Month: August 2020

Reduce Blood Pressure in Patients with Noncommunicable Diseases with Mindfulness

psyjdc Leave a comment

Reduce Blood Pressure in Patients with Noncommunicable Diseases with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness practice can be an effective way to reduce blood pressure (and along with it, the risk of stroke or heart attack).” – NICABM

 

High Blood Pressure (Hypertension) is an insidious disease because there are no overt symptoms. The individual feels fine. But it can be deadly as more than 360,000 American deaths, roughly 1,000 deaths each day, had high blood pressure as a primary or contributing cause. In addition, hypertension markedly increases the risk heart attack, stroke, heart failure, and kidney disease.  It is also a very common disorder with about 70 million American adults (29%) having high blood pressure and only about half (52%) of people with high blood pressure have their condition under control. Treatment frequently includes antihypertensive drugs. But these medications often have adverse side effects. So, patients feel lousy when taking the drugs, but fine when they’re not. So, compliance is a major issue with many patients not taking the drugs regularly or stopping entirely.

 

Obviously, there is a need for alternative to drug treatments for hypertension. Mindfulness practices have been shown to aid in controlling hypertension. Indeed, meditation, tai chi, and yoga, have also been shown to be helpful for heart health. Hypertension is frequently cooccurring with in patients with non-communicable diseases. In today’s Research News article “Mindfulness interventions reduce blood pressure in patients with non-communicable diseases: 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), Intarakamhang and colleagues review, summarize and perform a meta-analysis of the effectiveness of mindfulness training in reducing blood pressure in patients with non-communicable diseases.

 

They defined non-communicable diseases (NCDs) to include cancers, cardiovascular diseases, respiratory diseases and diabetes and identified 14 published controlled studies including a total of 1117 patients. They report that the studies found that mindfulness training significantly reduced both systolic and diastolic blood pressure in the patients with NCDs.

 

The results are compatible with previous findings that mindfulness training reduces blood pressure in a wide variety of healthy and ill individuals. The present study demonstrates that mindfulness training is effective in reducing blood pressure in patients with non-communicable diseases (NCDs). This is reasonable given that mindfulness training has been shown to improve the symptoms of patients with the included NCDs, cancers, cardiovascular diseases, respiratory diseases and diabetes.

 

There are a number of possible mechanisms for this blood pressure reduction. Mindfulness training is known to reduce the physiological and psychological responses to stress and this may in turn lower blood pressure. Also mindfulness training has been shown to affect the autonomic nervous system increasing parasympathetic activity that tends to reduce blood pressure.

 

So, reduce blood pressure in patients with noncommunicable diseases with mindfulness.

 

“The hope is that if we can start mindfulness training early in life, we can promote a trajectory of healthy aging across the rest of people’s lives. That will reduce their chances of getting high blood pressure in the first place.” – Eric Loucks

 

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

 

Intarakamhang, U., Macaskill, A., & Prasittichok, P. (2020). Mindfulness interventions reduce blood pressure in patients with non-communicable diseases: A systematic review and meta-analysis. Heliyon, 6(4), e03834. https://doi.org/10.1016/j.heliyon.2020.e03834

 

Abstract

Purpose

Mindfulness based interventions (MBIs) are an emerging area of empirical study, not only in positive psychology, but also in clinical health care. This research aims to synthesize the evidence about whether MBIs reduce blood pressure (BP) in patients with non-communicable diseases (NCDs).

Methods

Relevant studies were identified via PubMed, the Cochrane Library, Embase and the CINAHL database between 2009 and 2019. The papers selected focused on mindfulness and the effect of these on the BP of patients with NCDs. The change in SBP and DBP were meta-analyzed, stratified by type of intervention (Breathing awareness meditation (BAM), Mindfulness Meditation (MM), and Mindfulness-based Stress Reduction (MBSR).

Results

Fourteen articles met eligibility criteria and were included in the final review. Among the studies using the type and duration of intervention, systolic BP was reduced after the mindfulness-based stress reduction for 8 weeks (-6.90 mmHg [95% CI: -10.82, -2.97], p < .050), followed by the breathing awareness meditation for 12 weeks (-4.10 mmHg [95% CI: -7.54, -0.66], p < .050) and the mindfulness-based intervention for 8 weeks (-2.69 mmHg [95% CI: -3.90, -1.49], p < .050) whereas diastolic BP was reduced after the mindfulness-based stress reduction for 8 weeks (-2.45 mmHg [95% CI: -3.74, -1.17], p < .050) and the mindfulness-based intervention for 8 weeks (-2.24 mmHg [95% CI: -3.22, -1.26], p < .050).

Conclusion

MBIs can provide effective alternative therapies to assist in blood pressure reduction for patients with NCDs.

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

 

Generalized Anxiety Disorder with Co-occurring Major Depression is Associated with Lower Mindfulness

psyjdc Leave a comment

Generalized Anxiety Disorder with Co-occurring Major Depression is Associated with Lower Mindfulness

 

By John M. de Castro, Ph.D.

 

“attempts to avoid uncomfortable thoughts and feelings may worsen anxiety. The paradox here is that mindfulness helps us turn toward those and learn to change our relationship to the actual thoughts and the physical sensations, rather than try to change them in any way. By changing [that] relationship, we actually stop feeding those cyclical processes and they start to die off on their own.” – Judson Brewer

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. A characterizing feature of anxiety disorders is that the suffer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Anxiety disorders have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for anxiety. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments.

 

One of the premiere measurement tools for mindfulness is the Five Factors of Mindfulness Questionnaire. It measures overall mindfulness and also five facets; observing, describing, acting with awareness, non-judgement, and non-reactivity. People differ and an individual can be high or low on any of these facets and any combination of facets. It is not known what pattern of mindfulness facets are most predictive of the ability of mindfulness to improve anxiety disorders.

 

Depression often co-occurs with anxiety disorders. Recently, it has been found that mindfulness training can be effective for anxiety disorders. Mindfulness has also been shown to be effective for depression. So, patients with generalized anxiety with co-occurring depression may have lower ability to be mindful.

 

In today’s Research News article “Facets of Mindfulness in Adults with Generalized Anxiety Disorder and Impact of Co-occurring Depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6662732/), Baker and colleagues recruited adult patients with Generalized Anxiety Disorder (GAD) and measured them for mindfulness, including observing, describing, acting with awareness, nonjudging, and nonreactivity facets, worry, depression, and severity of psychopathology.

