Month: October 2019

Improve Psychological Need Satisfaction in School Students with Mindfulness

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Improve Psychological Need Satisfaction in School Students with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness does much more than just create a positive classroom culture. Some of the purported benefits of mindfulness include decreasing stress and anxiety, improving self-esteem and self-regulation, and increasing calm.” – Lily Jones

 

Adolescence is a time of mental, physical, social, and emotional growth. But adolescence can be a difficult time, fraught with challenges. During this time the child transitions to young adulthood; including the development of intellectual, psychological, physical, and social abilities and characteristics. There are so many changes occurring during this time that the child can feel overwhelmed and unable to cope with all that is required. Indeed, up to a quarter of adolescents suffer from depression or anxiety disorders, and an even larger proportion struggle with subclinical symptoms. The stresses can create difficulties in satisfying the adolescent’s needs and create frustration with the lack of need satisfaction.

 

Mindfulness training has been shown in adolescents to improve emotion regulation and to benefit the psychological and emotional health. Autonomy-supportive teaching involves taking students’ perspectives, offering choices to students, and providing rationales to decision making. This type of teaching may help adolescents to make better decisions and be better able to satisfy their needs. So, it would make sense to study the relationships of mindfulness and autonomy-supportive teaching on need satisfaction and frustration in adolescents.

 

In today’s Research News article “Autonomy-Supportive Teaching and Basic Psychological Need Satisfaction among School Students: The Role of Mindfulness. International journal of environmental research and public health.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6679142/), Li and colleagues recruited Chinese secondary school children (grades 7-12) and had them complete a questionnaire. They answered questions as to the autonomy-supportiveness of their Physical Education teacher, their need satisfaction, need frustration, and mindfulness.

 

They found that the higher the levels of autonomy-supportive teaching the higher the levels of mindfulness and need satisfaction and the lower the levels of need frustration. In addition, they found that the higher the levels of mindfulness the higher the levels of need satisfaction and the lower the levels of need frustration. Multiple regression analysis revealed that the relationship of autonomy-supportive teaching with higher need satisfaction and lower need frustration was greater with greater levels of mindfulness. A path analysis revealed the mindfulness was related to higher need satisfaction and lower need frustration both directly and indirectly by being associated with higher levels of autonomy-supportive teaching.

 

It should be kept in mind that the study was correlational and as such causation cannot be determined. Regardless, the study suggests that a teaching strategy of encouraging autonomy and decision making may enhance mindfulness and in turn improve ability to satisfy needs and decrease frustration. That mindfulness may enhance the influence of autonomy-supportive teaching makes sense as the development of mindfulness may provide a more accurate and non-judgmental awareness of the current environment allowing autonomous decision making to be better tailored to the current state of affairs and thereby be more effective.

 

So, improve psychological need satisfaction in school students with mindfulness.

 

“Students who received the mindfulness training reported that their stress levels went down after the training, while the students in the control group did not. Students in the mindfulness training group also reported fewer negative feelings, such as sadness or anger, after the training.” – Science Daily

 

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

 

Li, C., Kee, Y. H., Kong, L. C., Zou, L., Ng, K. L., & Li, H. (2019). Autonomy-Supportive Teaching and Basic Psychological Need Satisfaction among School Students: The Role of Mindfulness. International journal of environmental research and public health, 16(14), 2599. doi:10.3390/ijerph16142599

 

Abstract

Grounded in self-determination theory, the purpose of this study was to investigate the relationships between autonomy-supportive teaching, mindfulness, and basic psychological need satisfaction/frustration. Secondary school students (n = 390, Mage = 15) responded to a survey form measuring psychological constructs pertaining to the research purpose. A series of multiple regression analysis showed that autonomy-supportive teaching and mindfulness positively predicted need satisfaction and negatively predicted need frustration. In addition, the associations between autonomy-supportive teaching and need satisfaction/frustration were moderated by mindfulness. Students higher in mindfulness were more likely to feel need satisfaction and less likely to experience need frustration, even in a low autonomy-supportive teaching environment. These results speak to the relevance of creating autonomy-supportive teaching environments and highlight mindfulness as a potential pathway to basic psychological need satisfaction in educational settings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6679142/

 

Improve the Psychological Well-Being of Lupus Patients with Mindfulness

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Improve the Psychological Well-Being of Lupus Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“For someone with lupus who suffers from persistent joint or muscular pain, the struggle to find relief can be stressful and exhausting. But mindfulness meditation is not about fighting. It’s all about acceptance. And once you have achieved calm, it can help you regain a much-needed sense of control when your disease brings you discomfort.” – Lupus Foundation

 

Autoimmune diseases occur when the body’s systems that are designed to ward off infection attack the individual’s own tissues. Lupus is an autoimmune disease that affects a variety of organ systems including kidneys, joints, skin, blood, brain, heart and lungs. Lupus can produce fever, joint pain, stiffness and swelling, butterfly-shaped rash on the face or rashes elsewhere on the body, skin lesions that appear or worsen with sun exposure, fingers and toes that turn white or blue when exposed to cold or during stressful periods, shortness of breath, chest pain, dry eyes, headaches, confusion and memory loss. Lupus strikes between 10 to 25 people per 100,000, or about 322,000 cases in the U.S.

 

The symptoms of Lupus can look like a number of other diseases so it is hard to diagnose lupus. It is tipped off in many patients by the distinctive facial rash. There are no known cures for lupus and treatment is targeted at symptom relief. Drug treatments include pain relievers, corticosteroids, immunosuppressants, and even antimalarial drugs. Mindfulness practices have been shown to be effective for a wide variety of illnesses and to improve the immune system. So, it is possible that mindfulness training could improve Lupus and its symptoms.

 

Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that is employs many of the techniques of 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. 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 “Efficacy of Acceptance and Commitment Therapy in Reducing Disappointment, Psychological Distress, and Psychasthenia among Systemic Lupus Erythematosus (SLE) Patients.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6702277/), Sahebari and colleagues recruited female lupus patients and were randomly assigned to receive 8 weekly sessions of Acceptance and Commitment Therapy (ACT) or treatment as usual. They were measured before and after treatment for depression, psychological distress, fatigue, disappointment, and psychasthenia.

