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Online Mindfulness Training Improves Clinical Anxiety and Depression

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Online Mindfulness Training Improves Clinical Anxiety and Depression

 

By John M. de Castro, Ph.D.

 

“adding MMB [mindfulness training] to depression care led to greater reductions in depressive and anxious symptoms, higher rates of remission and higher levels of quality of life compared to patients receiving conventional depression care alone.” – Traci Pederson

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress. They have been shown to be very helpful in treating anxiety and depression. The vast majority of the mindfulness training techniques, however, require a certified 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 programs have been developed to be implemented over the internet. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. But, the question arises as to which forms of online mindfulness trainings are most effective for inducing mindfulness and improving the treatment of anxiety and depression.

 

In today’s Research News article “Transdiagnostic internet-delivered CBT and mindfulness-based treatment for depression and anxiety: A randomised controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044661/), Kladnitski and colleagues recruited online adults with a variety of either depression or anxiety disorders and randomly assigned them to receive either a 17-week internet-based cognitive behavioral therapy, mindfulness enhanced internet-based cognitive behavioral therapy, internet-based mindfulness training, or treatment-as-usual. “The programs consisted of six comic-style, story-based lessons, downloadable lesson summaries, reflective worksheets, and extra support materials including frequently asked questions and troubleshooting of common difficulties.” They were measured before, during, and after treatment and 3 months later for psychological illnesses, anxiety, depression, psychological distress, and functional impairment.

 

They found compared to baseline and the treatment-as-usual control group, there were large and highly significant decreases in anxiety, depression, functional impairment and psychological distress. These improvements were present both at the end of treatment and at the 3-month follow-up. There were no significant differences between the effectiveness of the 3 interventions. There were no adverse events reported. At the 3-month follow-up 60% to 73% of the treated participants improved to the point that they no longer met the criteria for a clinical diagnosis of an anxiety or depressive disorder.

 

It is interesting that the 3 different treatments did not differ in effectiveness. Each has been previously been demonstrated to be effective in treating anxiety and depressive disorders and it appears that their efficacy is almost equivalent. This suggests that patients can self-select the treatment that most appeals to them, improving completion rates, compliance, and perhaps effectiveness.

 

These are exciting and important findings. It has been previously demonstrated that mindfulness training can alleviate the symptoms of anxiety and depression. The advance here is in demonstrating that therapy delivered over the internet is safe, effective, and lasting in treating anxiety or depressive disorders. Internet delivery of treatment can be implemented conveniently, at low cost. and over wide areas making the therapy available to large numbers of patients who previously could not access treatment.

 

So, online mindfulness training improves clinical anxiety and depression.

 

“Mindfulness and other meditations, particularly combined with cognitive therapy, work just as well for anxiety or depression as the medications do, but they don’t have those side effects,” – Daniel Goleman

 

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

 

Kladnitski, N., Smith, J., Uppal, S., James, M. A., Allen, A. R., Andrews, G., & Newby, J. M. (2020). Transdiagnostic internet-delivered CBT and mindfulness-based treatment for depression and anxiety: A randomised controlled trial. Internet Interventions, 20, 100310. https://doi.org/10.1016/j.invent.2020.100310

 

Abstract

Aim

To examine the efficacy of transdiagnostic internet-delivered cognitive behavioural therapy (iCBT), mindfulness-enhanced iCBT, and stand-alone online mindfulness training compared with a usual care control group (TAU) for clinical anxiety and depression.

Method

Individuals (N = 158) with a DSM-5 diagnosis of a depressive and/or anxiety disorder were randomised to one of the three clinician-guided online interventions, or TAU over a 14-week intervention period. The primary outcomes were self-reported depression (PHQ-9) and anxiety (GAD-7) severity at post-treatment. Secondary outcomes included adherence rates, functional impairment (WHODAS-II), general distress (K−10), and diagnostic status at the 3-month follow-up (intervention groups).

Results

All three programs achieved significant and large reductions in symptoms of depression (g = 0.89–1.53), anxiety (g = 1.04–1.40), and distress (g = 1.25–1.76); and medium to large reductions in functional impairment (g = 0.53–0.98) from baseline to post-treatment and 3-month follow-up. Intention-to-treat linear mixed models showed that all three online programs were superior to usual care at reducing symptoms of depression (g = 0.89–1.18) and anxiety (g = 1.00–1.23).

Conclusion

Transdiagnostic iCBT, mindfulness-enhanced iCBT and online mindfulness training are more efficacious for treating depression and anxiety disorders than usual care, and represent an accessible treatment option for these disorders.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044661/

 

Improve Well-Being and Workplace Performance with Online Mindfulness Training

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Improve Well-Being and Workplace Performance with Online Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“online mindfulness intervention seems to be both practical and effective in decreasing employee stress, while improving resiliency, vigor, and work engagement, thereby enhancing overall employee well-being.” – Kimberly Aikens

 

Work is very important for our health and well-being. We spend approximately 25% of our adult lives at work. How we spend that time is immensely important for our psychological, social, and physical health. But, nearly 2/3 of employees worldwide are unhappy at work. This is partially due to work-related stress which is epidemic in the western workplace. Almost two thirds of workers reporting high levels of stress at work. This stress can result in impaired health and can result in burnout; producing fatigue, cynicism, and professional inefficacy.

 

To help overcome unhappiness, stress, and burnout, mindfulness practices have been implemented in the workplace. Indeed, mindfulness practices have been shown to markedly reduce the physiological and psychological responses to stress. As a result, it has become very trendy for business to incorporate meditation into the workday to help improve employee well-being, health, and productivity. These programs attempt to increase the employees’ mindfulness at work and thereby reduce stress and burnout. Online mindfulness training has the advantage of being convenient and easily integrated into a busy schedule. It is important, though, to verify its effectiveness for improving psychological health and workplace performance.

