Improve Borderline Personality Disorder with Dual Diagnosis with Mindfulness

Improve Borderline Personality Disorder with Dual Diagnosis with Mindfulness

 

By John M. de Castro, Ph.D.

 

The pain, emotional instability and impulsive behavior of borderline personality disorder place these individuals at risk of drug or alcohol abuse.– Foundation Recovery

 

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. BPD is associated with high rates of co-occurring depression, anxiety disorders, substance abuse, eating disorders, self-harm, suicidal behaviors, and completed suicides. Needless to say, it is widespread and debilitating.

 

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 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.

 

Borderline Personality Disorder (BPD) frequently occurs with other problems, particularly drug and alcohol abuse. This dual diagnosis increases the issues presenting with the patient. It is therefore important to establish if Dialectical Behavior Therapy (DBT) is effective in the dual diagnosis patients. In today’s Research News article “Does an adapted Dialectical Behaviour Therapy skills training programme result in positive outcomes for participants with a dual diagnosis? A mixed methods study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6694661/?report=classic), Flynn and colleagues examine the effectiveness of Dialectical Behavior Therapy (DBT) skills training for patients with dual diagnosis.

 

They recruited patients diagnosed with Borderline Personality Disorder (BPD) and substance abuse (primarily alcohol abuse). The patients were treated with a 48-week program of skills training adapted from Dialectical Behavior Therapy (DBT); mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness. They were measured before and after treatment and 6 months later for mindfulness, emotion regulation, coping behavior, and the frequency and severity of substance abuse. At the end of the program they were interviewed regarding their experiences with the program.

 

They found that compared with baseline, at the end of the program there were significant increases in mindfulness and Dialectical Behavior Therapy (DBT) skills use and significant reductions in dysfunctional coping behavior and emotional dysregulation that were maintained at the 6-month follow-up. Substance abuse was also significantly reduced after treatment. There was still a reduced use at the 6-month follow-up but it was no longer statistically significant. In the interviews the patients reported that the program improved their self-assurance and confidence, but there was a need for continued care after the end of the program.

 

These results are important as Borderline Personality Disorder (BPD) is extremely difficult to treat and when it is combined with substance abuse it is even more difficult to treat. It is very encouraging that training in Dialectical Behavior Therapy (DBT) skills of mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness is effective in improving emotion regulation and coping behavior and reducing substance abuse in BPD patients with dual diagnosis. This suggests that this skills training may be an acceptable and effective treatment for patients with both BPD and substance abuse.

 

So, improve borderline personality disorder with dual diagnosis with mindfulness.

 

“[Dialectical Behavior Therapy] DBT is reported to reduce suicidal behavior, non-suicidal self-injurious behavior, other impulsive behaviors strongly linked with borderline personality disorder, and significantly reduce psychiatric hospitalization (relapse), self-injury, and depression among adolescents and adults.” – Burning Tree

 

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

 

Flynn, D., Joyce, M., Spillane, A., Wrigley, C., Corcoran, P., Hayes, A., … Mooney, B. (2019). Does an adapted Dialectical Behaviour Therapy skills training programme result in positive outcomes for participants with a dual diagnosis? A mixed methods study. Addiction science & clinical practice, 14(1), 28. doi:10.1186/s13722-019-0156-2

 

Abstract

Background

Treating severe emotional dysregulation and co-occurring substance misuse is challenging. Dialectical behaviour therapy (DBT) is a comprehensive and evidence-based treatment for borderline personality disorder (BPD). It has been hypothesised that the skills training, which is a facet of the full DBT programme, might be effective for people with severe emotional dysregulation and other co-occurring conditions, but who do not meet the criteria for BPD. However, there is limited research on standalone DBT skills training for people with substance misuse and emotional dysregulation.

Methods

A mixed methods study employing an explanatory sequential design was conducted where participants with a dual diagnosis (n = 64) were recruited from a community-based public addiction treatment service in Ireland between March 2015 and January 2018. DBT therapists screened potential participants against the study eligibility criteria. Quantitative self-report measures examining emotion regulation, mindfulness, adaptive and maladaptive coping responses including substance misuse, and qualitative feedback from participants were collected. Quantitative data were summarised by their mean and standard deviation and multilevel linear mixed effects models were used to estimate the mean change from baseline to post-intervention and the 6-month follow-up period. Thematic analysis was used to analyse the qualitative data.

Results

Quantitative results indicated reductions in binge drinking and use of Class A, B and C drug use from pre-intervention (T1) to the 6-month follow-up (T3). Additionally, significant improvements were noted for mindfulness practice and DBT skills use from T1 to T3 (p < 0.001). There were also significant reductions in dysfunctional coping and emotional dysregulation from T1 to T3 (p < 0.001). Significant differences were identified from pre to post intervention in reported substance use, p = 0.002. However, there were no significant differences between pre-intervention and 6-month follow up reports of substance use or at post-intervention to 6 month follow up. Qualitative findings indicated three superordinate themes in relation to participants’ experiences of a DBT skills training programme, adapted from standard DBT: (1) new lease of life; (2) need for continued formal aftercare and (3) programme improvements. Participants described reductions in substance misuse, while having increased confidence to use the DBT skills they had learned in the programme to deal with difficult emotions and life stressors.

Conclusions

This DBT skills training programme, adapted from standard DBT, showed positive results for participants and appears effective in treating people with co-occurring disorders. Qualitative results of this mixed methods study corroborate the quantitative results indicating that the experiences of participants have been positive. The study indicates that a DBT skills programme may provide a useful therapeutic approach to managing co-occurring symptoms.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6694661/?report=classic

 

Improve Attention-Deficit/Hyperactivity Disorder (ADHD) Symptoms in Youth with Mind-Body Practices

Improve Attention-Deficit/Hyperactivity Disorder (ADHD) Symptoms in Youth with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

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

 

Attention Deficit Hyperactivity Disorder (ADHD) is most commonly found in children, but for about half it persists into adulthood. It’s estimated that about 5% of the adult population has ADHD. Hence, this is a very large problem that can produce inattention, impulsivity, hyperactivity, and emotional issues, and reduce quality of life. The most common treatment is drugs, like methylphenidate, Ritalin, which helps reducing symptoms in about 30% of the people with ADHD. Unfortunately, the effectiveness of the drugs appears to be markedly reduced after the first year. In addition, the drugs often have troublesome side effects, can be addictive, and can readily be abused. So, drugs, at present, do not appear to be a good solution, only affecting some, only for a short time, and with unwanted side effects.