 

They found that in comparison to baseline and the treatment as usual control condition, the lupus patients who received Acceptance and Commitment Therapy (ACT) had significantly lower levels of psychological distress, psychasthenia, and disappointment with large effect sizes. psychasthenia is a psychological disorder characterized by phobias, obsessions, compulsions, or excessive anxiety. Hence, ACT appears to be effective in improving the psychological state of lupus patients. It can be speculated that ACT has its benefits for lupus patients by increasing mindfulness and the patients’ ability to accept their situation without judgement.

 

So, improve the psychological well-being of lupus patients with mindfulness.

 

“Improvement was observed in several areas: patients’ increased ability to differentiate between themselves and the disease; increased ability to accept, rather than to actively fight the fact that one must live with the disease; and decreased behavioral avoidance. These observations speak to the significant therapeutic potential of mindfulness practice among SLE patients” – Danny Horash

 

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

 

Sahebari, M., Asghari Ebrahimabad, M. J., Ahmadi Shoraketokanlo, A., Aghamohammadian Sharbaf, H., & Khodashahi, M. (2019). Efficacy of Acceptance and Commitment Therapy in Reducing Disappointment, Psychological Distress, and Psychasthenia among Systemic Lupus Erythematosus (SLE) Patients. Iranian Journal of Psychiatry, 14(2), 130–136.

 

Abstract

Objective: The aim of this study was to evaluate the efficacy of acceptance and commitment therapy (ACT) in the reduction of disappointment, psychological distress, and psychasthenia among patients with systemic lupus erythematosus (SLE).

Method : This quasi-experimental study was conducted on 24 females with lupus who referred to the Rheumatoid Disease Research Center (RDRC) of Ghaem hospital in Mashhad, Iran. This study had a pretest-posttest control group design. The participants were randomly assigned into 2 groups of experimental and control. The experimental group was treated with ACT. Data were collected using the Beck’s Hopelessness Scale, Kessler’s Psychological Distress Inventory, and Krupp’s Psychasthenia Inventory.

Results: Mean age and mean duration of illness were 37.25±4.61 and 5.12±2.33 years, respectively. The mean disappointment score and psychological distress in the experimental group were lower compared to those in control group at the post experimental stage (P<0.001). Moreover, there was a significant difference between the experimental and control groups in the mean scores of psychasthenia in the posttest stage (P<0.001).

Conclusion: According to the obtained results of this study, the enhancement of psychological flexibility based on ACT positively affected disappointment, psychological distress, and psychasthenia among the lupus patients. Therefore, it can be concluded that this therapeutic approach could reduce psychasthenia in patients through clarification of the values.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6702277/

 

Treat Cancer with Mindfulness

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By John M. de Castro, Ph.D.

 

“A cancer diagnosis brings an awareness of the preciousness of life,” Fine explains. “And mindfulness can help us to experience that precious life with greater clarity, balance, and gratitude, one moment at a time.” – Micki Fine

 

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. Coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis. In addition, cancer patients are often challenged with a wide range of residual issues including chronic pain, sleep disturbance, sexual problems, loss of appetite, and chronic fatigue. Cancer survivors are also at greater risk for developing second cancers and other health conditions.

 

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. It is estimated that 15 million adults and children with a history of cancer are alive in the United States today. Hence there is a need to identify safe and effective treatments for the physical, emotional, and financial hardships that can persist for years after diagnosis and treatment.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. The evidence is rapidly accumulating, so it makes sense to step back and summarize what has been learned.

 

In today’s Research News article “Evidence for the Role of Mindfulness in Cancer: Benefits and Techniques.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6623989/), Mehta and colleagues review and summarize the published research literature on the effectiveness of mindfulness practice to relieve the physical and psychological suffering of cancer patients. They identified 124 published research studies using a variety of mindfulness training programs, most of which involved either the Mindfulness-Based Stress Reduction (MBSR) program or Mindfulness-Based Cognitive Therapy (MBCT) or versions of MBSR. or MBCT that were modified for the needs of cancer patients.

 

They report that the published research finds that mindfulness training is safe, resulting in few if any negative effects and effective, producing significant improvements in cancer-related stress, depression, pain intensity, fatigue, loss of appetite and weight loss, insomnia, immune responses, and psychological responses to chemotherapy. Mindfulness training also improved the ability of caregivers for cancer patients to deal with the psychological stresses. They also report that studies indicate that mindfulness training is cost effective in treating cancer patients compared to other approaches. Hence, the research to date suggests that mindfulness training is a safe, effective, and cost effective treatment for a variety of cancer-related problems in cancer survivors and their caregivers.

 

So, treat cancer with mindfulness.

 

“results show promise for mindfulness-based interventions to treat common psychological problems such as anxiety, stress, and depression in cancer survivors and to improve overall quality of life.” – Linda Carlson

 

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

 

Mehta, R., Sharma, K., Potters, L., Wernicke, A. G., & Parashar, B. (2019). Evidence for the Role of Mindfulness in Cancer: Benefits and Techniques. Cureus, 11(5), e4629. doi:10.7759/cureus.4629

 

Abstract

Mindfulness is being used increasingly in various aspects of cancer management. Benefits of mindfulness practices are being observed to manage the adverse effects of treatment, symptoms from cancer progression, and the cost-effectiveness compared to conventional contemporary management strategies. In this review article, we present clinical trial data showing the benefits of mindfulness in various aspects of cancer management as well as techniques that have been commonly used in this practice.

Conclusions

Mindfulness-based practices are being increasingly utilized in various aspects of cancer management. It has shown utility in multiple prospective trials and continues to be explored. Most of the evidence of the benefit of mindfulness in cancer is to reduce toxicity and stress. There is a need for more prospective trials exploring its use in reducing cancer incidence or preventing its recurrence.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6623989/

 

Improve Tinnitus by Changing the Brain with Mindfulness

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Improve Tinnitus by Changing the Brain with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The mindfulness approach is radically different from what most tinnitus sufferers have tried before, and it may not be right for everyone. We are confident, however, that the growing research base has demonstrated how it can offer an exciting new treatment to people who may have found that traditional treatment has not been able to help them yet.” – Liz Marks

 

Tinnitus is one of the most common symptoms to affect humanity. People with tinnitus live with a phantom noise that can range from a low hiss or ringing to a loud roar or squeal which can be present constantly or intermittently. It can have a significant impact on people’s ability to hear, concentrate, or even participate in everyday activities. Approximately 25 million to 50 million people in the United States experience it to some degree. Approximately 16 million people seek medical attention for their tinnitus, and for up to two million patients, debilitating tinnitus interferes with their daily lives.

