Internet

Improve the Symptoms of Myeloproliferative Neoplasm Patients with Online Yoga

psyjdc Leave a comment

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

psyjdc 1 Comment

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

psyjdc Leave a comment

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/

Lower College Student Stress Levels and Increase Self-Compassion with a Mindfulness Mobile App

psyjdc Leave a comment

Lower College Student Stress Levels and Increase Self-Compassion with a Mindfulness Mobile App

 

By John M. de Castro, Ph.D.

 

“mindfulness intervention can help reduce distress levels in college students during a stressful exam week, as well as increase altruistic action in the form of donating to charity.” – AMRA

 

In the modern world education is a key for success. Where a high school education was sufficient in previous generations, a college degree is now required to succeed in the new knowledge-based economies. There is a lot of pressure on students to excel so that they can get the best jobs after graduation. This stress might in fact be counterproductive as the increased pressure can actually lead to stress and anxiety which can impede the student’s physical and mental health, well-being, and school performance. It is, for the most part, beyond the ability of the individual to change the environment to reduce stress, so it is important that methods be found to reduce the college students’ responses to stress; to make them more resilient when high levels of stress occur.

 

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 and 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 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 reducing stress levels in college students.

 

In today’s Research News article “Efficacy of the Mindfulness Meditation Mobile App “Calm” to Reduce Stress Among College Students: Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6614998/), Huberty and colleagues recruited stressed college students and randomly assigned them to either a wait-list control condition or to receive 8 weeks of mindfulness training including 10 minutes of meditation per day via a smartphone app (“Calm”). They were measured before and after training and 4 weeks later for perceived stress, mindfulness, self-compassion, and health behaviors including sleep disturbance, alcohol consumption, physical activity, and fruit and vegetable consumption.

 

They found that in comparison to baseline and the wait-list control group, the groups that received the smartphone app mindfulness training had significantly higher levels of self-compassion and mindfulness, including all facets of mindfulness, and significantly lower levels of perceived stress with moderate to large effect sizes. They also found that these benefits persisted 4 weeks after the end of training.

 

The findings of strong effects are important as they suggest that the smartphone app produces effects similar to those of in person trainings on perceived stress and self-compassion. These are important benefits for college students, helping to relieve their stress and hopefully improve their performance in college. Additionally, smartphone apps can be distributed widely at low cost and practice can occur at the convenience of the participant. So, these apps may be a vehicle to expand the benefits of mindfulness practice to not only college students but also to the wider population.

 

So, lower college student stress levels and increase self-compassion with a mindfulness mobile app.

 

“studies have demonstrated that mindfulness can be an effective skill for reducing anxiety and stress, controlling attentional distractions and improving overall psychological well-being.” – Braver

 

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., Green, J., Glissmann, C., Larkey, L., Puzia, M., & Lee, C. (2019). Efficacy of the Mindfulness Meditation Mobile App “Calm” to Reduce Stress Among College Students: Randomized Controlled Trial. JMIR mHealth and uHealth, 7(6), e14273. doi:10.2196/14273

 

Abstract

Background

College students experience high levels of stress. Mindfulness meditation delivered via a mobile app may be an appealing, efficacious way to reduce stress in college students.

Objective

We aimed to test the initial efficacy and sustained effects of an 8-week mindfulness meditation mobile app—Calm—compared to a wait-list control on stress, mindfulness, and self-compassion in college students with elevated stress. We also explored the intervention’s effect on health behaviors (ie, sleep disturbance, alcohol consumption [binge drinking], physical activity, and healthy eating [fruit and vegetable consumption]) and the feasibility and acceptability of the app.

Methods

This study was a randomized, wait-list, control trial with assessments at baseline, postintervention (8 weeks), and at follow-up (12 weeks). Participants were eligible if they were current full-time undergraduate students and (1) at least 18 years of age, (2) scored ≥14 points on the Perceived Stress Scale, (3) owned a smartphone, (4) were willing to download the Calm app, (5) were willing to be randomized, and (7) were able to read and understand English. Participants were asked to meditate using Calm at least 10 minutes per day. A P value ≤.05 was considered statistically significant.

