Month: April 2021

Lower Cardiovascular Disease Risk by Improving Emotion Regulation with Mindfulness

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Lower Cardiovascular Disease Risk by Improving Emotion Regulation with Mindfulness

 

By John M. de Castro, Ph.D.

 

“People who meditate regularly reported feeling more balanced and less stressed, and . . . improved the outcomes when they were added to cardiac rehabilitation programmes for patients with CHD.” – Heart Matters

 

Cardiovascular disease is the number one killer. A myriad of treatments has been developed including a variety of surgical procedures and medications. In addition, lifestyle changes have proved to be effective including quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Unfortunately, for a variety of reasons, 60% of cardiovascular disease patients decline engaging in these lifestyle changes, making these patients at high risk for another attack.

 

Contemplative practices have been shown to be safe and effective alternative treatments for cardiovascular disease. Practices such as meditation, tai chi, and yoga, have been shown to be helpful for heart health and to reduce the physiological and psychological responses to stress. They have also been shown to be effective in maintaining cardiovascular health and the treatment of cardiovascular disease. The means by which mindfulness reduces cardiovascular disease risk have not been explored using the qualitative experiences of the patients.

 

In today’s Research News article “Mindfulness and cardiovascular health: Qualitative findings on mechanisms from the mindfulness-based blood pressure reduction (MB-BP) study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7510988/ ) Nardi and colleagues recruited patients with hypertension who had participated in a study of the effectiveness of Mindfulness-Based Stress Reduction (MBSR) modified for hypertension, to reduce blood pressure. The participants participated in focus groups or were interviewed individually with semi-structured interviews. The groups and interviews focused on their experiences with the intervention and its effects. Transcripts of the responses were subjected to thematic analysis to identify common themes and ideas.

 

They found that the participants practiced breath awareness and body scans most in their everyday lives. Breath awareness allowed them to pause and relax to better address issues while the body scans made them more aware of their bodily states. These practices produced a greater awareness of the present moment and their responses to emotional situations allowing them to better regulate their emotions in these situations. They learned to apply self-kindness rather than self-criticism and to direct attention to mindfulness when stressful situations came up rather than worrying about them. All of this resulted in the improved ability to deal with their emotions. The participants indicated that they used the emotion regulation abilities to effectively deal with stress, learning to relax in the face of stress. This led to important changes in their health behaviors particularly diet.

 

These qualitative results suggest that the mindfulness program improved the patients’ cardiovascular health. It provided them with tools to employ when emotional situations arose to heighten their awareness of exactly what was transpiring and how they felt in the present moment. This resulted in better regulation of emotions which in turn led to better responses to stress and improved health behaviors.

 

These qualitative results correspond to the results of controlled empirical studies of the effects of mindfulness training on a wide variety of individuals and conditions. These studies found that mindfulness training produced improved emotion regulation, increased self-kindness, improved responses to stress, and improved cardiovascular health.  Hence, mindfulness training provides individuals with skills that improve their lives and well-beeing.

 

So, lower cardiovascular disease risk by improving emotion regulation with mindfulness.

 

“there are four things that have scientifically been shown to reduce the risk of a heart attack in patients with mild to moderate coronary artery disease and they include – reduced stress (use meditation to do so), diet, exercise and love.” – Jeena Cho

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Nardi, W. R., Harrison, A., Saadeh, F. B., Webb, J., Wentz, A. E., & Loucks, E. B. (2020). Mindfulness and cardiovascular health: Qualitative findings on mechanisms from the mindfulness-based blood pressure reduction (MB-BP) study. PloS one, 15(9), e0239533. https://doi.org/10.1371/journal.pone.0239533

 

Abstract

Background

Mindfulness-based programs hold promise for improving cardiovascular health (e.g. physical activity, diet, blood pressure). However, despite theoretical frameworks proposed, no studies have reported qualitative findings on how study participants themselves believe mindfulness-based programs improved their cardiovascular health. With an emphasis on in-depth, open-ended investigation, qualitative methods are well suited to explore the mechanisms underlying health outcomes. The objective of this qualitative study was to explore the mechanisms through which the mindfulness-based program, Mindfulness-Based Blood Pressure Reduction (MB-BP), may influence cardiovascular health.

Methods

This qualitative study was conducted as part of a Stage 1 single arm trial with one-year follow-up. The MB-BP curriculum was adapted from Mindfulness-Based Stress Reduction to direct participants’ mindfulness skills towards modifiable determinants of blood pressure. Four focus group discussions were conducted (N = 19 participants), and seven additional participants were selected for in-depth interviews. Data analysis was conducted using the standard approach of thematic analysis. Following double-coding of audio-recorded transcripts, four members of the study team engaged in an iterative process of data analysis and interpretation.

Results

Participants identified self-awareness, attention control, and emotion regulation as key mechanisms that led to improvements in cardiovascular health. Within these broader themes, many participants detailed a process beginning with increased self-awareness to sustain attention and regulate emotions. Many also explained that the specific relationship between self-awareness and emotion regulation enabled them to respond more skillfully to stressors. In a secondary sub-theme, participants suggested that higher self-awareness helped them engage in positive health behaviors (e.g. healthier dietary choices).

Conclusion

Qualitative analyses suggest that MB-BP mindfulness practices allowed participants to engage more effectively in self-regulation skills and behaviors lowering cardiovascular disease risk, which supports recent theory. Results are consistent with quantitative mechanistic findings showing emotion regulation, perceived stress, interoceptive awareness, and attention control are influenced by MB-BP.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7510988/

 

Improve Autonomic Nervous System Function Reducing Stress with Online Mindfulness Training

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Improve Autonomic Nervous System Function Reducing Stress with Online Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“Research has found that meditation can positively affect a measure of heart health known as heart rate variability (HRV). HRV reflects how quickly your heart makes small changes in the time interval between each heartbeat. A high HRV is a sign of healthier heart. . . With regular meditation, you may be able to raise your HRV. – Harvard Mens Health

 

In our lives we are confronted with a variety of situations and environments. In order to successfully navigate these differing situations, we must be able to adapt and self-regulate. The Autonomic Nervous System (ANS) is designed to adapt physiologically to the varying demands on us. It is composed of 2 divisions; the sympathetic division underlies activation, including increases in heart rate and blood pressure, while the parasympathetic division underlies relaxation, including decreases in heart rate and blood pressure. A measure of the balance between these systems is provided by the variability of the heart rate.