 

There are a number of treatments for tinnitus including, counseling, sound therapy, drugs, and even brain stimulation. Unfortunately, none of these treatments is very effective. Mindfulness practices have been shown to be effective in treating Tinnitus. 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. It is unknown how mindfulness practices may change the brain to improve tinnitus.

 

In today’s Research News article “Functional Brain Changes During Mindfulness-Based Cognitive Therapy Associated With Tinnitus Severity.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6667657/), Zimmerman and colleagues recruited adult participants in an 8-week Mindfulness-Based Cognitive Therapy (MBCT) program consisting of 2-hour weekly sessions and 40-60 minutes daily home practice. The MBCT program consists of mindfulness training and Cognitive Behavioral Therapy (CBT). During therapy the patient is trained to investigate and alter aberrant thought patterns underlying their reactions to tinnitus symptoms. The participants brains were scanned before and after the MBCT program, and at follow-up 8 weeks later with functional Magnetic resonance Imaging (fMRI) and were measured for tinnitus, anxiety, depression, and mindfulness.

 

They found that the MBCT program produced a significant reduction in tinnitus symptoms that were maintained at the 8-week follow-up. With the fMRI scans they found widespread changes in brain functional connectivity following the MBCT program. Significantly, they found a reduced connectivity between the amygdala and parietal cortex that was negatively correlated with the reduction in tinnitus symptoms. In other words, the greater the decrease in functional connectivity, the greater the reductions in tinnitus symptoms. It will require further research to determine how this connectivity change might be related to tinnitus symptoms.

 

The study demonstrated that the Mindfulness-Based Cognitive Therapy (MBCT) program reduces the symptoms of tinnitus in a lasting way. The brain scan results suggest that alterations of the functional connectivity of brain areas may underlie the symptom improvements. It will require considerably more research to determine the exact nature of the changes and their relationship to tinnitus. But the study is a good first start.

 

So, improve tinnitus by changing the brain with mindfulness.

 

“Mindfulness is a special kind of awareness: it . . . frees you to be more present in your immediate experience, so that you can wake up to the wonder of the one life you are given. Others have found that cultivating this practice has helped reduce the negative impact of tinnitus on their lives. The more open you can be to whatever you are experiencing at any moment, the more awake, alive, happy, and balanced you can be.” – Jennifer Gans

“

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

 

Zimmerman, B., Finnegan, M., Paul, S., Schmidt, S., Tai, Y., Roth, K., … Husain, F. T. (2019). Functional Brain Changes During Mindfulness-Based Cognitive Therapy Associated With Tinnitus Severity. Frontiers in Neuroscience, 13, 747. doi:10.3389/fnins.2019.00747

 

Abstract

Mindfulness-based therapies have been introduced as a treatment option to reduce the psychological severity of tinnitus, a currently incurable chronic condition. This pilot study of twelve subjects with chronic tinnitus investigates the relationship between measures of both task-based and resting state functional magnetic resonance imaging (fMRI) and measures of tinnitus severity, assessed with the Tinnitus Functional Index (TFI). MRI was measured at three time points: before, after, and at follow-up of an 8-week long mindfulness-based cognitive therapy intervention. During the task-based fMRI with affective sounds, no significant changes were observed between sessions, nor was the activation to emotionally salient compared to neutral stimuli significantly predictive of TFI. Significant results were found using resting state fMRI. There were significant decreases in functional connectivity among the default mode network, cingulo-opercular network, and amygdala across the intervention, but no differences were seen in connectivity with seeds in the dorsal attention network (DAN) or fronto-parietal network and the rest of the brain. Further, only resting state connectivity between the brain and the amygdala, DAN, and fronto-parietal network significantly predicted TFI. These results point to a mostly differentiated landscape of functional brain measures related to tinnitus severity on one hand and mindfulness-based therapy on the other. However, overlapping results of decreased amygdala connectivity with parietal areas and the negative correlation between amygdala-parietal connectivity and TFI is suggestive of a brain imaging marker of successful treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6667657/

 

Therapeutic Alliance is Important for Success in Treating Cancer Patients with Mindfulness

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Therapeutic Alliance is Important for Success in Treating Cancer Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Compared with [treatment as usual], MBCT and eMBCT were similarly effective in reducing psychological distress in a sample of distressed heterogeneous patients with cancer.” – Felix Compen

 

Receiving a diagnosis of cancer has a huge impact on most people. Coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis. 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. It is estimated that 15 million adults and children with a history of cancer are alive in the United States today. But, surviving cancer carries with it a number of problems. “Physical, emotional, and financial hardships often persist for years after diagnosis and treatment. Cancer survivors are also at greater risk for developing second cancers and other health conditions.” National Cancer Survivors Day.

 

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. Mindfulness-Based Cognitive Therapy (MBCT) consists of mindfulness training and Cognitive Behavioral Therapy (CBT). During therapy the patient is trained to investigate and alter aberrant thought patterns underlying their reactions to cancer. So, it would make sense to study the effectiveness of MBCT and the characteristics of the therapy the psychological distress of cancer patients.

 

In today’s Research News article “Therapeutic alliance-not therapist competence or group cohesion-contributes to reduction of psychological distress in group-based mindfulness-based cognitive therapy for cancer patients.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6680267/ ), Bisseling and colleagues recruited cancer patients who were high in anxiety and depression and randomly assigned them to receive Mindfulness-Based Cognitive Therapy (MBCT) delivered either face-to-face in groups or online or to continue receiving treatment as usual. MBCT was delivered in 8 weekly 2.5 hour sessions along with audio guided home practice. They were measured before and after treatment for psychological distress, group cohesion, therapeutic alliance, and therapist competence.

 

Only the data from patients who had completed therapy were included in the analysis. They found that following treatment there was a significant decrease in anxiety and depression (psychological distress). They also found that the higher the levels of therapeutic alliance the greater the reduction in psychological distress. This was not true for either the group cohesion or the therapist competence.

 

Therapeutic alliance consists of “how closely client and therapist agree on and are mutually engaged in the goals of treatment; how closely client and therapist agree on how to reach the treatment goals; and the degree of mutual trust, acceptance, and confidence between client and therapist.” So, the results suggest that this relationship between patient and therapist is an important factor in the effectiveness of mindfulness treatment to improve the psychological distress of cancer patients. It is not how good the therapist is, but how well they create a mutual agreement regarding the therapy that is important for the effectiveness of the therapy.