 

There are indications that mind-body practices training may be an effective treatment for ADHD. It makes sense that it should be, as the skills and abilities strengthened by mind-body practices training are identical to those that are defective in ADHD,  attentionimpulse controlexecutive functionemotion control, and mood improvement. In addition, unlike drugs, they are relatively safe interventions that have minimal troublesome side effects. Since mind-body practices is so promising as treatments, it is important to step back and summarize what has been learned in the scientific research of the effectiveness of mindfulness training for ADHD.

 

In today’s Research News article “Interventions Based on Mind-Body Therapies for the Improvement of Attention-Deficit/Hyperactivity Disorder Symptoms in Youth: A Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6680862/), Barranco-Ruiz and colleagues review and summarize the published research studies of the effectiveness pf mind-body practices in the treatment of Attention Deficit Hyperactivity Disorder (ADHD). They found 12 published randomized trials employing the mind-body practices of school based 8-week mindfulness trainings and yoga practices that were applied to children and adolescents of 5 to 18 years of age.

 

They found that 11 of the 12 reviewed studies reported significant improvements in Attention-Deficit/Hyperactivity Disorder (ADHD) following mind-body treatment in the youths. There were significant improvements in the symptoms of ADHD including significant increases in attention and planning, and significant decreases in inattention, hyperactivity, impulsivity, anxiety, shyness, social problems, perfectionism, inhibition, self-reported emotion dysregulation, and depressive symptoms.

 

These are impressive results. It has been previously shown with disparate healthy and ill populations that mindfulness training produces increases in attention and significant decreases in inattention, hyperactivity, impulsivity, anxiety, social problems, perfectionism, inhibition, emotion dysregulation, and depression. The present review extends these findings to children and adolescents. This is important as Attention-Deficit/Hyperactivity Disorder (ADHD) is highest among children and adolescents. These results suggest that mindfulness training and yoga practices are safe and effective in improving ADHD and its symptoms. Mind-body practices may be an excellent alternative to standard drug treatment.

 

So, improve Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms in youth with mind-body practices.

 

Yoga has been shown to help improve ADHD symptoms. . . . Like mindfulness meditation, it ups dopamine levels and strengthens the prefrontal cortex. One study found that kids who practiced yoga moves for 20 minutes twice a week for 8 weeks improved on tests that measure attention and focus.” – WebMD

 

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

 

Barranco-Ruiz, Y., Etxabe, B. E., Ramírez-Vélez, R., & Villa-González, E. (2019). Interventions Based on Mind-Body Therapies for the Improvement of Attention-Deficit/Hyperactivity Disorder Symptoms in Youth: A Systematic Review. Medicina (Kaunas, Lithuania), 55(7), 325. doi:10.3390/medicina55070325

 

Abstract

Background and objectives: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in children and adolescents. Mind–body therapies (MBTs) seem to be effective for improving health in different populations; however, whether a positive effect occurs in children and adolescents with ADHD is still controversial. The main aim of this systematic review was to analyse the interventions based on MBT aimed to improve the main ADHD symptoms in children and adolescents. Materials and Methods: A systematic review was conducted following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines to identify MBT studies on children and adolescents (4–18 years) with a clinical diagnosis of ADHD. Study quality was evaluated by the NIH quality tool (U.S. National Institute of Health). Results: There were positive results in eleven out of twelve included studies regarding the effect of the MBT interventions on ADHD symptoms. With respect to ADHD symptoms, we observed differences across studies. In relation to the studies’ quality, eleven studies were rated “poor” and one was rated as “fair”. Conclusions: MBTs, such as yoga or mindfulness, could be positive strategies to mitigate ADHD symptoms in children and adolescents. However, further research with high-quality designs, with randomization, greater sample sizes, and more intensive supervised practice programs are needed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6680862/

 

Improve Brain Function and Mild Cognitive Impairment in the Elderly with Tai Chi

Improve Brain Function and Mild Cognitive Impairment in the Elderly with Tai Chi

 

By John M. de Castro, Ph.D.

 

in individuals age 60 or older with mild cognitive impairment . . . engaging in tai chi (a series of gentle, slow movements accompanied by deep breathing) reduces the risk of falling. What’s more, it may also improve cognitive abilities.” – Health and Wellness Alerts

 

The aging process involves a systematic progressive decline in every system in the body, the brain included. The elderly frequently have problems with attention, thinking, and memory, known as mild cognitive impairment. An encouraging new development is that mindfulness practices such as meditation training and mindful movement practices can significantly reduce these declines in cognitive ability. In addition, it has been found that mindfulness practices reduce the deterioration of the brain that occurs with aging restraining the loss of neural tissue. Indeed, the brains of practitioners of meditationyoga, and Tai Chi have been found to degenerate less with aging than non-practitioners.

 

Tai Chi has been practiced for thousands of years with benefits for health and longevityTai Chi training is designed to enhance function and regulate the activities of the body through regulated breathing, mindful concentration, and gentle movements. Tai Chi practice has been found to be effective for an array of physical and psychological issues. Tai Chi has been shown to help the elderly improve attentionbalance, reducing fallsarthritiscognitive function, memory, and reduce age related deterioration of the brain. So, it makes sense to further study the effectiveness of Tai Chi training on older adults with mild cognitive impairment to improve their cognitive performance.

 

In today’s Research News article “Mind-body exercise improves cognitive function and modulates the function and structure of the hippocampus and anterior cingulate cortex in patients with mild cognitive impairment.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6535682/), Tao and colleagues recruited sedentary patients over 60 years of age who were diagnosed with mild cognitive impairment. They were randomly assigned to receive 24 weeks, 3 times per week for 1 hour, of either Baduanjin Tai Chi or brisk walking, or 8 weeks, once a week for 30 minutes of health education. They were measured before and after the 24 weeks of training for cognitive function including naming, verbal memory registration, visuospatial/executive functions, and learning, attention, and abstraction. Their brains were also scanned with functional Magnetic Resonance Imaging (fMRI) before and after training.