Results

A total of 88 participants were included in the analysis. The mean age (SD) was 20.41 (2.31) years for the intervention group and 21.85 (6.3) years for the control group. There were significant differences in all outcomes (stress, mindfulness, and self-compassion) between the intervention and control groups after adjustment for covariates postintervention (all P<.04). These effects persisted at follow-up (all P<.03), except for the nonreacting subscale of mindfulness (P=.08). There was a significant interaction between group and time factors in perceived stress (P=.002), mindfulness (P<.001), and self-compassion (P<.001). Bonferroni posthoc tests showed significant within-group mean differences for perceived stress in the intervention group (P<.001), while there were no significant within-group mean differences in the control group (all P>.19). Similar results were found for mindfulness and self-compassion. Effect sizes ranged from moderate (0.59) to large (1.24) across all outcomes. A significant group×time interaction in models of sleep disturbance was found, but no significant effects were found for other health behaviors. The majority of students in the intervention group reported that Calm was helpful to reduce stress and stated they would use Calm in the future. The majority were satisfied using Calm and likely to recommend it to other college students. The intervention group participated in meditation for an average of 38 minutes/week during the intervention and 20 minutes/week during follow-up.

Conclusions

Calm is an effective modality to deliver mindfulness meditation in order to reduce stress and improve mindfulness and self-compassion in stressed college students. Our findings provide important information that can be applied to the design of future studies or mental health resources in university programs.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6614998/

 

Improve Weight-Related Eating Behaviors with a Mindfulness App

psyjdc Leave a comment

Improve Weight-Related Eating Behaviors with a Mindfulness App

 

By John M. de Castro, Ph.D.

 

“a slower, more thoughtful way of eating could help with weight problems and maybe steer some people away from processed food and unhealthy choices.” – Harvard Health

 

Eating is produced by two categories of signals. Homeostatic signals emerge from the body’s need for nutrients, is associated with feelings of hunger, and usually work to balance intake with expenditure. Non-homeostatic eating, on the other hand, is not tied to nutrient needs or hunger but rather to the environment and or to the pleasurable and rewarding qualities of food. These cues can be powerful signals to eat even when there is no physical need for food.

 

Mindful eating involves paying attention to eating while it is occurring, including attention to the sight, smell, flavors, and textures of food, to the process of chewing and may help reduce intake by affecting the individual’s response to non-homeostatic cues for eating. Indeed, high levels of mindfulness are associated with lower levels of obesity. Hence, mindful eating may counter non-homeostatic eating.

 

Mindfulness training programs over the internet and with smartphone apps 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. These online and smartphone app trainings have been shown to be effective. It is not known if a mindful eating smartphone app may be effective in reducing body weight and weight-related eating behaviors.

 

In today’s Research News article “The Mindfulness App Trial for Weight, Weight-Related Behaviors, and Stress in University Students: Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6479283/), Lyzwinski and colleagues recruited college students and randomly assigned them to receive apps for their smartphones for either mindfulness or a self-monitoring diet and exercise diary for an 11 week period. The mindfulness app consisted of body scan, diaphragmatic breathing, observing the breath, loving kindness meditation, concentration meditation, choiceless awareness mindfulness meditation, and Hatha yoga all adapted from the Mindfulness-Based Stress Reduction (MBSR) program. The students were measured before and after the 11-week training for body size, physical activity, eating behavior, mindful eating, mindfulness, perceived stress, and participant retention and adherence.

 

They found in comparison to baseline and to the diet and exercise diary group, the mindfulness group had significant increases in mindfulness and mindful eating, and significant decreases in emotional eating, uncontrolled eating, and perceived stress levels. The diet and exercise diary group had significantly higher levels of exercise. There were no significant changes in body size for either group. 80% of the participants completed the program and of the mindfulness app group only 14% reported completing all modules, while 61% reported sporadic use, and 23% reported using it very seldom.

 

The results are encouraging and suggest that the mindfulness smartphone app is a feasible and acceptable method of increasing mindfulness and improving weight-related eating behaviors. Although retention is good, adherence was not. The students recruited, though, were not particularly motivated to lose weight or practice mindfulness. Perhaps, a more motivated group of participants would have resulted in better adherence. There also may be a need to modify the app to make participation more interesting and fun.

 

The fact there no changes in weight were observed was no surprising as the 11-week period is short to detect significant changes in weight. A long-term study is needed here. In addition, maintaining a diet and exercise diary has been shown to reduce food intake and increase exercise. A comparison of the mindfulness app to a group participating in nutrition education ap might be better able to demonstrate changes in body size. Regardless, the results are encouraging and suggest that an app, training students in mindfulness, may be a convenient and inexpensive means to develop better eating habits.

 

So, improve weight-related eating behaviors with a mindfulness App.

