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Improve Depression with Diabetes with Mindfulness

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Improve Depression with Diabetes with Mindfulness

 

By John M. de Castro, Ph.D.

 

“There is reasonable evidence that mindfulness training decreases anxiety and depression in people with medical conditions like diabetes. On the other hand, what little evidence exists seems to suggest that this alone will not result in better self-management in chronic diseases such as diabetes.” – Andrew Keen

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. It is also generally episodic, coming and going. Some people only have a single episode but most have multiple reoccurrences of depression.  Depression can be difficult to treat. It 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. Mindfulness training is another alternative treatment for depression. It has been shown to be an effective treatment for depression and is also effective for the prevention of its recurrence. Mindfulness Based Cognitive Therapy (MBCT) was specifically developed to treat depression and can be effective even in the cases where drugs fail. It is a combination of two effective treatments; mindfulness training with Cognitive Behavioral Therapy (CBT). There have been very few controlled trials comparing MBCT to CBT. Such trials could be important for identifying which patients respond best to the which treatment.

 

In today’s Research News article “What works best for whom? Cognitive Behavior Therapy and Mindfulness-Based Cognitive Therapy for depressive symptoms in patients with diabetes.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5491069/, Tavote and colleagues conduct a comparison of the effectiveness of Mindfulness Based Cognitive Therapy (MBCT) and Cognitive Behavioral Therapy (CBT) for the treatment of depression that commonly occurs with diabetes patients. They recruited adult patients with Type I or Type II diabetes who were also depressed and randomly assigned them to receive either MBCT or CBT. Both treatments involved 8 weekly meetings lasting 45 to 60 minutes. Homework was also assigned. They were measured at baseline for demographic characteristics, clinical psychological symptoms, personality, and diabetes characteristics. They were also measured for depression prior to and following treatment and 9-months later.

 

They found, as have many others, that both Mindfulness Based Cognitive Therapy (MBCT) and Cognitive Behavioral Therapy (CBT) produced significant reductions in depression in the diabetic patients that were maintained at the 9-month follow-up. They also found that MBCT was superior to CBT in relieving depression in highly educated patients. The two treatments were not significantly different in effectiveness for patients who differed on disease-related characteristics, or on clinical and personality factors.

 

Hence, the results suggest that MBCT and CBT are equivalently effective for depression except for highly educated diabetics who respond best to MBCT. It is not clear why highly educated depressed diabetics respond better when mindfulness training is added to Cognitive Behavioral Therapy (CBT). This should be further investigated in future research studies.

 

So, improve depression with diabetes with mindfulness

 

“Many people with diabetes find it difficult not to judge themselves based on their blood glucose numbers. If the numbers are not in range, that makes them feel bad, and they stop turning to the meter. Mindfulness works not by eliminating guilt, shame, or depression but by guiding people to work though these emotions and accomplish what they need to do to feel better — either by pushing through a workout, passing up an extra piece of cake, or checking blood sugar even though they’re in a bad mood.” – Kara Harrington

 

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

 

Tovote, K. A., Schroevers, M. J., Snippe, E., Emmelkamp, P. M. G., Links, T. P., Sanderman, R., & Fleer, J. (2017). What works best for whom? Cognitive Behavior Therapy and Mindfulness-Based Cognitive Therapy for depressive symptoms in patients with diabetes. PLoS ONE, 12(6), e0179941. http://doi.org/10.1371/journal.pone.0179941

 

Abstract

Objective

Cognitive Behavior Therapy (CBT) and Mindfulness-Based Cognitive Therapy (MBCT) have shown to be effective interventions for treating depressive symptoms in patients with diabetes. However, little is known about which intervention works best for whom (i.e., moderators of efficacy). The aim of this study was to identify variables that differentially predicted response to either CBT or MBCT (i.e., prescriptive predictors).

Methods

The sample consisted of 91 adult outpatients with type 1 or type 2 diabetes and comorbid depressive symptoms (i.e., BDI-II ≥ 14) who were randomized to either individual 8-week CBT (n = 45) or individual 8-week MBCT (n = 46). Patients were followed for a year and depressive symptoms were measured at pre-treatment, post-treatment, and at 9-months follow-up. The predictive effect of demographics, depression related characteristics, and disease specific characteristics on change in depressive symptoms was assessed by means of hierarchical regression analyses.

Results

Analyses showed that education was the only factor that differentially predicted a decrease in depressive symptoms directly after the interventions. At post-treatment, individuals with higher educational attainment responded better to MBCT, as compared to CBT. Yet, this effect was not apparent at 9-months follow-up.