 

This agreement may signal a buy-in by the patient to the efficacy of the therapy. This, in turn, can drive a positive expectation for therapeutic success both from the patient and the therapist. It has been demonstrated that the beliefs of the patient and the therapist have powerful effects on the outcome. So, it is possible that the therapeutic alliance is simply a measure of the power of those expectations and, in turn, the effectiveness of the program.

 

“Mindfulness-based cognitive therapy (MBCT) and individual Internet-based MBCT (eMBCT) had comparable efficacy in improving psychological distress among patients with cancer.” – James Nam

 

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

 

Bisseling, E. M., Schellekens, M., Spinhoven, P., Compen, F. R., Speckens, A., & van der Lee, M. L. (2019). Therapeutic alliance-not therapist competence or group cohesion-contributes to reduction of psychological distress in group-based mindfulness-based cognitive therapy for cancer patients. Clinical psychology & psychotherapy, 26(3), 309–318. doi:10.1002/cpp.2352

 

Abstract

Mindfulness‐based cognitive therapy (MBCT) is an innovative evidence‐based intervention in mental and somatic health care. Gaining knowledge of therapeutic factors associated with treatment outcome can improve MBCT. This study focused on predictors of treatment outcome of MBCT for cancer patients and examined whether group cohesion, therapeutic alliance, and therapist competence predicted reduction of psychological distress after MBCT for cancer patients. Moreover, it was examined whether therapist competence facilitated therapeutic alliance or group cohesion. Multilevel analyses were conducted on a subsample of patients collected in a larger randomized controlled trial on individual internet‐based versus group‐based MBCT versus treatment as usual in distressed cancer patients. The current analyses included the 84 patients who completed group‐based MBCT out of 120 patients who were randomized to group‐based MBCT. Group cohesion and therapist competence did not predict reduction in psychological distress, whereas therapeutic alliance did. In addition, therapist competence did not predict therapeutic alliance but was associated with reduced group cohesion. Our findings revealed that therapeutic alliance significantly contributed to reduction of psychological distress in MBCT for cancer patients. Elaborating the clinical implications of the predictive significance of therapeutic alliance might be of added value to enhance the potential effect of MBCT.

Key Practitioner Message

  • Mindfulness‐based cognitive therapy (MBCT) is an innovative evidence‐based intervention in mental and somatic health care and has been increasingly applied in oncology to reduce psychological distress.
  • Therapeutic alliance predicts reduction in psychological distress after MBCT for cancer patients, whereas group cohesion and therapist competence did not.
  • Therapist competence did not appear to be a precondition for a good therapeutic alliance and high group cohesion.
  • Contrary to expectation, we found competence to be negatively related to group cohesion.
  • Elaborating the clinical implications of the predictive significance of therapeutic alliance might be of added value to enhance the potential effect of MBCT for cancer patients.
  • The current findings should be taken into account in the training of MBCT therapists.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6680267/

 

Improve Chronic Low Back Pain with Yoga

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Improve Chronic Low Back Pain with Yoga

 

By John M. de Castro, Ph.D.

 

“Yoga is great for working on flexibility and core stability, correcting posture, and breathing—all of which are necessary for a healthy back.” – Sasha Cyrelson

 

Low Back Pain is the leading cause of disability worldwide and affects between 6% to 15% of the population. It is estimated, however, that 80% of the population will experience back pain sometime during their lives. There are varied treatments for low back pain including chiropractic care, acupuncture, biofeedback, physical therapy, cognitive behavioral therapy, massage, surgery, opiate pain killing drugs, steroid injections, and muscle relaxant drugs. These therapies are sometimes effective particularly for acute back pain. But, for chronic conditions the treatments are less effective and often require continuing treatment for years and opiate pain killers are dangerous and can lead to abuse, addiction, and fatal overdoses. Obviously, there is a need for safe and effective treatments for low back pain that are low cost and don’t have troublesome side effects.

 

Mindfulness practices have been found to be effective in treating pain and have been shown to be safe and effective in the management of low back pain. Yoga practice has been shown to have a myriad of health benefits. These include relief of chronic pain. Yoga practice has also been shown to be effective for the relief of chronic low-back pain.  Many forms of yoga focus on the proper alignment of the spine, which could directly address the source of back and neck pain for many individuals. So, it makes sense to further explore the effectiveness of yoga practice for chronic low back pain.

 

In today’s Research News article “Yoga, Physical Therapy, or Education for Chronic Low Back Pain: A Randomized Noninferiority Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6392183/), Saper and colleagues recruited adult patients with low back pain lasting at least 12 weeks and randomly assigned them to receive yoga, physical therapy, or education. Yoga training consisted of 12 weekly, 75 minute classes with 30 minutes of daily practice at home including relaxation, breathing exercises, meditation, and poses. Drop-in yoga classes were available during the subsequent 40 weeks. Physical therapy occurred in 15 60-minute session of graded exercise over 12 weeks. Booster classes were offered during the subsequent 40 weeks. Education included information on chronic low back pain self-management, stretching, strengthening, and the role of emotions and fear avoidance. They were measured before and after training and at 14, 28, and 40 weeks later for back-related function, pain intensity, global improvement, patient satisfaction, and health related quality of life.

 

They found that in comparison to baseline both the yoga and physical therapy groups had improvements in back-related function and pain intensity and were less likely to use pain medication at the end of training. These improvements were maintained 40 weeks later. Hence, both yoga practice and physical therapy were equivalently safe and effective treatments for low back pain and the improvements produced were enduring.

 

So, improve chronic low back pain with yoga.

 

“Yoga is one of the more effective tools for helping soothe low back pain. The practice helps to stretch and strengthen muscles that support the back and spine, such as the paraspinal muscles that help you bend your spine, the multifidus muscles that stabilize your vertebrae, and the transverse abdominis in the abdomen, which also helps stabilize your spine.” – Matthew Solan

 

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

 

Saper, R. B., Lemaster, C., Delitto, A., Sherman, K. J., Herman, P. M., Sadikova, E., … Weinberg, J. (2017). Yoga, Physical Therapy, or Education for Chronic Low Back Pain: A Randomized Noninferiority Trial. Annals of internal medicine, 167(2), 85–94. doi:10.7326/M16-2579

 

Abstract

Background:

Yoga is effective for mild to moderate chronic low back pain (cLBP), but its comparative effectiveness with physical therapy (PT) is unknown. Moreover, little is known about yoga’s effectiveness in underserved patients with more severe functional disability and pain.

