Month: August 2018

Measure Mindfulness Better in Depressed Patients with Changes in the EEG

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Measure Mindfulness Better in Depressed Patients with Changes in the EEG

 

By John M. de Castro, Ph.D.

 

“as the popularity of mindfulness grows, brain imaging techniques are revealing that this ancient practice can profoundly change the way different regions of the brain communicate with each other – and therefore how we think – permanently.” – Tom Ireland

 

Mindfulness training has been shown to improve health and well-being. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. As a result, mindfulness training has been called the third wave of therapies. One problem with understanding mindfulness effects is that there are, a wide variety of methods of measuring mindfulness. These methods primarily involve self-reports on paper and pencil scales. Unfortunately, these different measures differ conceptually and frequently produce divergent results.

 

Mindfulness training produces changes in the brain’s electrical activity. This can be measured by recording the electroencephalogram (EEG). The brain produces rhythmic electrical activity that can be recorded from the scalp. It is usually separated into frequency bands. One method to indirectly observe information processing in the brain is to measure the changes in the electrical activity that occur in response to specific stimuli. These are called event-related potentials or ERPs. The signal following a stimulus changes over time. The fluctuations of the signal after specific periods of time are thought to measure different aspects of the nervous system’s processing of the stimulus. Perhaps change in the ERPs resulting from mindfulness training may be a good measure of the increased mindfulness produced by the training and a strong predictor of symptom improvements.

 

In today’s Research News article “Measuring Mindfulness: A Psychophysiological Approach.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6031749/ ), Bostanov and colleagues recruited adult patients with recurrent depression in remission and randomly assigned them to receive 8 weekly, 2 hour group sessions of either Mindfulness-Based Cognitive Therapy (MBCT) or group Cognitive Therapy (CT). They were also assigned 45 minutes of daily homework. MBCT begins with breath meditation and bodily sensation and progresses into learning to perceive thoughts and emotions as objects of mindful attention and as mental events and not as absolute truth, self or reality. CT contained all of the cognitive therapy components as MBCT but excluded mindfulness training.

 

The participants were measured before and after training for mindfulness, depression, positive and negative emotions, decentering, and curiosity. They also underwent recording from the scalp of electrical brain activity in response to a stimulus (event-related brain potentials, ERPs). With the participants instructed to perform breath meditation, they were periodically presented with a brief noise. The changes in the EEG in response to the noise were recorded and used to calculate the grand average event-related brain potentials.

 

They found that both the MBCT and CT groups had significant reductions in depression, rumination, and distraction and increases in mindfulness following the 8-week intervention period and one year later. Importantly, they found that the greater the change in the grand average event-related brain potentials resulting from treatment, the greater the reduction in depression symptoms and the greater the increase in mindfulness. These relationships were statistically strong. At the same time changes in the paper and pencil mindfulness measures were not significantly related to the improvements in depression.

 

These results suggest that changes in the brain are produced by mindfulness training and that these are reflected by changes in the electrical activity of the brain in response to sounds. The results further suggest that these brain activity changes are a better measure of the effectiveness of the mindfulness training than the traditional self-report measures. It was suggested that in the future these event related potential changes be used as the primary assessment instrument for mindfulness and the impact of mindfulness training on the individual.

 

So, measure mindfulness better in depressed patients with Changes in the EEG.

 

“Although meditation research is still in its infancy, a number of studies have investigated changes in brain activation at rest and during specific tasks that are associated with the practice of, or that follow, training in mindfulness meditation. There is emerging evidence that mindfulness meditation might cause neuroplastic changes in the structure and function of brain regions involved in regulation of attention, emotion and self-awareness.” – Sarah McKay

 

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

 

Bostanov, V., Ohlrogge, L., Britz, R., Hautzinger, M., & Kotchoubey, B. (2018). Measuring Mindfulness: A Psychophysiological Approach. Frontiers in Human Neuroscience, 12, 249. http://doi.org/10.3389/fnhum.2018.00249

 

Abstract

Mindfulness-based interventions have proved effective in reducing various clinical symptoms and in improving general mental health and well-being. The investigation of the mechanisms of therapeutic change needs methods for assessment of mindfulness. Existing self-report measures have, however, been strongly criticized on various grounds, including distortion of the original concept, response bias, and other. We propose a psychophysiological method for the assessment of the mindfulness learned through time-limited mindfulness-based therapy by people who undergo meditation training for the first time. We use the individual pre-post-therapy changes (dERPi) in the event-related brain potentials (ERPs) recorded in a passive meditation task as a measure of increased mindfulness. dERPi is computed through multivariate assessment of individual participant’s ERPs. We tested the proposed method in a group of about 70 recurrently depressed participants, randomly assigned in 1.7:1 ratio to mindfulness-based cognitive therapy (MBCT) or cognitive therapy (CT). The therapy outcome was measured by the long-term change (dDS) relative to baseline in the depression symptoms (DS) assessed weekly, for 60 weeks, by an online self-report questionnaire. We found a strong, highly significant, negative correlation (r = −0.55) between dERPi (mean = 0.4) and dDS (mean = −0.7) in the MBCT group. Compared to this result, the relationship between dDS and the other (self-report) measures of mindfulness we used was substantially weaker and not significant. So was also the relationship between dERPi and dDS in the CT group. The interpretation of dERPi as a measure of increased mindfulness was further supported by positive correlations between dERPi and the other measures of mindfulness. In this study, we also replicated a previous result, namely, the increase (dLCNV) of the late contingent negative variation (LCNV) of the ERP in the MBCT group, but not in the control group (in this case, CT). We interpreted dLCNV as a measure of increased meditative concentration. The relationship between dLCNV and dDS was, however, very week, which suggests that concentration might be relatively unimportant for the therapeutic effect of mindfulness. The proposed psychophysiological method could become an important component of a “mindfulness test battery” together with self-report questionnaires and other newly developed instruments.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6031749/

 

Improve Recovery from Stroke with Tai Chi Practice

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Improve Recovery from Stroke with Tai Chi Practice

 

By John M. de Castro, Ph.D.