 

They found that the group that practiced Baduanjin Tai Chi had significant improvements in cognitive functions that were about double those of the walking and health education groups. In the fMRI data they investigated the resting state amplitude of low-frequency fluctuations (ALFF), that is linked with cerebral blood flow. They found that Baduanjin Tai Chi group had significant decreases in ALFF in the right hippocampus and significant increases in the left medial prefrontal cortex and the anterior cingulate cortex. They also found that the Baduanjin Tai Chi group had significant increases in grey matter volume in the right hippocampus and the anterior cingulate cortex and increased functional connectivity between the hippocampus and right angular gyrus. Importantly, they found that the greater the change in the ALFF for the right hippocampus and also the anterior cingulate cortex the greater the improvement in cognitive function.

 

The hippocampus has been shown to be involved in information storage (memory). Since one of the biggest changes that accompany mild cognitive impairments are deficits in memory, it seems logical that interventions that improve cognitive function in these patients would affect the brain structure involved in the memory process.

 

These are very interesting results from a well-controlled study. They suggest that participation in Baduanjin Tai Chi changes the brain and increases cognitive function in patients with mild cognitive impairments. These results are in line with previous findings that Tai Chi improves cognitive function, memory, and reduces age related deterioration of the brain in the elderly. The results also suggest that the changes in the brain are associated with the changes in cognitive ability.

 

It’s important to note that Tai Chi is gentle and safe, appropriate for all ages, 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. Overall, the results suggest that participation in Tai Chi should be recommended for patients with mild cognitive impairments.

 

So, improve brain function and mild cognitive impairment in the elderly with Tai Chi

 

 

adults with mild cognitive impairment . . . found that a 12-week exercise program significantly improved performance on a semantic memory task, and also significantly improved brain efficiency.” – About Memory

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Tao, J., Liu, J., Chen, X., Xia, R., Li, M., Huang, M., … Kong, J. (2019). Mind-body exercise improves cognitive function and modulates the function and structure of the hippocampus and anterior cingulate cortex in patients with mild cognitive impairment. NeuroImage. Clinical, 23, 101834. doi:10.1016/j.nicl.2019.101834

 

Abstract

Mild cognitive impairment (MCI) is a common neurological disorder. This study aims to investigate the modulation effect of Baduanjin (a popular mind-body exercise) on MCI. 69 patients were randomized to Baduanjin, brisk walking, or an education control group for 24 weeks. The Montreal Cognitive Assessment (MoCA) and Magnetic Resonance Imaging scans were applied at baseline and at the end of the experiment. Compared to the brisk walking and control groups, the Baduanjin group experienced significantly increased MoCA scores. Amplitude of low-frequency fluctuations (ALFF) analysis showed significantly decreased ALFF values in the right hippocampus (classic low-freqency band, 0.01‐0.08 Hz) in the Baduanjin group compared to the brisk walking group and increased ALFF values in the bilateral anterior cingulate cortex (ACC, slow-5 band, 0.01-0.027 Hz) in the Baduanjin group compared to the control group. Further, ALFF value changes in the right hippocampus and bilateral ACC were significantly associated with corresponding MoCA score changes across all groups. We also found increased gray matter volume in the Baduanjin group in the right hippocampus compared to the brisk walking group and in the bilateral ACC compared to the control group. In addition, there was an increased resting state functional connectivity between the hippocampus and right angular gyrus in the Baduanjin group compared to the control group. Our results demonstrate the potential of Baduanjin for the treatment of MCI.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6535682/

 

Improve Gulf War Illness in Veterans with Tai Chi

Improve Gulf War Illness in Veterans with Tai Chi

 

By John M. de Castro, Ph.D.

 

A prominent condition affecting Gulf War Veterans is a cluster of medically unexplained chronic symptoms that can include fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, and memory problems.” – US Department of Veterans Affairs

 

Engaging in warfare has many consequences to society and individuals, including the warriors themselves. Post-Traumatic Stress Disorder (PTSD) is a common problem among military veterans with between 11% to 20% of veterans who were involved in combat developing PTSD. There is a specific syndrome that has been identified in about 36% of veterans of the Persian Gulf war of 1991. The cluster of symptoms include fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, and memory problems.

 

It has been demonstrated that mindfulness training is effective for PTSD symptoms . In addition, Yoga practice is a mindfulness practice that has been shown to be helpful for PTSD. Mindful movement practices such as Tai Chi and Qigong have been found to be beneficial for individuals with a myriad of physical and psychological problems. This raises the possibility that Tai Chi practice may be beneficial for veterans suffering from Gulf War Illness.

 

In today’s Research News article “The Effects of Tai Chi Mind-Body Approach on the Mechanisms of Gulf War Illness: an Umbrella Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6600798/), Reid and colleagues review and summarize the published research studies of the effectiveness of Tai Chi practice in relieving the symptoms of participants whose symptoms were similar to Gulf War Illness. They identified multiple randomized controlled trials and meta-analyses of Tai Chi practice for these symptoms.

 

They report that the published research indicates that Tai Chi practice significantly improves mood, sleep, global cognitive function, and respiratory function and significantly decreases insomnia, anxiety, depression, stress, and chronic pain. Hence Tai Chi practice has been shown to be effective in relieving symptoms that commonly occur in Gulf War Illness. This suggests that Tai Chi practice should be tried directly to treat veterans with Gulf War Syndrome. It remains for future research to test this hypothesis.

 

So, improve Gulf War Illness in veterans with Tai Chi.

 

Mindfulness-based stress reduction may provide significant benefits to symptoms associated with Gulf War Illness in veterans.” – Laura Stiles

 

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

 

Reid, K. F., Bannuru, R. R., Wang, C., Mori, D. L., & Niles, B. L. (2019). The Effects of Tai Chi Mind-Body Approach on the Mechanisms of Gulf War Illness: an Umbrella Review. Integrative medicine research, 8(3), 167–172. doi:10.1016/j.imr.2019.05.003

 

Abstract

Gulf War illness (GWI) is a chronic and multisymptom disorder affecting military veterans deployed to the 1991 Persian Gulf War. It is characterized by a range of acute and chronic symptoms, including but not limited to, fatigue, sleep disturbances, psychological problems, cognitive deficits, widespread pain, and respiratory and gastrointestinal difficulties. The prevalence of many of these chronic symptoms affecting Gulf War veterans occur at markedly elevated rates compared to nondeployed contemporary veterans. To date, no effective treatments for GWI have been identified. The overarching goal of this umbrella review was to critically evaluate the evidence for the potential of Tai Chi mind-body exercise to benefit and alleviate GWI symptomology. Based on the most prevalent GWI chronic symptoms and case definitions established by the Centers for Disease Control and Prevention and the Kansas Gulf War Veterans Health Initiative Program, we reviewed and summarized the evidence from 7 published systematic reviews and meta-analyses. Our findings suggest that Tai Chi may have the potential for distinct therapeutic benefits on the major prevalent symptoms of GWI. Future clinical trials are warranted to examine the feasibility, efficacy, durability and potential mechanisms of Tai Chi for improving health outcomes and relieving symptomology in GWI.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6600798/