 

In today’s Research News article “Online Mindfulness Training Increases Well-Being, Trait Emotional Intelligence, and Workplace Competency Ratings: A Randomized Waitlist-Controlled Trial.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2020.00255/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1254058_69_Psycho_20200225_arts_A), Nadler and colleagues recruited healthy adults in their workplace and randomly assigned them to either a wait-list control condition or to receive an 8-week online workplace-based mindfulness training. The training was based upon the Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) programs. Mindfulness training was practiced 6 or 7 days per week. The workers were measured before and after training for mindfulness, perceived stress, resilience, positive and negative emotions, emotional intelligence, and workplace competence.

 

They found that in comparison to baseline and the wait-list control condition, mindfulness training produced significant increases in mindfulness, resilience, and positive emotions and significant decreases in perceived stress and negative emotions. Also, there were significant increase in emotional intelligence, including recognition of emotion in self and recognition of emotion in others, regulation of emotion in self, and regulation of emotion in others. In addition, they found that the greater the change in mindfulness, particularly in the acting with awareness and non-reactivity to inner experience facets of mindfulness, in the intervention group, the greater the increases in resilience, positive emotions, and emotional intelligence and the greater the decreases in negative emotions and perceived stress.  Finally, mindfulness training produced an increase in job performance, including decisiveness, making tough calls, assuming responsibility, interpersonal relationships, and creativity.

 

The present study results suggest the online mindfulness training is effective in improving psychological health, emotional intelligence, and job performance. Mindfulness training has been previously shown to improve resilience, emotions and emotional intelligence, perceived stress, and job performance. It appears that mindfulness training improves the employees ability to act mindfully with awareness and not react to their inner feelings. This means that they pay better attention to their jobs and are less reactive to their emotions during work. This make them better employees and improves their well-being.

 

The contribution of the present work is to demonstrate that these benefits can be produce by online training. This improves the usefulness of mindfulness training for workers as it can be accomplished inexpensively and conveniently with minimal disruption of work. This can make them better at their jobs and mentally and emotionally healthier. It was not studied here but this would predice not only better performance but also less burnout and better employee retention.

 

So, improve well-being and workplace performance with online mindfulness training.

 

“Mindfulness can encourage divergent thinking, enabling you to generate more innovative solutions to business problems.” – Mind Tools

 

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

 

Nadler R, Carswell JJ and Minda JP (2020) Online Mindfulness Training Increases Well-Being, Trait Emotional Intelligence, and Workplace Competency Ratings: A Randomized Waitlist-Controlled Trial. Front. Psychol. 11:255. doi: 10.3389/fpsyg.2020.00255

 

A randomized waitlist-controlled trial was conducted to assess the effectiveness of an online 8-week mindfulness-based training program in a sample of adults employed fulltime at a Fortune 100 company in the United States. Baseline measures were collected in both intervention and control groups. Following training, the intervention group (N = 37) showed statistically significant increases in resilience and positive mood, and significant decreases in stress and negative mood. There were no reported improvements in the wait-list control group (N = 65). Trait mindfulness and emotional intelligence (EI) were also assessed. Following the intervention mindfulness intervention participants reported increases in trait mindfulness and increases on all trait EI facets with the exception of empathy. The control group did not report any positive changes in these variables, and reported reductions in resilience and increases in negative mood. Finally, both self and colleague ratings of workplace competencies were collected in the intervention group only and provided preliminary evidence that mindfulness training enhanced performance on key leadership competencies including competencies related to decisiveness and creativity. The present study demonstrates the effectiveness of an online-based mindfulness training program for enhancing well-being, self-perceptions of emotional intelligence, and workplace performance.

https://www.frontiersin.org/articles/10.3389/fpsyg.2020.00255/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1254058_69_Psycho_20200225_arts_A

 

Improve Smartphone Addiction with Mindfulness

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Improve Smartphone Addiction with Mindfulness

 

By John M. de Castro, Ph.D.

 

“As we get more connected to our wireless technology, we appear to run the risk of damaging our brains’ wiring, and disconnecting from the face-to-face interaction that our social and psychological systems need. With its emphasis on harnessing attention with intention (i.e. redirecting it on purpose), mindfulness—with all its scientifically-established health and well-being benefits—has the potential to keep us from drifting hopelessly away from one another.” – Mitch Abblett

 

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. As useful as the internet may be, it can also produce negative consequences. “Problematic Internet Use” is now considered a behavioral addiction, with almost half of participants in one study considered “Internet addicts”, developing greater levels of “tolerance” and experiencing “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. The dominant mode of accessing the internet is through smartphones creating smartphone addictions.

 

Future time perspective is the ability to anticipate and plan to bring about desired outcomes in the future. Most addictions involve being completely driven by present needs. So, future time perspective is contrary to addiction and may help to overcome addiction. Mindfulness training has been shown to be helpful with each of the components of addictions, decreasing cravings, impulsiveness, and psychological and physiological responses to stress, and increasing emotion regulation.  Mindfulness has also been shown to be associated with a balanced time perspective. It is no wonder then that mindfulness training has been found to be effective for the treatment of a variety of addictions. Hence, there is a need to further explore the relationships of smartphone addiction with future time perspective and mindfulness.

 

In today’s Research News article “Smartphone use disorder and future time perspective of college students: the mediating role of depression and moderating role of mindfulness.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6969420/), Zhang and colleagues recruited freshman and sophomore college students aged 18-22 years. The completed measures of future time perspective, smartphone use disorder, depression, and mindfulness.

 

They found that the higher the levels of mindfulness the higher the levels of future time perspective and the lower the levels of depression and smartphone use disorder. They also found that the higher the levels of future time perspective the higher the levels of mindfulness and the lower the levels of depression and smartphone use disorder. They then performed a mediation analysis and found that future time perspective had not only a direct and relationship with smartphone use disorder but also was indirectly related via depression such that future time perspective was negatively related to depression which, in turn, was positively related to. smartphone use disorder. Finally, they found that mindfulness moderated the indirect path with high mindfulness decreasing the relationship of future time perspective on depression and decreasing the relationship of depression with smartphone use disorder.