 

“Suffering from a stroke is a tremendous event for anyone to face, but the practice of tai chi offers the possibility for a regeneration of the mind, body, and spirit.“ – Saebo

 

Every year, more than 795,000 people in the United States have a stroke and it is the third leading cause of death, killing around 140,000 Americans each year. A stroke results from an interruption of the blood supply to the brain, depriving it of needed oxygen and nutrients. This can result in the death of brain cells and depending on the extent of the damage produce profound loss of function. Strokes come in two varieties. The most common (87%) is ischemic stroke resulting from a blocked artery. But strokes can also occur due to leaking or rupture of a blood vessel in the brain, known as hemorrhagic stroke.

 

There are a number of risk factors for stroke that are unchangeable, such as family history, age, and genes. But there are a very large number of factors that are under our control including high blood pressure, smoking, high cholesterol, poor diet, sedentariness, and obesity. Given this list it is clear that basic physical fitness and exercise would be excellent for stroke prevention. The ancient mindful movement technique Tai Chi is a very safe form of gentle exercise that appears to be beneficial for stroke victims. It is difficult to get stroke survivors to engage in exercise. Perhaps the practice of Tai Chi, since it is very gentle, might be acceptable and effective in the treatment of stroke survivors.

 

In today’s Research News article “Tai Chi for Stroke Rehabilitation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6068268/ ), Lyu and colleagues review, summarize, and perform a meta-analysis of the 21 published research studies of the effectiveness of Tai Chi practice for patients undergoing rehabilitation from a stroke.

 

They found that Tai Chi practice in addition to conventional rehabilitation therapy in comparison to conventional rehabilitation therapy alone produced significantly greater gains in the victims ability to conduct daily living activities, in their limb motor abilities, balance, and walking ability. These results are impressive and suggest that Tai Chi practice is a safe and effective addition to conventional rehabilitation therapy for stroke victims to improve movement and thereby improve their ability to conduct their normal daily activities.

 

Tai Chi is gentle and safe, is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion, such as stroke recovery, is inexpensive to administer, can be performed in groups or alone, at home or in a facility, and can be quickly learned. In addition, it can be practiced in social groups. This can make it fun, improving the likelihood of long-term engagement in the practice. So, Tai Chi practice would appear to be an almost ideal gentle exercise to be added to conventional rehabilitation therapy for the treatment of stroke survivors.

 

So, improve recovery from stroke with tai chi practice.

 

“Learning how to find and maintain your balance after a stroke is a challenge. Tai Chi is effective in improving both static and dynamic balance, which is important to prevent falls.” – Ruth Taylor-Piliae

 

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

 

Lyu, D., Lyu, X., Zhang, Y., Ren, Y., Yang, F., Zhou, L., … Li, Z. (2018). Tai Chi for Stroke Rehabilitation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Frontiers in Physiology, 9, 983. http://doi.org/10.3389/fphys.2018.00983

 

Abstract

Background: Stroke is a major cause of poor health and has numerous complications. Tai Chi (TC) may have positive effects on the rehabilitation of stroke survivors, but recent clinical findings have not been included in previously published reviews.

Objectives: We conducted this systematic review and meta-analysis to determine the effectiveness of all types of TC vs. conventional rehabilitation therapy for all aspects of stroke survivors’ rehabilitation that have been studied.

Method: We searched seven electronic literature databases (three in English, four in Chinese) and one clinical registry platform using established strategies to identify randomized controlled trials performed up to October 2017. Screening, quality assessment, and data collection were performed by two researchers separately, using the same standard. The results were analyzed using RevMan 5.3.0. The quality of evidence was evaluated with GRADEpro.

Results: A total of 21 studies with 1,293 stroke survivors met inclusion criteria; 14 were included in the quantitative synthesis to evaluate four aspects and five outcomes. Nine studies indicated that TC was able to improve independent activities of daily living (ADL), especially TC vs. conventional rehabilitation therapy [mean difference (MD) [95% confidence interval (CI)] = 9.92 [6.82, 13.02], P < 0.00001]. Five studies reported significant effects of TC plus conventional rehabilitation therapy in increasing scores on the Fugl–Meyer Assessment for the upper limb [MD (95%CI) = 8.27 [4.69, 11.84], P < 0.0001], lower limb [MD (95%CI) = 2.75 [0.95, 4.56], P = 0.003], and overall [MD (95%CI) = 4.49 [1.92, 7.06], P = 0.0006]. The Berg Balance Scale revealed significant improvements according to pooled estimates for TC vs. conventional rehabilitation therapy [MD (95%CI) = 5.23 [3.42, 7.05], P < 0.00001]. TC plus conventional rehabilitation therapy also improved walking ability as measured by the Holden scale [MD (95%CI) = 0.61 [0.38, 0.85], P < 0.00001] and up-and-go time [MD (95%CI) = 2.59 [1.76, 3.43], P < 0.00001].

Conclusion: TC has an overall beneficial effect on ADL, balance, limb motor function, and walking ability among stroke survivors, based on very low-quality evidence, and may also improve sleep quality, mood, mental health, and other motor function. Well-designed, higher-quality trials with longer-term follow-up periods are needed to develop better-quality evidence.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6068268/

 

Mindfulness Improves Psychological and Physical Health in South Africans

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Mindfulness Improves Psychological and Physical Health in South Africans

 

By John M. de Castro, Ph.D.

 

“mindfulness-based stress reduction (MBSR) can be seen as a public health intervention, designed to over time move the bell curve of society as a whole toward greater health.” – Jon Kabat-Zinn

 

Mindfulness training has been shown to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress. Techniques such as Mindfulness Training, 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 effective. This has led to an increasing adoption of these mindfulness techniques for the health and well-being of both healthy and ill individuals. Although these benefits have been well established in western populations, there is a need to demonstrate that these same benefits accrue across cultures.

 

In today’s Research News article “Examining the impact of a Mindfulness-Based Stress Reduction intervention on the health of urban South Africans.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6018653/ ), Whitesman and colleagues performed a retrospective analysis of South African participants in an 8-week Mindfulness-Based Stress Reduction (MBSR) program. MBSR was delivered in weekly 2.5-hour sessions accompanied with home practice. It consisted of meditation, yoga, and body scan practices and group discussion. The participants were measured before and after treatment for mindfulness, perceived stress, positive and negative emotions, and medical and psychological symptoms.

 

They found that in comparison to baseline, after the MBSR program there were significant increases in mindfulness and positive emotions, and significant decreases in perceived stress, negative emotions, medical symptoms, and psychological symptoms. They also found that the greater the increase in mindfulness scores after the MBSR program the higher the scores for positive emotions and the lower the levels of perceived stress, negative emotions, medical symptoms, and psychological symptoms. So, mindfulness training improved mental and physical health in participants from South Africa and the great the improvement in mindfulness the greater the benefits.