 

The participants were separated into GAD with and without Major Depressive Disorder. They found that the GAD participants who also had co-occurring Major Depressive Disorder were lower in mindfulness, especially the acting with awareness facet of mindfulness. They also found that over the entire sample that higher levels of depression and worry were associated with lover levels of mindfulness. Looking at the facets of mindfulness they found that depression was negatively associated with acting with awareness and worry was negatively associated with the nonjudging and nonreactivity facets.

 

These are correlative findings and causation cannot be determined. But previous research has demonstrated that mindfulness training reduces anxiety and depression.  So, a causal connection is likely. The results, then, suggest that patients with Generalized Anxiety Disorder (GAD) are less likely to act with awareness if they also have Major Depressive Disorder. In addition, With GAD patients in general higher levels of depression were associated with lower levels of acting with awareness. Depression is associated with very low energy levels. So, it makes sense that the presence of depression would interfere with taking mindful action.

 

They also found that the higher the levels of worry the lower the levels of the nonjudging and nonreactivity mindfulness facets. This suggests that worry in patients with Generalized Anxiety Disorder (GAD) interferes with the ability to not judge and not react to inner experience. Conversely, worry promotes judging and reacting to inner experience. Patients who have high anxiety are worried about potential future negative occurrences and as such may judge inner experience as indicative of a problematic future and so react to it more.

 

So, the results indicate that Generalized Anxiety Disorder with co-occurring Major Depression is associated with lower mindfulness.

 

“a way to reduce the symptoms of anxiety is to be fully, mindfully, anxious. As anxiety reveals itself to be a misperception, symptoms will dissipate.” – George Hofmann

 

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

 

Baker AW, Frumkin MR, Hoeppner SS, et al. Facets of Mindfulness in Adults with Generalized Anxiety Disorder and Impact of Co-occurring Depression. Mindfulness (N Y). 2019;10(5):903‐912. doi:10.1007/s12671-018-1059-0

 

Abstract

Anxiety and depressive symptoms are associated with lower levels of mindfulness, yet few studies to date have examined facets of mindfulness in adults with Generalized Anxiety Disorder (GAD). In this study, we examined differences in mindfulness between individuals with GAD with and without concurrent Major Depressive Disorder (MDD) and/or Dysthymic Disorder (DD). We also examined the associations of anxiety and depressive symptoms with facets (subscales) of mindfulness. We hypothesized that individuals with primary GAD and co-occurring MDD/DD would exhibit lower mindfulness than those without a concurrent depressive disorder. We also hypothesized that mindfulness would be negatively correlated with worry and depressive symptom severity. Subjects were 140 adults (M (SD) age = 33.4 (12.9); 73% female) with a primary diagnosis of GAD; 30.8% (n = 43) also met criteria for current MDD/DD as determined by a structured clinical interview for DSM-IV. Current worry and depressive symptoms were assessed using self-report measures at baseline of a 12-week treatment study. Individuals with GAD and co-occurring MDD/DD exhibited significantly lower mindfulness than those without a depressive disorder diagnosis and specifically lower scores on the Awareness sub-scale compared to individuals with primary GAD and no comorbid depression. In terms of the dimensional impact of worry and depression ratings, depression symptoms independently predicted lower Awareness scores and worry independently predicted lower levels of Nonreacting and Nonjudging sub-scales. This may have direct treatment implications. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6662732/

 

Improve Balance in Parkinson’s Disease with Tai Chi and Yoga

psyjdc Leave a comment

Improve Balance in Parkinson’s Disease with Tai Chi and Yoga

 

By John M. de Castro, Ph.D.

 

“In addition to easing balance problems, and possibly other symptoms, tai chi can help ease stress and anxiety and strengthen all parts of the body, with few if any harmful side effects. . . with Parkinson’s disease.” – Peter Wayne

 

Parkinson’s Disease (PD) is an incurable progressive degenerative disease of the central nervous system. The condition is caused by the death of nerve cells in the brain that produce the neurotransmitter dopamine. There are around seven million people worldwide and one million people in the U.S. living with PD and about 60,000 people are diagnosed with PD every year. PD is associated with aging as the vast majority of patients are diagnosed after age 50. In fact, it has been speculated that everyone would eventually develop PD if they lived long enough.

 

Its physical symptoms include resting tremor, slow movements, muscle rigidity, problems with posture and balance, loss of automatic movements, and slurring of speech. PD itself is not fatal but is often associated with related complications which can reduce life expectancy, such as falls, choking, and cardiovascular problems. PD also has psychological effects, especially cognitive decline, anxiety, and depression. Balance is a particular problem as it effects mobility and increases the likelihood of falls, restricting activity and reducing quality of life.

 

There are no cures for Parkinson’s Disease (PD) or even treatments to slow its progression. There are only treatments that can produce symptomatic relief. So, there is a need to discover new and different treatments. Mindfulness training has been found to improve the psychological symptoms and the quality of life with PD patients.  In addition, Tai Chi and yoga practices have been shown to improve the symptoms of Parkinson’s Disease. Hence, mind-body practices may be excellent treatments for the symptoms of PD. It is important to discover which of various exercises works best to improve balance and mobility in patients with PD.

 

In today’s Research News article “Effect of home-based Tai Chi, Yoga or conventional balance exercise on functional balance and mobility among persons with idiopathic Parkinson’s disease: An experimental study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7136531/), Khuzema and colleagues recruited adult patients with Parkinson’s Disease and randomly assigned them to receive 5 days per week for 8 weeks for 30-40 minutes of either home based Tai Chi exercise, yoga exercise, or balance exercise training. They were measured before and after training for balance and mobility with a timed up and go test and a 10-minute walking test.

 

They found that all three exercise programs produced significant improvements in all measures. Balance increased significantly by 26.414%, 8.193% and 14.339%, Timed up and go time decreased by 22.695%, 7.187% and 8.902%, and 10-m Walk Time decreased by 24.469%, 5.914% and 8.986% in Tai Chi, yoga and balance exercise groups, respectively. Although, on average, Tai Chi exercise produced superior results on all measures, the study was too small (9 patients per group) to determine significant group differences. These results, however, support conducting a large randomized controlled trial in the future.

 

Tai Chi is an ancient mindfulness practice that involves slow prescribed movements. It is gentle and completely safe, can be used with the elderly and sickly, are inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, it can be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Hence Tai Chi training should be recommended to improve balance and mobility in patients with Parkinson’s Disease.

