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Yoga is an Effective Adjunct Practice for Mental Illness

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Yoga is an Effective Adjunct Practice for Mental Illness

 

By John M. de Castro, Ph.D.

 

“Yoga is about clearing away whatever is in us that prevents our living in the most full and whole way. With yoga, we become aware of how and where we are restricted — in body, mind, and heart — and how gradually to open and release these blockages. As these blockages are cleared, our energy is freed. We start to feel more harmonious, more at one with ourselves. Our lives begin to flow — or we begin to flow more in our lives.” – Cybele Tomlinson

 

There are vast numbers of people who suffer with mental illnesses. In the United States it has been estimated that in any given year 1 in 5 people will experience a mental illness. Many are treated with drugs. But drug treatment can produce unwanted side effects, don’t work for many patients, and often can lose effectiveness over time. Mindfulness practices provide a safe alternative treatment. They have been found to be helpful with coping with these illnesses and in many cases reducing the symptoms of the diseases. Yoga practice is a mindfulness practice that includes beneficial exercise. There is accumulating research that mindfulness and yoga practices may be beneficial for patients with major mental illnesses. Hence it makes sense to step back and summarize what has been learned regarding the effectiveness of yoga practice as an adjunct therapy for mental illnesses.

 

In today’s Research News article “Integration of hatha yoga and evidence-based psychological treatments for common mental disorders: An evidence map.” (See summary below or view the full text of the study at:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9546402/ ) O’Shea and colleagues review and summarize the published research studies of the effectiveness of adding yoga practice to other evidence based therapies for mental illness. They identified 15 published research studies.

 

They report that the research used mainly cognitive behavioral therapy (CBT) or Mindfulness-Based Cognitive Therapy (MBCT) as the evidence-based therapy. They found that either incorporating yoga practice into the therapeutic technique or adding it as an adjunct therapy produced significant improvement in anxiety, depression, and post-traumatic stress disorder (PTSD). Although, there are only a small number of research studies, they suggest that yoga added to other evidence-based therapies improves the outcomes for patients with mental illnesses.

 

“The nature of yoga is to shine the light of awareness into the darkest corners of the body.” – Jason Crandell

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

O’Shea M, Capon H, Evans S, Agrawal J, Melvin G, O’Brien J, McIver S. Integration of hatha yoga and evidence-based psychological treatments for common mental disorders: An evidence map. J Clin Psychol. 2022 Sep;78(9):1671-1711. doi: 10.1002/jclp.23338. Epub 2022 Mar 21. PMID: 35315071; PMCID: PMC9546402.

 

Abstract

Background

Interest in the use of yoga to enhance engagement with and augment the benefits of psychological treatment has grown. However, a systematic approach to reviewing existing research examining the use of yoga with psychological treatment is lacking.

Materials and Methods

This mapping review identified and synthesised research trialling yoga as an integrated or adjunct therapy with evidence‐based psychological interventions for the treatment of anxiety, depression, PTSD, and eating disorders.

Results

Overall, the review identified ten published and three unpublished studies, representing either single group or small quasi‐experimental research designs.

Discussion

Limited but promising findings were shown for yoga with CBT for anxiety and depression, and the integration of yoga within intensive treatment models for PTSD.

Conclusions

Future research is encouraged to focus on controlled trials that enable examination of the component effect of yoga when applied with evidence‐based psychological treatment and acceptability and feasibility data to further knowledge regarding a role for yoga in clinical practice.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9546402/

 

Improve generalized anxiety disorder with Mindfulness

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Improve generalized anxiety disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“You can’t always control what goes on outside. But you can always control what goes on inside.” – Wayne Dyer

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. 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 several 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.

 

Mindfulness-Based Cognitive Therapy (MBCT) has been shown to be effective in treating anxiety disorders. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior. But it is unclear if MBCT will be effective for generalized anxiety disorder when delivered in a group setting.

 

In today’s Research News article “Effects of group mindfulness-based cognitive therapy and group cognitive behavioural therapy on symptomatic generalized anxiety disorder: a randomized controlled noninferiority trial.” (See summary below or view the full text of the study at:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9295460/ ) Jiang and colleagues recruited patients with generalized anxiety disorder and randomly assigned them to receive 8-weekly group sessions along with home practice of either Mindfulness-Based Cognitive Therapy (MBCT) or Cognitive Behavioral Therapy. They were measured before and after treatment and 3 months later for mindfulness, anxiety including psychiatric and somatic anxiety.

 

They found that both treatments successfully produce remission in a number of patients but Mindfulness-Based Cognitive Therapy (MBCT) produced significantly lower clinical symptom severity and significantly greater mindfulness and remissions at the end of therapy than Cognitive Behavioral therapy. But at the 3-month follow up there were no significant differences in remission rates.

 

Hence group-based mindfulness training improves generalized anxiety disorder to a greater extent than cognitive behavioral therapy alone immediately after treatment, but both were similarly effective 3 months later. This suggests that the efficient method of group therapy is effective in treating generalized anxiety disorder.