 

This study is correlational and as such causation cannot be determined. Nevertheless, the results suggest that the ability of college students to focus on the future is associated with lower depression and smartphone addictions. Also, college students’ addictions to smartphones are lower when mindfulness is present. This relationship occurs directly and as a result of moderating the relationships between thinking and planning for the future, depression, and smartphone use disorder. It remains for future research to train students in mindfulness to determine if mindfulness can be used to treat addictions to smartphones.

 

So, improve smartphone addiction with mindfulness.

 

“just as technology is increasingly being developed to attract and hold our attention, with mindfulness we can develop the capability to be much more aware of where the spotlight of our attention is being drawn to, and consciously choose to direct and place our attention and energy on an activity of our choosing.” – Neil Tranter

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Zhang, Y., Lv, S., Li, C., Xiong, Y., Zhou, C., Li, X., & Ye, M. (2020). Smartphone use disorder and future time perspective of college students: the mediating role of depression and moderating role of mindfulness. Child and adolescent psychiatry and mental health, 14, 3. doi:10.1186/s13034-020-0309-9

 

Abstract

Background

Smartphone use disorder (SUD) of college students has drawn increasing attention. Although future time perspective (FTP) may be an important protective factor for individual SUD, the moderating and mediating mechanisms underlying this relationship remain unknown. We tested the individual roles of depression and mindfulness as moderators of this relationship.

Methods

A cross-sectional study was conducted in two colleges in Shandong and Chongqing in China using a sample of 1304 college students recruited by stratified cluster sampling. Data were collected through a validated self-report instrument. A moderation–mediation model was constructed, and an SPSS PROCESS macro was used to analyse the data.

Results

The correlation analyses showed that FTP was negatively associated with SUD of college students. The mediation model revealed that depression partially mediated the link between FTP and SUD of college students. The moderation–mediation model suggested that mindfulness moderates two direct paths: FTP to depression and depression to SUD. In the first path (FTP to depression), a high level of mindfulness among college students had weakened the relationship between FTP and depression. Here, the relationship is strengthened by a low level of mindfulness. In the second path (depression to SUD), low levels of mindfulness strengthen the link between depression and FTP. In contrast, significant association was not found with high levels of mindfulness.

Conclusions

Results suggest that interventions, such as improving the individual level of FTP and mindfulness, should be conducted. These interventions, in turn, help control the level of depression in college students and ultimately decrease their level of SUD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6969420/

 

Effective Online Mindfulness Training Characteristics

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Effective Online Mindfulness Training Characteristics

 

By John M. de Castro, Ph.D.

 

“Practicing mindfulness can help all sorts of people no matter what is going on in their lives. Learning mindfulness is very accessible, whether you have a center in your hometown or just an internet connection, whether you have enough money for a retreat or do not have any money at all, or if you want to learn how to teach mindfulness to others. No matter what your situation is, there is a mindfulness training option tailored to your needs.” – Joaquín Selva

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with reducing the physical and psychological reactions to stress and increasing resilience in the face of stress. 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 over the internet 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.

 

The research has indicated that mindfulness training online can be effective for improving the health and well-being of the participants. But the question arises as to what is the best way to train mindfulness online for improving psychological health. In today’s Research News article “Relating Instructional Design Components to the Effectiveness of Internet-Based Mindfulness Interventions: A Critical Interpretive Synthesis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6906627/?report=classic), Lippmann and colleagues review the research studies employing online mindfulness training.

 

They focused on the instructional designs used in the online trainings. In particular they focused on formal learning tasks, supportive educational materials, timely support and reminders, and informal practices of targeted skills. There were 18 published research studies of online mindfulness training that fulfilled the criteria. There were a variety of outcome measures that varied with different studies but primarily they measured anxiety, depression, stress, distress, pain, physical fitness, and quality of life.

 

They classified 11 studies as having highly effective outcomes, 6 as less effective, and 1 as ineffective. They found that the studies that produced more and less effective outcomes all implemented formal practice at least twice a week. But the studies with more effective outcomes also had good supportive educational materials, timely support and reminders, and informal practices of targeted skills, while the studies with less effective outcomes had much less robust implementations of supportive educational materials, timely support and reminders, and informal practices of targeted skills. The study that had ineffective outcomes had formal practice only once a week and none of the other instructional design components were present.

 

The results suggest that online mindfulness trainings can be very effective in improving the physical and psychological health of the participants. But there needs to be several instructional components present and well implemented to maximize effectiveness. These components include clear formal mindfulness training occurring at least twice a week, instruction in the ideas underlying the practices, frequent reminders to practice, and an emphasis on practice outside of the formal online instruction. The better these components are implemented in the online instruction the better the improvements in the well-being of the participants.

 

So, online mindfulness training programs are very effective if they are well designed to implement four important instructional components.

 

“participants who completed the online mindfulness course reported significantly lower levels of perceived stress, depression and anxiety. The large effect sizes associated with completing the intervention were maintained for all of the outcome variables at 3- and 6-month follow-up.” – Dawn Querstret

 

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

 

Lippmann, M., Laudel, H., Heinzle, M., & Narciss, S. (2019). Relating Instructional Design Components to the Effectiveness of Internet-Based Mindfulness Interventions: A Critical Interpretive Synthesis. Journal of medical Internet research, 21(11), e12497. doi:10.2196/12497

 

Abstract

Background

Internet-based mindfulness interventions are a promising approach to address challenges in the dissemination and implementation of mindfulness interventions, but it is unclear how the instructional design components of such interventions are associated with intervention effectiveness.

Objective

The objective of this study was to identify the instructional design components of the internet-based mindfulness interventions and provide a framework for the classification of those components relative to the intervention effectiveness.