 

“Increased mindful eating has been shown to help participants gain awareness of their bodies, be more in tune to hunger and satiety, recognize external cues to eat, gain self compassion, decrease food cravings, decrease problematic eating, and decrease reward-driven eating.” – Carolyn Dunn

 

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

 

Lyzwinski, L. N., Caffery, L., Bambling, M., & Edirippulige, S. (2019). The Mindfulness App Trial for Weight, Weight-Related Behaviors, and Stress in University Students: Randomized Controlled Trial. JMIR mHealth and uHealth, 7(4), e12210. doi:10.2196/12210

 

Abstract

Background

University students are at risk of weight gain during their studies. Key factors related to weight gain in this population include unhealthy weight-related behaviors because of stress. Mindfulness holds promise for weight management. However, there has not been any previous trial that has explored the effectiveness of a student-tailored mindfulness app for stress, weight-related behaviors, and weight. There is limited evidence that current mindfulness apps use evidence-based mindfulness techniques. A novel app was developed that combined evidence-based, mindfulness-based stress reduction and mindful eating (ME) techniques that were tailored to university students, with student-relevant themes for targeting weight behaviors, weight, and stress.

Objectives

The aim of this study was to test the effectiveness, acceptability, and feasibility of a student-tailored mindfulness app for weight, weight-related behaviors, and stress. Testing this app in a rigorous randomized controlled trial (RCT) for these outcomes is a novelty and contribution to this emerging field.

Methods

A 2-arm RCT of an 11-week duration was undertaken at the University of Queensland. Students were either randomized to the mindfulness app (n=45) or to a behavioral self-monitoring electronic diary (e-diary; n=45) for diet and exercise. Analysis of covariance was used to compare differences in weight, stress, mindfulness, ME, physical activity, and eating behaviors between both groups.

Results

Neither the mindfulness app group nor the e-diary group lost weight and there were no differences between the groups at follow-up. The mindfulness app group had significantly lower stress levels (P=.02) (adherers only), lower emotional eating (P=.02), and uncontrolled eating (P=.02) as well as higher mindfulness (P≤.001) and ME levels overall (P≤.001). The e-diary group had higher metabolic equivalents of moderate activity levels (P≤.01). However, the effect sizes were small. Regular adherence to mindfulness exercises in the app was low in the group. The majority of students (94%) liked the app and found it to be acceptable. Compared with other exercises, the most helpful reported meditation was the short breathing exercise observing the breath (39.4% [13/33] preferred it).

This was the first RCT that tested a mindfulness app for weight and weight-related behaviors in students. The modest level of user adherence likely contributes to the lack of effect on weight loss. However, there was a small, albeit promising, effect on weight-related eating behavior and stress.

Conclusions

A mindfulness app demonstrated effectiveness for stress, eating behaviors, mindfulness, and ME, but the effect sizes were small. Future studies should be conducted over longer periods of time and with greater participant compliance.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6479283/

 

Reduce Cell Phone Dependence in Adolescents with Mindfulness

psyjdc Leave a comment

Reduce Cell Phone Dependence in Adolescents with Mindfulness

 

By John M. de Castro, Ph.D.

 

“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. Perhaps it can keep us connected, even though we might only be feet away from one another as we tap out texts, emails ,or check up on our “social” life on social media.” – Mitch Abblett

 

Over the last few decades cell phones have gone from a rare curiosity to the dominant mode of electronic communications. They have also expanded well beyond a telephone and have become powerful hand-held computers known as smartphones. In fact, they have become a dominant force in daily life, occupying large amounts of time and attention. We have become seriously attached. They have become so dominant that, for many, the thought of being without it produces anxiety. Many people have become addicted. It is estimated that about 12% of the population is truly “addicted,” developing greater levels of “tolerance” and experiencing “withdrawal” and distress when deprived of them.

 

Recent surveys and studies paint a vivid picture of our cell phone addiction: we feel a surge of panic when we are separated from our beloved cell phones. This phenomenon is so new that there is little understanding of its nature and causes. In today’s Research News article “.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00598/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_943967_69_Psycho_20190326_arts_A), Li and colleagues examine the relationships of parental attachment, alexithymia, and mindfulness with cell phone dependence in adolescents. They recruited adolescents (average age 14.9 years) and had them complete scales measuring parental attachment, alexithymia, mindfulness, and mobile phone dependence.

 

They found that the higher the levels of mindfulness and parental attachment the lower the levels of mobile phone dependence and that the higher the levels of alexithymia the lower the levels of parental attachment and the higher the levels of mobile phone dependence. In a mediational analysis they found that the relationship between parental attachment and mobile phone dependence was moderated by mindfulness such that the higher the levels of mindfulness the greater the impact of parental attachment on lowering the levels of mobile phone dependence. Similarly, they found that the relationship between alexithymia and mobile phone dependence was moderated by mindfulness such that the higher the levels of mindfulness the less the impact of alexithymia on heightening the levels of mobile phone dependence.