Conclusions

This study did not identify variables that robustly differentially predicted treatment effectiveness of CBT and MBCT, indicating that both CBT and MBCT are accessible interventions that are effective for treating depressive symptoms in broad populations with diabetes. More research is needed to guide patient-treatment matching in clinical practice.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5491069/

Improve Attention Deficit Hyperactivity Disorder (ADHD) with Mindfulness

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Improve Attention Deficit Hyperactivity Disorder (ADHD) with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Unlike many tools for ADHD, mindfulness develops the individual’s inner skills. It improves your ability to control your attention by helping to strengthen your ability to self-observe, to train attention, and to develop different relationships to experiences that are stressful. In other words, it teaches you to pay attention to paying attention, and can also make people more aware of their emotional state, so they won’t react impulsively. That’s often a real problem for people with ADHD.” – Carl Sherman

 

Attention Deficit Hyperactivity Disorder (ADHD) is most commonly found in children, but for about half it persists into adulthood. It’s estimated that about 5% of the adult population has ADHD. Hence, this is a very large problem that can produce inattention, impulsivity, hyperactivity, and emotional issues, and reduce quality of life. The most common treatment is drugs, like methylphenidate, Ritalin, which helps reducing symptoms in about 30% of the people with ADHD. Unfortunately, the effectiveness of the drugs appears to be markedly reduced after the first year. In addition, the drugs often have troublesome side effects, including nervousness agitation, anxiety, irritability, sleep and appetite problems, head and stomach aches, nausea, dizziness, and heart palpitations. If that’s not enough they can be addictive and can readily be abused. So, drugs, at present, do not appear to be a good solution, only affecting some, only for a short time, and with unwanted side effects.

 

There are indications that mindfulness training may be an effective treatment for ADHD. It makes sense that it should be, as the skills and abilities strengthened by mindfulness training are identical to those that are defective in ADHD,  attention, impulse control, executive function, emotion control, and mood improvement. In addition, unlike drugs, it is a relatively safe intervention that has minimal troublesome side effects. Since mindfulness is so promising as a treatment, it is important to further investigate the role of mindfulness in ADHD and its treatment.

 

In today’s Research News article “Mindfulness-Based Cognitive Behavioral Therapy as an Adjunct Treatment of Attention Deficit Hyperactivity Disorder in Young Adults.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5526699/, Aadil and colleagues review and summarize the published research literature of the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in adults. MBCT involves both 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.

 

They identified 16 published trials and every one of them reported small but significant reductions in symptoms of ADHD. The improvements included significant reductions in ADHD severity, depression and emotional symptoms and increases in mindfulness, attentional ability, and quality of life. These improvements occurred even in patients who did not respond to drug treatment. Hence, MBCT is a safe and effective treatment for Attention Deficit Hyperactivity Disorder (ADHD). These are important and very impressive results. Mindfulness training is clearly a safe and effective treatment that may be used either as a supplement or instead of drug treatment and can help to alleviate the symptoms.

 

So, Improve Attention Deficit Hyperactivity Disorder (ADHD) with Mindfulness.

 

“78% of participants who practiced mindful awareness reported reduction in their ADHD symptoms.” – Lidia Zylowska

 

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

 

Aadil, M., Cosme, R. M., & Chernaik, J. (2017). Mindfulness-Based Cognitive Behavioral Therapy as an Adjunct Treatment of Attention Deficit Hyperactivity Disorder in Young Adults: A Literature Review. Cureus, 9(5), e1269. http://doi.org/10.7759/cureus.1269

 

Abstract

Attention deficit hyperactivity disorder (ADHD) is a childhood-onset neurological disorder that often continues into adult age. Stimulants medication are the mainstay of treatment, however, in the recent years, there has been a lot of studies conducted to understand the effectiveness and feasibility of mindfulness-based cognitive behavioral therapy for treatment of attention deficit hyperactivity disorder in children and adults. In this article, we have reviewed 17 articles to look for the beneficial effects of such therapy in adults. Overall, we found that there is a clear beneficial effect of such therapies, especially when used in adjunct with stimulant medication and may increase overall compliance. For better understanding, we suggest that large, well-designed studies should be conducted with robust strategies, allowing more comparison studies with the better analytical outcome.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5526699/

Improve Psychological Health in Pregnancy with Mindfulness

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Improve Psychological Health in Pregnancy with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Not only does cultivating moment-to-moment awareness of thoughts and surroundings seem to help pregnant women keep their stress down and their spirits up—benefits that are well-documented among other groups of people—it may also lead to healthier newborns with fewer developmental problems down the line.” – Kira Newman

 

The perinatal period, from the onset of pregnancy to the end of the infants first year, is a time of intense physiological and psychological change in both the mother and the infant. Anxiety, depression, and fear are quite common during pregnancy. More than 20 percent of pregnant women have an anxiety disorder, depressive symptoms, or both during pregnancy. A debilitating childbirth fear has been estimated to affect about 6% or pregnant women and 13% are sufficiently afraid to postpone pregnancy. It is difficult to deal with these emotions under the best of conditions but in combinations with the stresses of pregnancy can turn what could be a joyous experience of creating a human life into a horrible worrisome, torment.