 

Heart Rate Variability (HRV) refers to the change in the time intervals between consecutive heart beats. Higher levels of HRV are indicative of flexibility in the Autonomic Nervous System and are associated with adaptability to varying environments. Mindfulness has been associated with psychological flexibility and a greater ability to adapt appropriately to differing situations. Indeed, mindfulness practice improves Heart Rate Variability (HRV). It makes sense to explore the ability of real world mindfulness training with an online app to improve autonomic nervous system function as measured by heart rate variability.

 

In today’s Research News article “Heart rate variability is enhanced during mindfulness practice: A randomized controlled trial involving a 10-day online-based mindfulness intervention.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746169/ ) Kirk and Axelsen recruited healthy adults online and randomly assigned them to either a mindfulness, music, or no treatment control group. The mindfulness group received mindfulness training with a smartphone app (Headspace) while the music group listened to music also with a smartphone app for 10 days. Before and after training they were measured for mindfulness, sleep quality, perceived stress, and respiration rate and had their electrocardiogram measured to determine heart rate and heart rate variability.

 

They found that in comparison to baseline and the no-treatment control group, the mindfulness training group had significantly greater mindfulness and sleep quality and significantly lower perceived stress. Although the music group also had a reduction in perceive stress, the mindfulness group had a significantly greater reduction.

 

They found that during the mindfulness and music sessions there were significant increases in heart rate variability but only during the mindfulness sessions was there a significant reduction in respiration rate. Outside of the sessions, they found that the mindfulness group and not the music or control groups had significant increases in heart rate variability during the daytime, nighttime, and during sleep.

 

This was a well-controlled study in that an active as well as passive control conditions were present. So, clear conclusions about causation can be reached. The results suggest that mindfulness trained with a smartphone app increases heart rate variability both acutely, during the sessions, and chronically, outside of the training sessions across the day including during sleep. These increases in heart rate variability suggest an increase in parasympathetic activity and a decrease in sympathetic activity. These reflect an improved balance and relaxation in the autonomic nervous system. These increases in heart rate variability are physiological measures reflecting the psychological measures of decreased perceived stress and improved sleep quality. Hence, online mindfulness training of relatively short duration is capable of improving both physiological and psychological indicators of stress and improving sleep.

 

So, improve autonomic nervous system function reducing stress with online mindfulness training.

 

“Generally speaking, a low and irregular HRV indicates a stressed state and a high and regular HRV indicates a relaxed state such as mindfulness.” – Mindfio

 

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

 

Kirk, U., & Axelsen, J. L. (2020). Heart rate variability is enhanced during mindfulness practice: A randomized controlled trial involving a 10-day online-based mindfulness intervention. PloS one, 15(12), e0243488. https://doi.org/10.1371/journal.pone.0243488

 

Abstract

Objectives

The goal of the present study was to probe the effects of mindfulness practice in a naturalistic setting as opposed to a lab-based environment in the presence of continuous heart rate variability (HRV) measurements. The specific experimental goals were to examine the effects of a brief 10-day online-based mindfulness intervention on both chronic and acute HRV responses.

Method

We conducted a fully randomized 10-day longitudinal trial of mindfulness practice, explicitly controlling for practice effects with an active-control group (music listening) and a non-intervention control group. To assess chronic cardiovascular effects, we asked participants in the 3 groups to complete 2-day HRV pre- and post-intervention measurement sessions. Using this experimental setup enabled us to address training effects arising from mindfulness practice to assess physiological impact on daytime as well as nighttime (i.e. assessing sleep quality) on the underlying HRV response. To assess acute cardiovascular effects, we measured HRV in the 2 active intervention groups during each of the 10 daily mindfulness or music sessions. This allowed us to track the development of purported training effects arising from mindfulness practice relative to the active-control intervention in terms of changes in the HRV slope over the 10-day time-course.

Results

Firstly, for the acute phase we found increased HRV during the daily practice sessions in both the mindfulness and active-control group indicating that both interventions were effective in decreasing acute physiological stress. Secondly, for the chronic phase we found increased HRV in both the day- and nighttime indicating increased sleep quality, specifically in the mindfulness group.

Conclusion

These results suggest causal effects in both chronic and acute phases of mindfulness practice in formerly naïve subjects and provides support for the argument that brief online-based mindfulness interventions exert positive impact on HRV.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746169/

 

Type 2 Diabetes is not Improved with Tai Chi and Qigong Practices

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Type 2 Diabetes is not Improved with Tai Chi and Qigong Practices

 

By John M. de Castro, Ph.D.

 

“Diet and exercise are the cornerstone of diabetes management. People with diabetes who exercise regularly have better control over their blood glucose levels and fewer complications such as heart disease and stroke. Many people, however, are unable to keep up with their regular exercise because they either don’t enjoy it, or have a problem finding time to exercise. Tai chi offers a major advantage: It’s enjoyable, and to many, it’s almost addictive.“ – Paul Lam

 

Diabetes is a major health issue. It is estimated that 30 million people in the United States and nearly 600 million people worldwide have diabetes and the numbers are growing. Type II Diabetes results from a resistance of tissues, especially fat tissues, to the ability of insulin to promote the uptake of glucose from the blood. As a result, blood sugar levels rise producing hyperglycemia. Diabetes is heavily associated with other diseases such as cardiovascular disease, heart attacks, stroke, blindness, kidney disease, and circulatory problems leading to amputations. As a result, diabetes doubles the risk of death of any cause compared to individuals of the same age without diabetes.

 

Type 2 diabetes is a common and increasingly prevalent illness that is largely preventable.

One of the reasons for the increasing incidence of Type 2 Diabetes is its association with overweight and obesity which is becoming epidemic in the industrialized world. A leading cause of this is a sedentary life style. Current treatments for Type 2 Diabetes focus on diet, exercise, and weight control. Recently, mindfulness practices have been shown to be helpful in managing diabetes. Mindful movement practices such as Tai Chi and Qigong  are mindfulness practices that are also gentle exercises that appear to improve type 2 diabetes.

