contact makes us miserable. It’s the close relationship that is so important as we can be around people all day at work and still feel deep loneliness. These contacts are frequently superficial and do not satisfy our deepest need. People can be involved in a lifelong marriage and still be lonely as sometimes these marriages lack the intimacy that is so needed. Hence, loneliness is common even when surrounded by other people.

 

It is sometimes said that we live in “the age of loneliness.” It is estimated that 20% of Americans suffer from persistent loneliness. This even when we are more connected than ever with the internet, text messaging, social media, etc. But, these create the kinds of superficial contacts that we think should be satisfying, but are generally not. This has led to the counterintuitive findings that young adults, 18-34, have greater concerns with loneliness than the elderly. This is very surprising as the elder years are considered a time of increasing loneliness. Indeed 18% of seniors live alone and 43% report feeling lonely on a regular basis.

 

The consequences of loneliness are dire. It has been estimated that being socially isolated increases mortality by 14%. This is twice the elevation produced by obesity. Even worse, for people over 60, loneliness increases their risk of death by 45%. When a spouse loses a marital partner there’s a 30% increase in mortality in the 6-months following the death. Hence, loneliness is not only an uncomfortable and unhappy state, but it is also a threat to health and longevity. It is clear that this epidemic of loneliness needs to be addressed.

 

Mindfulness is not a solution for loneliness, but it can help. Being in the present moment while we’re in the presence of others can heighten the intimacy of the interaction. Deeply listening to others and feeling loving kindness and compassion makes us closer to them and makes them feel closer to us. So, even in superficial contexts like work environments, mindfulness can make the relationships more satisfying and counteract loneliness. Mindfulness can be applied in many situations that seemingly anonymous and superficial, such as going for a walk. Just being fully present with the people you pass and who pass you, looking with compassion and smiling, can produce a smile in return or a “good morning” and produces a connection, albeit small, that decreases the loneliness of the moment. Just being in the present moment will almost automatically produce feelings of connectedness toward others and to some extent, reduce loneliness.

 

One of the keys to coping with loneliness is the realization that ultimately, we, like everyone else, are alone. Only we are aware of our true feelings, our experiences and how we’re interpreting them, our memories, and our consciousness itself. Someone very close to us can get some idea of what’s going on in our heads, but it is at best a poor approximation, and never exactly what we’re experiencing. So, one of the most important things that we can do to counteract loneliness is to become comfortable with ourselves, to really get to know ourselves deeply, with mindfulness, without judgment, and with loving kindness.

 

We do everything we can to avoid dealing with our aloneness. Particularly in modern society we never allow ourselves to truly be alone. Even when isolated from others we distract ourselves constantly with TV, movies, music, the internet, games, social media, etc. I was recently on a wonderful walk with my spouse along a beautiful path by a river. It was a great place to be connected to the environment in the present moment and enjoy just being with yourself. Yet I saw many people with earphones on listening to music and others on their phones, talking, texting, or immersed in whatever was on their screens. They distracted themselves from being alone even though they were in a fantastic place to be alone.

 

Distracting ourselves is a symptom of the fact that most westerners don’t actually like themselves. Our society somehow creates feelings of self-dislike. There’s a deep feeling engendered that there’s something wrong with us. Our way of coping with this uncomfortable and threatening situation is by avoiding ourselves and distracting our minds whenever there may be any hint of being alone and having to deal with our perceived unworthy selves. But, this suggests that the antidote to loneliness may be finding a way to love ourselves. This could transform loneliness into an enjoyable state of solitude. Loneliness and solitude are objectively the same, we’re by ourselves. But, loneliness is an unhappy state where we rue the lack of intimate contact with others while solitude is the joy of being alone. It is being in harmony with ourselves and enjoying the process of being by ourselves. Developing self-like, then may be the key to transforming loneliness to happy solitude.

 

Meditation practice can be a key to attaining a state of joyous solitude. In meditation, we can learn to be comfortable with our internal state. Others are not needed to validate our feelings and experiences. We can simply experience our feeling without judging them. We can see feelings arising and falling away. We can see them as just another thing that is impermanent. One strategy is to actually meditation on loneliness. In this practice, we engage in deeply feeling loneliness, experiencing how we feel inside when we are lonely; not judging it, just feeling it. We focus on the physiological expression of loneliness; sensing the internal sensations that accompany it. This helps us to become sensitive to this state and recognize it, even when it’s mild and subtle. Once we are aware that loneliness is what we’re feeling, we’re better able to address it in real time, we’re better able to see it as just a feeling that doesn’t say anything about ourselves, we’re better able to understand that it doesn’t mean that there’s something wrong with us, we’re better able to know that it is impermanent and will fall away. In other words, we become much better at being alone, being in solitude.