 

“Our anxiety does not come from thinking about the future, but from wanting to control it.” – Kahlil Gibran

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Jiang SS, Liu XH, Han N, Zhang HJ, Xie WX, Xie ZJ, Lu XY, Zhou XZ, Zhao YQ, Duan AD, Zhao SQ, Zhang ZC, Huang XB. Effects of group mindfulness-based cognitive therapy and group cognitive behavioural therapy on symptomatic generalized anxiety disorder: a randomized controlled noninferiority trial. BMC Psychiatry. 2022 Jul 19;22(1):481. doi: 10.1186/s12888-022-04127-3. PMID: 35854250; PMCID: PMC9295460.

 

Abstract

Background

Mindfulness-based cognitive therapy (MBCT) is a promising alternative treatment for generalized anxiety disorder (GAD). The objective of this study was to examine whether the efficacy of group MBCT adapted for treating GAD (MBCT-A) was noninferior to group cognitive behavioural therapy (CBT) designed to treat GAD (CBT-A), which was considered one of first-line treatments for GAD patients. We also explored the efficacy of MBCT-A in symptomatic GAD patients compared with CBT-A for a variety of outcomes of anxiety symptoms, as well as depressive symptoms, overall illness severity, quality of life and mindfulness.

Methods

This was a randomized, controlled, noninferiority trial with two arms involving symptomatic GAD patients. Adult patients with GAD (n = 138) were randomized to MBCT-A or CBT-A in addition to treatment as usual (TAU). The primary outcome was the anxiety response rate assessed at 8 weeks after treatment as measured using the Hamilton Anxiety Scale (HAMA). Secondary outcomes included anxiety remission rates, scores on the HAMA, the state-trait anxiety inventory (STAI), the Hamilton Depression Scale (HAMD), the Severity Subscale of the Clinical Global Impression Scale (CGI-S), and the 12-item Short-Form Health Survey (SF-12), as well as mindfulness, which was measured by the Five Facet Mindfulness Questionnaire (FFMQ). Assessments were performed at baseline, 8 weeks after treatment, and 3 months after treatment. Both intention-to-treat (ITT) and per-protocol (PP) analyses were performed for primary analyses. The χ2 test and separate two-way mixed ANOVAs were used for the secondary analyses.

Results

ITT and PP analyses showed noninferiority of MBCT-A compared with CBT-A for response rate [ITT rate difference = 7.25% (95% CI: -8.16, 22.65); PP rate difference = 5.85% (95% CI: − 7.83, 19.53)]. The anxiety remission rate, overall illness severity and mindfulness were significantly different between the two groups at 8 weeks. There were no significant differences between the two groups at the 3-month follow-up. No severe adverse events were identified.

Conclusions

Our data indicate that MBCT-A was noninferior to CBT-A in reducing anxiety symptoms in GAD patients. Both interventions appeared to be effective for long-term benefits.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9295460/

Reduce Rumination in Bipolar Disorder with Mindfulness

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Reduce Rumination in Bipolar Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“If you are someone who tends to ruminate, or who suffers from anxiety and depression, it’s important that you don’t judge yourself for this way of being.” ― Kristin Neff

 

Bipolar disorder, also known as manic depressive disorder, is a mood disorder characterized by alternating states of extreme depression, relative normalcy, and extreme euphoria (mania). The symptoms of depression and mania are so severe that the individual is debilitated and unable to conduct their normal daily lives. The depression is so severe that suicide occurs in about 1% of cases of bipolar disorder. There are great individual differences in bipolar disorder. The extreme mood swings can last for a few days to months and can occur only once or reoccur frequently.

 

Bipolar disorder is usually treated with drugs. But these medications are not always effective and can have difficult side effects. Mindfulness practices and treatments have been shown to be effective for major mental disorders, including  depression and anxiety disorders and to improve the regulation of emotions.  Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior. This may be very effective particularly in reducing the repetitive negative thought patterns, ruminations. These intrusive thoughts are common in bipolar disorder and tend to support the disorder.

 

In today’s Research News article “The effect of mindfulness-based cognitive therapy on rumination and a task-based measure of intrusive thoughts in patients with bipolar disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9374865/ ) Lubbers and colleagues recruited patients with bipolar disorder and randomly assigned them to receive Mindfulness-Based Cognitive Therapy (MBCT) or treatment as usual. They were measured before and after treatment for depression, mania, brooding, positive rumination, and intrusive thoughts.

 

They found that the greater the levels of rumination the greater the levels of depression. Mindfulness-Based Cognitive Therapy (MBCT) resulted in a significant decrease in brooding and intrusive thoughts. These findings suggest that MBCT reduces the negative rumination characteristic of bipolar disorder and associated with their depression. Hence mindfulness training appears to reduce the symptoms of bipolar disorder.