 

The psychological health of pregnant women has consequences for fetal development, birthing, and consequently, child outcomes. Depression during pregnancy is associated with premature delivery and low birth weight. Childbirth fear is associated with “low childbirth self-efficacy, greater use of pain medication during labor, more unwanted obstetric interventions in labor, as well as increased risk of postpartum depression.” Hence, it is clear that there is a need for methods to treat childbirth fear, depression, and anxiety during pregnancy. Since the fetus can be negatively impacted by drugs, it would be preferable to find a treatment that did not require drugs. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy. So, it would make sense to further study the effects of mindfulness training during the perinatal period.

 

In today’s Research News article “A Comparative Study of Mindfulness Efficiency Based on Islamic-Spiritual Schemes and Group Cognitive Behavioral Therapy on Reduction of Anxiety and Depression in Pregnant Women.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5385237/, Aslami and colleagues recruited Islamic women in their 16th to 32nd week of pregnancy and based upon pretesting of anxiety and depression selected two groups; a high anxiety and a high depression group. The groups were then randomly divided into a no-treatment control condition, a 12-week Cognitive Behavioral Therapy (CBT) condition or an 8-week Mindfulness-Based Stress Reduction (MBSR) condition. Traditional MBSR consists of training and practice in meditation, yoga, and body scan. The researchers modified the training protocol to include Islamic spiritual teachings. The CBT and MBSR conditions were assigned home practice for 45 minutes per day for 6 days per week. The participants were measured for anxiety and depression before and after treatment.

 

They found that both the Cognitive Behavioral Therapy (CBT) and Mindfulness-Based Stress Reduction (MBSR) conditions produced significant decreases in both anxiety and depression while the no-treatment control group did not. In addition, the MBSR condition produced significantly greater reductions than the CBT condition. In fact, MBSR produced a very large reduction, on average, of 79% in anxiety and 81% in depression while CBT produced, on average, only a 45% reduction in anxiety and a 43% reduction in depression. Hence, although CBT was effective, MBSR produced far greater improvements in the pregnant women’s psychological states.

 

These are excellent results. It has been well established that mindfulness training produces significant reductions in anxiety and depression in a wide variety of people with a variety of conditions. But, this trial compared its effectiveness to another known effective treatment, Cognitive Behavioral Therapy (CBT) and found MBSR to be far superior. I am not aware of any other direct comparisons of the two forms of therapy. It is not known, however, if the inclusion of Islamic spiritual teachings added to MBSR’s effectiveness in this group of Islamic women. Regardless, it is clear the MBSR training is highly effective in reducing anxiety and depression in pregnant women. This should be of great assistance in making for a smooth remainder of the pregnancy and delivery and may well produce better outcomes with the infant.

 

So, improve psychological health in pregnancy with mindfulness.

 

“There could not be a better time to learn mindfulness than during pregnancy and early motherhood. For one thing, this is a time when most people have a strong motivation to become the best person they can be in a relatively short period of time. When you realize the full enormity of the responsibility you have taken on by becoming a mom, the primary source of care for another whole human being, not to mention one that you love more than you thought you could ever love, there is a really high level of motivation to try your best to get yourself into the best mental and emotional shape possible.” – Cassandra Vieten

 

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

 

Aslami, E., Alipour, A., Najib, F. S., & Aghayosefi, A. (2017). A Comparative Study of Mindfulness Efficiency Based on Islamic-Spiritual Schemes and Group Cognitive Behavioral Therapy on Reduction of Anxiety and Depression in Pregnant Women . International Journal of Community Based Nursing and Midwifery, 5(2), 144–152.

 

Abstract

Background:

Anxiety and depression during the pregnancy period are among the factors affecting the pregnancy undesirable outcomes and delivery. One way of controlling anxiety and depression is mindfulness and cognitive behavioral therapy. The purpose of this study was to compare the efficiency of mindfulness based on the Islamic-spiritual schemas and group cognitive behavioral therapy on reduction of anxiety and depression in pregnant women.