 

Improve Knee and Hip Osteoarthritis with Exercise and Mind-Body Practices

Improve Knee and Hip Osteoarthritis with Exercise and Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

studies suggest that specific mind-body therapies may help reduce pain and improve physical function in persons with osteoarthritis of the knee.” – Terry Selfe

 

Osteoarthritis is a chronic degenerative joint disease that is the most common form of arthritis. It produces pain, swelling, and stiffness of the joints. It is the leading cause of disability in the U.S., with about 43% of arthritis sufferers limited in mobility and about a third having limitations that affect their ability to perform their work. Knee osteoarthritis effects 5% of adults over 25 years of age and 12% of those over 65. Hip osteoarthritis effects 9% of adults. It is painful and disabling. Its causes are varied including, hereditary, injury including sports injuries, repetitive stress injuries, infection, or from being overweight.

 

There are no cures for knee or hip osteoarthritis. Treatments are primarily symptomatic, including weight loss, exercise, braces, pain relievers and anti-inflammatory drugs, corticosteroids, arthroscopic knee surgery, or even knee or hip replacement. Gentle movements of the joints with exercise and physical therapy appear to be helpful in the treatment of knee or hip osteoarthritis. This suggests that alternative and mind-body practices that involve gentle knee movements may be useful in for treatment. Indeed, yoga practice has been shown to be effective in treating arthritis and Tai Chi and Qigong have also been shown to reduce the physical symptoms of knee osteoarthritis. So, it would seem reasonable to summarize the research into the effectiveness of mind-body practices relative to other exercises in treating knee or hip osteoarthritis.

 

In today’s Research News article “Relative Efficacy of Different Exercises for Pain, Function, Performance and Quality of Life in Knee and Hip Osteoarthritis: Systematic Review and Network Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459784/), Goh and colleagues review, summarize, and perform a meta-analysis of the published research studies of the effectiveness of mind-body practices and exercise on knee or hip osteoarthritis. They found 103 controlled trials including a total of 9134 participants. Exercises were separated in strengthening, aerobic, and flexibility exercises and movements combined with mindfulness (e.g. yoga, Tai Chi, Qigong); mind-body practices. Most studies (76) compared these practices versus usual medical care.

 

They report that the published research studies found that in comparison to usual care, all exercises produced significant benefits including reduced pain, improved movement performance, self-reported motor abilities, and quality of life. These benefits were greater for knee osteoarthritis than for hip osteoarthritis. Of the various exercises they found that in general aerobic exercise produced the greatest benefits for pain and movement performance, while mind-body practices had equivalent benefit for pain and produced the greatest benefits for self-reported motor abilities.

 

These results confirm that exercise is good for patients with hip or knee osteoarthritis, improving movement and quality of life and reducing pain. It appears that aerobic exercises and mind-body exercises produce the greatest benefits. This suggests that these practices be recommended for patients with hip or knee osteoarthritis to reduce their difficulties with movement and reduce their suffering.

 

So, improve knee and hip osteoarthritis with exercise and mind-body practices.

 

We don’t choose to have arthritis, but we can choose how to respond to and cope with it. By not allowing pain to define our lives, we can change how we view and relate to pain. That’s mindfulness – we are changing our feelings and thoughts around pain.” – Andrea Minick Rudolph

 

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

 

Goh, S. L., Persson, M., Stocks, J., Hou, Y., Welton, N. J., Lin, J., … Zhang, W. (2019). Relative Efficacy of Different Exercises for Pain, Function, Performance and Quality of Life in Knee and Hip Osteoarthritis: Systematic Review and Network Meta-Analysis. Sports medicine (Auckland, N.Z.), 49(5), 743–761. doi:10.1007/s40279-019-01082-0

 

Abstract

Background

Guidelines recommend exercise as a core treatment for osteoarthritis (OA). However, it is unclear which type of exercise is most effective, leading to inconsistency between different recommendations.

Objectives

The aim of this systematic review and network meta-analysis was to investigate the relative efficacy of different exercises (aerobic, mind–body, strengthening, flexibility/skill, or mixed) for improving pain, function, performance and quality of life (QoL) for knee and hip OA at, or nearest to, 8 weeks.

Methods

We searched nine electronic databases up until December 2017 for randomised controlled trials that compared exercise with usual care or with another exercise type. Bayesian network meta-analysis was used to estimate the relative effect size (ES) and corresponding 95% credibility interval (CrI) (PROSPERO registration: CRD42016033865).

Findings

We identified and analysed 103 trials (9134 participants). Aerobic exercise was most beneficial for pain (ES 1.11; 95% CrI 0.69, 1.54) and performance (1.05; 0.63, 1.48). Mind–body exercise, which had pain benefit equivalent to that of aerobic exercise (1.11; 0.63, 1.59), was the best for function (0.81; 0.27, 1.36). Strengthening and flexibility/skill exercises improved multiple outcomes at a moderate level. Mixed exercise was the least effective for all outcomes and had significantly less pain relief than aerobic and mind–body exercises. The trend was significant for pain (p = 0.01), but not for function (p = 0.07), performance (p = 0.06) or QoL (p = 0.65).

Conclusion

The effect of exercise varies according to the type of exercise and target outcome. Aerobic or mind–body exercise may be the best for pain and function improvements. Strengthening and flexibility/skill exercises may be used for multiple outcomes. Mixed exercise is the least effective and the reason for this merits further investigation.

Electronic supplementary material

The online version of this article (10.1007/s40279-019-01082-0) contains supplementary material, which is available to authorized users.

Background

Guidelines recommend exercise as a core treatment for osteoarthritis (OA). However, it is unclear which type of exercise is most effective, leading to inconsistency between different recommendations.

Objectives

The aim of this systematic review and network meta-analysis was to investigate the relative efficacy of different exercises (aerobic, mind–body, strengthening, flexibility/skill, or mixed) for improving pain, function, performance and quality of life (QoL) for knee and hip OA at, or nearest to, 8 weeks.