 

“Life is a series of moments and moments are always changing, just like thoughts, negative and positive. And although it may be human nature to dwell, like many natural things it’s senseless, senseless to allow a single thought to inhabit a mind because thoughts are like guests or fair-weather friends.” ― Cecelia Ahern

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Lubbers J, Geurts D, Hanssen I, Huijbers M, Spijker J, Speckens A, Cladder-Micus M. The effect of mindfulness-based cognitive therapy on rumination and a task-based measure of intrusive thoughts in patients with bipolar disorder. Int J Bipolar Disord. 2022 Aug 12;10(1):22. doi: 10.1186/s40345-022-00269-1. PMID: 35960403; PMCID: PMC9374865.

 

Abstract

Background

Preliminary evidence suggests that Mindfulness-Based Cognitive Therapy (MBCT) is a promising treatment for bipolar disorder (BD). A proposed working mechanism of MBCT in attenuating depressive symptoms is reducing depressive rumination. The primary aim of this study was to investigate the effect of MBCT on self-reported trait depressive rumination and an experimental state measure of negative intrusive thoughts in BD patients. Exploratively, we investigated the effect of MBCT on positive rumination and positive intrusive thoughts.

Methods

The study population consisted of a subsample of bipolar type I or II patients participating in a multicenter randomized controlled trial comparing MBCT + treatment as usual (TAU) (N = 25) to TAU alone (N = 24). Trait depressive rumination (RRS brooding subscale) and intrusive thoughts (breathing focus task (BFT)) were assessed at baseline (full subsample) and post-treatment (MBCT + TAU; n = 15, TAU; n = 15). During the BFT, participants were asked to report negative, positive and neutral intrusive thoughts while focusing on their breathing.

Results

Compared to TAU alone, MBCT + TAU resulted in a significant pre- to post-treatment reduction of trait depressive rumination (R2 = .16, F(1, 27) = 5.15, p = 0.031; medium effect size (f2 = 0.19)) and negative intrusive thoughts on the BFT (R2 = .15, F(1, 28) = 4.88, p = 0.036; medium effect size (f2 = 0.17)). MBCT did not significantly change positive rumination or positive intrusive thoughts.

Conclusions

MBCT might be a helpful additional intervention to reduce depressive rumination in BD which might reduce risk of depressive relapse or recurrence. Considering the preliminary nature of our findings, future research should replicate our findings and explore whether this reduction in rumination following MBCT indeed mediates a reduction in depressive symptoms and relapse or recurrence in BD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9374865/

 

Improve Well-Being in Cancer Survivors with Mindfulness

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Improve Well-Being in Cancer Survivors with Mindfulness

 

By John M. de Castro, Ph.D.

 

“You can be a victim of cancer, or a survivor of cancer. It’s a mindset.” — Dave Pelzer

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. The research is accumulating. So it makes sense to summarize what has been learned.

 

In today’s Research News article “The effects of mindfulness-based interventions on symptoms of depression, anxiety, and cancer-related fatigue in oncology patients: A systematic review and meta-analysis.” (See summary below or view the full text of the study at:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9282451/ ) Chayadi and colleagues review summarize and perform a meta-analysis of the published research studies of  the effectiveness of mindfulness training (Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), or Mindfulness-Based Cancer Recovery (MBCR) on the psychological well-being of cancer patients. They identified 36 published research studies including a total of 1650 cancer patients. Most of the studies employed MBSR.

 

They report that in comparison to baseline and to control conditions, mindfulness training produced significant reductions in anxiety, depression, and fatigue in the cancer patients. These improvements were present immediately after training and 3-months later. Hence, mindfulness training improved the physical and psychological well-being of cancer patients. This suggests that mindfulness training should be incorporated into the routine care of patients with cancer..

 

“Cancer is a journey, but you walk the road alone. There are many places to stop along the way and get nourishment — you just have to be willing to take it.” — Emily Hollenberg

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Chayadi E, Baes N, Kiropoulos L. The effects of mindfulness-based interventions on symptoms of depression, anxiety, and cancer-related fatigue in oncology patients: A systematic review and meta-analysis. PLoS One. 2022 Jul 14;17(7):e0269519. doi: 10.1371/journal.pone.0269519. PMID: 35834503; PMCID: PMC9282451.

 

Abstract

Objective

Mindfulness-based interventions (MBIs) are increasingly being integrated into oncological treatment to mitigate psychological distress and promote emotional and physical well-being. This review aims to provide the most recent evaluation of Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), and Mindfulness-Based Cancer Recovery (MBCR) treatments, in reducing symptoms of depression, anxiety and CRF in oncology populations.