 

In the contemplative meditative state, we can develop self-like. Seeing ourselves without judgment is helpful, but it is often important to nurture good feeling about ourselves. Loving kindness meditation can be very helpful in this regard. This technique helps us to be kind and compassionate toward ourselves. In this meditation, we focus on bringing lovingkindness to ourselves. Envisioning a time when we felt completely loved and accepted, feeling what it was like, feeling the inner sensations and the ease of well-being. Once this is fully present we begin slowly and meaningfully to say to ourselves: “May I be happy. May I be well. May I be safe. May I be peaceful and at ease.” We wholeheartedly engage in honestly wishing ourselves well and visualizing how it would feel to truly be happy, well, safe, and peaceful; sincerely making these wishes in the unshakable knowledge that we deserve to be happy, well, safe, and peaceful. This is a seemingly ridiculously simple technique has been demonstrated to be very impactful. It improves our emotional state and develops self-love overcoming self-dislike.

 

In order to overcome loneliness, we must be comfortable with ourselves first. We must be good company for ourselves. This stops the running away and constantly needing to distract ourselves. When we can do this we then become much better companions for others. We are no longer using them to validate ourselves, to work out our problems, and to feel better about ourselves by denigrating them. Others come to like us more and want to be around us more, counteracting loneliness. So, learning to like being with ourselves, finding solitude joyous, we can not only feel better about being alone, but also improve our social situation and be alone less often.

 

So, don’t try to overcome loneliness by looking to others to fix the problem. Get comfortable with the ourselves first, learning to enjoy solitude. Then develop loving kindness towards ourselves and learn to like ourselves. This is the magic formula for coping with loneliness; learning to enjoy being with ourselves. So, even when we’re alone, we’re still happy. But, in the process, we become more likable and attractive to others, making being alone occur less often. It seems strange to think that developing our experience of solitude is the solution to loneliness. But, that is exactly the necessary solution.

 

“Slowly practicing mindfully to move away from the story, solitude can emerge. It can be beautiful, for in your solitude you actually end up connecting to humanity by connecting to your own humanness. Slowly you stop over analyzing your story and stop running away from your feelings and space opens up to do whatever you enjoy when you are by yourself.” – Sadia Raval

 

“Becoming mindful in this way of what factors give rise to loneliness in your life, and learning to question the validity of the stories you tell yourself about it, makes it more manageable. Then, with an attitude of kind benevolence toward yourself, let the loneliness be and allow compassion to arise over any suffering you’re experiencing. “ – Toni Bernhard

 

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

Mindfulness Training Benefits Neurotic Individuals the Most

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Mindfulness Training Benefits Neurotic Individuals the Most

 

By John M. de Castro, Ph.D.

 

“Do you have neurotic tendencies? You might give mindfulness a try. The practice has been shown to help quell the voice of the “obnoxious roommate” in your head. One of the “Big Five” personality traits, neuroticism is characterized by negative affect, rumination on the past and worry about the future, moodiness and loneliness. Practicing mindfulness may be a powerful way for people to detach from common characteristics of neuroticism, including obsessive negative thoughts and worries, and challenges regulating one’s emotions and behavior.” – Carolyn Gregoire

 

We know that people differ in how they interact with the environment and other people. We call these differences personality. Personality characteristics are thought to be relatively permanent traits that form an individual’s distinctive character. Different personalities predict different behaviors and different responses to the environment. This suggests that different personality types might respond differently to mindfulness training.

 

Current psychological research and theorization on personality has suggested that there are five basic personality characteristics. The so called “Big 5” are Extraversion, Agreeableness, Openness to Experience, Conscientiousness, and Neuroticism. Extraversion involves engagement with the external world, particularly other people. Agreeableness involves trust and helpfulness and a positive temperament. Openness to Experience is intellectual curiosity and is associated with creativity and a preference for novelty and variety. Conscientiousness involves planning, organization, dependability and self-discipline. Finally, Neuroticism involves moodiness, negative emotions, and a tendency to perceive even minor things as threatening or impossible. It is thought that most individual personalities can be captured by these five characteristics.