 

This study did not contain a control condition and was thus subject to contamination and potential confounding. But, similar results have been repeated found with randomized clinical trials employing MBSR. So, it is unlikely that bias and confounding are responsible. In addition, the current study simply demonstrated that training is similarly effective in people from a different culture. This suggests that Mindfulness-Based Stress Reduction (MBSR) is a safe and effective program for the enhancement of mental and physical well-being in diverse populations of participants.

 

So, it appears that mindfulness improves psychological and physical health in South Africans.

 

“mindfulness practices may help people manage stress, cope better with serious illness and reduce anxiety and depression. Many people who practice mindfulness report an increased ability to relax, a greater enthusiasm for life and improved self-esteem.” – NIH News

 

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

 

Whitesman, S. L., Hoogenhout, M., Kantor, L., Leinberger, K. J., & Gevers, A. (2018). Examining the impact of a Mindfulness-Based Stress Reduction intervention on the health of urban South Africans. African Journal of Primary Health Care & Family Medicine, 10(1), 1614. http://doi.org/10.4102/phcfm.v10i1.1614

 

Abstract

Background

Mindfulness-based stress reduction (MBSR) has been found to have significant health benefits in studies conducted in the global North.

Aim

This study examined the effects of MBSR on stress, mood states and medical symptoms among urban South Africans to inform future research and clinical directions of MBSR in local settings.

Setting

Participants completed an 8-week MBSR programme based in central Cape Town.

Method

A retrospective analysis of 276 clinical records was conducted. Mindfulness, stress, negative and positive mood, medical symptoms and psychological symptoms were assessed before and after the intervention using self-report questionnaires. We compared pre and post-intervention scores and examined the relationship between changes in mindfulness and changes in stress, mood and medical symptoms.

Results

Mindfulness scores were significantly higher after intervention, both on the Kentucky Inventory of Mindfulness Skills (KIMS) and the Mindful Attention Awareness Scale (MAAS). Changes on the KIMS were associated with reductions in stress, negative mood, psychological symptoms and total medical symptoms, and improvement in positive mood. Changes in mindfulness, as measured by the MAAS, were significantly correlated only with reduced total number of medical symptoms.

Conclusion

This study provides preliminary evidence for the positive health impact of MBSR on urban South Africans, and in turn acceptability and feasibility evidence for MBSR in South Africa and supports the case for larger trials in different local settings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6018653/

 

Improve Eating Behavior with Mindfulness

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Improve Eating Behavior with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindful eating involves paying full attention to the experience of eating and drinking, both inside and outside the body. We pay attention to the colors, smells, textures, flavors, temperatures, and even the sounds (crunch!) of our food. We pay attention to the experience of the body. Where in the body do we feel hunger? Where do we feel satisfaction? What does half-full feel like, or three quarters full?” – Jan Chozen Bays

 

Eating is produced by two categories of signals. Homeostatic signals emerge from the body’s need for nutrients, is associated with feelings of hunger, and usually work to balance intake with expenditure. Non-homeostatic eating, on the other hand, is not tied to nutrient needs or hunger but rather to the environment and or to the pleasurable and rewarding qualities of food. These cues can be powerful signals to eat even when there is no physical need for food.

 

Mindful eating involves paying attention to eating while it is occurring, including attention to the sight, smell, flavors, and textures of food, to the process of chewing and may help reduce intake by affecting the individual’s response to non-homeostatic cues for eating. Indeed, high levels of mindfulness are associated with lower levels of obesity. Hence, mindful eating may counter non-homeostatic eating.

 

Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that is based upon Cognitive Behavioral Therapy (CBT). ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. Additionally, ACT helps people strengthen aspects of cognition such as in committing to valued living. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

In today’s Research News article “The effects of acceptance and commitment therapy on eating behavior and diet delivered through face-to-face contact and a mobile app: a randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5828146/ ), Järvelä-Reijonen and colleagues examine the effectiveness of Acceptance and Commitment Therapy (ACT) on facilitating mindful eating and as a result improving eating behavior and diet. They recruited overweight and obese adults (aged 25-60 years) and randomly assigned them to receive ACT either face-to-face in a group setting or on line or to a no-treatment control. ACT was delivered for 90 minutes, once a week over 8 weeks.

 

The participants were measured before and 2 weeks and 28 weeks after the intervention for perceived stress, intuitive eating, including unconditional permission to eat, eating for physical rather than emotional reasons, and reliance on internal hunger/satiety cue. They were also measured for cognitive restraint of eating, uncontrolled eating, emotional eating, taste pleasure, using food as a reward, eating attitudes, food acceptance, internal regulation, contextual skills, and eating behaviors, including intrinsic motivation, integrated regulation, identified regulation, introjected regulation, external regulation, and amotivation. Finally, they were measured for food and nutrient intakes including alcohol.

 

They found that both the face-to-face and the on-line Acceptance and Commitment Therapy (ACT) training produced significant improvements in the reasons for eating from emotional or environmental triggers towards hunger and satiety cues, acceptance of a variety of foods, and perceptions of healthy eating. They also showed significant increases in eating for physical rather than emotional reasons while decreases in using food as a reward. In general, the face-to-face ACT training produced larger improvements than the on-line ACT training. But, both were effective. Even though there were many improvements in the psychological components surrounding eating produced by ACT training, there were no significant changes in actual dietary intake.

 

These results are interesting and suggest that ACT training, regardless of whether it occurs face-to-face or on-line, alters the psychology of eating toward more mindful eating and toward homeostatic eating. These are very healthy changes. The fact, however, that they were not reflected in actual changes in intake is disappointing. Perhaps if there was an active dietary reduction component, there might have been a change in intake. But, without this emphasis on intake reduction it is hard to see what the motivation might be for the participants to reduce the amounts of food ingested. It is also possible that given more time for the psychological changes to take hold, intake changes may have occurred. Finally, even though the participants were overweight and obese they were weight stable, neither increasing or decreasing intake. They were eating an appropriate amount for their metabolic needs, neither overeating nor undereating. So, changing then psychology of eating may not affect their intake as it is appropriate for the circumstances.

 

So, improve eating behavior with mindfulness.