Objective:

To determine whether yoga is noninferior to PT for cLBP.

Design:

12-week, single-blind, 3-group randomized noninferiority trial and subsequent 40-week maintenance phase. (ClinicalTrials.gov: NCT01343927)

Setting:

Academic safety-net hospital and 7 affiliated community health centers.

Participants:

320 predominantly low-income, racially diverse adults with nonspecific cLBP.

Intervention:

Participants received 12 weekly yoga classes, 15 PT visits, or an educational book and newsletters. The maintenance phase compared yoga drop-in classes versus home practice and PT booster sessions versus home practice.

Measurements:

Primary outcomes were back-related function, measured by the Roland Morris Disability Questionnaire (RMDQ), and pain, measured by an 11-point scale, at 12 weeks. Prespecified noninferiority margins were 1.5 (RMDQ) and 1.0 (pain). Secondary outcomes included pain medication use, global improvement, satisfaction with intervention, and health-related quality of life.

Results:

One-sided 95% lower confidence limits were 0.83 (RMDQ) and 0.97 (pain), demonstrating noninferiority of yoga to PT. However, yoga was not superior to education for either outcome. Yoga and PT were similar for most secondary outcomes. Yoga and PT participants were 21 and 22 percentage points less likely, respectively, than education participants to use pain medication at 12 weeks. Improvements in yoga and PT groups were maintained at 1 year with no differences between maintenance strategies. Frequency of adverse events, mostly mild self-limited joint and back pain, did not differ between yoga and PT.

Limitations:

Participants were not blinded to treatment assignment. The PT group had disproportionate loss to follow-up.

Conclusion:

A manualized yoga program for nonspecific cLBP was noninferior to PT for function and pain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6392183/

 

Possibly Improve Dementia Patient Caregiver Mental Health with Mindfulness

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Possibly Improve Dementia Patient Caregiver Mental Health with Mindfulness

 

By John M. de Castro, Ph.D.

 

“One of the major difficulties that individuals with dementia and their family members encounter is that there is a need for new ways of communicating due to the memory loss and other changes in thinking and abilities. The practice of mindfulness places both participants in the present and focuses on positive features of the interaction, allowing for a type of connection that may substitute for the more complex ways of communicating in the past. It is a good way to address stress.” – Sandra Weintraub

 

Dementia is a progressive loss of mental function produced by degenerative diseases of the brain. Dementia patients require caregiving particularly in the later stages of the disease. Caregiving for dementia patients is a daunting intense experience that can go on for four to eight years with increasing responsibilities as the loved one deteriorates. This places tremendous psychological and financial stress on the caregiver. Hence, there is a need to both care for the dementia patients and also for the caregivers. Mindfulness practice for caregivers has been shown to help them cope with the physical and psychological demands of caregiving. In addition, mindfulness training has been found to help protect aging individuals from physical and cognitive declines.

 

There has accumulated a considerable body of research on the effectiveness of mindfulness to improve the psychological health of caregivers for dementia patients. In today’s Research News article “Mindfulness-based stress reduction for family carers of people with dementia.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6513415/), Liu and colleagues review, summarize, and perform a meta-analysis of the published research studies on the effectiveness of Mindfulness-Based Stress Reduction (MBSR) training for the relief of the psychological distress produced by caring for a patient with dementia. The MBSR program generally consisted of 8 weekly group sessions involving meditation, yoga, body scan, and discussion. The patients were also encouraged to perform daily practice.

 

They found and included 5 controlled research studies containing a total of 201 caregivers. They report that the published research was generally of low quality with great concerns regarding the precision of measurements. Ignoring these concerns the studies that Mindfulness-Based Stress Reduction (MBSR) training in comparison to active control conditions produced small reductions in caregivers levels of depression and anxiety.

 

In general, there are indications that the MBSR program produces small improvements in caregivers’ levels of anxiety and depression but the quality of the evidence is low. This is an important area as caregiving for dementia patients is needed but difficult and exacts a toll on the caregiver. So, relieving the caregivers suffering is very important. Hence, the review identified a great need for more better designed and executed research.

 

So, possibly improve dementia patient caregiver mental health with mindfulness.

 

“In regard to dementia care, mindfulness is not just a stress-reduction tool. It can also help with another critical aspect of dementia caregiving: the need to meet the person in the present moment, where they are most likely to reside and engage due to the dementia.” – Marguerite Manteau-Rao

 

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

 

Liu, Z., Sun, Y. Y., & Zhong, B. L. (2018). Mindfulness-based stress reduction for family carers of people with dementia. The Cochrane database of systematic reviews, 8(8), CD012791. doi:10.1002/14651858.CD012791.pub2

 

Abstract

Background

Caring for people with dementia is highly challenging, and family carers are recognised as being at increased risk of physical and mental ill‐health. Most current interventions have limited success in reducing stress among carers of people with dementia. Mindfulness‐based stress reduction (MBSR) draws on a range of practices and may be a promising approach to helping carers of people with dementia.

Objectives

To assess the effectiveness of MBSR in reducing the stress of family carers of people with dementia.

Search methods

We searched ALOIS ‐ the Cochrane Dementia and Cognitive Improvement Group’s Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (all years to Issue 9 of 12, 2017), MEDLINE (Ovid SP 1950 to September 2017), Embase (Ovid SP 1974 to Sepetmber 2017), Web of Science (ISI Web of Science 1945 to September 2017), PsycINFO (Ovid SP 1806 to September 2017), CINAHL (all dates to September 2017), LILACS (all dates to September 2017), World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov, and Dissertation Abstracts International (DAI) up to 6 September 2017, with no language restrictions.

Selection criteria

Randomised controlled trials (RCTs) of MBSR for family carers of people with dementia.

Data collection and analysis

Two review authors independently screened references for inclusion criteria, extracted data, assessed the risk of bias of trials with the Cochrane ‘Risk of bias’ tool, and evaluated the quality of the evidence using the GRADE instrument. We contacted study authors for additional information, then conducted meta‐analyses, or reported results narratively in the case of insufficient data. We used standard methodological procedures expected by Cochrane.