 

In today’s Research News article “Effects of fitness qigong and tai chi on middle-aged and elderly patients with type 2 diabetes mellitus.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746158/ ) Li and colleagues recruited sedentary adults over 40 years of age who were diagnosed with type 2 diabetes and who did not practice Tai Chi or Qigong. They were randomly assigned to receive 60 minutes of practice, 5 times per week for 12 weeks of either fitness qigong, Tai Chi, or stretching exercise. They were measured before and after training for body size and blood samples were taken and assayed for fasting plasma glucose, glycated hemoglobin (HbA1C), and C-peptide levels.

 

Compared to baseline and the stretching group after training there were no significant changes in fasting plasma glucose but the fitness qigong and Tai Chi groups maintained significantly higher levels of HbA1C and the Tai Chi group had significantly lower levels of c-peptide. They also found that the longer the patients had type 2 diabetes the greater the reduction in fasting plasma glucose after fitness qigong practice. In contrast, the greater the waist to hip ratio the greater the increase in HbA1C in the Tai Chi group.

 

These are interesting but disappointing results that suggest that neither Tai Chi nor Qigong practice improve blood glucose levels in patients with type 2 diabetes. Furthermore, Tai Chi appears to increase HbA1C levels particularly in overweight patients suggesting poorer glucose regulation. In contrast patients who have had type 2 diabetes for a long period of time appear to benefit from Qigong practice.

 

These are complex results that do not fit with prior findings by other researchers that Tai Chi and Qigong practices improve type 2 diabetes. It may be due to relatively small sample sizes. One possibility is the comparison condition employed, active stretching. Many prior research studies compared Tai Chi and Qigong practice to treatment as usual groups that do not control for participant expectancy, experimenter bias, and attentional effects. It is possible that in comparison to a stronger active control condition these practices do not show benefit. This would suggest that any active practice might produce benefits for sedentary patients with type 2 diabetes.

 

“Tai Chi can prompt a declination in blood glucose levels, perhaps by improving blood glucose metabolism, prompting a decrease in the inflammatory response. . . the exercise may boost levels of fitness along with a feeling of well being — this in turn may boost the health of the immune system.” – Anna Sophia McKenney

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Li, X., Si, H., Chen, Y., Li, S., Yin, N., & Wang, Z. (2020). Effects of fitness qigong and tai chi on middle-aged and elderly patients with type 2 diabetes mellitus. PloS one, 15(12), e0243989. https://doi.org/10.1371/journal.pone.0243989

 

Abstract

Currently, qigong and tai chi exercises are the two most common preventive as well as therapeutic interventions for chronic metabolic diseases such as type 2 diabetes mellitus (T2DM). However, the quantitative evaluation of these interventions is limited. This study aimed to evaluate the therapeutic efficacy of qigong and tai chi intervention in middle-aged and older adults with T2DM. The study included 103 eligible participants, who were randomized to participate for 12 weeks, in one of the following intervention groups for the treatment of T2DM: fitness qigong, tai chi, and control group. Three biochemical measures, including fasting plasma glucose (FPG), glycated hemoglobin (HbA1C), and C-peptide (C-P) levels, assessed at baseline and 12 weeks, served as the primary outcome measures. During the training process, 16 of the 103 participants dropped out. After the 12-week intervention, there were significant influences on HbA1C (F2,83 = 4.88, p = 0.010) and C-P levels (F2,83 = 3.64, p = 0.031). Moreover, significant reduction in C-P levels was observed after 12-week tai chi practice (p = 0.004). Furthermore, there was a significant negative correlation between the duration of T2DM and the relative changes in FPG levels after qigong intervention, and the relative changes in HbA1C levels were positively correlated with waist-to-height ratio after tai chi practice. Our study suggests that targeted qigong exercise might have a better interventional effect on patients with a longer duration of T2DM, while tai chi might be risky for people with central obesity.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746158/

 

Spirituality is Associated with Reduced Emotional Distress in Lung Cancer Survivors

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Spirituality is Associated with Reduced Emotional Distress in Lung Cancer Survivors

 

By John M. de Castro, Ph.D.

 

“However you define spirituality, studies show that it can play an important role in coping with the recovery and healing process from cancer treatment and its after effects.” – LungCancer.org

 

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. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotional distress and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis.

 

Religion and spirituality become much more important to people when they’re diagnosed with cancer or when living with cancer. It is thought that people take comfort in the spiritual when facing mortality. Hence, spirituality may be a useful tool for the survivors of cancer to cope with their illness and the consequent emotional distress. Thus, it makes sense to study the relationships of spirituality with the mental health of cancer survivors.

 

In today’s Research News article “Spirituality and Emotional Distress Among Lung Cancer Survivors.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6859202/ ) Gudenkauf and colleagues recruited adult patients with lung cancer and had them complete questionnaires measuring spirituality, emotional distress, and quality of life. within 1 year of their diagnosis and 1 year later.

 

They found that the lung cancer survivors, not surprisingly, were generally high in emotional distress. But those survivors who were high in spirituality, including the meaning, peace, and faith dimensions, were high in quality of life and low in emotional distress. In addition, those survivors who were high in distress at the first measurement, if they were also high in spirituality meaning, were more likely to have low emotional distress 1 year later.

 

It should be kept in mind that the present study was observational and as a result causation cannot be determined. But it appears that in these lung cancer survivors, spirituality is associated with better quality of life and lower emotional distress and that spirituality tends to predict lower emotional distress a year later. Hence, spirituality appears to help survivors cope with their emotional reactions to their diagnosis. Future studies should investigate whether promoting spirituality in these survivors may improve their emotions and quality of life.

 

So, spirituality is associated with reduced emotional distress in lung cancer survivors.