 

“Mindless eating happens when you are distracted by something else so that all of your attention is not on what you are eating or how you are eating.  When distracted, we are far more likely to shift into autopilot and overeat and this is one very common reason for weight gain.” – J. Marlin

 

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

 

Järvelä-Reijonen, E., Karhunen, L., Sairanen, E., Muotka, J., Lindroos, S., Laitinen, J., … Kolehmainen, M. (2018). The effects of acceptance and commitment therapy on eating behavior and diet delivered through face-to-face contact and a mobile app: a randomized controlled trial. The International Journal of Behavioral Nutrition and Physical Activity, 15, 22. http://doi.org/10.1186/s12966-018-0654-8

 

Abstract

Background

Internal motivation and good psychological capabilities are important factors in successful eating-related behavior change. Thus, we investigated whether general acceptance and commitment therapy (ACT) affects reported eating behavior and diet quality and whether baseline perceived stress moderates the intervention effects.

Methods

Secondary analysis of unblinded randomized controlled trial in three Finnish cities. Working-aged adults with psychological distress and overweight or obesity in three parallel groups: (1) ACT-based Face-to-face (n = 70; six group sessions led by a psychologist), (2) ACT-based Mobile (n = 78; one group session and mobile app), and (3) Control (n = 71; only the measurements). At baseline, the participants’ (n = 219, 85% females) mean body mass index was 31.3 kg/m2 (SD = 2.9), and mean age was 49.5 years (SD = 7.4). The measurements conducted before the 8-week intervention period (baseline), 10 weeks after the baseline (post-intervention), and 36 weeks after the baseline (follow-up) included clinical measurements, questionnaires of eating behavior (IES-1, TFEQ-R18, HTAS, ecSI 2.0, REBS), diet quality (IDQ), alcohol consumption (AUDIT-C), perceived stress (PSS), and 48-h dietary recall. Hierarchical linear modeling (Wald test) was used to analyze the differences in changes between groups.

Results

Group x time interactions showed that the subcomponent of intuitive eating (IES-1), i.e., Eating for physical rather than emotional reasons, increased in both ACT-based groups (p = .019); the subcomponent of TFEQ-R18, i.e., Uncontrolled eating, decreased in the Face-to-face group (p = .020); the subcomponent of health and taste attitudes (HTAS), i.e., Using food as a reward, decreased in the Mobile group (p = .048); and both subcomponent of eating competence (ecSI 2.0), i.e., Food acceptance (p = .048), and two subcomponents of regulation of eating behavior (REBS), i.e., Integrated and Identified regulation (p = .003, p = .023, respectively), increased in the Face-to-face group. Baseline perceived stress did not moderate effects on these particular features of eating behavior from baseline to follow-up. No statistically significant effects were found for dietary measures.

Conclusions

ACT-based interventions, delivered in group sessions or by mobile app, showed beneficial effects on reported eating behavior. Beneficial effects on eating behavior were, however, not accompanied by parallel changes in diet, which suggests that ACT-based interventions should include nutritional counseling if changes in diet are targeted.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5828146/

 

Reduce Anxiety and Depression with Mindfulness

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Reduce Anxiety and Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“If you have unproductive worries, you can train yourself to experience those thoughts completely differently. “You might think ‘I’m late, I might lose my job if I don’t get there on time, and it will be a disaster!’ Mindfulness teaches you to recognize, ‘Oh, there’s that thought again. I’ve been here before. But it’s just that—a thought, and not a part of my core self,’” – Elizabeth Hoge.

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. A characterizing feature of anxiety disorders is that the suffer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. This may indicate that treating the cognitive processes that underlie the anxiety may be an effective treatment. Indeed, Mindfulness practices have been shown to be quite effective in relieving anxiety. Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Depression can be difficult to treat. Fortunately, Mindfulness training is also effective for treating depression.

 

Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that is based upon Cognitive Behavioral Therapy (CBT) and has also been shown to relieve anxiety and to be effective for depression. ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. Additionally, ACT helps people strengthen aspects of cognition such as in committing to valued living. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

In today’s Research News article “Effectiveness of Acceptance and Commitment Therapy on Anxiety and Depression of Razi Psychiatric Center Staff.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839459/ ), Heydari and colleagues recruited adult volunteers with moderate symptoms of burnout and randomly assigned them to either receiving a program of Acceptance and Commitment Therapy (ACT) or to a no-treatment control condition. The ACT program was delivered over 8 weeks in once a week, 90-minute sessions. The participants were measured before and after training and 2 months later for anxiety and depression.

 

They found that after treatment and 2 months later the group that received Acceptance and Commitment Therapy (ACT) had large and significant decreases in both anxiety (35% reduction) and depression (20% reduction) while there were no significant changes in the no-treatment control participants. It is interesting that the participants were suffering from moderate burnout in their jobs. This indicates that ACT may be effective in treating career burnout.

 

It is important to note that these effects were still present 2 months after the completion of the therapy program. They thus appear to have lasting beneficial effects. It should be noted that since the there was no treatment in the control condition that a placebo effect may still be present and may potentially account for at least some of the improvements. Nevertheless the results are in line with previous studies that demonstrate that mindfulness training is effective in relieving anxiety and depression.

 

So, Reduce Anxiety and Depression with Mindfulness

 

“Anxiety softens when we can create a space between ourselves and what we’re experiencing. . .

When you become aware of the present moment, you gain access to resources you may not have had before. You may not be able to change a situation, but you can mindfully change your response to it.” – Mindful

 

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

 

Heydari, M., Masafi, S., Jafari, M., Saadat, S. H., & Shahyad, S. (2018). Effectiveness of Acceptance and Commitment Therapy on Anxiety and Depression of Razi Psychiatric Center Staff. Open Access Macedonian Journal of Medical Sciences, 6(2), 410–415. http://doi.org/10.3889/oamjms.2018.064

 

Abstract

AIM:

Considering the key role of human resources as the main operator of organisations, the present research aimed to determine the effectiveness of acceptance and commitment therapy for anxiety and depression of Razi Psychiatric Center staff.

MATERIALS AND METHODS:

This research follows a quasi-experimental type with pre-test, post-test plans, and control group. Accordingly, 30 people were selected through volunteered sampling among Razi Psychiatric Center staff. Then, they were randomly placed into two groups of 15 (experimental and control) and evaluated using research tools. Research tools consisted of Beck Anxiety and Depression Inventories whose reliability and validity have been confirmed in several studies. Research data were analysed using the analysis of covariance (ANCOVA).