Methods

We searched nine electronic databases up until December 2017 for randomised controlled trials that compared exercise with usual care or with another exercise type. Bayesian network meta-analysis was used to estimate the relative effect size (ES) and corresponding 95% credibility interval (CrI) (PROSPERO registration: CRD42016033865).

Findings

We identified and analysed 103 trials (9134 participants). Aerobic exercise was most beneficial for pain (ES 1.11; 95% CrI 0.69, 1.54) and performance (1.05; 0.63, 1.48). Mind–body exercise, which had pain benefit equivalent to that of aerobic exercise (1.11; 0.63, 1.59), was the best for function (0.81; 0.27, 1.36). Strengthening and flexibility/skill exercises improved multiple outcomes at a moderate level. Mixed exercise was the least effective for all outcomes and had significantly less pain relief than aerobic and mind–body exercises. The trend was significant for pain (p = 0.01), but not for function (p = 0.07), performance (p = 0.06) or QoL (p = 0.65).

Conclusion

The effect of exercise varies according to the type of exercise and target outcome. Aerobic or mind–body exercise may be the best for pain and function improvements. Strengthening and flexibility/skill exercises may be used for multiple outcomes. Mixed exercise is the least effective and the reason for this merits further investigation.

Key Points

The effect of exercise in knee and hip osteoarthritis depends on type of exercise and outcome of interest.
Aerobic and mind–body exercises appear to be the two most effective exercise therapies for pain and function, whereas strengthening and flexibility exercises appear to be good for moderate improvement of multiple outcomes.
Mixed exercise is the least effective exercise. However, it may be used for patients who do not respond to other types of exercise therapy because it is still better than no exercise control for all four patient-centred outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459784/

 

Reduce Fear of Cancer Return with Mind-Body Practices

Reduce Fear of Cancer Return with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

the mind and body are really one entity, not two separate parts. Stated simply, there is no separation or division between the mind, body, spirit, and emotions. The best stress management program is one that moves you from fear toward peace, however you understand that concept.” – Health Encyclopedia

 

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. But 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. Cancer survivors are also at greater risk for developing second cancers and other health conditions and as a result fear of cancer recurrence is a major problem that can interfere with recovery. Hence there is a need to identify safe and effective treatments to reduce fear of cancer return.

 

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, fear, and anxiety and depression. There has been considerable research conducted on the effectiveness of mind-body practices in treating fear of cancer return. So it makes sense to step back and summarize what has been learned.

 

In today’s Research News article “Mind-body interventions for fear of cancer recurrence: A systematic review and meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6488231/), Hall and colleagues reviewed, summarized, and performed a meta-analysis of the published randomized controlled trials (RCTs) of the effects of mind-body practices on the fear of cancer recurrence. They included studies employing meditation, yoga, Tai Chi and Qigong, cognitive-behavioral skills, spirituality, relaxation, and various art therapies. They uncovered 18 published RCTs that included 2806 total participants.

 

They found that mind-body practices produced significant reduction in fear of cancer recurrence regardless of whether the comparison condition was an active control condition, whether the treatment occurred in group or individual format, whether the treatment contained cognitive behavioral skills or not, or whether the treatment contained meditation practice or not. These reductions were still present, albeit at reduced magnitude, up to 2 years after treatment.

 

Fear of cancer recurrence can produce behaviors that interfere with cancer recovery including increased stress, worry, rumination, etc. So, reducing this fear not only improves the psychological health of the patients but also improves their prognosis. These results suggest that mind-body are safe and effective, and have lasting effects reducing fear of cancer recurrence and thus should be incorporated in the treatments for patients recovering from cancer.

 

So, reduce fear of cancer return with mind-body practices.

 

“It is not usually possible for doctors to say for certain that your cancer has been cured. They can’t definitely say that it will never come back. Living with this uncertainty is one of the most difficult things about having cancer.” – Cancer Research UK

 

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

 

Hall, D. L., Luberto, C. M., Philpotts, L. L., Song, R., Park, E. R., & Yeh, G. Y. (2018). Mind-body interventions for fear of cancer recurrence: A systematic review and meta-analysis. Psycho-oncology, 27(11), 2546–2558. doi:10.1002/pon.4757

 

Abstract

Objective

Fear of cancer recurrence (FCR) is a common existential concern and source of distress among adults with a cancer history. Multiple randomized controlled trials (RCTs) have examined mind-body approaches to mitigating FCR. We summarized characteristics of these trials and calculated their pooled effects on decreasing FCR.

Methods

Six electronic databases were systematically searched from inception to May 2017, using a strategy that included multiple terms for RCTs, cancer, mind-body medicine, and FCR. Data extraction and reporting followed Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pooled effect sizes on self-report measures of FCR were computed by using random-effects models.

Results

Nineteen RCTs (pooled N = 2806) were included. Most studies (53%) were published since 2015 and targeted a single cancer type (84%; mostly breast). Intervention sessions (median = 6, mode = 4) tended to last 120 minutes and occur across 1.5 months. Delivery was predominantly in-person (63%) to either groups (42%) or individuals (42%). Most interventions incorporated multiple mind-body components (53%), commonly cognitive-behavioral skills (58%), or meditative practices (53%). Small-to-medium pooled effect sizes were observed post-intervention (Hedges’ g = −0.36, 95% CI = −0.49, −0.23, P < .001) and at follow-up assessments (median = 8 months, P < .001). Potential modifiers (control group design, group/individual delivery, use of cognitive-behavioral or mindfulness skills, number of mind-body components, cancer treatment status, and number of sessions) did not reach statistical significance.

Conclusions

Mind-body interventions are efficacious for reducing FCR, with small-to-medium effect sizes that persist after intervention delivery ends. Recommendations include testing effects among survivors of various cancers and exploring the optimal integration of mind-body practices for managing fundamental uncertainties and fears during cancer survivorship.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6488231/

 

Improve Cognitive Function in the Elderly with Mind-Body Practices

Improve Cognitive Function in the Elderly with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

adults with Mild Cognitive Impairment can learn to practice mindfulness meditation, and by doing so may boost their cognitive reserve.” – Rebecca Erwin Wells

 

The aging process involves a systematic progressive decline in every system in the body, the brain included. This includes our cognitive (mental) abilities which decline with age including impairments in memory, attention, and problem-solving ability. It is inevitable and cannot be avoided. Research has found that mindfulness practices reduce the deterioration of the brain that occurs with aging restraining the loss of neural tissue. Indeed, the brains of practitioners of meditation and yoga have been found to degenerate less with aging than non-practitioners. Tai Chi and Qigong have also been shown to be beneficial in slowing or delaying physical and mental decline with aging.