 

“While having a spiritual or religious foundation can’t change your diagnosis or the effectiveness of treatment, some patients find their beliefs help them find meaning and cope. “It may not impact your prognosis, but it can help improve your overall outlook during treatment,” – Tiffany Meyer

 

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

 

Gudenkauf, L. M., Clark, M. M., Novotny, P. J., Piderman, K. M., Ehlers, S. L., Patten, C. A., Nes, L. S., Ruddy, K. J., Sloan, J. A., & Yang, P. (2019). Spirituality and Emotional Distress Among Lung Cancer Survivors. Clinical lung cancer, 20(6), e661–e666. https://doi.org/10.1016/j.cllc.2019.06.015

 

Abstract

Background:

Emerging research is highlighting the importance of spirituality in cancer survivorship as well as the importance of early distress screening. The purpose of this study was to prospectively examine the relationships among spirituality, emotional distress, and sociodemographic variables during the early period of lung cancer survivorship.

Patients and Methods:

864 lung cancer survivors completed the Functional Assessment of Chronic Illness Therapy – Spiritual Well-Being (FACIT-Sp), and the Short-Form-8 (SF-8) for emotional distress within the first year following lung cancer diagnosis, and 474 of these survivors completed the survey again one year later.

Results:

At baseline, spirituality was associated with lower prevalence of emotional distress, being married, fewer years of cigarette smoking, and better ECOG performance status. Additionally, high baseline spirituality was associated with lower rates of high emotional distress at one-year follow-up.

Conclusion:

These findings suggest that spirituality may serve as a protective factor for emotional distress among lung cancer survivors. Further research is warranted to explore the role of spirituality in promoting distress management among lung cancer survivors.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6859202/

 

Control Chronic Pain with Mindfulness

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Control Chronic Pain with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is not like traditional painkillers, which are intended to dull or eliminate pain. While many experts recommend mindfulness-based practices to manage pain, the goal of those practices is typically not to remove pain entirely, but to change your relationship with it so that you are able to experience relief and healing in the middle of uncomfortable physical sensations.” – Andrea Uptmor

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain.

 

There is an accumulating volume of research findings that demonstrate that mindfulness practices, in general, are effective in treating pain. Mindfulness appears to work by changing how the patient relates to pain rather than actually reducing or eliminating the pain. Cognitive Behavioral Therapy (CBT) is directed to change thought patterns and has also been shown to be an effective therapy for chronic pain. What is not known is the most effective treatment for chronic pain. The evidence has been accumulating. So, it makes sense to step back and summarize what has been learned.

 

In today’s Research News article “Differential efficacy between cognitive-behavioral therapy and mindfulness-based therapies for chronic pain: Systematic review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7753033/ ) Pardos-Gascón and colleagues review and summarize the published randomized clinical trials of the effectiveness of mindfulness-based and cognitive-behavioral treatments for chronic pain. They identified 18 published randomized clinical trials.

 

They report that the published studies found that mindfulness-based treatments produced significant reductions in symptoms and impact of the pain on the patients’ lives for patients with fibromyalgia, low back pain, and headache. There were few studies that compared mindfulness-based treatment to Cognitive Behavioral Therapy (CBT) but the few that did, did not find significant differences in effectiveness. It is clear that more direct comparisons are needed. Regardless, mindfulness-based treatments are effective for chronic pain.

 

So, control chronic pain with mindfulness.

 

“Daily mindfulness practice can be helpful for people living with chronic pain because sometimes there are negative or worrisome thoughts about the pain. These thoughts are normal, and can affect mood and increase pain. Being able to focus on relaxing the body, noticing the breath and body sensations as being there just as they are, can help manage pain, as well as reduce depression and anxiety symptoms.” – Andrea Neckar

 

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

 

Pardos-Gascón, E. M., Narambuena, L., Leal-Costa, C., & van-der Hofstadt-Román, C. J. (2021). Differential efficacy between cognitive-behavioral therapy and mindfulness-based therapies for chronic pain: Systematic review. International journal of clinical and health psychology : IJCHP, 21(1), 100197. https://doi.org/10.1016/j.ijchp.2020.08.001

 

Abstract

Background/Objective: To assess the differential efficacy between mindfulness-based interventions and cognitive-behavioral Therapy (CBT) on chronic pain across medical conditions involving pain. Method: ProQuest, Science Direct, Google Scholar, Pubmed, and Embase databases were searched to identify randomized clinical trials. Measurements of mindfulness, pain, mood, and further miscellaneous measurements were included. Results: 18 studies met the inclusion criteria (fibromyalgia, n = 5; low back pain, n = 5; headache/migraine, n = 4; non-specific chronic pain, n = 4). In fibromyalgia, mindfulness based stress reduction (MBSR) was superior to the usual care and Fibroqol, in impact and symptoms. In low back pain, MBSR was superior to the usual care, but not to CBT, in physical functionality and pain intensity. There were no studies on differential efficacy between mindfulness and CBT for headache and non-specific chronic pain, but Mindfulness interventions were superior to the usual care in these syndromes. Conclusions: Mindfulness interventions are superior to usual cares in all diagnoses, but it is not possible to conclude their superiority over CBT. Comparisons between mindfulness interventions are scarce, with MBSR being the most studied. In central sensitization syndromes, variables associated with pain tend to improve with treatment. More research is needed to differentiate diagnosis and intervention.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7753033/

 

Change the Brain to Improve Emotion Regulation in Bereaved Individuals with Mindfulness

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Change the Brain to Improve Emotion Regulation in Bereaved Individuals with Mindfulness

 

By John M. de Castro, Ph.D.

 

“It takes a boat load of self-compassion to allow oneself to feel whatever it is you are feeling at any given time, without judgment, without comparison relative to another’s explicit portrayal of their own process. In this way, to grieve is to be mindful of our thoughts and feelings.” – Jennifer Wolkin

 

Grief is a normal, albeit complex, process that follows a loss of a significant person or situation in one’s life. This can involve the death of a loved one, a traumatic experience, termination of a relationship, relationship to a long-missing person, etc. Exactly what transpires depends upon the individual and the nature of the loss. It involves physical, emotional, psychological and cognitive processes. In about 15% of people grief can be overly intense or long and therapeutic intervention may become necessary.

 

Mindfulness practices have been found to help with coping with loss and its consequent grief.  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 is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. Mindfulness training has been shown to change the size, activity and connectivity of brain structures. Hence, MBCT may reduce grief by altering the brain.