Methods

A search using the following search terms was conducted: (mindful* OR mindfulness* OR mindfulness-based* OR MBI* OR MBCT OR MBSR OR MBCR) AND (Oncol* OR cancer OR neoplasm OR lymphoma OR carcinoma OR sarcoma) to obtain relevant publications from five databases: PsycINFO, PubMed, Embase, and MEDLINE by EC, and ProQuest Dissertations & Theses Global from January 2000 to February 2022. 36 independent studies (n = 1677) were evaluated for their overall effect sizes (using random-effects models), subgroup analyses, and quality appraisals. Evaluations were performed separately for non-randomized (K = 20, n = 784) and randomized controlled trials (K = 16, n = 893).

Results

The results showed that MBIs have significant medium effects in reducing symptoms of depression (Hedges’ g = 0.43), anxiety (Hedges’ g = 0.55) and CRF (Hedges’ g = 0.43), which were maintained at least three months post-intervention. MBIs were also superior in reducing symptoms of anxiety (Hedges’ g = 0.56), depression (Hedges’ g = 0.43), and CRF (Hedges’ g = 0.42) in oncology samples relative to control groups. The superiority of MBIs to control groups was also maintained at least three months post-intervention for anxiety and CRF symptoms, but not for depressive symptoms. The risk of bias of the included studies were low to moderate.

Conclusions

This review found that MBIs reduced symptoms of depression, anxiety and CRF in oncology populations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9282451/

Improve Female Sexual Dysfunction with Mindfulness

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Improve Female Sexual Dysfunction with Mindfulness

 

By John M. de Castro, Ph.D.

 

“No amount of talking about sex is going to diminish the mystery of the experience of it. Sex is Sacred, Not Secret.” ― Christine Laplante

 

Sex is a very important aspect of life. Problems with sex are very common and have negative consequences for relationships. While research suggests that sexual dysfunction is common, it is a topic that many people are hesitant or embarrassed to discuss. Women suffer from sexual dysfunction more than men with 43% of women and 31% of men reporting some degree of difficulty. Hence, sex has major impacts on people’s lives and relationships. Greater research attention to sexual activity and sexual satisfaction and the well-being of the individual is warranted.

 

Mindfulness trainings have been found to improve relationships and to be useful in treating sexual problems.  In today’s Research News article “Behavioral Therapies for Treating Female Sexual Dysfunctions: A State-of-the-Art Review.” (See summary below or view the full text of the study at:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9144766/ ) Mestre-Bach and colleagues review and summarize the published research studies on the effectiveness of psychotherapeutic for the treatment of female sexual dysfunction disorders including female orgasmic disorder, female sexual interest/arousal disorder, and genito-pelvic pain/penetration disorder.

 

They report that the published research demonstrate that psychotherapeutic treatments are effective for female sexual dysfunctions. But Cognitive Behavioral Therapy (CBT) and Mindfulness-Based Cognitive Therapy (MBCT) have been shown to be especially effective. Women with these disorders appear to helped by mindfulness and cognitive therapy allowing for more satisfying sexual relations.

 

“We are the embodiment of the Love behind and beyond lovemaking.” – Michael Mirdad

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Mestre-Bach G, Blycker GR, Potenza MN. Behavioral Therapies for Treating Female Sexual Dysfunctions: A State-of-the-Art Review. J Clin Med. 2022 May 16;11(10):2794. doi: 10.3390/jcm11102794. PMID: 35628920; PMCID: PMC9144766.

 

Abstract

Many possible factors impact sexual wellbeing for women across the lifespan, and holistic approaches are being utilized to promote health and to address sexual concerns. Female sexual dysfunction disorders, including female orgasmic disorder, female sexual interest/arousal disorder and genito-pelvic pain/penetration disorder, negatively impact quality of life for many women. To reduce distress and improve sexual functioning, numerous behavioral therapies have been tested to date. Here, we present a state-of-the-art review of behavioral therapies for female sexual dysfunction disorders, focusing on empirically validated approaches. Multiple psychotherapies have varying degrees of support, with cognitive-behavioral and mindfulness-based therapies arguably having the most empirical support. Nonetheless, several limitations exist of the studies conducted to date, including the frequent grouping together of multiple types of sexual dysfunctions in randomized clinical trials. Thus, additional research is needed to advance treatment development for female sexual dysfunctions and to promote female sexual health.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9144766/

 

Improve the Psychological Well-Being of Patients with Parkinson’s Disease with Mindfulness

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Improve the Psychological Well-Being of Patients with Parkinson’s Disease with Mindfulness

 

By John M. de Castro, Ph.D.

 

“People with Parkinson’s reported that stress worsened both motor and non-motor symptoms, especially tremor and anxiety. More than 38 percent of respondents found mindfulness helped manage their stress and improved motor and non-motor symptoms, including anxiety and depressed mood.” – Christina Destro

 

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

 

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

 

There are no cures for Parkinson’s Disease (PD) or even treatments to slow its progression. There are only treatments that can produce symptomatic relief. So, there is a need to discover new and different treatments. Mindfulness training has been found to improve the psychological symptoms and the quality of life with PD patients.  Mindfulness-Based Cognitive Therapy (MBCT) involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior. So, there is a need to further investigate the effectiveness of mindfulness training in the treatment of Parkinson’s Disease (PD).