 

It has been shown that people high in mindfulness are also high in the “Big 5” traits of Conscientiousness, and Neuroticism.  It is possible that people high in these traits are more susceptible to the effects of mindfulness training. In today’s Research News article “For Whom Does Mindfulness-Based Stress Reduction Work? Moderating Effects of Personality.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506177/, Nyklíček, I., & Irrmischer examine whether the effectiveness of mindfulness training is affected by the individual’s personality. They recruited adults and provided them with Mindfulness-Based Stress Reduction (MBSR) program. MBSR consists of meditation, yoga and body scan and training occurs over 8 weeks in 2.5-hour weekly sessions with daily homework assignments. Before training their personality was measured and before and after training and 3-months later, they were measured for anxiety and depression.

 

They found that as has been previously demonstrated MBSR resulted in substantial significant reductions in anxiety and depression after training and these mood states continued to improve and were even lower 3 months later. They then tested for mediation effects to determine if personality characteristics affected the MBSR reductions in anxiety and depression. They found that the personality characteristic of neuroticism accentuated the effect such that the higher the levels of neuroticism the greater the reductions in anxiety and depression produced by MBSR. This mediation effect, however, was in part due to the fact that high neuroticism was related to higher depression and anxiety. When they controlled for the levels of depression and anxiety present when the study began, the mediation effect for depression was no longer significant while neuroticism continued to mediate the effect of MBSR on anxiety.

 

So, they found that MBSR training produces a long-lasting reduction in anxiety and depression. The effect of MBSR on depression occurs equally regardless of personality characteristics. On the other hand, MBSR training reduces anxiety to a greater extent in people high in neuroticism. By focusing attention more on the present moment, MBSR training reduces the past orientation that energizes depression and the future orientation that fuels anxiety. It appears to have its effect on anxiety magnified in highly neurotic people. Neuroticism involves a tendency to perceive even minor things as threatening. Focusing on the present moment interrupts seeing future threat and thereby may make the neuroticism less impactful.

 

So, mindfulness training benefits neurotic individuals the most.

 

“By the posture, by the action,
By eating, seeing, and so on,
By the kind of states occurring,
May temperament be recognized.” – Path of Purification

 

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

 

Nyklíček, I., & Irrmischer, M. (2017). For Whom Does Mindfulness-Based Stress Reduction Work? Moderating Effects of Personality. Mindfulness, 8(4), 1106–1116. http://doi.org/10.1007/s12671-017-0687-0

 

Abstract

The aim of the present study was to examine potentially moderating effects of personality characteristics regarding changes in anxious and depressed mood associated with Mindfulness-Based Stress Reduction (MBSR), controlling for socio-demographic factors. Meditation-naïve participants from the general population self-presenting with psychological stress complaints (n = 167 participants, 70% women, mean age 45.8 ± 9.3 years) were assessed in a longitudinal investigation of change in mood before and after the intervention and at a 3-month follow-up. Participants initially scoring high on neuroticism showed stronger decreases in both anxious and depressed mood (both p < 0.001). However, when controlled for baseline mood, only the time by neuroticism interaction effect on anxiety remained significant (p = 0.001), reflecting a smaller decrease in anxiety between pre- and post-intervention but a larger decrease in anxiety between post-intervention and follow-up in those with higher baseline neuroticism scores. Most personality factors did not show moderating effects, when controlled for baseline mood. Only neuroticism showed to be associated with delayed benefit. Results are discussed in the context of findings from similar research using more traditional cognitive-behavioral interventions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506177/

Slow Age-Related Physical Decline with Tai Chi

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Slow Age-Related Physical Decline with Tai Chi

 

By John M. de Castro, Ph.D.

 

“This peaceful type of moving meditation is primarily used to improve strength, balance, flexibility and posture. Recent studies of Tai Chi shows that this mind-body practice is able to alleviate pain, improve mood, increase immunity and support heart health.” – World Health net

 

We celebrate the increasing longevity of the population. But, aging is a mixed blessing. The aging process involves a systematic progressive decline of the body and the brain. Every system in the body deteriorates including motor function with a decline in strength, flexibility, and balance. It is inevitable. In addition, many elderly experience withdrawal and isolation from social interactions. There is some hope as there is evidence that these declines can be slowed. For example, a healthy diet and a regular program of exercise can slow the physical decline of the body with aging. Also, contemplative practices such as meditation, yoga, and tai chi or qigong have all been shown to be beneficial in slowing or delaying physical and mental decline.