 

In today’s Research News article “Mindfulness-based cognitive therapy on bereavement grief: Alterations of resting-state network connectivity associate with changes of anxiety and mindfulness.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7775995/ ) Huang and colleagues recruited adults who had lost a first degree relative within the last 4 years and had unresolved grief. The patients received an 8-week program of Mindfulness-Based Cognitive Therapy (MBCT). They met weekly for 2.5 hours and were encouraged to practice for 45 minutes daily at home. They were measured before and after the training for grief, generalized anxiety, depression, emotion regulation, and mindfulness. After training they underwent brain functional Magnetic Resonance Imaging (fMRI) at rest and while viewing pictures of faces with either neutral or negative emotional expressions.

 

They found that in comparison to baseline, after Mindfulness-Based Cognitive Therapy (MBCT) the participants had significant increases in mindfulness, particularly the describing and non-reacting mindfulness facets, and emotion regulation and significant decreases in grief, anxiety, and depression. The brain connectivity as revealed in the fMRI scans changed after MBCT training with decreased connectivity within the Default Mode Network of the brain and connectivity between the Auditory, Visual, Salience, and frontal-parietal networks during rest but not emotion arousal. In addition, the connectivity between the subcortical caudate with the cortex correlated positively with mindfulness and emotion regulation and negatively with anxiety.

 

The Default Mode Network is thought to underly mind wandering and self-referential thinking. So, the decreases in connectivity may signal heightened present moment awareness. In addition, the changes in the connectivity between cortical areas were negatively related to emotion regulation while the connectivity between cortical and subcortical areas were positively related to emotion regulation. This suggests that MBCT training decreased effects of external perception on emotion regulation while increasing the effects of internal sensations.

 

It should be noted that there wasn’t a comparison, control, condition. So, the passage of time, participant expectancy effects, attentional effects, or experimenter bias may have been responsible for the observed changes. Nevertheless, the results suggest that MBCT training for bereaved patients improves their mental health and reduces grief. The brain scans suggest that the training altered the brain to increase present moment awareness and dependence of the person’s internal state in regulating emotions.

 

So, change the brain to improve emotion regulation in bereaved individuals with mindfulness.

 

“Mindfulness practice is not meant to minimize that pain or to convince people that everything is OK, but rather to help you recognize the reality of your circumstances, and to do so in a nonjudgmental and self-compassionate way.” – Stephanie Pritchard

 

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

 

Huang, F. Y., Hsu, A. L., Chao, Y. P., Shang, C. M., Tsai, J. S., & Wu, C. W. (2020). Mindfulness-based cognitive therapy on bereavement grief: Alterations of resting-state network connectivity associate with changes of anxiety and mindfulness. Human brain mapping, 42(2), 510–520. Advance online publication. https://doi.org/10.1002/hbm.25240

 

Abstract

Bereavement, the experience of losing a loved one, is one of the most catastrophic but inevitable events in life. It causes grief and intense depression‐like sadness. Recent studies have revealed the effectiveness and proficiency of mindfulness‐based cognitive therapy (MBCT) in emotional regulation among bereavement populations. MBCT improves the well‐being of the bereaved by enhancing cognitive performances. Regarding the neural correlates of bereavement grief, previous studies focused on the alleviation of emotion–cognition interferences at specific brain regions. Here, we hypothesized that the bereavement grief fundamentally triggers global alterations in the resting‐state brain networks and part of the internetwork connectivity could be reformed after MBCT intervention. We recruited 19 bereaved individuals who participated the 8‐week MBCT program. We evaluated (a) the large‐scale changes in brain connectivity affected by the MBCT program; as well as (b) the association between connectivity changes and self‐rated questionnaire. First, after MBCT, the bereaved individuals showed the reduction of the internetwork connectivity in the salience, default‐mode and fronto‐parietal networks in the resting state but not under emotional arousal, implying the alleviated attention to spontaneous mind wandering after MBCT. Second, the alterations of functional connectivity between subcortical (e.g., caudate) and cortical networks (e.g., cingulo‐opercular/sensorimotor) were associated with the changes of the mindfulness scale, the anxiety and the emotion regulation ability. In summary, MBCT could enhance spontaneous emotion regulation among the bereaved individuals through the internetwork reorganizations in the resting state.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7775995/

 

Improve Major Depression in the Real World with Mindfulness

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Improve Major Depression in the Real World with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Depression is not only the most common mental illness, it’s also one of the most tenacious. Up to 80 percent of people who experience a major depressive episode may relapse. Drugs may lose their effectiveness over time, if they work at all. But 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. Even after remission some symptoms of depression may still be present (residual symptoms).

 

Being depressed and not responding to treatment 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. MBCT has been found to be effective in treating depression.

 

Most of the research studies that have examined the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for depression were conducted in controlled laboratory settings. But the real world of therapeutic interventions are less consistent and much more complex and messy. This raises the question as to how effective MBCT may be for the treatment of major depression in real world.

 

In today’s Research News article “The effectiveness of mindfulness-based cognitive therapy for major depressive disorder: evidence from routine outcome monitoring data.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7745235/ ) Geurts and colleagues recruited patients with major depressive disorder who had received treatment with Mindfulness-Based Cognitive Therapy (MBCT). Their psychiatric diagnosis was recorded and before and after treatment they completed measures of mindfulness, depression, worry, and self-compassion.

 

They found that after treatment the patients had significant increases in mindfulness and self-compassion and significant decreases in depression and worry. The also found that the greater the increases in mindfulness and self-compassion and decreases in worry, the greater the decreases in depression. They found that having a job mattered as those patients who had employment had significantly greater reductions in depression than the unemployed.

 

These findings are in line with those in more controlled lab studies of significant improvements in major depressive disorder produced by Mindfulness-Based Cognitive Therapy (MBCT). The importance of the present studies is that they demonstrate that similar improvement occur in real world clinical settings. Finally, they suggest that MBCT may increase mindfulness and self-compassion and decrease worry and these improvements are associated with greater relief of depression.