Results:

The statistical analysis confirmed the difference in the components of anxiety and depression in the experimental group, which had received acceptance and commitment therapy compared to the group that had not received any therapy in this regard (control group) (p < 0.05).

CONCLUSION:

Acceptance and commitment therapy reduces anxiety and depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839459/

 

Reduce Self-Harming in Adolescents with Mindfulness

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Reduce Self-Harming in Adolescents with Mindfulness

 

By John M. de Castro, Ph.D.

 

“In order to end self-harm, one needs to change one’s whole relationship with oneself, and how one sees oneself. A good starting point is with one’s thoughts. Mindfulness keeps one fully grounded in the present … in the presence of the action of the present moment. Mindfulness helps one to observe and note thoughts, positive or negative, without feeling the need to act upon them.” – Ian Ellis-Jones

 

Self-injury is a disturbing phenomenon occurring worldwide, especially in developed countries, such as the U.S. and those in western Europe. Approximately two million cases are reported annually in the U.S. Each year, 1 in 5 females and 1 in 7 males engage in self-injury usually starting in the teen years. Frequently, untreated depression and other mental health challenges create an environment of despair that leads people to cope with these challenges in unhealthy ways. Nearly 50 percent of those who engage in self-injury have been sexually abused. Borderline Personality Disorder (BPD) is a very serious mental illness that is estimated to affect 1.6% of the U.S. population. It involves unstable moods, behavior, and relationships, problems with regulating emotions and thoughts, impulsive and reckless behavior, and unstable relationships. About ¾ of BPD patients engage in self-injurious behaviors.

 

One of the few treatments that appears to be effective for Borderline Personality Disorder (BPD) is Dialectical Behavior Therapy (DBT). It is targeted at changing the problem behaviors characteristic of BPD including self-injury. Behavior change is accomplished through focusing on changing the thoughts and emotions that precede problem behaviors, as well as by solving the problems faced by individuals that contribute to problematic thoughts, feelings and behaviors. In DBT five core skills are practiced; mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness. DBT reduces self-injurious behaviors in BPD patients.

 

In today’s Research News article “Cost-effectiveness of dialectical behaviour therapy vs. enhanced usual care in the treatment of adolescents with self-harm.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5928596/ ), Haga and colleagues recruited adolescents who had repeatedly harmed themselves and randomly assigned then to receive 19 once a week 1 hour sessions of either Dialectical Behavior Therapy (DBT) or enhanced usual care. Enhanced usual care consisted of a combination of psychotherapy and cognitive behavioral therapy tailored to treat suicidality and self-harm. They were measured before and after treatment and 1 year later for self-harm episodes and global functioning. The costs of treatment were also estimated.

 

They found that at the end of treatment the adolescents who received Dialectical Behavior Therapy (DBT) had significantly fewer self-harm episodes and lower levels of suicide ideation and depression than those who received enhanced usual care. Importantly, a year later, the group that received DBT still had significantly fewer self-harm episodes. In addition, DBT did not cost more than the enhanced usual care program to implement.

 

These results are important and suggest that Dialectical Behavior Therapy (DBT) is an effective and cost-effective treatment for adolescents who harm themselves. This is particularly important as self-harm is often a predictor of eventual suicide. The reduction in suicidal ideation in these adolescents is an indication of this. Hence, DBT can reduce self-harm behaviors and reduce the suffering of these troubled adolescents.

 

So, reduce self-harming in adolescents with mindfulness.

 

“dialectical behavior therapy, or DBT, for treatment of children and adolescents. DBT, regarded as one of the few treatments that has shown success in combating self-injury behaviors, combines Buddhism’s mindfulness with cognitive behavior therapy in a program that teaches coping and communication skills.” – Paradigm Malibu

 

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

 

Haga, E., Aas, E., Grøholt, B., Tørmoen, A. J., & Mehlum, L. (2018). Cost-effectiveness of dialectical behaviour therapy vs. enhanced usual care in the treatment of adolescents with self-harm. Child and Adolescent Psychiatry and Mental Health, 12, 22. http://doi.org/10.1186/s13034-018-0227-2

 

Abstract

Background

Studies have shown that dialectical behaviour therapy (DBT) is effective in reducing self-harm in adults and adolescents.

Aims

To evaluate the cost-effectiveness of DBT for adolescents (DBT-A) compared to enhanced usual care (EUC).

Methods

In a randomised study, 77 adolescents with repeated self-harm were allocated to 19 weeks of outpatient treatment, either DBT-A (n = 39) or EUC (n = 38). Cost-effective analyses, including estimation of incremental cost-effectiveness ratios, were conducted with self-harm and global functioning (CGAS) as health outcomes.

Results

Using self-harm as effect outcome measure, the probability of DBT being cost-effective compared to EUC increased with increasing willingness to pay up to a ceiling of 99.5% (threshold of € 1400), while with CGAS as effect outcome measure, this ceiling was 94.9% (threshold of € 1600).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5928596/

 

Improve the Emotional and Psychosocial Quality of Life of Grammar School Children with Yoga

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Improve the Emotional and Psychosocial Quality of Life of Grammar School Children with Yoga

 

By John M. de Castro, Ph.D.

 

“Studies show that mindfulness- and yoga-based skills, conscious breath work, and body awareness improve academic performance and emotional regulation. Mindfulness-based practices also reduce anxiety and increase attention. . . . Research also reveals that mindfulness strategies enhance executive function in kids, supporting positive behavioral changes. In addition, a yoga practice promotes confidence and strength along with compassion and self-acceptance.” – Kimberly Jordan Allen

 

Yoga practice has been shown to have a large number of beneficial effects on the psychological, emotional, and physical health of the individual and is helpful in the treatment of mental and physical illness. The acceptance of yoga practice has spread from the home and yoga studios to its application with children in schools. Studies of these school programs have found that yoga practice produces a wide variety of positive psychosocial and physical benefits.

 

Teachers also note improvements in their students following yoga practice. These include improved classroom behavior and social–emotional skills, concentration, mood, ability to function under pressure, social skills, and attention and lower levels of hyperactivity. In addition, school records, academic tests have shown that yoga practice produces improvements in student grades and academic performance. This, in turn, improves the classroom experience for the teachers. Hence there are very good reasons to further study the effects of yoga practice in school on grammar school children.