Methods

The critical interpretive synthesis method was applied. In phase 1, a strategic literature review was conducted to generate hypotheses for the relationship between the effectiveness of internet-based mindfulness interventions and the instructional design components of those interventions. In phase 2, the literature review was extended to systematically explore and revise the hypotheses from phase 1.

Results

A total of 18 studies were identified in phase 1; 14 additional studies were identified in phase 2. Of the 32 internet-based mindfulness interventions, 18 were classified as more effective, 11 as less effective, and only 3 as ineffective. The effectiveness of the interventions increased with the level of support provided by the instructional design components. The main difference between effective and ineffective interventions was the presence of just-in-time information in the form of reminders. More effective interventions included more supportive information (scores: 1.91 in phases 1 and 2) than less effective interventions (scores: 1.00 in phase 1 and 1.80 in phase 2), more part-task practice (scores: 1.18 in phase 1 and 1.60 in phase 2) than less effective interventions (scores: 0.33 in phase 1 and 1.40 in phase 2), and provided more just-in-time information (scores: 1.35 in phase 1 and 1.67 in phase 2) than less effective interventions (scores: 0.83 in phase 1 and 1.60 in phase 2). The average duration of more effective, less effective, and ineffective interventions differed for the studies of phase 1, with more effective interventions taking up more time (7.45 weeks) than less effective (4.58 weeks) or ineffective interventions (3 weeks). However, this difference did not extend to the studies of phase 2, with comparable average durations of effective (5.86 weeks), less effective (5.6 weeks), and ineffective (7 weeks) interventions.

Conclusions

Our results suggest that to be effective, internet-based mindfulness interventions must contain 4 instructional design components: formal learning tasks, supportive information, part-task practice, and just-in-time information. The effectiveness of the interventions increases with the level of support provided by each of these instructional design components.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6906627/?report=classic

 

Improve Well-Being with a Smartphone Mindfulness App

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Improve Well-Being with a Smartphone Mindfulness App

 

By John M. de Castro, Ph.D.

 

“What do you do when you can’t afford therapy but are struggling to handle your mental illness alone? You could download an app. In recent years, there’s been a proliferation of mental health apps available to smartphone users. These reasonably-priced, or most often free, mental health apps offer a wealth of resources that make therapeutic techniques more accessible, portable, and cost-effective.” – Jessica Truchel

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health. The vast majority of the mindfulness training techniques, however, require a trained teacher. This results in costs that many college students 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 college 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. But the question arises as to the effectiveness of these Apps in inducing mindfulness and improving psychological health in college students.

 

In today’s Research News article “Intermittent mindfulness practice can be beneficial, and daily practice can be harmful. An in depth, mixed methods study of the “Calm” app’s (mostly positive) effects.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6928287/?report=classic), Clarke and Draper recruited healthy college students and had them complete a 7-day mindfulness training with the “Calm” smartphone app. The program consists of once a day 10-minute trainings. The students completed measures before and after training of mindfulness, well-being, and self-efficacy.

 

They found that after the 7-day training there were significant increases in mindfulness, well-being, and self-efficacy. They report that students who only completed 1 or 2 of the 7 “Calm” modules did not obtain the benefits. It appears that completing 3 or more of the modules is necessary to improve the students’ psychological health.

 

This is a brief study without a comparison condition and so the results must be interpreted cautiously. But, a number of prior studies have demonstrated that mindfulness trainings with smartphone apps are effective in improving well-being. In addition, the students who did not complete a significant number of the 7 training modules did not show improvements in psychological health. So, it would appear that the use of smartphone apps are a convenient method to teach mindfulness and this can have a significant impact on the psychological health of the users.

 

So, improve well-being with a smartphone mindfulness app.

 

“Mental health apps can be effective in making therapy more accessible, efficient, and portable.” – Mary Let

 

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

 

Clarke, J., & Draper, S. (2019). Intermittent mindfulness practice can be beneficial, and daily practice can be harmful. An in depth, mixed methods study of the “Calm” app’s (mostly positive) effects. Internet interventions, 19, 100293. doi:10.1016/j.invent.2019.100293

 

Abstract

Objectives

Despite a weak evidence base, daily use of mindfulness-based self-help smartphone applications (apps) is said to promote wellbeing. However, many do not use these apps in the way that app developers and mindfulness proponents recommend. We sought to determine whether the “Calm” app works, and whether it does so even when it is used intermittently.

Methods

Employing a mixed-methods design, we recruited a self-selected sample of 269 students from a Scottish university (81% female, 84% white, mean age 23.89) to engage with a seven-day introductory mindfulness course, delivered using Calm, currently one of the most popular, yet under-researched, apps.

Results

Daily course engagement was associated with significant gains in wellbeing (p ≤.001, d = 0.42), trait mindfulness (p ≤.001, d = 0.50) and self-efficacy (p ≤.014, d = 0.21). Intermittent course engagement was also associated with significant gains in wellbeing (p ≤.028, d = 0.34), trait mindfulness (p ≤.010, d = 0.47) and self-efficacy (p ≤.028, d = 0.32). This study is therefore the first to demonstrate that the Calm app is associated with positive mental health outcomes. It also shows that regular use is not essential. A thematic analysis of qualitative data supported these quantitative findings. However it also revealed that some participants had negative experiences with the app.

Conclusions for practice

Mindfulness-based self-help apps such as Calm have the potential to both enhance and diminish users’ wellbeing. Intermittent mindfulness practice can lead to tangible benefits. Therefore, mindfulness proponents should not recommend daily practice, should increase awareness of the potential for negative outcomes, and resist the idea that mindfulness practice works for everyone. Developers of mindfulness apps ought to make specific features customisable in order to enhance their effectiveness.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6928287/?report=classic

 

Be Better Parents with Online Mindful Parenting

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Be Better Parents with Online Mindful Parenting

 

By John M. de Castro, Ph.D.