 

The research findings are accumulating suggesting that a summarization of what has been learned is called for. In today’s Research News article “The Effects of Mind-Body Exercise on Cognitive Performance in Elderly: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313783/), Zhang and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled studies (RCTs) of the effectiveness of the mind-body practices of yoga, Tai Chi and Qigong, and Pilates to improve cognitive performance in the elderly (aged 60 and over).

 

They identified 19 published RCTs that included a total of 2539 participants. They report that the published studies reveal a significant, albeit small, improvement in global cognitive function after mind-body practices. This included significant improvements in executive function, language ability, memory, and visuospatial ability. They also report that the amount of improvement was significantly related to the amount of mind-body exercise training. Interestingly, the effects appear to be better in elderly without any signs of dementia than in those with mild dementia symptoms.

 

The findings based upon a fair number of well-controlled studies are relatively consistent revealing that mind-body practices are safe and effective in improving cognitive function in individuals over 60 years of age. This suggests that engaging in these practices can reduce the decline in mental abilities occurring with aging. This suggests that engaging in yoga, Tai Chi and Qigong, or Pilates practices should be recommended for people over 60 years of age.

 

So, improve cognitive function in the elderly with mind-body practices.

 

engagement in mindfulness meditation may enhance cognitive performance in older adults, and that with persistent practice, these benefits may be sustained.” – Grace Bullock

 

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

 

Zhang, Y., Li, C., Zou, L., Liu, X., & Song, W. (2018). The Effects of Mind-Body Exercise on Cognitive Performance in Elderly: A Systematic Review and Meta-Analysis. International journal of environmental research and public health, 15(12), 2791. doi:10.3390/ijerph15122791

 

Abstract

Background: As the situation of cognitive aging is getting worse, preventing or treating cognitive decline through effective strategies is highly important. This systematic review aims to investigate whether mind-body exercise is an effective approach for treating cognition decline. Methods: Searches for the potential studies were performed on the eight electronic databases (MEDLINE, Scopus, Web of Science, SPORTDiscus, CINAHL, PsycArtilces, CNKI, and Wanfang). Randomized controlled trials (RCTs) examining the effect of mind-body exercise on cognitive performance in older adults were included. Data were extracted and effect sizes were pooled with 95% confidence intervals (95% CI) using random-effects models. The Physiotherapy Evidence Database Scale was employed to examine the study quality. Results: Nineteen RCTs including 2539 elders (67.3% female) with fair to good study quality were identified. Mind-body exercise, relative to control intervention, showed significant benefits on cognitive performance, global cognition (Hedges’g = 0.23), executive functions (Hedges’g = 0.25 to 0.65), learning and memory (Hedges’g = 0.37 to 0.49), and language (Hedges’g = 0.35). In addition, no significant adverse events were reported. Conclusion: Mind-body exercise may be a safe and effective intervention for enhancing cognitive function among people aged 60 years or older. Further research evidence is still needed to make a more conclusive statement.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313783/

 

Help Relieve Asthma Symptoms with Yoga

Help Relieve Asthma Symptoms with Yoga

 

By John M. de Castro, Ph.D.

 

Yoga can help increase breath and body awareness, slow your respiratory rate, and promote calm and relieve stress — all of which are beneficial for people who have asthma.” – Judi Bar

 

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

 

Asthma is not fatal and those with moderate asthma have an equivalent life expectancy to those that don’t. There is no cure for asthma. So, it is a chronic disease that must be coped with throughout the lifetime. Treatments are aimed at symptomatic relief. Most frequently drugs, anti-inflammatory hormones, and inhalers are used to help control the inflammation. Exercise can be difficult with asthma and may actually precipitate an attack. This can be a problem as maintaining fitness with asthma can be difficult. A relatively gentle form of exercise, yoga practice can be practiced without heavy breathing and thus may not provoke asthma. In addition, breathing exercises like those incorporated into yoga practice are known to help control asthma. This suggests that yoga practice may be a helpful exercise for people with asthma.

 

In today’s Research News article “Yoga for asthma.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6880926/), Yang and colleagues review, summarize, and perform a meta-analysis of the effectiveness of yoga practice for the treatment of asthma. They found 15 randomized controlled trials (RCTs).

 

They report that the research found that yoga practice produced a significant improvement in the asthma patients’ symptoms, control of asthma, and quality of life and a significant reduction in asthma medication use. In terms of lung function, the research found that yoga practice produced significant improvements in forced vital capacity and peak expiratory flow rate.

 

Hence, yoga practice appears to be beneficial for asthma patients, improving lung function, asthma symptoms, drug use, and improving the patient’s quality of life. There were no recorded adverse events associated with the yoga practice. This is important as exercise is often difficult for asthma patients. Yoga practice appears to be feasible and well tolerated and beneficial for asthma patients.

 

So, help relieve asthma symptoms with yoga.

 

Having asthma means it can be a struggle to breathe properly, but yoga involves learning how to breathe deeply in and out through the nose to filter the air, and find a natural, balanced breathing pattern. Over time this helps to increase lung capacity and gives you more control of your breathing day-to-day.” – Julia White

 

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

 

Yang, Z. Y., Zhong, H. B., Mao, C., Yuan, J. Q., Huang, Y. F., Wu, X. Y., … Tang, J. L. (2016). Yoga for asthma. The Cochrane database of systematic reviews, 4(4), CD010346. doi:10.1002/14651858.CD010346.pub2

 

Abstract

Background

Asthma is a common chronic inflammatory disorder affecting about 300 million people worldwide. As a holistic therapy, yoga has the potential to relieve both the physical and psychological suffering of people with asthma, and its popularity has expanded globally. A number of clinical trials have been carried out to evaluate the effects of yoga practice, with inconsistent results.

Objectives

To assess the effects of yoga in people with asthma.