 

These findings suggest that youth with secure attachment to their parents become less dependent on their mobile phones and that this association is strengthened by mindfulness. In other words, mindful youths are more highly impacted by their attachment to their parents. Alexithymia “is characterized by reduced capacity to identify, analyze and express emotions, restricted imagination, and an externally oriented thinking.” Hence, the findings also suggest that youth with poor emotion regulation become more attached to the mobile phones and that mindful youths are less impacted by their lack of emotion regulation. So, mindfulness is associated with lower dependence on mobile phones by moderating the associations of parental attachment and alexithymia on mobile phone dependence.

 

Since mobile phone dependence is becoming more and more of a problem it is important to find antidotes. Mindfulness may be just such an antidote. The present results, though, are correlational and causation cannot be determined. So, it remains to be seen if mindfulness training can, in fact, alter the relationships of parental attachment and alexithymia with mobile phone dependence. This will be important to determine in the future as mindfulness training may be used to lower the dependence of youths on mobile phones and thereby improve their connections with other people and their environment, improving their well-being.

 

So, reduce cell phone dependence in adolescents with mindfulness.

 

“To say we are addicted to our phones is not merely to point out that we use them a lot. It signals a darker notion: that we use them to keep our own selves at bay. Because of our phones, we may find ourselves incapable of sitting alone in a room with our own thoughts floating freely in our own heads, daring to wander into the past and the future, allowing ourselves to feel pain, desire, regret and excitement.” – Stephany Tlalka

 

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 and Hao C (2019) The Relationship Between Parental Attachment and Mobile Phone Dependence Among Chinese Rural Adolescents: The Role of Alexithymia and Mindfulness. Front. Psychol. 10:598. doi: 10.3389/fpsyg.2019.00598

 

Mobile phone has experienced a significant increase in popularity among adolescents in recent years. Findings indicate dependence on mobile phone is related to poor parent-child relationship. However, previous research on mobile phone dependence (MPD) is scant and mainly focus on adult samples. In this view, the present study investigated the association between parental attachment and MPD as well as its influence mechanism, in sample of adolescents in rural China. Data were collected from three middle schools in rural areas of Jiangxi and Hubei Province (N = 693, 46.46% female, Mage = 14.88, SD = 1.77). Participants completed the Inventory of Parent and Peer Attachment (IPPA), the twenty-item Toronto alexithymia scale (TAS-20), the Mindful Attention Awareness Scale (MAAS) and the Mobile Phone Addiction Index Scale (MPAI). Among the results, parental attachment negatively predicted MPD and alexithymia were exerting partial mediation effect between parental attachment and MPD. Further, mindfulness acted as moderator of the relationship between alexithymia and MPD: The negative impact of alexithymia on MPD was weakened under the condition of high level of mindfulness. Knowledge of this mechanism could be useful for understanding adolescents’ MPD in terms of the interaction of multiple factors.

https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00598/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_943967_69_Psycho_20190326_arts_A

 

Improve Resilience in First-Responders with a Smartphone Mindfulness App

psyjdc Leave a comment

Improve Resilience in First-Responders with a Smartphone Mindfulness App

 

By John M. de Castro, Ph.D.

 

“The mindfulness practices work at both a preventative and remedial level by assisting them to maintain higher levels of resilience to deal with their emergency responder roles and helping to reduce and cease distressing reactions after difficult personal and traumatic incidents.” – Mark Molony

 

First responders such as firefighters and police experience a great deal of stress and frequent traumatic events and as a part of their jobs. The first-responders need to be resilient in the face of these difficult circumstances to cope with the stress. It is possible that mindfulness training might help. Mindfulness has been shown to increase resilience and reduce the psychological and physiological responses to stress. So, it is reasonable to infer that mindfulness training may help to develop resilience in first-responders and be of benefit to their mental health.

 

In today’s Research News article “Resilience@Work Mindfulness Program: Results From a Cluster Randomized Controlled Trial With First Responders.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399574/), Joyce and colleagues examine the ability of mindfulness training delivered with a smartphone app to increase the levels of resilience in first-responders. They recruited Primary Rescue and Hazmat firefighters and randomly assigned their stations to either receive 6, 20-25 minute, sessions  of mindfulness training or to an Healthy Living control condition. The mindfulness training was based upon Acceptance and Compassion Therapy (ACT) and emphasized mindfulness, self-acceptance, and compassion. Both programs were delivered through a smartphone app. The first-responders were measured before and after training and 6 months later for mindfulness, resilience, cognitive fusion, experiential avoidance and psychological inflexibility, self-compassion, optimism, coping orientation, and life purpose.