Main results

We included five RCTs involving 201 carers assessing the effectiveness of MBSR. Controls used in included studies varied in structure and content. Mindfulness‐based stress reduction programmes were compared with either active controls (those matched for time and attention with MBSR, i.e. education, social support, or progressive muscle relaxation), or inactive controls (those not matched for time and attention with MBSR, i.e. self help education or respite care). One trial used both active and inactive comparisons with MBSR. All studies were at high risk of bias in terms of blinding of outcome assessment. Most studies provided no information about selective reporting, incomplete outcome data, or allocation concealment.

  1. Compared with active controls, MBSR may reduce depressive symptoms of carers at the end of the intervention (3 trials, 135 participants; standardised mean difference (SMD) ‐0.63, 95% confidence interval (CI) ‐0.98 to ‐0.28; P<0.001; low‐quality evidence). We could not be certain of any effect on clinically significant depressive symptoms (very low‐quality evidence).

Mindfulness‐based stress reduction compared with active control may decrease carer anxiety at the end of the intervention (1 trial, 78 participants; mean difference (MD) ‐7.50, 95% CI ‐13.11 to ‐1.89; P<0.001; low‐quality evidence) and may slightly increase carer burden (3 trials, 135 participants; SMD 0.24, 95% CI ‐0.11 to 0.58; P=0.18; low‐quality evidence), although both results were imprecise, and we could not exclude little or no effect. Due to the very low quality of the evidence, we could not be sure of any effect on carers’ coping style, nor could we determine whether carers were more or less likely to drop out of treatment.

  1. Compared with inactive controls, MBSR showed no clear evidence of any effect on depressive symptoms (2 trials, 50 participants; MD ‐1.97, 95% CI ‐6.89 to 2.95; P=0.43; low‐quality evidence). We could not be certain of any effect on clinically significant depressive symptoms (very low‐quality evidence).

In this comparison, MBSR may also reduce carer anxiety at the end of the intervention (1 trial, 33 participants; MD ‐7.27, 95% CI ‐14.92 to 0.38; P=0.06; low‐quality evidence), although we were unable to exclude little or no effect. Due to the very low quality of the evidence, we could not be certain of any effects of MBSR on carer burden, the use of positive coping strategies, or dropout rates.

We found no studies that looked at quality of life of carers or care‐recipients, or institutionalisation.

Only one included study reported on adverse events, noting a single adverse event related to yoga practices at home

Authors’ conclusions

After accounting for non‐specific effects of the intervention (i.e. comparing it with an active control), low‐quality evidence suggests that MBSR may reduce carers’ depressive symptoms and anxiety, at least in the short term.

There are significant limitations to the evidence base on MBSR in this population. Our GRADE assessment of the evidence was low to very low quality. We downgraded the quality of the evidence primarily because of high risk of detection or performance bias, and imprecision.

In conclusion, MBSR has the potential to meet some important needs of the carer, but more high‐quality studies in this field are needed to confirm its efficacy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6513415/

 

Improve Psychological Functioning with Mindfulness

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Improve Psychological Functioning with Mindfulness

 

By John M. de Castro, Ph.D.

 

” the positive potential benefits of mindfulness practice are more attentional control, more effective emotional regulation, enhanced social relationships, reduced risk for physical ailments, enhanced immune system functioning, and better sleep quality.” – Jason Linder

 

Over the last several decades, research and anecdotal experiences have accumulated an impressive evidential case that the development of mindfulness has positive benefits for the individual’s mental, physical, and spiritual life. Mindfulness appears to be beneficial both for healthy people and for people suffering from a myriad of mental and physical illnesses. It appears to be beneficial across ages, from children to the elderly. And it appears to be beneficial across genders, personalities, race, and ethnicity. The breadth and depth of benefits is unprecedented. There is no other treatment or practice that has been shown to come anyway near the range of mindfulness’ positive benefits.

 

The clustering of these benefits may supply a clue as to how mindfulness training is working to improve mental health. This can be investigated by looking at the interrelationships between the effects of mindfulness training. In today’s Research News article “Does mindfulness change the mind? A novel psychonectome perspective based on Network Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6638953/), Roca and colleagues apply network analysis to investigate the interrelationships between a large number of effects of Mindfulness-Based Stress Reduction (MBSR) training.

 

They recruited healthy adult participants in a Mindfulness-Based Stress Reduction (MBSR) program. The MBSR program consisted of 32 hours of training separated into 8 weekly group sessions involving meditation, yoga, body scan, and discussion. The patients were also encouraged to perform daily practice. They were measured before and after MBSR training for meditation experience, and psychological and physical health problems, and 5 categories of mindfulness effects; 1) Mindfulness, including five facets, decentering, non-attachment, and bodily awareness, 2) Compassion, including compassion towards oneself and others and empathy, 3) Psychological well-being, including satisfaction with life, optimism, and overall well-being, 4) Psychological distress, including anxiety, stress, and depression, and 5) Emotional and cognitive control, including emotional regulation, rumination, thought suppression and attentional control.

 

They found that after MBSR training there were significant improvements in effectively all of the five categories. This is not new as much research has demonstrated that mindfulness training produces improvements in mindfulness, compassion, psychological well-being, psychological distress, and emotional and cognitive control.

 

These data were then subjected to network analysis. Prior to MBSR training the network analysis revealed clustering in three paths “mindfulness and self-compassion; clinical symptoms and rumination; and most of FFMQ mindfulness components with attentional control measure.” After MBSR training, however, there was a network reorganization such that the three paths disappeared and were replaced by two paths, psychopathological and adaptive.

 

Centrality measures in the network analysis indicated that both prior to and after MBSR training the most central, fundamental, and interrelated components were all facets of mindfulness and all well-being measures. In addition, Community Analysis revealed that mindfulness, compassion, and emotional regulation were the most highly associated components.

 

The results are complex but suggest that Mindfulness-Based Stress Reduction (MBSR) training reorganizes the associations of psychological variables, simplifying them into two categories representing distress and adaptation. The training may help the individual see the interrelationships of the problems they have and the solutions employed. The results further suggest, not surprisingly, that mindfulness, compassion, and emotion regulation are central to the benefits of mindfulness training. Many other benefits flow from these.

 

So, improve psychological functioning with mindfulness.