 

So, improve major depression in the real world with mindfulness.

 

“Still, there are a handful of key areas — including depression, chronic pain, and anxiety — in which well-designed, well-run studies have shown benefits for patients engaging in a mindfulness meditation program, with effects similar to other existing treatments.” – Alvin Powell

 

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

 

Geurts, D., Compen, F. R., Van Beek, M., & Speckens, A. (2020). The effectiveness of mindfulness-based cognitive therapy for major depressive disorder: evidence from routine outcome monitoring data. BJPsych open, 6(6), e144. https://doi.org/10.1192/bjo.2020.118

 

Abstract

Background

Meta-analyses show efficacy of mindfulness-based cognitive therapy (MBCT) in terms of relapse prevention and depressive symptom reduction in patients with major depressive disorder (MDD). However, most studies have been conducted in controlled research settings.

Aims

We aimed to investigate the effectiveness of MBCT in patients with MDD presenting in real-world clinical practice. Moreover, we assessed whether guideline recommendations for MBCT allocation in regard to recurrence and remission status of MDD hold in clinical practice.

Method

This study assessed a naturalistic cohort of patients with (recurrent) MDD, either current or in remission (n = 765), who received MBCT in a university hospital out-patient clinic in The Netherlands. Outcome measures were self-reported depressive symptoms, worry, mindfulness skills and self-compassion. Predictors were MDD recurrence and remission status, and clinical and sociodemographic variables. Outcome and predictor analyses were conducted with linear regression.

Results

MBCT adherence was high (94%). Patients with a lower level of education had a higher chance of non-adherence. Attending more sessions positively influenced improvement in depressive symptoms. Depressive symptoms significantly reduced from pre- to post-MBCT (Δ mean = 7.7, 95%CI = 7.0–8.5, Cohen’s d = 0.75). Improvement of depressive symptoms was independent from MDD recurrence and remission status. Unemployed patients showed less favourable outcomes. Worry, mindfulness skills and self-compassion all significantly improved. These improvements were related to changes in depressive symptoms.

Conclusions

Previous efficacy results in controlled research settings are maintained in clinical practice. Results illustrate that MBCT is effective in routine clinical practice for patients suffering from MDD, irrespective of MDD recurrence and remission status.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7745235/

 

Improve Autonomic Nervous System Function with Yoga

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Improve Autonomic Nervous System Function with Yoga

 

By John M. de Castro, Ph.D.

 

“Among its many beneficial effects, yoga has been shown to increase strength, flexibility, and balance; enhance immune function; lower blood sugar and cholesterol levels; and improve psychological well-being.” – Timothy McCall

 

There is an accumulating volume of research findings to demonstrate that Mind-body practices have highly beneficial effects on the health and well-being of humans. These include yoga, tai chi, and qigong, among many others. Because of their proven benefits the application of these practices to relieving human suffering has skyrocketed. Yoga practice has been shown to have a large number of beneficial effects on the psychological, emotional, and physical health of the individual and is helpful in the treatment of mental and physical illness.

 

One way that these Yoga may have their beneficial effects is by providing balance in the autonomic nervous system. The sympathetic division underlies activation while the parasympathetic division underlies relaxation. When these divisions are out of balance the individual may be overly stressed or overly sedentary. Appropriate balance is important for health and well-being. A measure of balance is provided by the parasympathetic produced baroreflex. It regulates blood pressure fluctuations.

 

In today’s Research News article “Autonomic Tone and Baroreflex Sensitivity during 70° Head-up Tilt in Yoga Practitioners.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7735502/ ) Anasuya and colleagues recruited adults aged 20-50 who were aged matched and either yoga-naïve or trained experienced yoga practitioners. The participants underwent a 70 degree head up tilt. “Participants lay on the table and the table is tilted from a supine position to an angle of 70° at a speed of ~2.3°/s. Each subject was held at 70° HUT position for 5 min.” They were measured before during and after the tilt for blood pressure, respiration, respiratory carbon dioxide, and electrocardiogram (ECG).

 

They found that at rest the yoga group had significantly lower respiration rate at rest and significantly higher respiratory carbon dioxide at rest and also during the tilt. They also found that during the tilt the yoga practitioners had a significantly larger baroreceptor response, that is decrease in blood pressure, and a significantly larger increase in heart rate variability.

 

Both increases in the baroreceptor sensitivity and heart rate variability are indicative of increased activity on the Vagus nerve producing increased parasympathetic (relaxation) activity and decreased sympathetic (activation) activity in the autonomic nervous system. Hence, yoga practice produces a greater relaxation response in the practitioners at rest and when challenged with a tilt. This suggests that yoga practice alter the autonomic nervous system to produce a larger parasympathetic dominance and thereby greater ability to physiologically relax. In essence this reduces stress responses. Such improvements in the practitioner’s ability to deal with stress may underlie, at least in part, many of the health benefits of yoga practice.

 

So, Improve Autonomic Nervous System Function with Yoga.

 

“Yoga is a practice which helps regulate the nervous system. Yoga trains our mind and body to find a healthy balance within our nervous system, or in other words to help our bodies find homeostasis.’ – Anne Spear

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Anasuya, B., Deepak, K. K., & Jaryal, A. K. (2020). Autonomic Tone and Baroreflex Sensitivity during 70° Head-up Tilt in Yoga Practitioners. International journal of yoga, 13(3), 200–206. https://doi.org/10.4103/ijoy.IJOY_29_20

 

Abstract

Introduction:

The intervention of yoga was shown to improve the autonomic conditioning in humans evident from the enhancement of parasympathetic activity and baroreflex sensitivity (BRS). From the documented health benefits of yoga, we hypothesized that the experience of yoga may result in adaptation to the orthostatic stress due to enhanced BRS.

Aim:

To decipher the effects of yoga in the modulation of autonomic function during orthostatic challenge.

Materials and Methods:

This was a comparative study design conducted in autonomic function test lab, of the Department of Physiology, All India Institute of Medical Sciences, New Delhi, India. Heart rate variability (HRV), blood pressure variability, and BRS were analyzed on forty naïve to yoga (NY) subjects and forty yoga practitioners with an average age of 31.08 ± 7.31 years and 29.93 ± 7.57 years, respectively. All participants were healthy. Seventy degrees head up tilt (HUT) was used as an intervention to evaluate the cardiovascular variability during orthostatic challenge.