 

They found that in comparison to baseline and the control condition, participation in the mindfulness training resulted in a significant increase in adaptive resilience and mindfulness which continued to increase over the 6-month follow-up period. Significant differences in optimism, and the use of instrumental and emotional support were present at the end of training but were not sustained at follow-up. Interestingly, there were no significant differences in “bounce-back” resilience.

 

Adaptive resilience involves the ability to adapt to stressful life circumstances and events. It involves the “individual’s ability to tolerate experiences such as change, personal problems, illness, pressure, failure, and painful feelings.” On the other hand, “bounce-back” resilience involves the ability to recover from stressful events. Since mindfulness focuses the individual on the present moment, it would be expected that it would influence the experience and coping with stressful events as they’re occurring. This is the case with adaptive resilience. On the other hand, mindfulness moves attention away from past events and would thus not be expected to influence coping with past stressful events as is the case with “bounce-back” resilience. Hence, it makes sense that mindfulness training would affect adaptive resilience and not “bounce-back” resilience.

 

It is important for the well-being of first responders that they be able to cope with the, at times, intense stress and trauma involved in their jobs. Hence, mindfulness training may be very beneficial as the present results suggest. This may help to prevent illness, burnout, and post-traumatic stress disorder (PTSD). In addition, the fact that mindfulness was taught with a smartphone app is important as it makes the training convenient and adaptable to the individual’s schedule. It is also highly scalable allowing for inexpensive widespread availability of the training.

 

So, Improve Resilience in First-Responders with a Smartphone Mindfulness App.

 

“Because PTSD is an anxiety disorder, episodes of distress occur when a person begins to worry about the future based on previous painful, intense or stressful memories. Meditation can help bring that person’s attention back to the current moment, which reduces or eliminates anxiety.” – Erin Fletcher

 

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

 

Joyce, S., Shand, F., Lal, T. J., Mott, B., Bryant, R. A., & Harvey, S. B. (2019). Resilience@Work Mindfulness Program: Results From a Cluster Randomized Controlled Trial With First Responders. Journal of medical Internet research, 21(2), e12894. doi:10.2196/12894

 

Abstract

Background

A growing body of research suggests that resilience training can play a pivotal role in creating mentally healthy workplaces, particularly with regard to protecting the long-term well-being of workers. Emerging research describes positive outcomes from various types of resilience training programs (RTPs) among different occupational groups. One specific group of workers that may benefit from this form of proactive resilience training is first responders. Given the nature of their work, first responders are frequently exposed to stressful circumstances and potentially traumatic events, which may impact their overall resilience and well-being over time.

Objective

This study aimed to examine whether a mindfulness-based RTP (the Resilience@Work [RAW] Mindfulness Program) delivered via the internet can effectively enhance resilience among a group of high-risk workers.

Methods

We conducted a cluster randomized controlled trial (RCT) comprising 24 Primary Fire and Rescue and Hazmat stations within New South Wales. Overall, 12 stations were assigned to the 6-session RAW Mindfulness Program and 12 stations were assigned to the control condition. A total of 143 active full-time firefighters enrolled in the study. Questionnaires were administered at baseline, immediately post training, and at 6-month follow-up. Measurements examined change in both adaptive and bounce-back resilience as well as several secondary outcomes examining resilience resources and acceptance and mindfulness skills.

Results

Mixed-model repeated measures analysis found that the overall test of group-by-time interaction was significant (P=.008), with the intervention group increasing in adaptive resilience over time. However, no significant differences were found between the intervention group and the control group in terms of change in bounce-back resilience (P=.09). At 6-month follow-up, the group receiving the RAW intervention had an average increase in their resilience score of 1.3, equating to a moderate-to-large effect size compared with the control group of 0.73 (95% CI 0.38-1.06). Per-protocol analysis found that compared with the control group, the greatest improvements in adaptive resilience were observed among those who completed most of the RAW program, that is, 5 to 6 sessions (P=.002).

Conclusions

The results of this RCT suggest that mindfulness-based resilience training delivered in an internet format can create improvements in adaptive resilience and related resources among high-risk workers, such as first responders. Despite a number of limitations, the results of this study suggest that the RAW Mindfulness Program is an effective, scalable, and practical means of delivering online resilience training in high-risk workplace settings. To the best of our knowledge, this is the first time a mindfulness-based RTP delivered entirely via the internet has been tested in the workplace.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399574/

 

Relieve Anxiety Disorders with Online Acceptance and Commitment Therapy

psyjdc Leave a comment

Relieve Anxiety Disorders with Online Acceptance and Commitment Therapy

 

By John M. de Castro, Ph.D.