Methods:

The research design was semi-experimental in the form of pretest-posttest using a control group. Among the pregnant women in the 16th to 32nd weeks of pregnancy who referred to the health center, 30 pregnant women with high anxiety level and 30 pregnant women with high depression participated in the research. Randomly 15 participants with high depression and 15 participants with high anxiety were considered in the intervention group under the treatment of mindfulness based on Islamic-spiritual schemes. In addition, 15 participants with high scores regarding depression and 15 with high scores in anxiety were considered in the other group. The control group consisted of 15 pregnant women with high anxiety and depression. Beck anxiety-depression questionnaire was used in two steps of pre-test and post-test. Data were analyzed using SPSS, version 20, and P≤0.05 was considered as significant.

Results:

The results of multivariate analysis of variance test and tracking Tukey test showed that there was a significant difference between the mean scores of anxiety and depression in the two groups of mindfulness based on spiritual- Islamic scheme (P<0.001) and the group of cognitive behavioral therapy with each other (P<0.001) and with the control group(P<0.001). The mean of anxiety and depression scores decreased in the intervention group, but it increased in the control group.

Conclusion:

Both therapy methods were effective in reduction of anxiety and depression of pregnant women, but the effect of mindfulness based on spiritual- Islamic schemes was more.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5385237/

Add Home Practice to Mindfulness Training for Maximum Benefit

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Add Home Practice to Mindfulness Training for Maximum Benefit

 

By John M. de Castro, Ph.D.

 

“This is the clearest evidence we have that mindfulness-home practice can make a difference. This is a big source of debate because there are many components at play in a MBSR or MBCT course.“ – Christine Parsons

 

Mindfulness practices have been demonstrated to produce significant benefits for the practitioners’ health and well-being. Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) are specified practices that have proven track records over many years of effectiveness. They are both complex containing discussions, meditation, body scans, and yoga practices. Each is an 8-week program with participants only meeting for instruction once a week. They both rely on the participants practicing the techniques at home daily. There is, however, very little information regarding compliance with the home practice, to what extent do the participants fully comply with the instructions to practice at home, and what effects that may have on the effectiveness of the programs.

 

In today’s Research News article “Home practice in Mindfulness-Based Cognitive Therapy and Mindfulness-Based Stress Reduction: A systematic review and meta-analysis of participants’ mindfulness practice and its association with outcomes.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501725/, Parsons and colleagues review, summarize, and perform a meta-analysis of adherence to home practice requirements during 8 weeks of mindfulness training. They found 49 research articles employing Mindfulness-Based Stress Reduction (MBSR) or Mindfulness-Based Cognitive Therapy (MBCT) which required home practice.

 

They found that the studies reported that participants performed about 64% of the required home practice. That translated into an average of 29 minutes per day of the required 45 minutes. This level of compliance was found to be true regardless of whether clinical or non-clinical samples were used, or whether the primary outcomes were psychological or physical, or between MBSR or MBCT programs. They also found that there was a small, albeit significant, relationship between the amount of home practice and the magnitude of the benefits from the treatment, such that the greater the amount of home practice, the greater the benefit.

 

Hence, the published research literature suggests that participants in both MBSR and MBCT programs perform on average about 2/3rds of the required home practice and that the better the compliance with the home practice requirement the better the outcomes. This is actually surprising good levels of compliance. Unfortunately, most of the studies used self-reports of home practice and the participants may have felt compelled to report better compliance than what they actually did. Nevertheless, the research suggests that home practice is a beneficial component of the practices. It is possible that this is true because it brings the practice into the everyday environment of the participants, away from the artificiality of the clinic. This may help to more readily transfer what is learned from the clinic to the real world and thereby heighten the impact of the practices.

 

So, add home practice to mindfulness training for maximum benefit.

 

“home practice helps generate meaningful change in dispositional mindfulness, which is purportedly a key mechanism of action in mindfulness-based interventions.” – Dawn Epstein

 

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

 

Parsons, C. E., Crane, C., Parsons, L. J., Fjorback, L. O., & Kuyken, W. (2017). Home practice in Mindfulness-Based Cognitive Therapy and Mindfulness-Based Stress Reduction: A systematic review and meta-analysis of participants’ mindfulness practice and its association with outcomes. Behaviour Research and Therapy, 95, 29–41. http://doi.org/10.1016/j.brat.2017.05.004

 

Abstract

Mindfulness-Based Cognitive Therapy (MBCT) and Mindfulness-Based Stress Reduction (MBSR) emphasize the importance of mindfulness practice at home as an integral part of the program. However, the extent to which participants complete their assigned practice is not yet clear, nor is it clear whether this practice is associated with positive outcomes.