 

So, improve balance in Parkinson’s Disease with Tai Chi and Yoga.

 

“Benefits of Tai Chi and Yoga for those with Parkinson’s Disease:

  1. Promotes conscious awareness of movement and actions.
  2. Increases awareness of proper body alignment/posture
  3. Improves balance with reduced fall risk
  4. Enhances flexibility
  5. Affords a greater sense of well-being
  6. Offers relaxation which can help to lessen Parkinson’s symptoms (tremor, rigidity) or manage medication side effects such as dyskinesia
  7. Improves breath support and control
  8. Helps to build healthy bones through weight-bearing activities
  9. Increases strength, especially in core muscles” – National Parkinson’s Foundation

 

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

 

Khuzema, A., Brammatha, A., & Arul Selvan, V. (2020). Effect of home-based Tai Chi, Yoga or conventional balance exercise on functional balance and mobility among persons with idiopathic Parkinson’s disease: An experimental study. Hong Kong physiotherapy journal : official publication of the Hong Kong Physiotherapy Association Limited = Wu li chih liao, 40(1), 39–49. https://doi.org/10.1142/S1013702520500055

 

Abstract

Background:

Individuals with Parkinson’s disease (PD) invariably experience functional decline in a number of motor and non-motor domains affecting posture, balance and gait. Numerous clinical studies have examined effects of various types of exercise on motor and non-motor problems. But still much gap remains in our understanding of various therapies and their effect on delaying or slowing the dopamine neuron degeneration. Recently, Tai Chi and Yoga both have gained popularity as complementary therapies, since both have components for mind and body control.

Objective:

The aim of this study was to determine whether eight weeks of home-based Tai Chi or Yoga was more effective than regular balance exercises on functional balance and mobility.

Methods:

Twenty-seven individuals with Idiopathic PD (Modified Hoehn and Yahr stages 2.5–3) were randomly assigned to either Tai Chi, Yoga or Conventional exercise group. All the participants were evaluated for Functional Balance and Mobility using Berg Balance Scale, Timed 10 m Walk test and Timed Up and Go test before and after eight weeks of training.

Results:

The results were analyzed using two-way mixed ANOVA which showed that there was a significant main effect for time as F (1, 24) =74.18, p=0.000, ηp2=0.76 for overall balance in Berg Balance Scale. There was also significant main effect of time on mobility overall as F(1, 24) =77.78, p=0.000, ηp2=0.76 in Timed up and Go test and F(1, 24) =48.24, p=0.000, ηp2=0.67 for 10 m Walk test. There was a significant interaction effect for time×group with F(2, 24) =8.67, p=0.001, ηp2=0.420 for balance. With respect to mobility, the values F(2, 24) =5.92, p=0.008, ηp2=0.330 in Timed Up and Go test and F(2, 24) =10.40, p=0.001, ηp2=0.464 in 10 m Walk test showed a significant interaction. But there was no significant main effect between the groups for both balance and mobility.

Conclusion:

The findings of this study suggest that Tai Chi as well as Yoga are well adhered and are attractive options for a home-based setting. As any form of physical activity is considered beneficial for individuals with PD either Tai Chi, Yoga or conventional balance exercises could be used as therapeutic intervention to optimize balance and mobility. Further studies are necessary to understand the mind–body benefits of Tai Chi and Yoga either as multicomponent physical activities or as individual therapies in various stages of PD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7136531/

 

Control Binge Eating Disorder with Mindfulness

psyjdc Leave a comment

Control Binge Eating Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Psychotherapy approaches, including DBT, have been shown to be effective in helping a person with binge eating disorder overcome abnormal eating behaviors.” – Jacquelyn Ekern

 

Around 30 million people in the United States of all ages and genders suffer from an eating disorder; either anorexia nervosa, bulimia, or binge eating disorder. 95% of those who have eating disorders are between the ages of 12 and 26. Eating disorders are not just troubling psychological problems, they can be deadly, having the highest mortality rate of any mental illness. Binge eating disorder involves eating a large amount of food within a short time-period while experiencing a sense of loss of control over eating.

 

Eating disorders can be difficult to treat because eating is necessary and cannot be simply stopped as in smoking cessation or abstaining from drugs or alcohol. One must learn to eat appropriately not stop. So, it is important to find methods that can help prevent and treat eating disorders. Contemplative practices, mindfulness, and mindful eating have shown promise for treating eating disorders. Acceptance and Commitment Therapy (ACT) is a mindfulness-based therapy that has also been shown to alter eating behavior. Dialectical Behavior Therapy (DBT) produces behavior change by 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.

 

In today’s Research News article “Dialectical behavior therapy adapted for binge eating compared to cognitive behavior therapy in obese adults with binge eating disorder: a controlled study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7285554/), Lammers and colleagues  recruited obese (BMI>30) adults who were diagnosed with binge eating disorder and engaged in emotional eating. They were randomly assigned to receive once a week for 20 weeks of either 3.75 hours of Cognitive Behavioral Therapy (CBT) or 2 hours of Dialectical Behavior Therapy (DBT). They were measured before and after treatment and 6 months later for eating disorders, emotion regulation, general psychopathology, depression, and body size.

 

They found that both groups had reduced eating disorder psychopathology after treatment and 6 months later with the Cognitive Behavioral Therapy (CBT) group having better outcomes with 65% of the patients shifting from dysfunctional to functional at follow-up as compared to 46% for the Dialectical Behavior Therapy (DBT) group.

 

These results were contrary to the researchers’ expectation that Dialectical Behavior Therapy (DBT) would be more efficacious than Cognitive Behavioral Therapy (CBT). One possible explanation for the superiority of CBT was that it contained a greater amount of therapeutic contact hours, 3.75 hours per week, than DBT, 2 hours per week. But the results clearly show that both treatments were effective in treating binge eating disorder in obese patients with emotional eating.

 

So, control binge eating disorder with mindfulness.