 

“Managing our own emotions and behaviors is the key to teaching kids how to manage theirs. . . Unfortunately, when you’re stressed out, exhausted, and overwhelmed, you can’t be available for your child.” – Jill Cedar

 

Raising children, parenting, is very rewarding. But it can also be challenging. Children test parents frequently. They test the boundaries of their freedom and the depth of parental love. They demand attention and seem to especially when parental attention is needed elsewhere. They don’t always conform to parental dictates or aspirations for their behavior. The challenges of parenting require that the parents be able to deal with stress, to regulate their own emotions, and to be sensitive and attentive their child. These skills are exactly those that are developed in mindfulness training. It improves the psychological and physiological responses to stress. It improves emotion regulation. It improves the ability to maintain attention and focus in the face of high levels of distraction.

 

Mindful parenting involves the parents having emotional awareness of themselves and compassion for the child and having the skills to pay full attention to the child in the present moment, to accept parenting non-judgmentally and be emotionally non-reactive to the child. Mindful parenting has been shown to have positive benefits for both the parents and the children.

 

The vast majority of the mindfulness training techniques, however, require a trained therapist. This results in costs that many parents 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 parents’ busy schedules and at locations that may not be convenient. As an alternative, mindfulness trainings over the internet 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. But the question arises as to the effectiveness of these online trainings in reducing parental stress and improving parenting.

 

In today’s Research News article “A Randomized Control Trial Evaluating an Online Mindful Parenting Training for Mothers With Elevated Parental Stress.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6650592/), Potharst and colleagues recruited mothers who were high in perceived stress and reported parenting problems. The mothers were randomly assigned to either receive an online mindful parenting program or to a wait list control condition. The online mindful parenting program consisted of 8 weekly session with instructions and exercises on meditation, mindful parenting, and self-compassion. They were measured before and after the training and 10 weeks later after the wait list group had received the intervention for parental stress, overreactive parenting discipline, mindful parenting, self-compassion, anxiety, and depression. In addition, both parents rated the child for child aggressive behavior and emotional reactivity.

 

They found that the online mindful parenting program in comparison to baseline and the wait-list control group produced significant reductions in anxiety, depression, overreactive parenting discipline, parental role restriction and child emotional reactivity and significant increases in self-compassion.

 

These results suggest that an online mindful parenting program can be successfully implemented and that it significantly improves the psychological health of the mothers, their parenting, and the child’s behavior. Mindful parenting has been previously shown to have positive benefits for both the parents and the children. The contribution of the present study is in demonstrating that mindful parenting can be successfully conducted online with stressed mothers. This greatly increases the ability to roll out this effective program to a much wider audience at low cost.

 

Parenting is difficult and stressful enough under the best of conditions. It is encouraging to find a relatively simple, convenient and inexpensive program that can help the parents to become better parents and to ease their psychological burden.

 

So, be better parents with online mindful parenting.

 

“It seems there’s no one right way to parent mindfully. Happily, there are many right ways. Sometimes “It’s as simple as practicing paying full attention to our kids, with openness and compassion, and maybe that’s enough at any moment.” – Juliann Garey

 

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

 

Potharst, E. S., Boekhorst, M., Cuijlits, I., van Broekhoven, K., Jacobs, A., Spek, V., … Pop, V. (2019). A Randomized Control Trial Evaluating an Online Mindful Parenting Training for Mothers With Elevated Parental Stress. Frontiers in psychology, 10, 1550. doi:10.3389/fpsyg.2019.01550

 

Abstract

Objectives

The prevalence of maternal stress in early years of parenting can negatively impact child development. Therefore, there is a need for an early intervention that is easily accessible and low in costs. The current study examined the effectiveness of an 8-session online mindful parenting training for mothers with elevated levels of parental stress.

Methods

A total of 76 mothers were randomized into an intervention (n = 43) or a waitlist control group (n = 33). The intervention group completed pretest assessment prior to the online intervention. Participants completed a post intervention assessment after the 10 weeks intervention and a follow-up assessment 10 weeks later. The waitlist group completed waitlist assessment, followed by a 10-week waitlist period. After these 10 weeks, a pretest assessment took place, after which the waitlist group participants also started the intervention, followed by the posttest assessment. Participating mothers completed questionnaires on parental stress (parent-child interaction problems, parenting problems, parental role restriction) and other maternal (over-reactive parenting discipline, self-compassion, symptoms of depression and anxiety) and child outcomes (aggressive behavior and emotional reactivity) while the non-participating parents (father or another mother) were asked to also report on child outcomes.

Results

The online mindful parenting intervention was shown to be significantly more effective at a 95% level than a waitlist period with regard to over-reactive parenting discipline and symptoms of depression and anxiety (small and medium effect sizes), and significantly more effective at a 90% level with regard to self-compassion, and mother-rated child aggressive behavior and child emotional reactivity (small effect sizes). The primary outcome, parental stress, was found to have a 95% significant within-group effect only for the subscale parental role restriction (delayed small effect size improvement at follow-up). No significant improvements on child outcomes were found for the non-participating parent.

Conclusion

To conclude, the results provide first evidence that an online mindful parenting training may be an easily accessible and valuable intervention for mothers with elevated levels of parental stress.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6650592/

 

Reduce Depression Produced by Internet Addiction with Mindfulness

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Reduce Depression Produced by Internet Addiction with Mindfulness

 

By John M. de Castro, Ph.D.

 

“As we get more connected to our wireless technology, we appear to run the risk of damaging our brains’ wiring, and disconnecting from the face-to-face interaction that our social and psychological systems need. With its emphasis on harnessing attention with intention (i.e. redirecting it on purpose), mindfulness—with all its scientifically-established health and well-being benefits—has the potential to keep us from drifting hopelessly away from one another.” – Mitch Abblett

 

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. As useful as the internet may be, it can also produce negative consequences. “Problematic Internet Use” is now considered a behavioral addiction, with almost half of participants in one study considered “Internet addicts”, developing greater levels of “tolerance” and experiencing “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.