Results:

During HUT, the R-R interval (P = 0.042), root mean square of succesive R-R interval differences (RMSSD) (P = 0.039), standard deviation of instantaneous beat-to-beat R-R interval variability (SD1) (P = 0.039) of HRV, and sequence BRS (P = 0.017) and α low frequency of spectral BRS (P = 0.002) were higher in the yoga group. The delta decrease in RRI (P = 0.033) and BRS (P < 0.01) was higher in the yoga group than the NY group.

Conclusion:

The efferent vagal activity and BRS were higher in yoga practitioners. The delta change (decrease) in parasympathetic activity and BRS was higher, with relatively stable systolic blood pressure indicating an adaptive response to orthostatic challenge by the yoga practitioners compared to the NY group.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7735502/

 

Ethnicity Modulates Improvements in Sleep in Prehypertensive Patients with a Smartphone Meditation App

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Ethnicity Modulates Improvements in Sleep in Prehypertensive Patients with a Smartphone Meditation App

 

“Several practices that help calm the mind can also lower blood pressure. All are types of meditation.” – Harvard Health

 

By John M. de Castro, Ph.D.

 

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. The vast majority of the mindfulness training techniques, however, require a trained teacher. This results in costs that many patients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. As an alternative, Apps for smartphones have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations.

 

In today’s Research News article “Ethnicity Differences in Sleep Changes Among Prehypertensive Adults Using a Smartphone Meditation App: Dose-Response Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576537/ ) Sieverdes and colleagues recruited patients diagnosed with prehypertension. They had the participants use a smartphone app, “Tension Tamer” for 6 months. The app provided focused breath following meditation practice and also measured heart rate and blood pressure. The participants were randomized into 3 dosage groups, 5, 10, or 15 minutes of daily practice. They were measured before and after training and at 1 and 3-months during training for sleep with a self-reports and 7-days of wrist actigraphy which also measured activity levels.

 

They found that the 47% of the participants who were African American had significantly shorter sleep durations, poorer sleep quality, and greater sleep disturbance at baseline both in the self-report and actigraphy measures than non-Hispanic white participants. They also found that the effects of the meditation app on sleep varied according to ethnic group. For the Non-Hispanic White participants, the 5-minute per day dose of “Tension timer” use produced significantly greater improvements in sleep efficiency and quality, lower fragmentation, and longer sleep duration than the 10 or 15-minute doses. For the African American participants, the 5-minute dose produced significantly less sleep fragmentation and duration than the 10 or 15-minute doses. In comparing the ethnic groups, they found that the Non-Hispanic White participants had significantly greater improvements in sleep efficiency, reduced fragmentation, and longer sleep duration than the African American participants.

 

These results are interesting and suggest that smartphone app guided meditation practice improves sleep in patients diagnosed as prehypertensive. But the effects are less positive for African American participants than Non-Hispanic White participants. This is a bit surprising as African American participants appear to have more problematic sleep to start with and hence had greater room for improvement. It is also surprising that the lower amount of meditation practice, 5-minutes per day, was more beneficial that the longer daily meditations. It appears that the 5-minute practice participants tended to use the app more often and to use it more often just prior to going to bed than the other dose participants and this may have led to the differences.

 

Improving sleep is important in promoting relaxation and reducing the likelihood that prehypertension will progress to patent hypertension. So, the use of the app may be helpful in maintaining the health of prehypertensive patients. The ethnic differences, however, suggest that app usage may be more beneficial for white as opposed to black participant. The results also suggest that brief daily practice, 5-minutes, may promote more frequent use that improves effectiveness.

 

So, ethnicity modulates improvements in sleep in prehypertensive patients with a smartphone meditation app.

 

“If you struggle with “turning your brain off”, you may find yourself feeling restless and unable to sleep. Fortunately, meditation is one way to quiet your thoughts and fight insomnia. Meditation has been shown to help people who struggle with insomnia and other sleep disturbances.“ – Florida Medical Clinic

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Sieverdes, J. C., Treiber, F. A., Kline, C. E., Mueller, M., Brunner-Jackson, B., Sox, L., Cain, M., Swem, M., Diaz, V., & Chandler, J. (2020). Ethnicity Differences in Sleep Changes Among Prehypertensive Adults Using a Smartphone Meditation App: Dose-Response Trial. JMIR formative research, 4(10), e20501. https://doi.org/10.2196/20501

 

Abstract

Background

African Americans (AAs) experience greater sleep quality problems than non-Hispanic Whites (NHWs). Meditation may aid in addressing this disparity, although the dosage levels needed to achieve such benefits have not been adequately studied. Smartphone apps present a novel modality for delivering, monitoring, and measuring adherence to meditation protocols.

Objective

This 6-month dose-response feasibility trial investigated the effects of a breathing awareness meditation (BAM) app, Tension Tamer, on the secondary outcomes of self-reported and actigraphy measures of sleep quality and the modulating effects of ethnicity of AAs and NHWs.

Methods

A total of 64 prehypertensive adults (systolic blood pressure <139 mm Hg; 31 AAs and 33 NHWs) were randomized into 3 different Tension Tamer dosage conditions (5,10, or 15 min twice daily). Sleep quality was assessed at baseline and at 1, 3, and 6 months using the Pittsburgh Sleep Quality Index (PSQI) and 1-week bouts of continuous wrist actigraphy monitoring. The study was conducted between August 2014 and October 2016 (IRB #Pro00020894).