 

In today’s Research News article “). Online Mindfulness-Based Cognitive Therapy for People with Parkinson’s Disease and Their Caregivers: a Pilot Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9059916/ ) Seritan and colleagues recruited patients with Parkinson’s Disease who also had symptoms of anxiety and depression and their caregivers and provided them with 8 weekly 2.5 hour online sessions of Mindfulness-Based Cognitive Therapy (MBCT) along with home practice. They were measured before and after treatment for mindfulness, anxiety, depression, and caregiver burden.

 

They found that after Mindfulness-Based Cognitive Therapy (MBCT) training there were significant reductions in anxiety and depression and significant increases in mindfulness regardless of whether the patients were high in anxiety or high in depression before treatment. Hence, online mindfulness training improves the psychological well-being of patients with Parkinson’s Disease.

 

“like regular physical activity, mindfulness meditation can serve as the cornerstone for self-care that people with PD can use to manage their symptoms.” – Emily Delzell

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Seritan, A. L., Iosif, A. M., Prakash, P., Wang, S. S., & Eisendrath, S. (2022). Online Mindfulness-Based Cognitive Therapy for People with Parkinson’s Disease and Their Caregivers: a Pilot Study. Journal of technology in behavioral science, 1–15. Advance online publication. https://doi.org/10.1007/s41347-022-00261-7

 

Abstract

Anxiety and depression are common non-motor symptoms of Parkinson’s disease (PD). Caregivers of people with PD may experience severe caregiver burden. This study explored the feasibility and potential benefits of an online mindfulness-based cognitive therapy (MBCT) intervention for improving anxiety and depressive symptoms in people with PD and their caregivers (ClinicalTrials.gov NCT04469049, 7/8/2020). People with PD or parkinsonism and anxiety and/or depressive symptoms and caregivers of people with PD participated in one of three online MBCT groups. Demographic variables, pre- and post-MBCT behavioral measures (GAD-7, PHQ-9, Five Facet Mindfulness Questionnaire — FFMQ-15, Caregiver Self-Assessment Questionnaire — CSAQ), and satisfaction surveys were collected. Descriptive statistics were used to summarize data. Pre- and post-MBCT behavioral scores were compared using mixed-effect models. Fifty-six potential participants were assessed for eligibility. Twenty-eight entered MBCT groups; all but one completed the intervention. The overall sample analyzed (22 people with PD, 4 caregivers) showed significant GAD-7 and PHQ-9 score reductions and FFMQ-15 total and observing and non-reactivity subscale score increases (all p’s < 0.05). Participants with PD and anxiety symptoms (n = 14) had a significant GAD-7 score reduction; those with PD and depressive symptoms (n = 12) had a significant PHQ-9 score reduction (both p’s < 0.05). Participants with PD also had a significant FFMQ-15 observing subscale score increase (p < 0.05). The caregiver sample was too small to be analyzed separately. Online MBCT is feasible (as measured by high attendance, completion rate, and participant satisfaction) and may be effective in improving anxiety and depressive symptoms in people with PD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9059916/

 

Alter Cognition of Patients with Anxiety with Mindfulness

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Alter Cognition of Patients with Anxiety with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Anxiety can mentally exhaust you and have real impacts on your body. But before you get anxious about being anxious, know that research has shown you can reduce your anxiety and stress with a simple mindfulness practice.” – Mandy Ferreira 

 

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 sufferer 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 several 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.

 

Mindfulness-Based Cognitive Therapy (MBCT) has been shown to be effective in treating anxiety disorders. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior. But how MBCT affects the thought processes in anxiety disorders needs further investigation.

 

In today’s Research News article “Mindfulness-Based Cognitive Therapy: A Preliminary Examination of the (Event-Related) Potential for Modifying Threat-Related Attentional Bias in Anxiety.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9159034/ ) Gupta and colleagues recruited adults with high levels of anxiety and randomly assigned them to receive 8 weekly 2.5 hour sessions of Mindfulness-Based Cognitive Therapy (MBCT) along with home practice presented either online of in-person. Before and after training they were measured for anxiety, depression, and perceived stress. In addition, the participants had their electroencephalogram (EEG) recorded while performing a task to measure threat-related attentional bias.

 

They found that after Mindfulness-Based Cognitive Therapy (MBCT) there were significantly lower levels of anxiety, depression, and perceived stress. In addition, after MBCT EEG responses and response times to pictures of faces showing emotions were reduced. Hence, mindfulness training improved the psychological well-being of anxious adults in association with reduced brain responses to emotional faces.