 

Mindfulness training has been shown to be helpful with each of the components of addictions, decreasing cravings, impulsiveness, and psychological and physiological responses to stress, and increasing emotion regulation.  It is no wonder then that mindfulness training has been found to be effective for the treatment of a variety of addictions. Hence, there is a need to further explore the consequences of internet addiction and the relationship of mindfulness with internet addiction and its consequences.

 

In today’s Research News article “Internet Addiction and Depression in Chinese Adolescents: A Moderated Mediation Model.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6865207/), Chi and colleagues recruited middle school students (aged 11 to 15 years) and had them complete a questionnaire measuring internet addiction, depression, positive youth development (measuring positive psychological qualities), and mindfulness.

 

They found that 20% of the youths showed symptoms of internet addiction and 24% showed symptoms of depression. They also observed that the higher the levels of mindfulness, the lower the levels of depression and internet addiction and the higher the levels of positive youth development. On the other hand, the higher the levels of internet addiction the lower the levels of mindfulness and positive youth development and the higher the levels of depression. They also found mediation. The positive relationship between internet addiction and depression was present when mindfulness was low but not when it was high. Similarly, the negative relationship between depression and positive youth development was present when mindfulness was low but not when it was high.

 

These results are correlative and caution must be exercised in concluding causation. Nevertheless, the results replicate previous findings of mindfulness being negatively related to depression and internet addiction and positively related to positive psychological qualities. But the present findings add to these understandings by demonstrating that being addicted to the internet is related to higher depression and lower positive psychological qualities. Importantly, they found that mindfulness moderates the relationships between depression and both internet addiction and positive psychological qualities. High levels of mindfulness appear to prevent internet addiction from producing depression and from depression reducing positive psychological qualities.

 

Internet addiction is a growing problem especially in youths. These results are encouraging though that mindfulness not only is related to less internet addiction but also appears to blunt the relationships of internet addiction with depression and positive psychological qualities. This suggests that training in mindfulness with youths may help prevent addiction to the internet and its consequent effects on depression and youth development. Testing this remains for future research.

 

So, reduce depression produced by internet addiction with mindfulness.

 

“when correctly practised and administered, mindfulness meditation is a safe, non-invasive, and cost-effective tool for treating behavioural addictions and for improving psychological health more generally.” – Mark Griffiths

 

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

 

Chi, X., Liu, X., Guo, T., Wu, M., & Chen, X. (2019). Internet Addiction and Depression in Chinese Adolescents: A Moderated Mediation Model. Frontiers in Psychiatry, 10, 816. doi:10.3389/fpsyt.2019.00816

 

Abstract

Research has revealed that Internet addiction is a risk factor for adolescents’ development of depressive symptoms, although the underlying mechanisms are largely unknown. The present study examines the mediating role of positive youth development and the moderating role of mindfulness to determine the association between Internet addiction and depression. A sample of 522 Chinese adolescents completed measures related to Internet addiction, positive youth development, mindfulness, depression, and their background information, for which the results reveal that positive youth development mediates the relation between Internet addiction and depression. Moreover, the associations between both Internet addiction and depression as well as positive youth development and depression are moderated by mindfulness. These two effects were stronger for adolescents with low mindfulness than for those with high mindfulness. The present study contributes to a more thorough understanding of how and when Internet addiction increases the risk of depression in adolescents, suggesting that Internet addiction may affect adolescent depression through positive youth development and that mindfulness can alleviate the negative effect of Internet addiction or a low level of psychological resources on depression. The implications for research and practice are finally discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6865207/

 

Improve the Symptoms of Myeloproliferative Neoplasm Patients with Online Yoga

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Improve the Symptoms of Myeloproliferative Neoplasm Patients with Online Yoga

 

By John M. de Castro, Ph.D.

 

“Yoga classes specifically created for cancer patients offer more than a traditional support group. Yoga creates a sense of belonging, reduces feelings of stress and improves quality of life.” – Sara Szeglowski

 

“Myeloproliferative Neoplasms (MPNs) are blood cancers that occur when the body makes too many white or red blood cells, or platelets” (Cancer Support Community). It typically occurs in older adults and is fairly rare (1-2 cases/100,000 per year) and has a very high survival rate. It produces a variety of psychological and physical symptoms including fatigue, anxiety, pain, depression, and sleep disturbance, reduced physical, social, and cognitive functioning resulting. This produces a marked reduced in the patient’s quality of life.

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health including fatigue, anxiety, depression, pain, and sleep disturbance, and improves physical, social, and cognitive functioning as well as quality of life in cancer patients. Yoga practice also improves the physical and mental health of cancer patients. The vast majority of the yoga practice, however, requires a trained instructor. It also requires that the participants be available to attend multiple sessions at particular scheduled times that may be difficult for myeloproliferative neoplasm patients to attend and may or may not be compatible with their schedules and at locations that may not be convenient.

 

As an alternative, online yoga trainings 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. But the question arises as to the effectiveness of these online programs in relieving the psychological and physical symptoms of myeloproliferative neoplasm patients and improving their quality of life.

 

In today’s Research News article “Online yoga in myeloproliferative neoplasm patients: results of a randomized pilot trial to inform future research.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6556039/), Huberty and colleagues recruited adult myeloproliferative neoplasm patients and randomly assigned them to either receive online yoga training or to a wait-list control condition. Yoga training occurred via streamed videos for a total of 60 minutes training per week for 12 weeks. The individual training videos increased in duration from 5 minutes to 30 minutes over the 12 weeks. The participants were measured for adverse events and yoga participation by self-report and by clicking on the video links and over the training period. Before and after training they were measured for total symptoms, fatigue, pain intensity, anxiety, depression, sleep disturbance, sexual function, and quality of life. In, addition, blood was drawn and assayed for inflammatory cytokines.