 

In today’s Research News article “Effect of mindfulness and yoga on quality of life for elementary school students and teachers: results of a randomized controlled school-based study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5903833/ ), Bazzano and colleagues recruited third grade students who screened positive for symptoms of anxiety and randomly assigned them to receive either an 8-week yoga/mindfulness training or to a no-treatment control condition. The yoga program occurred in 10 in-class 40-minute sessions and included postures, breathing exercises, and relaxation. The students were measured at the beginning, middle, and end of the 8-week intervention period for life satisfaction and childhood quality of life including physical, emotional, social, and school domains. In addition, teachers were measured for health-related quality of life.

 

They found that in the middle and after the yoga/mindfulness intervention the students had significant improvements in psychosocial and emotional quality of life. The teachers reported that after the program they were significantly more likely to include yoga practice in their classrooms. Hence, the brief yoga/mindfulness program was successful in improving the social and emotional life conditions for the children and these improvements were sufficiently noticeable that the teachers decided to continue employing yoga practice in the classroom after the program was completed.

 

These results are encouraging and suggest that even at a relatively young age and early in children’s school life practicing yoga in school improves their and their teachers’ lives. It should be noted that the comparison condition did not include any treatment. In future research an active control condition such as aerobic exercise should be included to determine if the effects are specific for yoga practice or might occur with any exercise program. Regardless, the program helped to improve the lives of anxious young students.

 

So, improve the emotional and psychosocial quality of life of grammar school children with Yoga.

 

“Yoga in my classroom creates a sense of community. They are more of a unified group.  Something about yoga brings the students together, almost like team building.” – YogaCalm

 

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

 

Bazzano, A. N., Anderson, C. E., Hylton, C., & Gustat, J. (2018). Effect of mindfulness and yoga on quality of life for elementary school students and teachers: results of a randomized controlled school-based study. Psychology Research and Behavior Management, 11, 81–89. http://doi.org/10.2147/PRBM.S157503

 

Abstract

Objective

To assess the impact of a yoga curriculum in an elementary school on student quality of life, and to assess teacher and staff perception of potential barriers to, and benefits of, introducing yoga and mindfulness into the classroom.

Methods

A randomized controlled trial was utilized to assess the impact of a brief intervention on third-grade students who screened positive for symptoms of anxiety. Students were randomized to an intervention group of 20 students receiving small-group yoga/mindfulness activities for 8 weeks between October 2016 and February 2017, and a control group of 32 students receiving care as usual. The Brief Multidimensional Students’ Life Satisfaction Scale-Peabody Treatment Progress Battery and the Pediatric Quality of Life Inventory (PedsQL) served as outcomes. Teachers were invited to participate in two professional development sessions about introducing yoga and mindfulness into the classroom, and completed a survey following each of the sessions.

Results

In generalized estimating equation models adjusted for time, the yoga-based intervention was associated with a 14.17 unit increase in student emotional PedsQL (p-value 0.001) and a 7.43 unit increase in psychosocial PedsQL (p-value 0.01). Results were not attenuated by adjustment. Teachers and staff reported using yoga more frequently in the classroom following the second of two professional development sessions (p-value <0.05). Perceived barriers to introducing yoga to the classroom were similar at two data collection time points, while perceived benefits remained high.

Conclusion

The intervention was associated with a significant improvement in emotional and psychosocial quality of life in the intervention group when compared to the control group, suggesting that yoga/mindfulness interventions may improve symptoms of anxiety among students. Yoga/mindfulness activities may facilitate stress management among elementary school students and may be added as a complement to social and emotional learning activities.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5903833/

 

Improve Thinking in Substance Abusers with Yoga

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Improve Thinking in Substance Abusers with Yoga

 

By John M. de Castro, Ph.D.

 

“When people take substances, they’re seeking a certain experience, whether it’s escapist or transcendental or just wanting a different psychological state, to get away from whatever is making them unhappy. Yoga is an alternative, a positive way to generate a change in consciousness that, instead of providing an escape, empowers people with the ability to access a peaceful, restorative inner state that integrates mind, body, and spirit.” – Sat Bir Khalsa

 

Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use which includes unintentional overdoses, suicides, HIV and AIDS, and trauma. In the U.S. about 17 million people abuse alcohol. Drunk driving fatalities accounted for over 10,000 deaths annually. “Tobacco use remains the single largest preventable cause of death and disease in the United States. Cigarette smoking kills more than 480,000 Americans each year, with more than 41,000 of these deaths from exposure to secondhand smoke. In addition, smoking-related illness in the United States costs more than $300 billion a year. In 2013, an estimated 17.8% (42.1 million) U.S. adults were current cigarette smokers.”  (Centers for Disease Control and Prevention).

 

Obviously, there is a need to find effective methods to prevent and treat substance abuse. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers relapse and return to substance abuse. Hence, it is important to find an effective method to both treat substance abuse disorders and to prevent relapses. Mindfulness practices have been shown to improve recovery from various addictions. Yoga is a mindfulness practice that has documented benefits for the individual’s psychological and physical health and well-being. There has been a paucity of studies, however, on the use of yoga practice to treat substance abuse.

 

Substance abuse frequently produces cognitive deficits which interfere with the clear thinking needed for abstinence and recovery from substance abuse. So, it is important that methods be found to improve cognitive function in substance abusers undergoing treatment. In today’s Research News article “Effect of Add-On Yoga on Cognitive Functions among Substance Abusers in a Residential Therapeutic Center: Randomized Comparative Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5981665/ ), Gaihre and colleagues examine the ability of yoga practice in comparison to a physical exercise program to enhance the cognitive performance in substance abusers undergoing treatment.

 

They recruited adult substance abusers entering a treatment program and having successfully undergone 3 weeks of withdrawal and abstinence. They were randomly assigned to receive 12-week programs of either yoga practice or physical exercise. Both programs met 6 times per week for 90 minutes. The yoga program included postures, breathing exercises, stretching, relaxation, and meditation. The physical exercise program included stretching and walking and running aerobic exercise. The participants were measured before and after the 12-week intervention for cognitive performance including the Stroop interference task, digit span short-term memory task, and a sustained and selective task.