Search methods

We systematically searched the Cochrane Airways Group Register of Trials, which is derived from systematic searches of bibliographic databases including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED, and PsycINFO, and handsearching of respiratory journals and meeting abstracts. We also searched PEDro. We searched ClinicalTrials.gov and the WHO ICTRP search portal. We searched all databases from their inception to 22 July 2015, and used no restriction on language of publication. We checked the reference lists of eligible studies and relevant review articles for additional studies. We attempted to contact investigators of eligible studies and experts in the field to learn of other published and unpublished studies.

Selection criteria

We included randomised controlled trials (RCTs) that compared yoga with usual care (or no intervention) or sham intervention in people with asthma and reported at least one of the following outcomes: quality of life, asthma symptom score, asthma control, lung function measures, asthma medication usage, and adverse events.

Data collection and analysis

We extracted bibliographic information, characteristics of participants, characteristics of interventions and controls, characteristics of methodology, and results for the outcomes of our interest from eligible studies. For continuous outcomes, we used mean difference (MD) with 95% confidence interval (CI) to denote the treatment effects, if the outcomes were measured by the same scale across studies. Alternatively, if the outcomes were measured by different scales across studies, we used standardised mean difference (SMD) with 95% CI. For dichotomous outcomes, we used risk ratio (RR) with 95% CI to measure the treatment effects. We performed meta‐analysis with Review Manager 5.3. We used the fixed‐effect model to pool the data, unless there was substantial heterogeneity among studies, in which case we used the random‐effects model instead. For outcomes inappropriate or impossible to pool quantitatively, we conducted a descriptive analysis and summarised the findings narratively.

Main results

We included 15 RCTs with a total of 1048 participants. Most of the trials were conducted in India, followed by Europe and the United States. The majority of participants were adults of both sexes with mild to moderate asthma for six months to more than 23 years. Five studies included yoga breathing alone, while the other studies assessed yoga interventions that included breathing, posture, and meditation. Interventions lasted from two weeks to 54 months, for no more than six months in the majority of studies. The risk of bias was low across all domains in one study and unclear or high in at least one domain for the remainder.

There was some evidence that yoga may improve quality of life (MD in Asthma Quality of Life Questionnaire (AQLQ) score per item 0.57 units on a 7‐point scale, 95% CI 0.37 to 0.77; 5 studies; 375 participants), improve symptoms (SMD 0.37, 95% CI 0.09 to 0.65; 3 studies; 243 participants), and reduce medication usage (RR 5.35, 95% CI 1.29 to 22.11; 2 studies) in people with asthma. The MD for AQLQ score exceeded the minimal clinically important difference (MCID) of 0.5, but whether the mean changes exceeded the MCID for asthma symptoms is uncertain due to the lack of an established MCID in the severity scores used in the included studies. The effects of yoga on change from baseline forced expiratory volume in one second (MD 0.04 litres, 95% CI ‐0.10 to 0.19; 7 studies; 340 participants; I2 = 68%) were not statistically significant. Two studies indicated improved asthma control, but due to very significant heterogeneity (I2 = 98%) we did not pool data. No serious adverse events associated with yoga were reported, but the data on this outcome was limited.

Authors’ conclusions

We found moderate‐quality evidence that yoga probably leads to small improvements in quality of life and symptoms in people with asthma. There is more uncertainty about potential adverse effects of yoga and its impact on lung function and medication usage. RCTs with a large sample size and high methodological and reporting quality are needed to confirm the effects of yoga for asthma.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6880926/

 

Meditation Practice Does Not Change the Brain or Impulsivity

Meditation Practice Does Not Change the Brain or Impulsivity

 

By John M. de Castro, Ph.D.

 

Impulsivity is a characteristic of human behavior that can be both beneficial and detrimental to our everyday lives. For example, the ability to act on impulse may allow us to seize a valuable opportunity, or to make a disastrous decision that we then live to regret.” – Catharine Winstanley

 

Impulsivity “is a tendency to act on a whim, displaying behavior characterized by little or no forethought, reflection, or consideration of the consequences.” It can lead to taking unnecessary risks with at times disastrous consequences. It can also lead to inappropriate aggressive behavior also potentially leading to disastrous consequences including disciplinary problems and even criminal prosecution. There are some indications that mindfulness can help to reduce impulsivity. But there is a need for more study of this potential benefit of mindfulness.

 

The nervous system is a dynamic entity, constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. These changes in the brain are called neuroplasticity. Over the last decade neuroscience has been studying the effects of contemplative practices on the brain and has identified neuroplastic changes in widespread areas. In other words, meditation practice appears to mold and change the brain, producing psychological, physical, and spiritual benefits. The types of neural changes produced by meditation practice that might underlie changes in impulsivity have not been investigated.

 

In today’s Research News article “The Effect of Mindfulness Meditation on Impulsivity and its Neurobiological Correlates in Healthy Adults.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6700173/), Korponay and colleagues recruited long-term meditators with at least 3 years of experience and meditation naïve adults. They were measured for mindfulness, impulsivity and behavioral inhibition with a go-no-go task. In addition, their brains were scanned with functional Magnetic Resonance Imaging (fMRI) and their spontaneous eye blinks recorded. Then the meditation naïve participants were randomly assigned to receive either an 8-week Mindfulness-Based Stress Reduction (MBSR) program, an 8-week health education program, or a wait-list control condition. After treatment they underwent the same measurements.

 

They found that after the interventions the Mindfulness-Based Stress Reduction (MBSR) group had significantly higher levels of mindfulness but there were no significant changes in impulsivity or behavioral inhibition and no significant differences in brain volumes or connectivity, or in eye blink rates. Hence, short-term mindfulness training did improve mindfulness but did not produce changes in the brain or in impulsivity.

 

In comparing long-term meditators to meditation naïve participants, they found that the long-term meditators had lower attentional impulsivity, suggesting better attentional control, but higher motor and non-planning impulsivity. The long-term meditators had less striatal gray matter, greater cortico-striatal-thalamic functional connectivity, and lower spontaneous eye-blink rates.

 

The null findings regarding brain structural changes following Mindfulness-Based Stress Reduction (MBSR) training are curious as prior research has consistently demonstrated that this training produces significant changes in the brain. Only in comparing long-term meditators to meditation naïve participants were significant differences detected. This suggests that the brain difference may have been not been due to the effects of the meditation itself, but rather to brain differences in people who are drawn to long-term meditation practice compared to people who are not drawn.