Results

At baseline, PSQI and actigraphy data indicated that AAs had shorter sleep duration, greater sleep disturbance, poorer efficiency, and worse quality of sleep (range P=.03 to P<.001). Longitudinal generalized linear mixed modeling revealed a dose effect modulated by ethnicity (P=.01). Multimethod assessment showed a consistent pattern of NHWs exhibiting the most favorable responses to the 5-min dose; they reported greater improvements in sleep efficiency and quality as well as the PSQI global value than with the 10-min and 15-min doses (range P=.04 to P<.001). Actigraphy findings revealed a consistent, but not statistically significant, pattern in the 5-min group, showing lower fragmentation, longer sleep duration, and higher efficiency than the other 2 dosage conditions. Among AAs, actigraphy indicated lower sleep fragmentation with the 5-min dose compared with the 10-min and 15-min doses (P=.03 and P<.001, respectively). The 10-min dose showed longer sleep duration than the 5-min and 15-min doses (P=.02 and P<.001, respectively). The 5-min dose also exhibited significantly longer average sleep than the 15-min dose (P=.03).

Conclusions

These findings indicate the need for further study of the potential modulating influence of ethnicity on the impact of BAM on sleep indices and user-centered exploration to ascertain the potential merits of refining the Tension Tamer app with attention to cultural tailoring among AAs and NHWs with pre-existing sleep complaints.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576537/

 

Improve Psychological Health with a Self-Guided, Smartphone-Based Mindfulness App

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Improve Psychological Health with a Self-Guided, Smartphone-Based Mindfulness App

 

By John M. de Castro, Ph.D.

 

“Another part of the appeal of smartphone-based apps is their anonymity. “The apps also allow for privacy and confidentiality and can be a safe space for individuals who may be too ashamed to admit their mental health issues in person or who may feel that they will be negatively labeled or stigmatized by others,” – Sal Raichback

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health. But the vast majority of the mindfulness training techniques, however, require a trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. As an alternative, mindfulness training with smartphone apps has been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. In addition, research has indicated that mindfulness training via smartphone apps can be effective for improving the health and well-being of the participants.

 

In today’s Research News article “Testing the Efficacy of a Multicomponent, Self-Guided, Smartphone-Based Meditation App: Three-Armed Randomized Controlled Trial. JMIR mental health.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732708/ ) Goldberg and colleagues recruited adults who did not have extensive meditation experience and randomly assigned them to a wait-list control condition or to receive either of 2 8-week smartphone app mindfulness training with the Healthy Minds Program. They received 4 weeks of awareness training including awareness of breathing and awareness of sounds. They were then again randomly assigned to receive 4 weeks of either Connection training consisting or gratitude and kindness practices or Insight Training consisting of “the changing nature of the phenomenon (ie, impermanence) and examining how thoughts and emotions influence perception” practices. They were measured before after the first 4-week module and after the second 4-week module for mindfulness, psychological distress, perceived stress, interpersonal connections, interpersonal reactivity, compassion, self-reflection, rumination, and defusion.

 

They found that compared to baseline and the wait-list control group both intervention conditions produced significant increases in mindfulness, social connection, self-reflection and defusion and significant decreases in psychological distress, and rumination with no significant differences between the smartphone interventions. There were no differences between the wait-list controls and the intervention in compassion and empathy.

 

These are interesting findings that correspond to the finding in prior research that training the increases mindfulness produces significant increases in social connection, self-reflection and defusion and significant decreases in psychological distress, and rumination. They demonstrate that smartphone trainings that improve mindfulness produce improvement in the psychological health of the participants.

 

It was a bit surprising that the benefits of the awareness plus connection training did not significantly differ from the benefits of awareness plus insight training. But since both trainings equivalently higher mindfulness and increased mindfulness has been shown to produce these benefits, it is reasonable to conclude that any training the improves mindfulness will improve psychological health..

 

So, improve psychological health with a self-guided, smartphone-based mindfulness App.

 

“Using a smartphone app, may provide immediate effects on mood and stress while also providing long-term benefits for attentional control. . . there is evidence that with continued usage, [mindfulness training] via a smartphone app may provide long-term benefits in changing how one relates to their inner and outer experiences.” – Kathleen Marie Walsh

 

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

 

Goldberg, S. B., Imhoff-Smith, T., Bolt, D. M., Wilson-Mendenhall, C. D., Dahl, C. J., Davidson, R. J., & Rosenkranz, M. A. (2020). Testing the Efficacy of a Multicomponent, Self-Guided, Smartphone-Based Meditation App: Three-Armed Randomized Controlled Trial. JMIR mental health, 7(11), e23825. https://doi.org/10.2196/23825

 

Abstract

Background

A growing number of randomized controlled trials (RCTs) suggest psychological benefits associated with meditation training delivered via mobile health. However, research in this area has primarily focused on mindfulness, only one of many meditative techniques.

Objective

This study aims to evaluate the efficacy of 2 versions of a self-guided, smartphone-based meditation app—the Healthy Minds Program (HMP)—which includes training in mindfulness (Awareness), along with practices designed to cultivate positive relationships (Connection) or insight into the nature of the self (Insight).

Methods

A three-arm, fully remote RCT compared 8 weeks of one of 2 HMP conditions (Awareness+Connection and Awareness+Insight) with a waitlist control. Adults (≥18 years) without extensive previous meditation experience were eligible. The primary outcome was psychological distress (depression, anxiety, and stress). Secondary outcomes were social connection, empathy, compassion, self-reflection, insight, rumination, defusion, and mindfulness. Measures were completed at pretest, midtreatment, and posttest between October 2019 and April 2020. Longitudinal data were analyzed using intention-to-treat principles with maximum likelihood.

Results

A total of 343 participants were randomized and 186 (54.2%) completed at least one posttest assessment. The majority (166/228, 72.8%) of those assigned to HMP conditions downloaded the app. The 2 HMP conditions did not differ from one another in terms of changes in any outcome. Relative to the waitlist control, the HMP conditions showed larger improvements in distress, social connectedness, mindfulness, and measures theoretically linked to insight training (d=–0.28 to 0.41; Ps≤.02), despite modest exposure to connection- and insight-related practice. The results were robust to some assumptions about nonrandom patterns of missing data. Improvements in distress were associated with days of use. Candidate mediators (social connection, insight, rumination, defusion, and mindfulness) and moderators (baseline rumination, defusion, and empathy) of changes in distress were identified.

Conclusions

This study provides initial evidence of efficacy for the HMP app in reducing distress and improving outcomes related to well-being, including social connectedness. Future studies should attempt to increase study retention and user engagement.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732708/