 

“Integrating mindfulness techniques in binge eating disorder treatment has been shown to reduce binge eating, improve nutritional outcomes, improve weight management, as well as enhance diabetes management.” – Jacquelyn Ekern

 

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

 

Lammers, M. W., Vroling, M. S., Crosby, R. D., & van Strien, T. (2020). Dialectical behavior therapy adapted for binge eating compared to cognitive behavior therapy in obese adults with binge eating disorder: a controlled study. Journal of Eating Disorders, 8, 27. https://doi.org/10.1186/s40337-020-00299-z

 

Abstract

Background

Current guidelines recommend cognitive behavior therapy (CBT) as the treatment of choice for binge eating disorder (BED). Although CBT is quite effective, a substantial number of patients do not reach abstinence from binge eating. To tackle this problem, various theoretical conceptualizations and treatment models have been proposed. Dialectical behavior therapy (DBT), focusing on emotion regulation, is one such model. Preliminary evidence comparing DBT adapted for BED (DBT-BED) to CBT is promising but the available data do not favor one treatment over the other. The aim of this study is to evaluate outcome of DBT-BED, compared to a more intensive eating disorders-focused form of cognitive behavior therapy (CBT+), in individuals with BED who are overweight and engage in emotional eating.

Methods

Seventy-four obese patients with BED who reported above average levels of emotional eating were quasi-randomly allocated to one of two manualized 20-session group treatments: DBT-BED (n = 41) or CBT+ (n = 33). Intention-to-treat outcome was examined at post-treatment and at 6-month follow-up using general or generalized linear models with multiple imputation.

Results

Overall, greater improvements were observed in CBT+. Differences in number of objective binge eating episodes at end of treatment, and eating disorder psychopathology (EDE-Q Global score) and self-esteem (EDI-3 Low Self-Esteem) at follow-up reached statistical significance with medium effect sizes (Cohen’s d between .46 and .59). Of the patients in the DBT group, 69.9% reached clinically significant change at end of the treatment vs 65.0% at follow-up. Although higher, this was not significantly different from the patients in the CBT+ group (52.9% vs 45.8%).

Conclusions

The results of this study show that CBT+ produces better outcomes than the less intensive DBT-BED on several measures. Yet, regardless of the dose-difference, the data suggest that DBT-BED and CBT+ lead to comparable levels of clinically meaningful change in global eating disorder psychopathology. Future recommendations include the need for dose-matched comparisons in a sufficiently powered randomized controlled trial, and the need to determine mediators and moderators of treatment outcome.

Plain English summary

Binge eating disorder (BED) is mostly treated with cognitive behavior therapy (CBT). The treatment focusses on reducing efforts to diet. Yet, a substantial number of patients still suffer from binge eating after this treatment. We suggest that patients with BED are better served with a treatment that helps them cope with negative emotions in a healthier way. Dialectical behavior therapy for BED (DBT-BED) is one such treatment. To test this, we compared outcomes of DBT-BED to the intensive CBT program that is common in our treatment center. We did so, in individuals with BED who might especially benefit from DBT-BED: those who are overweight and eat in response to emotions. Greater improvements were observed in the CBT group regarding the number of objective binge eating episodes at the end of treatment, and regarding global eating disorder psychopathology and self-esteem 6 months after treatment. Yet, patients in the CBT group received more therapy hours than in the DBT-BED group, which may have advantaged the CBT treatment. Concurrently, in both groups a comparable percentage of patients showed clinically meaningful changes in global eating disorder psychopathology. In conclusion, our results overall support the intensive CBT program over DBT-BED. Yet, given the fact that DBT-BED is less time-consuming (so cheaper) and presents similar percentages of meaningful change in global eating disorder psychopathology, it is worthwhile to further test the effects of DBT-BED in future studies.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7285554/

 

Reduce the Risk of Major Depression Relapse with Mindfulness

psyjdc Leave a comment

Reduce the Risk of Major Depression Relapse with Mindfulness

 

By John M. de Castro, Ph.D.

 

“a growing body of research is pointing to an intervention that appears to help prevent relapse by altering thought patterns without side effects: mindfulness-based cognitive therapy, or MBCT.” – Stacy Lu

 

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.

 

Relapsing into depression 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. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior.

 

There has been considerable research demonstrating that Mindfulness-Based Cognitive Therapy (MBCT) is effective in treating depression.  In today’s Research News article “The effects of mindfulness-based cognitive therapy on risk and protective factors of depressive relapse – a randomized wait-list controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275325/), Schanche and colleagues investigate the ability of  MBCT to reduce risk factors associated with relapse in patients with major depressive disorder.

 

They recruited adult patients diagnosed with major depressive disorder who had at least 3 depressive episodes and who were currently in remission. They were randomly assigned to be on a wait list or to receive 8 weekly 2-hour sessions of Mindfulness-Based Cognitive Therapy (MBCT). They were measured before and after training for rumination, emotion regulation, anxiety, self-compassion, mindfulness, and depression.

 

They found that in comparison to baseline and the wait-list group after Mindfulness-Based Cognitive Therapy (MBCT) there were significant reductions in rumination, anxiety, emotional reactivity to stress and depression and significant increases in emotion regulation, self-compassion and mindfulness. Hence, MBCT significantly improved the psychological well-being of these patients.

 

These are interesting results that suggest that Mindfulness-Based Cognitive Therapy (MBCT) produces a reduction in the types of negative emotional symptoms that could promote a depressive relapse and an increase in factors that could promote resistance to relapse especially the ability to effectively cope with their emotions and compassion for themselves. Mindfulness training has been repeatedly shown in the past to reduce rumination, anxiety, emotional reactivity to stress and depression and increase emotion regulation and self-compassion. The present study demonstrates that these benefits occur in patients in remission from major depressive disorder. This suggests that MBCT is effective in improving the major depressive disorder patients psychological state in a way that suggests that they would be resistant to relapse in the future.

 

So, reduce the risk of major depression relapse with mindfulness.

 

“MBCT and CT attempt to reduce the risk of relapse by promoting different skill sets. CT promotes challenging dysfunctional thinking and increasing physical activity level. MBCT promotes nonjudgmental monitoring of moment-by-moment experience, and decentering from thoughts or seeing thoughts as transient mental phenomena and not necessarily valid.” – American Mindfulness Research Association

 

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

 

Elisabeth Schanche, Jon Vøllestad, Endre Visted, Julie Lillebostad Svendsen, Berge Osnes, Per Einar Binder, Petter Franer, Lin Sørensen. The effects of mindfulness-based cognitive therapy on risk and protective factors of depressive relapse – a randomized wait-list controlled trial. BMC Psychol. 2020; 8: 57. Published online 2020 Jun 5. doi: 10.1186/s40359-020-00417-1

 

Abstract

Background

The aim of this randomized wait-list controlled trial was to explore the effects of Mindfulness–Based Cognitive Therapy (MBCT) on risk and protective factors for depressive relapse within the domains of cognition, emotion and self-relatedness.