 

The present results suggest that neither long-term or short-term mindfulness practice changes impulsivity. Previous research found that mindfulness training reduced impulsivity in individuals who had difficulties with impulse control, prisoners, patients with borderline personality disorder, and out-of-control teenagers. It would appear that mindfulness training is effective in reducing impulsivity in people with low levels of impulse control but not in normal populations. Hence, mindfulness training is helpful for improving impulse control only where it is low to begin with.

 

It seems the longer you do meditation, the better your brain will be at self-regulation. You don’t have to consume as much energy at rest and you can more easily get yourself into a more relaxed state.” – Bin He

 

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

 

Korponay, C., Dentico, D., Kral, T., Ly, M., Kruis, A., Davis, K., … Davidson, R. J. (2019). The Effect of Mindfulness Meditation on Impulsivity and its Neurobiological Correlates in Healthy Adults. Scientific reports, 9(1), 11963. doi:10.1038/s41598-019-47662-y

 

Abstract

Interest has grown in using mindfulness meditation to treat conditions featuring excessive impulsivity. However, while prior studies find that mindfulness practice can improve attention, it remains unclear whether it improves other cognitive faculties whose deficiency can contribute to impulsivity. Here, an eight-week mindfulness intervention did not reduce impulsivity on the go/no-go task or Barratt Impulsiveness Scale (BIS-11), nor produce changes in neural correlates of impulsivity (i.e. frontostriatal gray matter, functional connectivity, and dopamine levels) compared to active or wait-list control groups. Separately, long-term meditators (LTMs) did not perform differently than meditation-naïve participants (MNPs) on the go/no-go task. However, LTMs self-reported lower attentional impulsivity, but higher motor and non-planning impulsivity on the BIS-11 than MNPs. LTMs had less striatal gray matter, greater cortico-striatal-thalamic functional connectivity, and lower spontaneous eye-blink rate (a physiological dopamine indicator) than MNPs. LTM total lifetime practice hours (TLPH) did not significantly relate to impulsivity or neurobiological metrics. Findings suggest that neither short- nor long-term mindfulness practice may be effective for redressing impulsive behavior derived from inhibitory motor control or planning capacity deficits in healthy adults. Given the absence of TLPH relationships to impulsivity or neurobiological metrics, differences between LTMs and MNPs may be attributable to pre-existing differences.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6700173/

 

Mindfulness Training Improves the Psychological Health of Health Care Professionals

Mindfulness Training Improves the Psychological Health of Health Care Professionals

 

By John M. de Castro, Ph.D.

 

Levels of stress and burnout in the healthcare profession have been exacerbated in recent decades by significant changes in how health care is delivered and administered. Extensive research has shown that mindfulness training . . . can have significant positive impacts on participants’ job satisfaction; their relationships with patients, co-workers and administration; and their focus and creativity at work.” – WPHP

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It is estimated that over 45% of healthcare workers experience burnout. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion.

 

Improving the psychological health of health care professionals has to be a priority. Contemplative practices have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnoutincreasing resilience, and improving sleep. Hence, mindfulness may be a means to improve the psychological health of medical professionals.

 

In today’s Research News article “Mindfulness-Based IARA Model® Proves Effective to Reduce Stress and Anxiety in Health Care Professionals. A Six-Month Follow-Up Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6888054/), Barattucci and colleagues recruited doctors, nurses, and healthcare assistants and randomly assigned them to either a no-treatment control condition or to receive self-awareness/mindfulness training. The training occurred in 4 8-hour group sessions and emphasized mindfulness, emotion regulation, counseling techniques and skills to deal with stress. They were measured before and 6 months after training for anxiety, perceived stress, and emotion regulation.

 

They found that 6 months after training the self-awareness/mindfulness training group had significant reductions in perceived stress and anxiety and significant improvements in emotion regulation while the control group did not. They also found that the higher the levels of emotion regulation the lower the levels of anxiety and perceived stress.

 

The intervention of self-awareness/mindfulness training involves a complex set of trainings and it cannot be determined which component or combination of components are responsible for the effects. But it has been shown in previous research showing that mindfulness training produces lasting improvements in emotion regulation, reductions in anxiety and perceived stress, and improvements in the psychological health of healthcare workers. Hence, it can be concluded that at least the mindfulness training component of the self-awareness/mindfulness training is effective. It was not established but it is assumed that these psychological improvements will lead to greater resilience and decrease burnout in healthcare workers.

 

So, mindfulness training improves the psychological health of health care professionals.

 

Mindfulness training has been shown to reduce depression, anxiety, rumination, and stress, and to improve self-compassion and positive mood states in health care professionals. Second, the practice of mindfulness improves qualities that are critical to effective treatment, such as attention, empathy, emotion regulation, and affect tolerance.” – Shauna Shapiro

 

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

 

Barattucci, M., Padovan, A. M., Vitale, E., Rapisarda, V., Ramaci, T., & De Giorgio, A. (2019). Mindfulness-Based IARA Model® Proves Effective to Reduce Stress and Anxiety in Health Care Professionals. A Six-Month Follow-Up Study. International journal of environmental research and public health, 16(22), 4421. doi:10.3390/ijerph16224421

 

Abstract

Changes in the health care environment, together with specific work-related stressors and the consequences on workers’ health and performance, have led to the implementation of prevention strategies. Among the different approaches, those which are mindfulness-based have been institutionally recommended with an indication provided as to their effectiveness in the management of stress. The aim of the present study was to analyze the efficacy of the mindfulness-based IARA Model® (an Italian acronym translatable into meeting, compliance, responsibility, autonomy) in order to ameliorate perceived stress, anxiety and enhance emotional regulation among health care professionals (HCPs; i.e., doctors, nurses, and healthcare assistants). Four hundred and ninety-seven HCPs, 215 (57.2%) of which were women, were randomly assigned to a mindfulness-based training or control group and agreed to complete questionnaires on emotion regulation difficulties (DERS), anxiety, and perceived stress. Results showed that HCPs who attended the IARA training, compared to the control group, had better emotional regulation, anxiety and stress indices after 6 months from the end of the intervention. Furthermore, the results confirmed the positive relationship between emotional regulation, perceived stress and anxiety. The present study contributes to literature by extending the effectiveness of IARA in improving emotional regulation and well-being in non-clinical samples. Moreover, the study provides support for the idea that some specific emotional regulation processes can be implicated in perceived stress and anxiety. From the application point of view, companies should invest more in stress management intervention, monitoring and training, in order to develop worker skills, emotional self-awareness, and relational resources.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6888054/