 

“Mindfulness-Based Stress Reduction . . . Participants experienced significant decreases in perceived stress, depression, anxiety, emotional dysregulation, and post-traumatic stress symptoms.” – Carolyn McManus

 

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

 

Roca, P., Diez, G. G., Castellanos, N., & Vazquez, C. (2019). Does mindfulness change the mind? A novel psychonectome perspective based on Network Analysis. PloS one, 14(7), e0219793. doi:10.1371/journal.pone.0219793

 

Abstract

If the brain is a complex network of functionally specialized areas, it might be expected that mental representations could also behave in a similar way. We propose the concept of ‘psychonectome’ to formalize the idea of psychological constructs forming a dynamic network of mutually dependent elements. As a proof-of-concept of the psychonectome, networks analysis (NA) was used to explore structural changes in the network of constructs resulting from a psychological intervention. NA was applied to explore the effects of an 8-week Mindfulness-Based Stress Reduction (MBSR) program in healthy participants (N = 182). Psychological functioning was measured by questionnaires assessing five key domains related to MBSR: mindfulness, compassion, psychological well-being, psychological distress and emotional-cognitive control. A total of 25 variables, covering the five constructs, were considered as nodes in the NA. Participants significantly improved in most of the psychological questionnaires. More interesting from a network perspective, there were also significant changes in the topological relationships among the elements. Expected influence and strength centrality indexes revealed that mindfulness and well-being measures were the most central nodes in the networks. The nodes with highest topological change after the MBSR were attentional control, compassion measures, depression and thought suppression. Also, cognitive appraisal, an adaptive emotion regulation strategy, was associated to rumination before the MBSR program but became related to mindfulness and well-being measures after the program. Community analysis revealed a strong topological association between mindfulness, compassion, and emotional regulation, which supports the key role of compassion in mindfulness training. These results highlight the importance of exploring psychological changes from a network perspective and support the conceptual advantage of considering the interconnectedness of psychological constructs in terms of a ‘psychonectome’ as it may reveal ways of functioning that cannot be analyzed through conventional analytic methods.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6638953/

 

Treat Depression with Tai Chi

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Treat Depression with Tai Chi

 

By John M. de Castro, Ph.D.

 

“A 12-week program of instruction and practice of the Chinese martial art tai chi led to significantly reduced symptoms of depression in Chinese Americans not receiving any other treatments.” – Science Daily

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. Depression can be difficult to treat and is usually treated with anti-depressive medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression. Even after remission some symptoms of depression may still be present (residual symptoms).

 

Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering. Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail.  Mindful Movement practices such as Qigong and Tai Chi have been found to be effective for depression. Research has been accumulating. So, it is important to step back and examine what has been learned regarding the application of Tai Chi practice for depression.

 

In today’s Research News article “Treating Depression With Tai Chi: State of the Art and Future Perspectives.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6474282/), Kong and colleagues review and summarize the published research on the effectiveness of Tai Chi practice for depression. They report that the published research has demonstrated that Tai Chi practice significantly decreases depression levels in a variety of groups including adults, the elderly, pregnant women, patients taking antidepressant drugs or not, and those with a variety of diseases including fibromyalgia, arthritis, multiple sclerosis, heart failure, mild dementia, and cerebrovascular disorder.

 

They report that the published research indicates that Tai Chi practice may lower depression by producing neuroplastic changes in the nervous system, particularly the brain’s Default Mode Network that’s known to be involved in self-referential thinking which is prevalent in depression. Another possible mechanism is indicated by the research demonstrating that Tai Chi reduces the physiological and psychological responses to stress, that are known to exacerbate depression. Tai Chi is also known to reduce the inflammatory response that is heightened in depression. In addition, Tai Chi is a mild exercise and exercise has been shown to reduce depression. Finally, Tai Chi practice appears to relax the autonomic component of the peripheral nervous system

 

The results of the published research suggests that Tai Chi  practice should be prescribed for depression. In addition, Tai Chi is a gentle and safe mindfulness practice. It is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It 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, treat depression with Tai Chi.

 

“A 12-week program of instruction and practice of the Chinese martial art tai chi led to significantly reduced symptoms of depression in Chinese Americans not receiving any other treatments.” – Mayo Clinic

 

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

 

Kong, J., Wilson, G., Park, J., Pereira, K., Walpole, C., & Yeung, A. (2019). Treating Depression With Tai Chi: State of the Art and Future Perspectives. Frontiers in psychiatry, 10, 237. doi:10.3389/fpsyt.2019.00237

 

Abstract

Major depressive disorder (MDD) is one of the most prevalent mental illnesses in America. Current treatments for MDD are unsatisfactory given high non-response rates, high relapse rates, and undesirable side effects. Accumulating evidence suggests that Tai Chi, a popular mind–body intervention that originated as a martial art, can significantly regulate emotion and relieve the symptoms of mood disorders. In addition, the availability of instructional videos and the development of more simplified and less structured Tai Chi has made it a promising low-intensity mind-body exercise. In this article, we first examine a number of clinical trials that implemented Tai Chi as a treatment for depression. Then, we explore several mechanisms by which Tai Chi may alleviate depressive symptoms, hypothesizing that the intervention may modulate the activity and connectivity of key brain regions involved in mood regulation, reduce neuro-inflammatory sensitization, modulate the autonomic nervous system, and regulate hippocampal neurogenesis. Finally, we discuss common challenges of the intervention and possible ways to address them. Specifically, we pose developing a simplified and tailored Tai Chi protocol for patients with depression, comparatively investigating Tai Chi with other mind–body interventions such as yoga and Baduanjin, and developing new mind–body interventions that merge the advantages of multiple mind–body exercises.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6474282/

 

Increase Social Contact and Reduce Loneliness with A Mindfulness Smartphone App

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Increase Social Contact and Reduce Loneliness with A Mindfulness Smartphone App

 

By John M. de Castro, Ph.D.

 

“Loneliness and social isolation are among the most robust known risk factors for poor health and early death. . . Our research shows that a 14-day smartphone-based mindfulness program can target both, and that practice in welcoming and opening to all of our inner experiences—good or bad—is the key ingredient for these effects,” – Emily Lindsay

 

Humans are social animals. 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. 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.

 

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.

 

In today’s Research News article “Mindfulness training reduces loneliness and increases social contact in a randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6397548/), Lindsay and colleagues recruited stressed but otherwise healthy adults and randomly assigned them to a 14 lesson smartphone app with one of three conditions; monitoring present moment experience, monitoring present moment experience plus accepting the experience, or reappraisal and coping strategies). They reported daily on their smartphones their level of loneliness, social contacts, and social support for three days before and 3 days after training with the App.