 

“The essential components of ACT include letting go of the struggle to control unwanted thoughts and feelings, being mindfully aware of the present moment, and committing to a course of action that is consistent with what you value most in life. . . Acceptance of your anxious thoughts and feelings allows you to focus more clearly on the present and to take the steps that move you closer to the life you truly want to live.” – AnxietyHappens

 

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

 

A therapeutic technique that contains mindfulness training is Acceptance and Commitment Therapy (ACT). It is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT) and has also been shown to relieve anxiety. ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

The original form of Acceptance and Commitment Therapy (ACT), however, required a certified trained therapist. This resulted in costs that many clients couldn’t afford. In addition, the participants had to be available to attend multiple sessions at particular scheduled times that were not always compatible with busy schedules and at locations that were not always convenient. As an alternative, mindfulness-based treatments delivered 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 ACT for anxiety disorder when delivered over the internet.

 

 

In today’s Research News article “Internet-Delivered Acceptance and Commitment Therapy for Anxiety Treatment: Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371070/ ), Kelson and colleagues review and summarize the published research literature on the effectiveness of Acceptance and Commitment Therapy (ACT) delivered online for the treatment of Anxiety Disorders. They discovered 20 published studies.

 

They found that on average 81% of participants completed the online ACT program. They also found that the ACT program produced small to moderate significant reduction in anxiety. These include generalized anxiety disorder, social anxiety disorder, and illness anxiety disorder. Hence, the published research suggests that Acceptance and Commitment Therapy (ACT) delivered online is effective for the treatment of Anxiety Disorders. This adds to the list of mindfulness-based therapies that can be successfully delivered online. This is important as online presentation is inexpensive, convenient, and available to a very large population of anxiety disorder sufferers.

 

So, relieve anxiety disorders with online acceptance and commitment therapy

 

“Research has shown that ACT can produce symptom improvement in people with GAD, and it may also be a particularly good fit for older adults.” – Deborah Glasofer

 

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

 

Kelson, J., Rollin, A., Ridout, B., & Campbell, A. (2019). Internet-Delivered Acceptance and Commitment Therapy for Anxiety Treatment: Systematic Review. Journal of medical Internet research, 21(1), e12530. doi:10.2196/12530

 

Abstract

Background

Anxiety conditions are debilitating and prevalent throughout the world. Acceptance and Commitment Therapy (ACT) is an effective, acceptance-based behavioral therapy for anxiety. However, there are treatment barriers (eg, financial, geographical, and attitudinal), which prevent people from accessing it. To overcome these barriers, internet-delivered ACT (iACT) interventions have been developed in recent years. These interventions use websites to deliver ACT information and skill training exercises on the Web, either as pure self-help or with therapist guidance.

Objective

This systematic review aimed to examine the therapeutic impact of iACT on all anxiety conditions.

Methods

The EMBASE, MEDLINE, ProQuest Central, PsycINFO, Scopus, and Web of Science databases were searched up to September 2018. The titles and abstracts of remaining records after deduplication were screened by 2 authors with a total of 36 full-text articles being retained for closer inspection next to eligibility criteria. Empirical studies of all designs, population types, and comparator groups were included if they appraised the impact of iACT treatment on any standardized measure of anxiety. Included studies were appraised on methodological quality and had their data extracted into a standardized coding sheet. Findings were then tabulated, and a narrative synthesis was performed because of the heterogeneity found between studies.

Results

A total of 20 studies met inclusion criteria. There were 11 randomized controlled trials (RCTs) and 9 uncontrolled pilot studies. Participants across all studies were adults. The anxiety conditions treated were as follows: generalized anxiety disorder (GAD), social anxiety disorder (SAD), illness anxiety disorder (IAD), and general anxiety symptoms, with or without comorbid physical and mental health problems. A total of 18 studies reported significant anxiety reduction after iACT treatment. This was observed in studies that delivered iACT with (n=13) or without (n=5) therapist guidance. The average attrition rate across all included studies during the active iACT treatment phase was 19.19%. In the 13 studies that assessed treatment satisfaction, participants on average rated their iACT experience with above average to high treatment satisfaction.

Conclusions

These findings indicate that iACT can be an efficacious and acceptable treatment for adults with GAD and general anxiety symptoms. More RCT studies are needed to corroborate these early iACT findings using empirical treatments in active control groups (eg, internet-delivered cognitive behavioral therapy). This would potentially validate the promising results found for SAD and IAD as well as address the full spectrum of anxiety disorders.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371070/

 

Improve Psychological Well-Being with a Smartphone Mindfulness App

psyjdc Leave a comment

Improve Psychological Well-Being with a Smartphone Mindfulness App

 

By John M. de Castro, Ph.D.