 

They found that 79% of the patients in the yoga group completed participation averaging 42 minutes per week and there were no adverse events reported. Self-reports of yoga participation were over-reported by on average 10 minutes as assessed by actual clicks on the yoga video links. They found that in comparison to baseline and the wait-list group, the yoga group reported a moderate decrease in depression and small decreases in anxiety, pain intensity, sleep disturbance, and in TNF-α blood levels.

 

This was a pilot feasibility study and did not have a sufficient number of participants to detect small effects. It also lacked an active control, such as aerobic exercise. Nevertheless, the trial suggests that teaching yoga online is feasible and can successfully improve the psychological health of myeloproliferative neoplasm patients and reduce inflammation. This is potentially important as yoga treatment can be successfully employed remotely, inexpensively, and conveniently and can reduce the suffering of myeloproliferative neoplasm patients. A large randomized clinical trial with an active control condition is justified by these encouraging results.

 

So, improve the symptoms of myeloproliferative neoplasm patients with online yoga.

 

“Some people with cancer say it helps calm their mind so that they can cope better with their cancer and its treatment. Others say it helps to reduce symptoms and side effects such as pain, tiredness, sleep problems and depression.” – Cancer Research UK

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Huberty, J., Eckert, R., Dueck, A., Kosiorek, H., Larkey, L., Gowin, K., & Mesa, R. (2019). Online yoga in myeloproliferative neoplasm patients: results of a randomized pilot trial to inform future research. BMC complementary and alternative medicine, 19(1), 121. doi:10.1186/s12906-019-2530-8

 

Abstract

Background

Myeloproliferative neoplasm (MPN) patients suffer from significant symptoms, inflammation and reduced quality of life. Yoga improves these outcomes in other cancers, but this hasn’t been demonstrated in MPNs. The purpose of this study was to: (1) explore the limited efficacy (does the program show promise of success) of a 12-week online yoga intervention among MPN patients on symptom burden and quality of life and (2) determine feasibility (practicality: to what extent a measure can be carried out) of remotely collecting inflammatory biomarkers.

Methods

Patients were recruited nationally and randomized to online yoga (60 min/week of yoga) or wait-list control (asked to maintain normal activity). Weekly yoga minutes were collected with Clicky (online web analytics tool) and self-report. Those in online yoga completed a blood draw at baseline and week 12 to assess inflammation (interleukin-6, tumor necrosis factor-alpha [TNF-α]). All participants completed questionnaires assessing depression, anxiety, fatigue, pain, sleep disturbance, sexual function, total symptom burden, global health, and quality of life at baseline, week seven, 12, and 16. Change from baseline at each time point was computed by group and effect sizes were calculated. Pre-post intervention change in inflammation for the yoga group was compared by t-test.

Results

Sixty-two MPN patients enrolled and 48 completed the intervention (online yoga = 27; control group = 21). Yoga participation averaged 40.8 min/week via Clicky and 56.1 min/week via self-report. Small/moderate effect sizes were generated from the yoga intervention for sleep disturbance (d = − 0.26 to − 0.61), pain intensity (d = − 0.34 to − 0.51), anxiety (d = − 0.27 to − 0.37), and depression (d = − 0.53 to − 0.78). A total of 92.6 and 70.4% of online yoga participants completed the blood draw at baseline and week 12, respectively, and there was a decrease in TNF-α from baseline to week 12 (− 1.3 ± 1.5 pg/ml).

Conclusions

Online yoga demonstrated small effects on sleep, pain, and anxiety as well as a moderate effect on depression. Remote blood draw procedures are feasible and the effect size of the intervention on TNF-α was large. Future fully powered randomized controlled trials are needed to test for efficacy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6556039/

 

Increase Social Contact and Reduce Loneliness with A Mindfulness Smartphone App

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Increase Social Contact and Reduce Loneliness with A Mindfulness Smartphone App

 

By John M. de Castro, Ph.D.

 

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

 

Humans are social animals. We are generally happiest when we’re with family and friends. Conversely, being without close social contact makes us miserable. It’s the close relationship that is so important as we can be around people all day at work and still feel deep loneliness. These contacts are frequently superficial and do not satisfy our deepest need. It is sometimes said that we live in “the age of loneliness.” It is estimated that 20% of Americans suffer from persistent loneliness. This even when we are more connected than ever with the internet, text messaging, social media, etc. But these create the kinds of superficial contacts that we think should be satisfying, but are generally not. This has led to the counterintuitive findings that young adults, 18-34, have greater concerns with loneliness than the elderly.

 

The consequences of loneliness are dire. It has been estimated that being socially isolated increases mortality by 14%. This is twice the elevation produced by obesity. Even worse, for people over 60, loneliness increases their risk of death by 45%. When a spouse loses a marital partner there’s a 30% increase in mortality in the 6-months following the death. Hence, loneliness is not only an uncomfortable and unhappy state, but it is also a threat to health and longevity. It is clear that this epidemic of loneliness needs to be addressed.

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

SIGNIFICANCE

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

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

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

ABSTRACT

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

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

 

Improve the Psychological and Physical Health of Myeloproliferative Neoplasm Patients with a Smartphone Mindfulness App

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Improve the Psychological and Physical Health of Myeloproliferative Neoplasm Patients with a Smartphone Mindfulness App

 

By John M. de Castro, Ph.D.

 

“Even with an app, mindfulness takes practice. Like playing an instrument or a sport, the more you practice, the better you get and the more you get out of it. . . Whatever you try, mindfulness training is considered very safe, and has a good chance of increasing your happiness and peacefulness, and reducing your depression, anxiety, and stress.” – James Cartreine

 

“Myeloproliferative Neoplasms (MPNs) are blood cancers that occur when the body makes too many white or red blood cells, or platelets” (Cancer Support Community). It typically occurs in older adults and is fairly rare (1-2 cases/100,000 per year) and has a very high survival rate. It produces a variety of psychological and physical symptoms including fatigue, anxiety, depression, pain, and sleep disturbance, reduced physical, social, and cognitive functioning resulting in a reduced quality of life.