Methods

Sixty-eight individuals with recurrent depressive disorder were randomized to MBCT or a wait-list control condition (WLC).

Results

Completers of MBCT (N = 26) improved significantly on measures assessing risk and protective factors of recurrent depression compared to WLC (N = 30) on measures of rumination (d = 0.59, p = .015), emotion regulation (d = 0.50, p = .028), emotional reactivity to stress (d = 0.32, p = .048), self-compassion (d = 1.02, p < .001), mindfulness (d = 0.59, p = .010), and depression (d = 0.40, p = .018). In the Intention To Treat sample, findings were attenuated, but there were still significant results on measures of rumination, self-compassion and depression.

Conclusions

Findings from the present trial contribute to evidence that MBCT can lead to reduction in risk factors of depressive relapse, and strengthening of factors known to be protective of depressive relapse. The largest changes were found in the domain of self-relatedness, in the form of large effects on the participants’ ability to be less self-judgmental and more self-compassionate.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275325/

 

Mindfulness is Associated with Lower Functional Impairment and Avoidance in Major Depressive Disorder

psyjdc Leave a comment

Mindfulness is Associated with Lower Functional Impairment and Avoidance in Major Depressive Disorder

 

By John M. de Castro, Ph.D.

 

“People at risk for depression are dealing with a lot of negative thoughts, feelings and beliefs about themselves and this can easily slide into a depressive relapse. MBCT helps them to recognize that’s happening, engage with it in a different way and respond to it with equanimity and compassion.” – Willem Kuyken

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating, impairing the ability of the patients to effectively conduct their lives. 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. Behavioral activation involves engaging with what is going on in the present moment and is thought to help with depression while avoiding symptoms and ruminating tend to exacerbate the depression. There is little data, however, of the interplay of activation and mindfulness in patients with major depression.

 

In today’s Research News article “Roles of Trait Mindfulness in Behavioral Activation Mechanism for Patients With Major Depressive Disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202344/), Takagaki and colleagues had adult patients with major depressive disorder complete questionnaires designed to measure behavioral activation for depression including subscales measuring activation, avoidance/rumination, work/school impairment, and social impairment; mindfulness including subscales measuring describe, observe, act with awareness, nonreactivity, and non-judging; depression; and disability.

 

They found that the greater the level of depression the greater the level of disability, avoidance/rumination, and mindful observing and the lower the levels of mindful describing, acting with awareness, nonreacting and non-judging. Similarly, they also found that the higher the levels of avoidance/rumination the greater the levels of depression, disability, and mindful observing and the lower the levels of mindful describing, acting with awareness, nonreacting and non-judging. Structural equation modelling revealed that mindful acting with awareness, nonreacting and non-judging was directly negatively related to avoidance/rumination which was in turn positively related to disability. In addition, mindful acting with awareness and nonreacting were directly negatively related to disability.

 

These results are correlative and caution must be taken in making causal inferences. Nevertheless, the results suggest that the degree of disability/impairment in patients with major depressive disorder is directly and indirectly associated with mindfulness with avoidance/rumination as an intermediary. That is, avoidance of a negative aversive state and engagement in rumination rather than active problem-solving to some extent mediates the association of mindfulness with lower levels of impairment in life. Hence, mindfulness is related to the patient’s ability to better conduct their life and it does so directly and indirectly by being associated with less avoidance of psychological pain and less rumination.

 

So, mindfulness is associated with lower functional impairment and avoidance in major depressive disorder.

 

“Mindfulness training can “generate positive emotions by cultivating self-compassion and self-confidence through an upward spiral process, although behavioral activation is action oriented while mindfulness emphasizes the acceptance and awareness of present moment emotions, thoughts, and bodily sensations, the two can be complementary.” _ Amanda MacMillan

 

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

 

Takagaki, K., Ito, M., Takebayashi, Y., Nakajima, S., & Horikoshi, M. (2020). Roles of Trait Mindfulness in Behavioral Activation Mechanism for Patients With Major Depressive Disorder. Frontiers in psychology, 11, 845. https://doi.org/10.3389/fpsyg.2020.00845

 

Abstract

Behavioral activation and mindfulness have both been shown to engender improvement of functional impairment in patients with major depressive disorder. In behavioral activation, the practice of engaging with the direct experience of the present moment is central, especially when targeting avoidance. Consequently, mindfulness affects changes of avoidance in behavioral activation. This study was designed to assess exploratory relations among trait mindfulness, avoidance, and functional impairment in behavioral activation mechanism for depression. For 1042 participants with depression only or for depression with anxiety disorders, we used structural equation modeling to examine relations among trait mindfulness, avoidance, and functional impairment. Trait mindfulness non-reactivity, non-judging, and acting with awareness had a direct negative effect on avoidance. Trait mindfulness non-reactivity, trait non-judging, and trait acting with awareness had indirect negative effects on functional impairment. Results show that each trait mindfulness facet exhibited a distinct pattern of relations with avoidance and impairment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202344/

 

Mindfulness is Associated with Greater Prosocial Behavior and Lower Rumination

psyjdc Leave a comment

Mindfulness is Associated with Greater Prosocial Behavior and Lower Rumination

 

By John M. de Castro, Ph.D.

 

“With mindfulness, people deeply experience the present feelings with clarity and emotionally calm, and thus prevents them from suppression or rumination.” – Ying Yang

 

Humans are social animals. This is a great asset for the species as the effort of the individual is amplified by cooperation. In primitive times, this cooperation was essential for survival. But in modern times it is also essential, not for survival but rather for making a living and for the happiness of the individual. Mindfulness has been found to increase prosocial emotions such as compassion, and empathy and prosocial behaviors such as altruism.

 

Worry (concern about the future) and rumination (repetitive thinking about the past) are associated with mental illness, particularly anxiety and depression. Fortunately, worry and rumination may be interrupted by mindfulness and emotion regulation improved by mindfulness. But there has been little study of the relationships between mindfulness, prosocial behaviors and rumination.

 

In today’s Research News article “Prosocial Behavior Can Moderate the Relationship Between Rumination and Mindfulness.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7180177/),  Meng and Meng recruited adults high in rumination and low in rumination and asked them to evaluate what actions that they might take in a number of situations. They randomly assigned half of each group to work with situations that evoked either helping others (prosocial behavior) and the other half to work with neutral situations that didn’t involve helping. They were measured before and after the task for mindfulness and rumination. In a second study they recruited undergraduate students and had them complete questionnaires measuring mindfulness, rumination, and prosocial tendencies.