 

“As you become more mindful, you will also notice that you will become more centered, happier, and less depressed and this in turn has a direct positive effect on your anxiety.” – Stefan G. Hofmann

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Gupta, R. S., Kujawa, A., Fresco, D. M., Kang, H., & Vago, D. R. (2022). Mindfulness-Based Cognitive Therapy: A Preliminary Examination of the (Event-Related) Potential for Modifying Threat-Related Attentional Bias in Anxiety. Mindfulness, 1–14. Advance online publication. https://doi.org/10.1007/s12671-022-01910-x

 

Abstract

Objectives

Mindfulness-based cognitive therapy (MBCT) can reduce anxiety and depression symptoms in adults with anxiety disorders, and changes in threat-related attentional bias may be a key mechanism driving the intervention’s effects on anxiety symptoms. Event-related potentials (ERPs) can illuminate the physiological mechanism through which MBCT targets threat bias and reduces symptoms of anxiety. This preliminary study examined whether P1 ERP threat–related attentional bias markers in anxious adults change from pre- to post-MBCT delivered in-person or virtually (via Zoom) and investigated the relationship between P1 threat–related attentional bias markers and treatment response.

Methods

Pre- and post-MBCT, participants with moderate to high levels of anxiety (N = 50) completed a dot-probe task with simultaneous EEG recording. Analyses focused on pre- and post-MBCT P1 amplitudes elicited by angry-neutral and happy-neutral face pair cues, probes, and reaction times in the dot-probe task and anxiety and depression symptoms.

Results

Pre- to post-MBCT, there was a significant reduction in P1-Probe amplitudes (d = .23), anxiety (d = .41) and depression (d = .80) symptoms, and reaction times (d = .10). Larger P1-Angry Cue amplitudes, indexing hypervigilance to angry faces, were associated with higher levels of anxiety both pre- and post-MBCT (d = .20). Post-MBCT, anxiety symptoms were lower in the in-person versus virtual group (d = .80).

Conclusions

MBCT may increase processing efficiency and decreases anxiety and depression symptoms in anxious adults. However, changes in threat bias specifically were generally not supported. Replication with a comparison group is needed to clarify whether changes were MBCT-specific.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9159034/

 

Improve Anxiety and the Gut Microbiome with Mindfulness

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Improve Anxiety and the Gut Microbiome with Mindfulness

 

By John M. de Castro, Ph.D.

 

“A healthy gut can be different iterations of bacteria for different people, because it is this diversity that maintains wellness.” – Jennifer Wolkin

 

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 sufferer 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 several 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.

 

The GI tract contains intestinal micro-organisms, flora, bacteria, known as the microbiome, that have major effects throughout the body through the bacteria-intestinal-brain axis. This can affect overall health and well-being including anxiety. So, it would make sense to investigate the relationship of mindfulness practice with anxiety and intestinal micro-organisms.

 

Mindfulness-Based Cognitive Therapy (MBCT) has been shown to be effective in treating anxiety disorders. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior. But whether MBCT affects both anxiety and the microbiome has not been investigated.

 

In today’s Research News article “Gut Microbiota Associated with Effectiveness And Responsiveness to Mindfulness-Based Cognitive Therapy in Improving Trait Anxiety.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8908961/ ) Wang and colleagues recruited young adults with high anxiety levels and a similar control group with normal anxiety levels. The high anxiety group were provided with 8 weekly 2.5 hour sessions of Mindfulness-Based Cognitive Therapy (MBCT). They were measured before and after treatment for anxiety, depression, resilience, and mindfulness. In addition, their feces were measured for microbiota.

 

They found that after Mindfulness-Based Cognitive Therapy (MBCT) there were significant decreases in anxiety and depression and significant increases in resilience and mindfulness. The gut microbiome significantly differed between the high anxiety group and the controls before trteatment in that the high anxiety participants had less bacterial diversity in the gut. But after MBCT the bacterial diversity levels increased to the levels of the healthy controls.

 

Hence, mindfulness training improves the psychological health of highly anxious young adults and simultaneously normalizes the deficiency in the bacterial diversity in the gut.

 

Mindfulness training is good for both physical and mental health.

 

“During stress, an altered gut microbial population affects the regulation of neurotransmitters mediated by the microbiome and gut barrier function. Meditation helps regulate the stress response, thereby suppressing chronic inflammation states and maintaining a healthy gut-barrier function.” – Ayman Mukerji Househam

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Wang, Z., Liu, S., Xu, X., Xiao, Y., Yang, M., Zhao, X., Jin, C., Hu, F., Yang, S., Tang, B., Song, C., & Wang, T. (2022). Gut Microbiota Associated With Effectiveness And Responsiveness to Mindfulness-Based Cognitive Therapy in Improving Trait Anxiety. Frontiers in cellular and infection microbiology, 12, 719829. https://doi.org/10.3389/fcimb.2022.71982

 

Abstract

Objective

Mindfulness-based interventions have been widely demonstrated to be effective in reducing stress, alleviating mood disorders, and improving quality of life; however, the underlying mechanisms remained to be fully understood. Along with the advanced research in the microbiota-gut-brain axis, this study aimed to explore the impact of gut microbiota on the effectiveness and responsiveness to mindfulness-based cognitive therapy (MBCT) among high trait anxiety populations.