 

They found that after the intervention the monitoring present moment experience plus accepting the experience group had significantly lower levels of loneliness than prior to training and significantly greater number of social contacts, while neither the monitoring present moment experience or reappraisal and coping strategies groups had significant improvements.

 

These are interesting and potentially important results. Training to monitor present moment experience is not enough by itself to improve loneliness or increase social contact. It requires additional training in acceptance of experience. Many mindfulness training programs, such as Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT),  Mindfulness-Based Relapse Prevention (MBRP), Mindfulness-Oriented Recovery Enhancement (MORE), and Acceptance and Commitment Therapy (ACT) already include both present moment and acceptance training. In fact, most meditation trainings emphasize both present moment and acceptance. So, it would be un usual for a training program not to have both components. But the present results suggest that is important to have both components to produce benefits.

 

The study did not have an acceptance alone condition. So, it cannot be determined if acceptance training also requires present moment training to produce benefits or if acceptance training alone can. Nevertheless, it is clear that the combination is a safe and effective means to reduce loneliness and enhance social contact. It is not clear whether the enhanced social contact was responsible for the reduced loneliness or that reducing loneliness encourages more social contact or that these two effects are produced separately by training.

 

Regardless, reducing loneliness is very important for the physical and psychological health and well-being of adults and mindfulness plus acceptance training is capable of doing just that. The fact that the training can occur without therapist contact with a smartphone App is important as this means that the treatment is scalable and can be implemented conveniently and at low cost.

 

So, increase social contact and reduce loneliness with a mindfulness smartphone App.

 

“In Unified Mindfulness terms, it appears that equanimity (acceptance) combines with concentration and sensory clarity to reduce loneliness and social isolation.” – Unmindfulness.com

 

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

 

Lindsay, E. K., Young, S., Brown, K. W., Smyth, J. M., & Creswell, J. D. (2019). Mindfulness training reduces loneliness and increases social contact in a randomized controlled trial. Proceedings of the National Academy of Sciences of the United States of America, 116(9), 3488–3493. doi:10.1073/pnas.1813588116

 

SIGNIFICANCE

Loneliness (i.e., feeling alone) and social isolation (i.e., being alone) are among the most robust known risk factors for poor health and accelerated mortality. Yet mitigating these social risk factors is challenging, as few interventions have been effective for both reducing loneliness and increasing social contact. Mindfulness interventions, which train skills in monitoring present-moment experiences with an orientation of acceptance, have shown promise for improving social-relationship processes. This study demonstrates the efficacy of a 2-wk smartphone-based mindfulness training for reducing loneliness and increasing social contact in daily life. Importantly, this study shows that developing an orientation of acceptance toward present-moment experiences is a critical mechanism for mitigating these social risk factors.

Loneliness (i.e., feeling alone) and social isolation (i.e., being alone) are among the most robust known risk factors for poor health and accelerated mortality. Yet mitigating these social risk factors is challenging, as few interventions have been effective for both reducing loneliness and increasing social contact. Mindfulness interventions, which train skills in monitoring present-moment experiences with an orientation of acceptance, have shown promise for improving social-relationship processes. This study demonstrates the efficacy of a 2-wk smartphone-based mindfulness training for reducing loneliness and increasing social contact in daily life. Importantly, this study shows that developing an orientation of acceptance toward present-moment experiences is a critical mechanism for mitigating these social risk factors.

Keywords: mindfulness, social relationships, loneliness, acceptance, ambulatory assessment

ABSTRACT

Loneliness and social isolation are a growing public health concern, yet there are few evidence-based interventions for mitigating these social risk factors. Accumulating evidence suggests that mindfulness interventions can improve social-relationship processes. However, the active ingredients of mindfulness training underlying these improvements are unclear. Developing mindfulness-specific skills—namely, (i) monitoring present-moment experiences with (ii) an orientation of acceptance—may change the way people perceive and relate toward others. We predicted that developing openness and acceptance toward present experiences is critical for reducing loneliness and increasing social contact and that removing acceptance-skills training from a mindfulness intervention would eliminate these benefits. In this dismantling trial, 153 community adults were randomly assigned to a 14-lesson smartphone-based intervention: (i) training in both monitoring and acceptance (Monitor+Accept), (ii) training in monitoring only (Monitor Only), or (iii) active control training. For 3 d before and after the intervention, ambulatory assessments were used to measure loneliness and social contact in daily life. Consistent with predictions, Monitor+Accept training reduced daily-life loneliness by 22% (d = 0.44, P = 0.0001) and increased social contact by two more interactions each day (d = 0.47, P = 0.001) and one more person each day (d = 0.39, P= 0.004), compared with both Monitor Only and control trainings. These findings describe a behavioral therapeutic target for improving social-relationship functioning; by fostering equanimity with feelings of loneliness and social disconnect, acceptance-skills training may allow loneliness to dissipate and encourage greater engagement with others in daily life.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6397548/Loneliness and social isolation are a growing public health concern, yet there are few evidence-based interventions for mitigating these social risk factors. Accumulating evidence suggests that mindfulness interventions can improve social-relationship processes. However, the active ingredients of mindfulness training underlying these improvements are unclear. Developing mindfulness-specific skills—namely, (i) monitoring present-moment experiences with (ii) an orientation of acceptance—may change the way people perceive and relate toward others. We predicted that developing openness and acceptance toward present experiences is critical for reducing loneliness and increasing social contact and that removing acceptance-skills training from a mindfulness intervention would eliminate these benefits. In this dismantling trial, 153 community adults were randomly assigned to a 14-lesson smartphone-based intervention: (i) training in both monitoring and acceptance (Monitor+Accept), (ii) training in monitoring only (Monitor Only), or (iii) active control training. For 3 d before and after the intervention, ambulatory assessments were used to measure loneliness and social contact in daily life. Consistent with predictions, Monitor+Accept training reduced daily-life loneliness by 22% (d = 0.44, P = 0.0001) and increased social contact by two more interactions each day (d = 0.47, P = 0.001) and one more person each day (d = 0.39, P= 0.004), compared with both Monitor Only and control trainings. These findings describe a behavioral therapeutic target for improving social-relationship functioning; by fostering equanimity with feelings of loneliness and social disconnect, acceptance-skills training may allow loneliness to dissipate and encourage greater engagement with others in daily life.