 

“Mobile phones are often scorned as devices of distraction, but paradoxically, they may serve as a good platform to practice being in the moment and being mindful given their wide use,” – Jayde Flett

 

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 and 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, 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 today’s Research News article “). Effects of a Mindfulness Meditation App on Subjective Well-Being: Active Randomized Controlled Trial and Experience Sampling Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6329416/ ), Walsh and colleagues recruited undergraduate students and randomly assigned them to practice with one of two smartphone apps, “Wildflowers” Mindfulness Training or “2048” Cognitive Training, for 10 minutes per day for three weeks. “2048” is described as “fun and relaxing puzzle game”. “Wildflowers” involves a variety of meditation trainings. “Ratings of current mood, stress level, and heart rate were recorded within each app before and after each training session.” Also, before and after the 3 weeks of training with the Apps the participants completed online measures of perceived stress, personality, well-being, psychological inflexibility, experiential avoidance, mindfulness, interoceptive awareness, spirituality, meaning in life, attentional control, interoceptive attention, and positive and negative mood.

 

They found that in comparison to the before session mood and the cognitive training group, after the session the participants who engaged in mindfulness training had significantly improved mood and reduced perceived stress. Hence, on the short term, engagement with the mindfulness app improved the emotional state of the participants.

 

They also found that both groups significantly improved over the 3 weeks of training on awareness and self-acceptance. The mindfulness training group, however, had significantly greater improvement in self-acceptance. In addition, the mindfulness training group had a significant improvement in attentional control, specifically increased ability to deal with conflicts for attention. This may be particularly helpful for the academic ability of college students. Hence on the longer term, engaging with the mindfulness app results in improved attentional ability and self-acceptance.

 

This research is well structured as the control, comparison, condition involved an equivalent amount of practice, time commitment, and expectation of benefit. So, the findings can be viewed as solid. The study, however, lacks a follow-up to determine if the effects are lasting or fleeting. The results though demonstrate that engaging in mindfulness practices with a smartphone produces short-term benefits for the individual’s emotional and psychological state and attentional ability. These are substantial benefits for a 10 minute per day investment of time. The low cost, scalability, flexibility, and convenience of training using a smartphone make it an important advance in mindfulness training.

 

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

 

“Mindfulness does not mean avoiding digital media, nor does it mean making one’s own mindfulness dependent on it – so let’s be more mindful when it comes to mindfulness!” – Annika Heinemeyer

 

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

 

Walsh, K. M., Saab, B. J., & Farb, N. A. (2019). Effects of a Mindfulness Meditation App on Subjective Well-Being: Active Randomized Controlled Trial and Experience Sampling Study. JMIR mental health, 6(1), e10844. doi:10.2196/10844

 

Abstract

Background

Mindfulness training (MT) includes a variety of contemplative practices aimed at promoting intentional awareness of experience, coupled with attitudes of nonjudgment and curiosity. Following the success of 8-week, manualized group interventions, MT has been implemented in a variety of modalities, including smartphone apps that seek to replicate the success of group interventions. However, although smartphone apps are scalable and accessible to a wider swath of population, their benefits remain largely untested.

Objective

This study aimed to investigate a newly developed MT app called Wildflowers, which was codeveloped with the laboratory for use in mindfulness research. It was hypothesized that 3 weeks of MT through this app would improve subjective well-being, attentional control, and interoceptive integration, albeit with weaker effects than those published in the 8 week, manualized group intervention literature.

Methods

Undergraduate students completed 3 weeks of MT with Wildflowers (n=45) or 3 weeks of cognitive training with a game called 2048 (n=41). State training effects were assessed through pre- and postsession ratings of current mood, stress level, and heart rate. Trait training effects were assessed through pre- and postintervention questionnaires canvassing subjective well-being and behavioral task measures of attentional control and interoceptive integration. State and trait training data were analyzed in a multilevel model using emergent latent factors (acceptance, awareness, and openness) to summarize the trait questionnaire battery.

Results

Analyses revealed both state and trait effects specific to MT; participants engaging in MT demonstrated improved mood (r=.14) and a reduction of stress (r=−.13) immediately after each training session compared with before the training session and decreased postsession stress over 3 weeks (r=−.08). In addition, MT relative to cognitive training resulted in greater improvements in attentional control (r=−.24). Interestingly, both groups demonstrated increased subjective ratings of awareness (r=.28) and acceptance (r=.23) from pre- to postintervention, with greater changes in acceptance for the MT group trending (r=.21).