Design

A standard MBCT was performed among 21 young adults with high trait anxiety. A total of 29 healthy controls were matched for age and sex. The differences in gut microbiota between the two groups were compared. The changes in fecal microbiota and psychological indicators were also investigated before and after the intervention.

Results

Compared with healthy controls, we found markedly decreased bacterial diversity and distinctive clusters among high trait anxiety populations, with significant overgrowth of bacteria such as Streptococcus, Blautia, and Romboutsia, and a decrease in genera such as Faecalibacterium, Coprococcus_3, and Lachnoclostridium. Moreover, MBCT attenuated trait anxiety and depression, improved mindfulness and resilience, and increased the similarity of gut microbiota to that of healthy controls. Notably, a high presence of intestinal Subdoligranulum pre-MBCT was associated with increased responsiveness to MBCT. Decreases in Subdoligranulum post-MBCT were indicative of ameliorated trait anxiety. The tryptophan metabolism pathways were significantly over-represented among high responders compared to low responders.

Conclusion

The significantly increased diversity post-MBCT added evidence to gut-brain communication and highlighted the utility of mycobiota-focused strategies for promoting the effectiveness and responsiveness of the MBCT to improve trait anxiety.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8908961/

 

Improve Depression by Changing the Brain with Mindfulness

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Improve Depression by Changing the Brain with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness-based cognitive therapy is just as effective as medication in preventing depression relapse among adults with a history of recurrent depression, and in reducing depressive symptoms among those with active depression.” – Deborah Yip

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. Depression can be difficult to treat and is usually treated with anti-depressive medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression. Even after remission some symptoms of depression may still be present (residual symptoms).

 

Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering, and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering. Mindfulness training has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail.

 

The most used mindfulness technique for the treatment of depression is Mindfulness-Based Cognitive Therapy (MBCT).  MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. MBCT has been shown to be as effective as antidepressant drugs in relieving the symptoms of depression and preventing depression reoccurrence and relapse. In addition, it appears to be effective as either a supplement to or a replacement for these drugs. It is unclear, however if MBCT is also effective in treating late life depression in the elderly.

 

In today’s Research News article “Mindfulness-Based Cognitive Therapy Regulates Brain Connectivity in Patients With Late-Life Depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8882841/ ) Li and colleagues recruited older adults (over 60 years of age) with late life depression and randomly assigned them to receive 8 weekly sessions of Mindfulness-Based Cognitive Therapy (MBCT) with daily home practice or treatment as usual. They were measured before and after training and 3 months later for depression, anxiety, and cognitive function, they also underwent functional magnetic resonance imaging (fMRI).

 

They found that in comparison to baseline and the treatment as usual group, those that received Mindfulness-Based Cognitive Therapy (MBCT) had significantly lower depression after training and at the 3 month follow-up. In addition, the greater the amount of home meditation practice the greater the reductions in depression. They also found that after treatment there was a significant increase in functional connectivity between the amygdala and cerebral cortex. In addition, the greater the increase in functional connectivity, the greater the reductions in depression.

 

These findings suggest that Mindfulness-Based Cognitive Therapy (MBCT) is a safe and effective treatment for late life depression. But they also suggest that changes in the connectivity between brain areas may underlie the improvements in depression.

 

So, change the brain to improve late life depression with mindfulness.

 

“MBCT (combined with antidepressants or delivered alongside antidepressant tapering/discontinuation) is comparable to maintenance antidepressants alone in preventing subsequent relapse.” – Oxford Mindfulness Centre

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Li, H., Yan, W., Wang, Q., Liu, L., Lin, X., Zhu, X., Su, S., Sun, W., Sui, M., Bao, Y., Lu, L., Deng, J., & Sun, X. (2022). Mindfulness-Based Cognitive Therapy Regulates Brain Connectivity in Patients With Late-Life Depression. Frontiers in psychiatry, 13, 841461. https://doi.org/10.3389/fpsyt.2022.841461

 

Abstract

Late-life depression (LLD) is an important public health problem among the aging population. Recent studies found that mindfulness-based cognitive therapy (MBCT) can effectively alleviate depressive symptoms in major depressive disorder. The present study explored the clinical effect and potential neuroimaging mechanism of MBCT in the treatment of LLD. We enrolled 60 participants with LLD in an 8-week, randomized, controlled trial (ChiCTR1800017725). Patients were randomized to the treatment-as-usual (TAU) group or a MBCT+TAU group. The Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) were used to evaluate symptoms. Magnetic resonance imaging (MRI) was used to measure changes in resting-state functional connectivity and structural connectivity. We also measured the relationship between changes in brain connectivity and improvements in clinical symptoms. HAMD total scores in the MBCT+TAU group were significantly lower than in the TAU group after 8 weeks of treatment (p < 0.001) and at the end of the 3-month follow-up (p < 0.001). The increase in functional connections between the amygdala and middle frontal gyrus (MFG) correlated with decreases in HAMA and HAMD scores in the MBCT+TAU group. Diffusion tensor imaging analyses showed that fractional anisotropy of the MFG-amygdala significantly increased in the MBCT+TAU group after 8-week treatment compared with the TAU group. Our study suggested that MBCT improves depression and anxiety symptoms that are associated with LLD. MBCT strengthened functional and structural connections between the amygdala and MFG, and this increase in communication correlated with improvements in clinical symptoms.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8882841/