 

They found that after 12-weeks of practice both yoga practice and physical exercise groups had large and significant improvements in all of the cognitive tasks. Hence, both types of exercise were associated with clearer thought processes in the substance abusers. It is unfortunate that there a no-treatment control wasn’t included as the improvements might have occurred anyway over the 12-weeks of residential substance abuse treatment. It will remain for future research to examine this possibility.

 

Substance abuse treatment is difficult and relapse is very common. So, finding methods that can enhance the abuser’s ability to process information and think clearly about their addiction and its treatment would be very helpful. The findings suggest that exercise programs including yoga practice may be able to help clear the cognitive fog and enhance the abuser’s ability to successfully complete treatment and resist relapse.

 

So, improve thinking in substance abusers with Yoga.

 

“Since most meditation practices involve management of the mind’s energy and impulses, practitioners of yoga and meditation experience greater mood stability in the face of outside pressures. Having a calm mind and being mentally stable can contribute to the avoidance of self-harming behaviors and activities, like substance abuse.” – Addiction Resources

 

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

 

Gaihre, A., & Rajesh, S. K. (2018). Effect of Add-On Yoga on Cognitive Functions among Substance Abusers in a Residential Therapeutic Center: Randomized Comparative Study. Annals of Neurosciences, 25(1), 38–45. http://doi.org/10.1159/000484165

 

Abstract

Background

Chronic vulnerability characterizes substance abuse disorder with consequent relapse. The process of abstinence depends on cognitive recovery. Hence, behavioral intervention should account for cognitive dimension of substance abusers. Recent studies highlight yoga-based intervention as a promising add-on therapy for treating and preventing addictive behaviors.

Purpose

The study aimed to evaluate the efficacy of a yoga-based intervention as an add-on in enhancing cognitive functions, compared with physical exercise to newly admitted substance abusers seeking an inpatient treatment program.

Methods

The study was a single-blind, randomized, comparative design that included 96 male participants, between 18 and 40 years in a residential rehabilitation treatment unit. Partakers in the yoga or physical exercise group received supervised daily training for 12 weeks, in addition to standard rehabilitation treatment. Raters blind to the study assessed the patients on digit span task, cancellation test, and Stroop tests at the baseline and following 12 weeks of intervention.

Results

A significant enhancement in digit forward (yoga – p < 0.0005, d = 0.81; exercise – p < 0.0005, d = 0.73), digit backward (yoga – p < 0.0005, d = 0.88; exercise – p < 0.0005, d = 0.58), and letter cancellation test scores (yoga – p < 0.0005, d = 1.31; exercise – p < 0.0005, d = 1.4) were observed in both the yoga and the exercise groups. Stroop word and color task scores were seen significantly higher following yoga (p <0.005, d = 0.74; p < 0.005, d = 1.13) and exercise (p < 0.0005, d = 0.62; p < 0.0005, d = 0.61). Furthermore, Stroop color-word test showed significant enhancement after yoga (p < 0.0005, d = 1.10) and exercise (p < 0.0005, d = 0.42), with degree of variation higher in the yoga group.

Conclusion

Our results suggest that the add-on yoga or exercise-based intervention show enhancement of cognitive functions. These findings provide the utility of yoga and exercise-based intervention in improving cognitive functions among substance abusers. Furthermore, rigorous trials are needed to explore the potential long-term effects of these procedures.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5981665/

 

Treat Insomnia in Breast Cancer Survivors with Tai Chi

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Treat Insomnia in Breast Cancer Survivors with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Breast cancer survivors often don’t just come to physicians with insomnia. They have insomnia, fatigue and depression. And this intervention, tai chi, impacted all those outcomes in a similar way, with benefits that were as robust as the gold standard treatment for insomnia.” – Leigh Hopper

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Insomnia is a common occurrence in the aftermath of surviving breast cancer.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. Tai Chi or Qigong practice has been shown to improve quality of life, reduce fatigue, lower blood pressure and cortisol levels, improve balance and reduce the likelihood of falls. Mindfulness-based practices have been reported to improve sleep amount and quality. Tai Chi practice has also been shown to improve sleep. It is not known, however, how effective Tai Chi practice is relative to other know insomnia treatments.

 

In today’s Research News article “Tai Chi Chih Compared with Cognitive Behavioral Therapy for the Treatment of Insomnia in Survivors of Breast Cancer: A Randomized, Partially Blinded, Noninferiority Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5549450/ ), Irwin and colleagues recruited women who had survived breast cancer and who were diagnosed with insomnia. They were randomly assigned to receive a 3-month program of either Tai Chi or Cognitive Behavioral Therapy for Insomnia (CBT-I). Both treatments were delivered in groups of 7 to 10 participants in weekly 120-minute sessions. CBT-I contained cognitive therapy, stimulus control, sleep restriction, sleep hygiene, and relaxation. Tai Chi consisted of mindful performance of repetitious, nonstrenuous, slow-paced movement. Participants were measured during baseline, at the end of the treatment period and three months and one year later, for insomnia severity, insomnia remission, sleep quality, sleep diary records, fatigue, daytime sleepiness, depression, body size, and physical activity.

 

They found that both groups showed equivalent and significant improvement in insomnia severity, insomnia remission, sleep quality, fatigue, daytime sleepiness, and depression at posttreatment and 3 and 12 months later. Hence, both Tai Chi practice and Cognitive Behavioral Therapy for Insomnia (CBT-I) were effective in treating insomnia in breast cancer survivors with insomnia.

 

It is remarkable that Tai Chi practice is just as effective as a psychotherapy that was designed specifically to treat insomnia and which is considered the gold standard of insomnia treatments. Tai Chi practice, though, has marked advantages over CBT-I. Tai Chi is gentle and safe, is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion, is inexpensive to administer, can be performed in groups or alone, at home or in a facility, and can be quickly learned. In addition, it can be practiced in social groups. This can make it fun, improving the likelihood of long-term engagement in the practice. So, Tai Chi practice would appear to be an almost ideal gentle exercise to releive insomnia is breast cancer survivors.