 

Tai Chi has been practiced for thousands of years with benefits for health and longevity. Tai Chi training is designed to enhance function and regulate the activities of the body through regulated breathing, mindful concentration, and gentle movements. Only recently though have the effects of Tai Chi practice been scrutinized with empirical research. But, it has been found to be effective for an array of physical and psychological issues. It appears to strengthen the immune system, reduce inflammation and increase the number of cancer killing cells in the bloodstream. Because Tai Chi is not strenuous, involving slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. Tai Chi has been shown to help the elderly improve attention, balance, reducing falls, arthritis, cognitive function, memory, and reduce age related deterioration of the brain.

 

In today’s Research News article “Effect of Taichi Softball on Function-Related Outcomes in Older Adults: A Randomized Control Trial.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5397616/, Lou and colleagues recruited individuals from a senior living community (mean age 63 years) and randomly assigned them to either receive Tai Chi Softball Training for 7 weeks, four times a week, for 90 minutes each, or a no-treatment control group. Tai Chi Softball Training requires practitioners to hold a racket and control a softball on the surface of the racket while performing Tai Chi. Participants were measured before, at 7 weeks, and after training for lower limb strength and balance, and upper limb shoulder mobility, handgrip strength, and fine motor control.

 

They found that while the control group had deterioration in all measures, the participants in Tai Chi Softball Training had significant improvements in these same measures, including fine motor control, fine motor function, handgrip strength, hand and forearm strength, shoulder mobility, leg strength, and dynamic balance. The practice was found to be safe, as there were no significant adverse effects observed for participation in Tai Chi Softball Training.

 

These are wonderful results demonstrating that Tai Chi Softball Training is very effective in improving physical functional health in the elderly. This is particularly important as the progressive decline in motor ability in this group impacts their quality of life, health, and even their longevity. It would be interesting in future research to compare Tai Chi Softball Training to regular Tai Chi practice and other exercise programs to determine if one is superior to the others. Hence, Tai Chi because it is effective and gentle, is almost an ideal program for the elderly.

 

So, slow age-related physical decline with tai chi.

 

“tai chi may be an easier and more convenient than brisk walking as an anti-aging choice. Previous studies have shown tai chi also improves balance and may help boost brain functioning.” – Linda Melone

 

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

 

Lou, L., Zou, L., Fang, Q., Wang, H., Liu, Y., Tian, Z., & Han, Y. (2017). Effect of Taichi Softball on Function-Related Outcomes in Older Adults: A Randomized Control Trial. Evidence-Based Complementary and Alternative Medicine : eCAM, 2017, 4585424. http://doi.org/10.1155/2017/4585424

 

Abstract

The purpose of this present study was to examine the effect of Taichi softball (TCSB) on physical function in Chinese older adults. Eighty Chinese older adults were randomly assigned into either an experimental group experiencing four 90-minute TCSB sessions weekly for seven consecutive weeks or a control group. At baseline and 7 weeks later, all participants were asked to perform physical functional tests for both lower and upper limbs. Multiple separate Analyses of Variance (ANOVA) with repeated measures were applied to evaluate the effects of TCSB on function-related outcomes between baseline and postintervention in the two groups. The findings indicate that a short-term and intensive TCSB training program does not only improve low limb-related physical function such as dynamic balance and leg strength, but also strengthen upper limb-related physical function (e.g., arm and forearm strength, shoulder mobility, fine motor control, handgrip strength, and fine motor function). Health professionals could take into account TCSB exercise as an alternative method to help maintain or alleviate the inevitable age-related physical function degeneration in healthy older adults. In addition, researchers could investigate the effect of TCSB exercise on physical function in special populations such as patients with different chronic diseases or neurological disorder (e.g., Parkinson’s disease).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5397616/

Mindfulness-Based Cognitive Therapy is Effective Regardless of Teacher Competence

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Mindfulness-Based Cognitive Therapy is Effective Regardless of Teacher Competence

 

By John M. de Castro, Ph.D.

 

 “Over the past 15 years, the results of numerous randomized controlled trials have demonstrated that MBCT can be a powerful intervention for people who have experienced clinical depression three or more times. Evidence indicates MBCT may reduce the rate of relapse for individuals with recurrent depression by 50%. MBCT has also been applied to mood and anxiety concerns other than depression, with reported success.” – Good Therapy .org

 

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. MBCT is usually delivered by trained certified teachers but is fairly scripted and standardized. So, it is unclear what the importance of the level of teacher training and competence is.