Conclusions

MT, using a smartphone app, may provide immediate effects on mood and stress while also providing long-term benefits for attentional control. Although further investigation is warranted, there is evidence that with continued usage, MT via a smartphone app may provide long-term benefits in changing how one relates to their inner and outer experiences.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6329416/

 

Improve Psychological Well-Being with a Smartphone Mindfulness App

psyjdc Leave a comment

 

Improve Psychological Well-Being with a Smartphone Mindfulness App

 

By John M. de Castro, Ph.D.

 

“Mindfulness mediation apps can be useful for some people, but for others, when unwell, using these apps or even engaging in mediation its self can be quite difficult,” – Kym Jenkins

 

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 and resilience in the face of stress. 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, 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 today’s Research News article “The efficacy of a brief app-based mindfulness intervention on psychosocial outcomes in healthy adults: A pilot randomised controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312207/ ), Champion and colleagues recruited over the internet healthy adults who were not mindfulness practitioners and randomly assigned them to either a wait-list control condition or to receive mindfulness training via a smartphone app (Headspace). They practiced once a day for 10 minutes for 30 days. “The program is intended to introduce the key principles behind mindfulness, and how one can apply mindfulness to their daily life, using technique such as breath awareness, body scanning, and noting. . . The audio content is supplemented with educational videos and animations.” The participants completed questionnaires over the internet measuring general health, satisfaction with life, perceived stress, resilience, and engagement and experience with the app.

 

They found in comparison to baseline and to the wait-list controls that the participants who used the app had significant improvements in satisfaction with life, perceived stress, and resilience. The increases in psychological health were greatest between baseline and day 10 of practice but continued to increase over the next 20 days. This suggests that the benefits are available relatively rapidly but continued practice produces greater benefits. It remains to be determined whether these effects are enduring or are only present in the immediate aftermath of training.

 

These effects of mindfulness training are well established. This study adds to the accumulating evidence of the effectiveness of mindfulness training over the internet or with smartphone apps. The present study demonstrates that a widely available commercial smartphone app is also effective. This is important as it suggests that training in mindfulness can be made widely and inexpensively available without the presence of a trained therapist and at the convenience of the participant. This may allow for the benefits of mindfulness practice to spread far and wide to tremendous numbers of people. In this regard the Headspace app has already been downloaded 30 million times.

 

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

 

“A good number of new meditators begin sitting with the hope that the holistic benefits of meditation will make themselves felt in a matter of days. They expect meditation to act as a quick fix – like swallowing a pain relief tablet. It isn’t a reasonable expectation. Most genuine meditation teachers say that while a fortunate few newbies experience benefits very quickly, for the rest of us, meditation has to be practiced regularly over time before its beneficial effects can be appreciated.” – Mindworks

 

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

 

Champion, L., Economides, M., & Chandler, C. (2018). The efficacy of a brief app-based mindfulness intervention on psychosocial outcomes in healthy adults: A pilot randomised controlled trial. PloS one, 13(12), e0209482. doi:10.1371/journal.pone.0209482

 

Abstract

Background

Previous evidence suggests that mindfulness training may improve aspects of psychosocial well-being. Whilst mindfulness is traditionally taught in person, consumers are increasingly turning to mindfulness-based smartphone apps as an alternative delivery medium for training. Despite this growing trend, few studies have explored whether mindfulness delivered via a smartphone app can enhance psychosocial well-being within the general public.

Methods

The present pilot randomised controlled trial compared the impact of engaging with the self-guided mindfulness meditation (MM) app ‘Headspace’ (n = 38) for a period of 10 or 30 days, to a wait-list (WL) control (n = 36), using a cohort of adults from the general population. The Satisfaction with Life Scale, Perceived Stress Scale, and Wagnild Resilience Scale were administered online at baseline and after 10 and 30 days of the intervention.

Results

Twelve participants (MM n = 9, WL n = 3) were lost to follow-up for unknown reasons. Relative to the WL control, the MM app positively impacted self-reported satisfaction with life, stress, and resilience at day 10, with further improvements emerging at day 30 (Cohen’s d = 0.57, 1.42, 0.63 respectively). The rate of improvement was largest at the 10-day assessment point, dropping moderately by day 30. Participants that rated the MM app as easy to engage with experienced the largest self-reported benefits. Moreover, the MM app was able to protect against an unexpected increase in perceived stress that emerged in the control group.

Conclusions

This pilot randomised controlled trial shows that self-reported improvements in psychosocial outcomes can be achieved at low cost through short-term engagement with a mindfulness-based smartphone app, and should be followed up with more substantive studies.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312207/