 

So, treat insomnia in breast cancer survivors with Tai Chi

 

“given that standardized TCC is both scalable and community accessible compare with the limited availability of CBT in most medical centers, immediate access to TCC would address the need to reduce the morbidity associated with insomnia in survivors of breast and other cancers.” – Irwin et al. 2017

 

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

 

Irwin, M. R., Olmstead, R., Carrillo, C., Sadeghi, N., Nicassio, P., Ganz, P. A., & Bower, J. E. (2017). Tai Chi Chih Compared With Cognitive Behavioral Therapy for the Treatment of Insomnia in Survivors of Breast Cancer: A Randomized, Partially Blinded, Noninferiority Trial. Journal of Clinical Oncology, 35(23), 2656–2665. http://doi.org/10.1200/JCO.2016.71.0285

 

Abstract

Purpose

Cognitive behavioral therapy for insomnia (CBT-I) and Tai Chi Chih (TCC), a movement meditation, improve insomnia symptoms. Here, we evaluated whether TCC is noninferior to CBT-I for the treatment of insomnia in survivors of breast cancer.

Patients and Methods

This was a randomized, partially blinded, noninferiority trial that involved survivors of breast cancer with insomnia who were recruited from the Los Angeles community from April 2008 to July 2012. After a 2-month phase-in period with repeated baseline assessment, participants were randomly assigned to 3 months of CBT-I or TCC and evaluated at months 2, 3 (post-treatment), 6, and 15 (follow-up). Primary outcome was insomnia treatment response—that is, marked clinical improvement of symptoms by the Pittsburgh Sleep Quality Index—at 15 months. Secondary outcomes were clinician-assessed remission of insomnia; sleep quality; total sleep time, sleep onset latency, sleep efficiency, and awake after sleep onset, derived from sleep diaries; polysomnography; and symptoms of fatigue, sleepiness, and depression.

Results

Of 145 participants who were screened, 90 were randomly assigned (CBT-I: n = 45; TCC: n = 45). The proportion of participants who showed insomnia treatment response at 15 months was 43.7% and 46.7% in CBT-I and TCC, respectively. Tests of noninferiority showed that TCC was noninferior to CBT-I at 15 months (P = .02) and at months 3 (P = .02) and 6 (P < .01). For secondary outcomes, insomnia remission was 46.2% and 37.9% in CBT-I and TCC, respectively. CBT-I and TCC groups showed robust improvements in sleep quality, sleep diary measures, and related symptoms (all P < .01), but not polysomnography, with similar improvements in both groups.

Conclusion

CBT-I and TCC produce clinically meaningful improvements in insomnia. TCC, a mindful movement meditation, was found to be statistically noninferior to CBT-I, the gold standard for behavioral treatment of insomnia.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5549450/

Mindfulness Effects on Eating Disorders Depends on Ethnicity

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Mindfulness Effects on Eating Disorders Depends on Ethnicity

 

By John M. de Castro, Ph.D.

 

“The practice of mindful eating may be helpful to those struggling with eating disorders, such as bulimia, binge eating disorder and compulsive overeating. It is common for individuals with eating disorders to numb emotions through restricting, binging or choosing foods that are not pleasurable while eating. Mindful eating can help a person reconnect to the joy and experience of eating by creating an awareness of thoughts, emotions, feeling, and behaviors associated with the eating experience.” – Julia Casidy

 

Around 30 million people in the United States of all ages and genders suffer from an eating disorder; either anorexia nervosa, bulimia, or binge eating disorder. 95% of those who have eating disorders are between the ages of 12 and 26. Eating disorders are not just troubling psychological problems, they can be deadly, having the highest mortality rate of any mental illness. Eating disorders can be difficult to treat because eating is necessary and cannot be simply stopped as in smoking cessation or abstaining from drugs or alcohol. One must learn to eat appropriately not stop. So, it is important to find methods that can help prevent and treat eating disorders. Contemplative practices, mindfulness, and mindful eating have shown promise for treating eating disorders.

 

In today’s Research News article “Mindfulness as a Moderator of the Association Between Eating Disorder Cognition and Eating Disorder Behavior Among a Non-clinical Sample of Female College Students: A Role of Ethnicity.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2018.00700/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_695451_69_Psycho_20180705_arts_A ), Masuda and colleagues recruited college women  and had them complete online demographic characteristics including racial identity and body size and measures of eating disorder behaviors, mindfulness, and the thought patterns associated with eating disorders (eating disorder cognitions). These include “rigid beliefs about the importance of weight regulation, strong beliefs in appearance as the basis of self-worth, and inflexible beliefs in self-control as the basis of self-esteem.”

 

They found that the higher the levels of mindfulness the lower the levels of eating disorder cognitions but only for Asian and white American and not black women mindfulness was also associated with lower levels of eating disorder behaviors. They then performed a hierarchical regression to determine moderation effects and found that only for white women mindfulness moderated the effects of eating disorder cognitions on eating disorder behaviors such that high mindfulness significantly weakened the association of cognitions with behavior.

 

These are interesting results that suggest that how young women think about eating disorders affects eating disordered behavior. Mindfulness only appeared to influence this association for a single racial group, white American women. Since most research with eating disorders is performed with young white women, these results call into question the generalizability of mindfulness ability to reduce eating disorders. It would appear to be not true for black and Asian American women. Why mindfulness effects differ between racial groups is unknown and will require future research to investigate.

 

What is clear is that how a woman thinks about her weight and self-worth is a significant contributor to the potential development of an eating disorder. This predicts that perhaps Mindfulness-Based Cognitive Therapy (MBCT) might be particularly useful in treating or preventing eating disorders particularly in white women.

 

“Practicing mindfulness techniques has proven to be extremely helpful in aiding individuals to understand the driving forces behind their eating disorder. . . students receiving mindfulness demonstrated significant reductions in weight and shape concern, dietary restraint, thin-ideal internalization, eating disorder symptoms, and psychosocial impairment.”

 

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

 

Masuda A, Marshall RD and Latner JD (2018) Mindfulness as a Moderator of the Association Between Eating Disorder Cognition and Eating Disorder Behavior Among a Non-clinical Sample of Female College Students: A Role of Ethnicity. Front. Psychol. 9:700. doi: 10.3389/fpsyg.2018.00700

 

The present cross-sectional study examined whether mindfulness moderated the association between eating disorder cognition and eating disorder behaviors among Asian American, Black American, and White American female college students in the United States. Participants (N = 463, age range = 18–25 years) completed self-report measures online. Results revealed that mindfulness moderated the association between eating disorder cognition and eating disorder behavior in the White American group, but not in Asian American or Black American samples. Future research should replicate these differential findings across ethnic groups and investigate the factors that may contribute to this group difference.

https://www.frontiersin.org/articles/10.3389/fpsyg.2018.00700/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_695451_69_Psycho_20180705_arts_A