 

In the first study they found that overall, those participants high in rumination had significantly lower mindfulness than those low in rumination. They also found that the group working with helping situations had a significantly greater increase in mindfulness after the task than those working with the neutral situations and this effect was greatest in participants high in rumination.

 

In the second study they found that the higher the levels or all aspects of rumination the lower the levels of mindfulness. They also found that the higher the levels of mindfulness the greater the tendencies for prosocial behavior. Finally, they performed a moderation analysis and found that those participants high in prosocial tendencies had greater reductions in mindfulness produced by the reflective pondering aspect of rumination than the participants low in tendencies for prosocial behavior.

 

Overall, they found that rumination was associated with lower levels of mindfulness. This is not surprising as rumination involves repetitive thinking about past and future events that is incompatible with present moment awareness, mindfulness. In addition, they found that working on tasks that demanded helping behavior tended to increase mindfulness especially when rumination was high. Further they found that tendencies for prosocial behaviors were associated with higher levels of mindfulness. This suggests that prosocial behavior and mindfulness are significantly related and that evoking thinking about prosocial behavior tends to make the individual more mindful.

 

Although many aspects of this study were correlative and do not indicate causal relationships, it is clear that mindfulness and prosocial behavior are positively related and that rumination interferes with this relationship. They also suggest that engaging in prosocial behavior helps make people who ruminate a lot to be more mindful.

 

Previous research has shown that training in mindfulness increases the tendency to engage in prosocial behavior. This study turns the tables and demonstrates that engaging in prosocial behaviors increases mindfulness. All of which suggests that being aware of what’s going on in the present moment makes the individual more likely to see what others may need and that tending to the needs of others evokes present moment awareness.

 

Mindfulness is associated with greater prosocial behavior and lower rumination.

 

“mindfulness meditation training increases compassionate prosocial behaviors.” – J. David Cresswell

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

 

Meng, Y., & Meng, G. (2020). Prosocial Behavior Can Moderate the Relationship Between Rumination and Mindfulness. Frontiers in psychiatry, 11, 289. https://doi.org/10.3389/fpsyt.2020.00289

 

Abstract

Objective

Rumination, which is a coping style to distress, has become a common mode of thinking about mental illnesses such as depression and anxiety. Improving mindfulness is an effective way to help people cope with rumination. Individuals who had higher prosocial behaviors reported a high level of mindfulness. This study aimed to explore whether prosocial behavior helps individuals with high-level rumination improve their mindfulness, and explain the reason why prosocial behavior can influence the relationship between mindfulness and rumination.

Methods

Introducing prosocial behavior situations, the first study chose 51 high-level rumination and 53 low-level rumination participants and measured the influence of prosocial behavior on mindful attention awareness in the present moment. In the second study, a questionnaire was conducted among 261 participants to explore the moderating effect of prosocial behavior between rumination and mindfulness.

Results

In individuals with high-level rumination, ΔMAAS (mindful attention awareness scale) (posttest-baseline) scores in the prosocial behavior condition were significantly higher compared to those in the control condition (p=0.003). Meanwhile, prosocial behavior played a moderating effect between reflective pondering of rumination and mindfulness (R2 = 0.03, p=0.004).

Conclusions

Encouraging prosocial behavior is an effective way to improve mindfulness in highly ruminative individuals.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7180177/

 

Reduce Smartphone Addiction and Improve Stress Coping in Adolescents with Meditation

psyjdc Leave a comment

Reduce Smartphone Addiction and Improve Stress Coping in Adolescents with Meditation

 

By John M. de Castro, Ph.D.

 

“over a third of us check our phones in the middle of the night. And a further third check our phones within five minutes of waking up. The same survey also revealed that about a third of us have argued with our partners about using their phones too much.” – Neil Tranter

 

Over the last few decades, the internet has gone from a rare curiosity to the dominant mode of electronic communications. In fact, it has become a dominant force in daily life, occupying large amounts of time and attention. The dominant mode of accessing the internet is through smartphones creating smartphone addictions. Individuals with smartphone addiction develop greater levels of “tolerance” and experience “withdrawal” and distress when deprived. This phenomenon is so new that there is little understanding of its nature, causes, and consequences and how to treat it.

 

Adolescence is a time of mental, physical, social, and emotional growth. It is during this time that higher levels of thinking, sometimes called executive function, develops. But adolescence can be a difficult time, fraught with challenges and stresses. 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 stressed and unable to cope with all that is required.

 

Mindfulness training has been shown to be helpful with addictions, decreasing cravings, impulsiveness, and psychological and physiological responses to stress, and increasing emotion regulation.  Mindfulness has also been shown to be effective for the treatment of a variety of addictions. Meditation, a core mindfulness training technique, has been shown to be effective in treating addictions. Hence, there is a need to further explore the ability of meditation training to treat smartphone addiction in adolescents.

 

In today’s Research News article “The Effect of Mind Subtraction Meditation Intervention on Smartphone Addiction and the Psychological Wellbeing among Adolescents.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246924/), Choi and colleagues recruited High School sophomores at two different schools and provided one group with school based meditation training for 20 minutes twice a week for 12 weeks while the second group received no treatment. They were measured before and after training and 4 weeks later for smartphone addiction, self-control, perceived stress, and stress coping skills.

 

They found that after treatment the meditation but not the control group had a significant reduction in perceived stress and smartphone addiction, including decreases in daily life disturbance, tolerance, and withdrawal symptoms. They also found significant increases in self-control and stress coping strategies including problem focusing coping and social support navigation coping. They also found that theses effects were still present and significant 4 weeks after the end of training.

 

These are interesting results that would have been stronger is an active control condition such as exercise was used. Nevertheless, the results suggest that school-based meditation practice can reduce stress, improve stress coping and self-control and decrease addiction to smartphones in adolescents. This should help these young people to better deal with their school stress and be better able to perform academically and socially.

 

So, reduce smartphone addiction and improve stress coping in adolescents with meditation.