 

In today’s Research News article “Teacher Competence in Mindfulness-Based Cognitive Therapy for Depression and Its Relation to Treatment Outcome.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506231/, Huijbers and colleagues examine the importance of the competence of the MBCT teacher in the effectiveness of MBCT for depression. They recruited patients who had had at least 3 episodes of depression, were in remission, taking antidepressants, and were engaged in a Mindfulness Based Cognitive Therapy (MBCT) program. MBCT was delivered in of 8 weekly sessions of 2.5 hours.

 

Patients were measured before and after MBCT training and 15 months later for rumination, self-compassion, mindfulness, cognitive reactivity, depressive symptoms, and depression relapse. The MBCT teachers were assessed for competence by two independent professional evaluators who rated a tape recorded MBCT session for “(1) coverage, pacing, and organization of session curriculum; (2) relational skills; (3) embodiment of mindfulness; (4) guiding mindfulness practices; (5) conveying course themes through interactive inquiry and didactic teaching; and (6) holding of group learning environment.” An overall competence rating was calculated as the sum of the 6 component competence scores.

 

They found that following treatment there were significant increases in patient self-compassion and mindfulness and significant decreases in rumination and cognitive reactivity. They also found that teacher competence did not significantly predict the number of sessions that the patients attended, and patient changes in self-compassion, mindfulness, rumination, and cognitive reactivity, or depression severity. In addition, the likelihood of relapse during the 15 month follow-up period was not significantly related to teacher competence. This was true for the overall competence and for each of the 6 competence domains.

 

These results are quite remarkable and suggest that the level of competence and expertise of the instructors in Mindfulness Based Cognitive Therapy (MBCT) does not affect the patient outcomes. These results are contrary to the recent findings that the level of teacher training with Mindfulness-Based Stress Reduction (MBSR) programs is associated with the effectiveness of the program to reduce stress and improve well-being.

 

It’s difficult to reach firm conclusion from the negative results of the present study as the range of teacher competencies was restricted wherein only 2 teachers were characterized as beginner and 2 as advanced. The lack of effect of teacher competence may also be due to the fact that MBCT programs are highly standardized and scripted by the treatment protocol and that patients are supplied with prerecorded materials for home practice. Nevertheless, the results suggest that only modest teacher competence and training is sufficient, with a standardized program, to produce maximal results.

 

So, it appears that Mindfulness-Based Cognitive Therapy is effective regardless of teacher competence.

 

“MBCT teaches people to pay attention to the present moment, rather than worrying about the past or the future, and to let go of the negative thoughts that can tip them over into depression. It also gives people a greater awareness of their own body, helping them to identify the signs of oncoming depression and ward off the episode before it starts.” – BeMindful

 

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

 

Huijbers, M. J., Crane, R. S., Kuyken, W., Heijke, L., van den Hout, I., Donders, A. R. T., & Speckens, A. E. M. (2017). Teacher Competence in Mindfulness-Based Cognitive Therapy for Depression and Its Relation to Treatment Outcome. Mindfulness, 8(4), 960–972. http://doi.org/10.1007/s12671-016-0672-z

 

Abstract

As mindfulness-based cognitive therapy (MBCT) becomes an increasingly mainstream approach for recurrent depression, there is a growing need for practitioners who are able to teach MBCT. The requirements for being competent as a mindfulness-based teacher include personal meditation practice and at least a year of additional professional training. This study is the first to investigate the relationship between MBCT teacher competence and several key dimensions of MBCT treatment outcomes. Patients with recurrent depression in remission (N = 241) participated in a multi-centre trial of MBCT, provided by 15 teachers. Teacher competence was assessed using the Mindfulness-Based Interventions: Teaching Assessment Criteria (MBI:TAC) based on two to four randomly selected video-recorded sessions of each of the 15 teachers, evaluated by 16 trained assessors. Results showed that teacher competence was not significantly associated with adherence (number of MBCT sessions attended), possible mechanisms of change (rumination, cognitive reactivity, mindfulness, and self-compassion), or key outcomes (depressive symptoms at post treatment and depressive relapse/recurrence during the 15-month follow-up). Thus, findings from the current study indicate no robust effects of teacher competence, as measured by the MBI:TAC, on possible mediators and outcome variables in MBCT for recurrent depression. Possible explanations are the standardized delivery of MBCT, the strong emphasis on self-reliance within the MBCT learning process, the importance of participant-related factors, the difficulties in assessing teacher competence, the absence of main treatment effects in terms of reducing depressive symptoms, and the relatively small selection of videotapes. Further work is required to systematically investigate these explanations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506231/