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health including fatigue, anxiety, depression, pain, and sleep disturbance, and improves physical, social, and cognitive functioning as well as quality of life in cancer patients. The vast majority of the mindfulness training techniques, however, require a trained therapist. 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. But the question arises as to the effectiveness of these Apps in relieving the psychological and physical symptoms of cancer and improving their quality of life.

 

In today’s Research News article “Smartphone-Based Meditation for c: Feasibility Study to Inform Future Trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6658299/), Huberty and colleagues recruited Myeloproliferative Neoplasm Patients and randomly assigned them to either to receive 4 weeks of mindfulness training including 10 minutes of meditation per day via a smartphone app (“Calm”) followed by mindfulness training via another smartphone app (“10% Happier App”), the 2 apps in reverse order, education about Myeloproliferative Neoplasm followed by “10% Happier App”, or education followed by “Calm” app. They were measured before and after training and for Myeloproliferative Neoplasm symptoms, fatigue, anxiety, depression, pain, sleep disturbance, sexual function, health, and quality of life.

 

They found that the participants used the “Calm” App to a significantly greater extent and enjoyed it more than the “10% Happier” App. But following mindfulness training with both apps there were significant improvements. For the “10% Happier” App after training there were significant increases in health, and mental health and decreases in fatigue, anxiety, depression, and sleep disturbance. For the “Calm” App after training there were significant increases in health, and decreases in Myeloproliferative Neoplasm symptoms, fatigue, depression, vaginal discomfort, and sleep disturbance.

 

This was a relatively small pilot study that demonstrated the feasibility and efficacy of mindfulness training smartphone apps for the treatment of Myeloproliferative Neoplasm patients. It would appear that the “Calm” App is the preferred app. But both were effective in producing benefits. The improvements were significant and helpful in relieving the suffering of the patients. This is important as the use of smartphone apps makes it easier, more convenient, and more cost effective to provide mindfulness training to a wide swath of Myeloproliferative Neoplasm patients thus maximizing the utilization of mindfulness training for the improvement of the symptoms of patients with Myeloproliferative Neoplasm.

 

So, improve the psychological and physical health of myeloproliferative neoplasm patients with a smartphone mindfulness app.

 

“So how can this practice of mindfulness help people with cancer? . . . Routinely, we see large and meaningful improvements in mood, stress levels, depression, anger, worry, and rumination. We also see people having an increased sense of meaning and purpose in life, better sleep, and more energy, as well as displaying biological changes like a healthier pattern of stress hormones and less inflammation in the immune system.” – Linda Carlson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Jennifer Huberty, Ryan Eckert, Linda Larkey, Jonathan Kurka, Sue A Rodríguez De Jesús, Wonsuk Yoo, Ruben Mesa. Smartphone-Based Meditation for Myeloproliferative Neoplasm Patients: Feasibility Study to Inform Future Trials. JMIR Form Res. 2019 Apr-Jun; 3(2): e12662. Published online 2019 Apr 29. doi: 10.2196/12662

 

 

Abstract

Background

Myeloproliferative neoplasm (MPN) patients often report high symptom burden that persists despite the best available pharmacologic therapy. Meditation has gained popularity in recent decades as a way to manage cancer patient symptoms.

Objective

The aim of this study was to examine the feasibility of 2 different consumer-based meditation smartphone apps in MPN patients and to examine the limited efficacy of smartphone-based meditation on symptoms compared with an educational control group.

Methods

Patients (n=128) were recruited nationally through organizational partners and social media. Eligible and consented patients were enrolled into 1 of 4 groups, 2 of which received varying orders of 2 consumer-based apps (10% Happier and Calm) and 2 that received one of the apps alone for the second 4 weeks of the 8-week intervention after an educational control condition. Participants were asked to perform 10 min of meditation per day irrespective of the app and the order in which they received the apps. Feasibility outcomes were measured at weeks 5 and 9 with a Web-based survey. Feasibility outcomes were acceptability, demand, and limited efficacy for depression, anxiety, pain intensity, sleep disturbance, sexual function, quality of life, global health, and total symptom burden.

Results

A total of 128 patients were enrolled across all 4 groups, with 73.4% (94/128) patients completing the intervention. Of the participants who completed the 10% Happier app, 61% (46/76) enjoyed it, 66% (50/76) were satisfied with the content, and 77% (59/76) would recommend to others. Of those who completed the Calm app, 83% (56/68) enjoyed it, 84% (57/68) were satisfied with the content, and 97% (66/68) would recommend to others. Of those who completed the educational control, 91% (56/61) read it, 87% (53/61) enjoyed it, and 71% (43/61) learned something. Participants who completed the 10% Happierapp averaged 31 (SD 33) min/week; patients completing the Calm app averaged 71 (SD 74) min/week. 10% Happier app participants saw small effects on anxiety (P<.001 d=−0.43), depression (P=.02; d=−0.38), sleep disturbance (P=.01; d=−0.40), total symptom burden (P=.13; d=−0.27), and fatigue (P=.06; d=−0.30), and moderate effects on physical health (P<.001; d=0.52). Calm app participants saw small effects on anxiety (P=.29; d=−0.22), depression (P=.09; d=−0.29), sleep disturbance (P=.002; d=−0.47), physical health (P=.005; d=0.44), total symptom burden (P=.13; d=−0.27), and fatigue (P=.13; d=−0.27). Educational control participants (n=61) did not have effects on any patient-reported outcome except for a moderate effect on physical health (P<.001; d=0.77).

Conclusions

Delivering meditation via the Calm app is feasible and scored higher in terms of feasibility when compared with the 10% Happier app. The Calm app will be used to implement a randomized controlled trial, testing the effects of meditation on symptom burden in MPNs.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6658299/