 

“These devices and capabilities do bring incredible benefits and possibilities for sharing information and creating global interaction than ever before. We simply (and yet with great difficulty) need to learn to hold our technology more lightly—with more awareness.” – Mitch Abblett

 

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

 

Choi, E. H., Chun, M. Y., Lee, I., Yoo, Y. G., & Kim, M. J. (2020). The Effect of Mind Subtraction Meditation Intervention on Smartphone Addiction and the Psychological Wellbeing among Adolescents. International journal of environmental research and public health, 17(9), 3263. https://doi.org/10.3390/ijerph17093263

 

Abstract

As the smartphone has become an indispensable device in modern lives, consequential psychosocial problems such as smartphone addiction have been getting attention worldwide, especially regarding adolescents. Based on its positive effect on young individuals’ mental health, mind subtraction meditation has been widely applied to many school-based programs in South Korea. This study aims to identify the effects of a school program based on mind subtraction on the smartphone addiction of adolescents. A total of 49 high school sophomores, 24 from the experimental group (mean age = 16), and 25 from the control group (mean age = 16) are included in this case-control study. The experimental group is given the meditation program sessions in the morning, two times a week for 20 min per session, for a total of 12 weeks. The experimental group shows improvements regarding the ‘smartphone addiction’ section (p < 0.001), for instant satisfaction (p < 0.001) and long-term satisfaction (p < 0.001). Concerning the ‘self-control’ section and decreasing stress (p < 0.001), problem focusing (p < 0.001), and social support navigation (p = 0.018), there are improvements in these ‘stress coping strategies’ sections. This study directly shows the positive effect of mind subtraction meditation on smartphone addiction in adolescents and, thus, provides guidance to the future development of smartphone addiction prevention programs for young individuals.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246924/

 

Relieve Generalized Anxiety and Depression with a 2-Session Acceptance and Commitment Therapy (ACT)

psyjdc Leave a comment

Relieve Generalized Anxiety and Depression with a 2-Session Acceptance and Commitment Therapy (ACT)

 

By John M. de Castro, Ph.D.

 

“ACT is about acceptance and it is about change at the same time. Applied to anxiety disorders, patients learn to end the struggle with their anxiety-related discomfort and take charge by engaging in actions that move them related to their chosen life aims.” – Mohsen Hasheminasab 

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. A characterizing feature of anxiety disorders is that the suffer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Anxiety disorders have generally been treated with drugs. But there are considerable side effects and these drugs are often abused.

 

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.

 

There are a number of psychological therapies for anxiety and depression. But, les than half the patients treated respond to the therapy and do not relapse. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders. A therapeutic technique that contains mindfulness training is Acceptance and Commitment Therapy (ACT). It is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT) and has also been shown to relieve anxiety. 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 prior research Ruiz and associates have demonstrated that a 3 session Acceptance and Commitment Therapy (ACT) is effective Generalized Anxiety Disorder (GAD) and for depression. In today’s Research News article “Efficacy of a two-session repetitive negative thinking-focused acceptance and commitment therapy (ACT) protocol for depression and generalized anxiety disorder: A randomized waitlist control trial.” (See summary below or at: https://pubmed.ncbi.nlm.nih.gov/31944806/), Ruiz and colleagues examine the efficacy of a 2-session ACT for Generalized Anxiety Disorder (GAD) and for depression.

 

They recruited via social media patients diagnosed with either Generalized Anxiety Disorder (GAD) or depression and randomly assigned them to either a wait-list control condition or to receive 2 60-minute individual sessions of Acceptance and Commitment Therapy (ACT). They were measured before and after treatment and 1- and 3-months month later for anxiety, depression, perceived stress, perseverative thinking, experiential avoidance, cognitive fusion, valued living, and generalized pliance (rule governed behavior).

 

They found that in comparison to baseline and the wait-list control group, the patients who received Acceptance and Commitment Therapy (ACT) had significantly improved levels of all outcome measures including anxiety, depression, perceived stress, perseverative thinking, experiential avoidance, cognitive fusion, valued living, and generalized pliance that persisted at the 1- and 3-month follow-ups. Fully 91% of the patients receiving ACT had clinically significant changes in their Generalized Anxiety Disorder (GAD) or depression compared to 9% of the wait-list controls.

 

The findings are remarkable in that 2 1-hour sessions of Acceptance and Commitment Therapy (ACT) produced such large, significant and lasting improvements in patients with Generalized Anxiety Disorder (GAD) or depression. These disorders are widespread affecting a large number of people and are frequently debilitating or at least interfere with their ability to conduct their lives. It is exciting that a brief treatment that can be implemented cost-effectively is capable of relieving their suffering.

 

The study, however, lacked an active control condition, e.g. exercise, and so is open to a variety of confounding variables. Future research should include such an active control. The effects of confounding variables, however, generally fade fairly quickly over time. So, the fact that the current results were still large and significant 3-months later argues that the benefits were produced by ACT.

 

So, relieve generalized anxiety and depression with a 2-session Acceptance and Commitment Therapy (ACT).

 

“ACT has been used effectively to help treat workplace stress, test anxiety, social anxiety disorder, depression, obsessive-compulsive disorder, and psychosis.” – Psychology Today

 

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

 

Ruiz FJ, Peña-Vargas A, Ramírez ES, et al. Efficacy of a two-session repetitive negative thinking-focused acceptance and commitment therapy (ACT) protocol for depression and generalized anxiety disorder: A randomized waitlist control trial [published online ahead of print, 2020 Jan 16]. Psychotherapy (Chic). 2020;10.1037/pst0000273. doi:10.1037/pst0000273

 

Abstract

This parallel randomized controlled trial aimed to evaluate the effect of acceptance and commitment therapy (ACT) focused on disrupting repetitive negative thinking (RNT) versus a waitlist control (WLC) in the treatment of depression and generalized anxiety disorder (GAD). Forty-eight participants with a main diagnosis of depression and/or GAD were allocated by means of simple randomization to a 2-session RNT-focused ACT intervention or to the WLC. The primary outcomes were emotional symptoms as measured by the Depression, Anxiety, and Stress Scales-21. Process outcomes included ACT- and RNT-related measures: general RNT, experiential avoidance, cognitive fusion, values, and generalized pliance. At the 1-month follow-up, linear mixed effects models showed that the intervention was efficacious in reducing emotional symptoms (d = 2.42, 95% confidence interval [1.64, 3.19]), with 94.12% of participants in the RNT-focused ACT condition showing clinically significant change in the Depression, Anxiety, and Stress Scales-21 total scores versus 9.09% in the WLC condition (70% vs. 8% in intention-to-treat analysis). The intervention effects were maintained at the 3-month follow-up. No adverse events were found. A very brief RNT-focused ACT intervention was highly effective in the treatment of depression and GAD.