 

Mindfulness Changes Neural Activity and Improves Major Depressive Disorder

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Mindfulness Changes Neural Activity and Improves Major Depressive Disorder

 

By John M. de Castro, Ph.D.

 

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

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. Depression can be difficult to treat and is usually treated with anti-depressive medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression. Even after remission some symptoms of depression may still be present (residual symptoms).

 

Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering. Mindfulness training has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail.

 

The most commonly used mindfulness technique for the treatment of depression is Mindfulness-Based Cognitive Therapy (MBCT).  MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. MBCT has been shown to be as effective as antidepressant drugs in relieving the symptoms of depression and preventing depression reoccurrence and relapse. In addition, it appears to be effective as either a supplement to or a replacement for these drugs. It is not known how MBCT produces its effects on major depression.

 

One way to observe the effects of MBCT on neural activity is to measure changes in the electroencephalogram (EEG), the rhythmic electrical activity that can be recorded from the scalp. The recorded activity can be separated into frequency bands. Delta activity consists of oscillations in the 0.5-3 cycles per second band. Theta activity in the EEG consists of oscillations in the 4-8 cycles per second band. Alpha activity consists of oscillations in the 8-12 cycles per second band. Beta activity consists of oscillations in the 15-25 cycles per second band while Gamma activity occurs in the 35-45 cycles per second band. Changes in these brain activities can be compared during different depths of meditation.

 

In today’s Research News article “Mindfulness-Based Cognitive Therapy in Recurrent MDD Patients With Residual Symptoms: Alterations in Resting-State Theta Oscillation Dynamics Associated With Changes in Depression and Rumination.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8936084/ ) Wang and colleagues recruited patients with major depressive disorder being treated with drugs but with residual symptoms. They were provided with an 8-week program of Mindfulness-Based Cognitive Therapy (MBCT). Before and after training they were measured for mindfulness, depression, and rumination and had their resting state electroencephalogram (EEG) recorded.

 

After completing Mindfulness-Based Cognitive Therapy (MBCT) there were significant reductions in depression which produced an 88% remission rate. There were also significant increases in mindfulness and reductions in brooding rumination. In addition, there was a significant increase in the theta rhythm power in the electroencephalogram (EEG). Finally, the greater the increase in theta power the greater the reductions in depression and rumination.

 

Hence, they found that Mindfulness-Based Cognitive Therapy (MBCT) is effective in treating depression even in patients under treatment with drugs. They also found that these improvements were related to increased theta power in the electroencephalogram (EEG). So, MBCT appears to change brain activity along with depression. The changes in the neural activity may be a mechanism by which MBCT helps improve depression symptoms.

 

“mindfulness is added to the standard depression treatment protocols, relapse rates decline.” – Sara Altshul

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Wang, J., Ren, F., Gao, B., & Yu, X. (2022). Mindfulness-Based Cognitive Therapy in Recurrent MDD Patients With Residual Symptoms: Alterations in Resting-State Theta Oscillation Dynamics Associated With Changes in Depression and Rumination. Frontiers in psychiatry, 13, 818298. https://doi.org/10.3389/fpsyt.2022.818298

 

Abstract

Many patients with major depressive disorder (MDD) suffer from residual symptoms. Rumination is a specific known risk factor for the onset, severity, prolongation, and relapse of MDD. This study aimed to examine the efficacy and EEG substrates of mindfulness-based cognitive therapy (MBCT) in alleviating depression and rumination in an MDD population with residual symptoms. We recruited 26 recurrent MDD individuals who had residual symptoms with their current antidepressants to participate in the 8-week MBCT intervention. We evaluated the efficacy and changes in the dynamics of resting-state theta rhythm after the intervention, as well as the associations between theta alterations and improvements in depression and rumination. The participants showed reduced depression, enhanced adaptive reflective rumination, and increased theta power and phase synchronization after MBCT. The increased theta-band phase synchronizations between the right occipital regions and the right prefrontal, central, and parietal regions were associated with reduced depression, while the increase in theta power in the left parietal region was associated with improvements in reflective rumination. MBCT could alleviate depression and enhance adaptive, reflective rumination in recurrent MDD individuals with residual symptoms through the modulation of theta dynamics in specific brain regions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8936084/