Clinical Impact Statement Question: What is the applied clinical practice question this paper is hoping to address?

To analyze whether a 2-session acceptance and commitment therapy (ACT) intervention focused on disrupting repetitive negative thinking (RNT) is effective in treating depression and GAD. Findings: How would clinicians meaningfully use the primary findings of this paper in their applied practice? Clinicians might use the RNT-focused ACT protocol to treat depression and GAD. Meaning: What are the key conclusions and implications for future clinical practice and research? The RNT-focused ACT protocol was highly effective in treating depression and GAD. Next Steps: Based on the primary findings and limitations of this paper, what are future directions to be explored in clinical practice and research? To analyze the long-term effects of the RNT-focused ACT protocol.

https://pubmed.ncbi.nlm.nih.gov/31944806/

 

Improve Tolerance for Distress with Brief Mindfulness Training

psyjdc Leave a comment

Improve Tolerance for Distress with Brief Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“when you are being mindful of your emotions you don’t fight the wave, but instead allow the wave to carry you over its crest and down the other side, or you might choose to surf the wave allowing it to carry you into shore.” – Lisa Saulsman

 

Psychological distress is related to an increase in physiological stress responses. That is, when the individual is anxious, ruminating, or having negative emotions, the physiology including the hormonal system reacts. The increased activity can be measured in heightened stress hormones in the blood and increased heart rate, blood pressure etc. These physiological stress responses on the short-term are adaptive and help to fight off infection, toxins, injury, etc. Unfortunately, psychological distress is often persistent and chronic and resulting in chronic stress which in turn can produce disease.

 

Many of the symptoms of psychological distress have been shown to be related to a lack of mindfulness. Anxiety is often rooted in a persistent dread of future negative events while rumination is rooted in the past, with persistent replaying of negative past events. Since mindfulness is firmly rooted in the present it is antagonistic toward anything rooted in the past or future. Hence, high levels of mindfulness cannot coexist with anxiety and rumination. In addition, high mindfulness has been shown to be related to high levels of emotion regulation and positive emotions. So, mindfulness would appear to be an antidote to psychological distress.

 

In today’s Research News article “The Effect of a Brief Mindfulness Training on Distress Tolerance and Stress Reactivity.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6494113/), Carpenter and colleagues recruited undergraduate students who had no experience with mindfulness or meditation practices and measured them for mindfulness, anxiety, depression, perceived stress. mindfulness use, and respiration. They were then measured for distress tolerance with a cold pressor task in which they were asked to keep their arm in very cold water for as long as they could (up to a maximum of 180 seconds). They were also asked to hyperventilate for as long as they could (up to a maximum of 300 seconds). After having completed these tasks they were randomly assigned to receive either 15 minutes of relaxation with music or mindfulness training with meditation and non-judgmental awareness. They then repeated the distress tasks. Finally, only after training they were asked to write a sentence stating that a good friend will be in a bad car accident and think about and visualize the scene. Participants were asked to rate their level of distress prior to each task and after the task to rate their maximal level of distress during the task,

 

They found that in comparison to baseline and the relaxation condition, after mindfulness training there was a significant increase in persistence of hyperventilation, time continuing to hyperventilate. The mindfulness participants also were less likely to attempt to neutralize feelings produced by stating and visualizing a friend in a future car accident. There were no significant effects of training on the reported levels of distress. They also found that using mindfulness nonjudging and nonreacting mediated the effect of mindfulness training on persistence in the cold pressor and urge to neutralize feelings in the car accident tasks, such that mindfulness training not only directly affected these outcomes but also indirectly by increasing these uses of mindfulness which in turn affected performance.

 

These results suggest that a brief mindfulness training produces a greater ability to tolerate physical and psychological distress. They also suggest that mindfulness has these effects in part by inducing mindful nonjudgment and nonreaction. The ability to engage in a stressful task appears to be improved by observing it in the present moment nonjudgmentally and nonreactively.

 

Mindfulness training has been previously shown to reduce distress, pain, and responding to stress. What is new and interesting here is that such a brief mindfulness training can have significant effects like these. This suggests that brief mindfulness training may be beneficially employed whenever and individual is about to engage in a distressful task, such as working through traumatic experiences, engaging in athletic endeavors, etc., making the individual better able to focus on the present moment and better cope with the distress.

 

So, improve tolerance for distress with brief mindfulness training.

 

“mindfulness is believed to facilitate increased distress tolerance and nonjudgmental acceptance of unpleasant experiences.” – Andrew Bliesner

 

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

 

Carpenter, J. K., Sanford, J., & Hofmann, S. G. (2019). The Effect of a Brief Mindfulness Training on Distress Tolerance and Stress Reactivity. Behavior therapy, 50(3), 630–645. https://doi.org/10.1016/j.beth.2018.10.003

 

Highlights

  • Mindfulness training increased distress tolerance on the hyperventilation challenge
  • Mindfulness training led to reduced urges to neutralize an upsetting thought
  • No effect of the intervention was seen on subjective distress
  • Lower trait awareness predicted a greater effect of mindfulness on hyperventilation

Abstract

Distress tolerance (DT) is considered an underlying facet of anxiety, depression and a number of other psychological disorders. Mindfulness may help to increase DT by fostering an attitude of acceptance non-judgment toward distressing experiences. Accordingly, the present study examined the effects of a brief mindfulness training on tolerance of different types of distress, and tested whether trait mindfulness moderates the effect of such training. Undergraduates (n = 107) naïve to mindfulness completed a measure of trait mindfulness and underwent a series of stress tasks (cold pressor, hyperventilation challenge, neutralization task) before and after completing a 15-minute mindfulness training or a no-instruction control in which participants listened to relaxing music. Participants in the mindfulness condition demonstrated greater task persistence on the hyperventilation task compared to the control group, as well as a decreased urge to neutralize the effects of writing an upsetting sentence. No effect on distress ratings during the tasks were found. Overall trait mindfulness did not significantly moderate task persistence, but those with lower scores on the act with awareness facet of mindfulness demonstrated greater relative benefit of mindfulness training on the hyperventilation challenge. Mediation analyses revealed significant indirect effects of mindfulness training on cold pressor task persistence and urges to neutralize through the use of the non-judge and non-react facets of mindfulness. These results suggest that a brief mindfulness training can increase DT without affecting the subjective experience of distress.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6494113/