For this systematic review and meta-analysis, searches were performed using Scopus and PubMed for studies published through to the end of 2015, reporting on formal home practice of mindfulness by MBSR or MBCT participants.

Across 43 studies (N = 1427), the pooled estimate for participants’ home practice was 64% of the assigned amount, equating to about 30 minutes per day, six days per week [95% CI 60–69%]. There was substantial heterogeneity associated with this estimate. Across 28 studies (N = 898), there was a small but significant association between participants’ self-reported home practice and intervention outcomes (r = 0·26, 95% CI 0·19,–0·34).

MBSR and MBCT participants report completing substantial formal mindfulness practice at home over the eight-week intervention, albeit less than assigned amounts. There is a small but significant association between the extent of formal practice and positive intervention outcomes for a wide range of participants.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501725/

Mindfulness-Based Cognitive Therapy is Effective Regardless of Teacher Competence

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Mindfulness-Based Cognitive Therapy is Effective Regardless of Teacher Competence

 

By John M. de Castro, Ph.D.

 

 “Over the past 15 years, the results of numerous randomized controlled trials have demonstrated that MBCT can be a powerful intervention for people who have experienced clinical depression three or more times. Evidence indicates MBCT may reduce the rate of relapse for individuals with recurrent depression by 50%. MBCT has also been applied to mood and anxiety concerns other than depression, with reported success.” – Good Therapy .org

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. It is also generally episodic, coming and going. Some people only have a single episode but most have multiple reoccurrences of depression.  Depression can be difficult to treat and usually treated with anti-depressive medication. But, of patients treated initially with antidepressant drugs only about a third attained remission of the depression. After repeated and varied treatments including antidepressant drugs, therapy, exercise etc. only about two thirds of patients attained remission. Also, many patients who achieve remission have relapses and recurrences of the depression. In addition, antidepressant drugs often have troubling side effects and can lose effectiveness over time.

 

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. Mindfulness training is another alternative treatment for depression. It has been shown to be an effective treatment for depression and is also effective for the prevention of its recurrence. Mindfulness Based Cognitive Therapy (MBCT) was specifically developed to treat depression and can be effective even in the cases where drugs fail. MBCT is usually delivered by trained certified teachers but is fairly scripted and standardized. So, it is unclear what the importance of the level of teacher training and competence is.

 

In today’s Research News article “Teacher Competence in Mindfulness-Based Cognitive Therapy for Depression and Its Relation to Treatment Outcome.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506231/, Huijbers and colleagues examine the importance of the competence of the MBCT teacher in the effectiveness of MBCT for depression. They recruited patients who had had at least 3 episodes of depression, were in remission, taking antidepressants, and were engaged in a Mindfulness Based Cognitive Therapy (MBCT) program. MBCT was delivered in of 8 weekly sessions of 2.5 hours.

 

Patients were measured before and after MBCT training and 15 months later for rumination, self-compassion, mindfulness, cognitive reactivity, depressive symptoms, and depression relapse. The MBCT teachers were assessed for competence by two independent professional evaluators who rated a tape recorded MBCT session for “(1) coverage, pacing, and organization of session curriculum; (2) relational skills; (3) embodiment of mindfulness; (4) guiding mindfulness practices; (5) conveying course themes through interactive inquiry and didactic teaching; and (6) holding of group learning environment.” An overall competence rating was calculated as the sum of the 6 component competence scores.

 

They found that following treatment there were significant increases in patient self-compassion and mindfulness and significant decreases in rumination and cognitive reactivity. They also found that teacher competence did not significantly predict the number of sessions that the patients attended, and patient changes in self-compassion, mindfulness, rumination, and cognitive reactivity, or depression severity. In addition, the likelihood of relapse during the 15 month follow-up period was not significantly related to teacher competence. This was true for the overall competence and for each of the 6 competence domains.

 

These results are quite remarkable and suggest that the level of competence and expertise of the instructors in Mindfulness Based Cognitive Therapy (MBCT) does not affect the patient outcomes. These results are contrary to the recent findings that the level of teacher training with Mindfulness-Based Stress Reduction (MBSR) programs is associated with the effectiveness of the program to reduce stress and improve well-being.

 

It’s difficult to reach firm conclusion from the negative results of the present study as the range of teacher competencies was restricted wherein only 2 teachers were characterized as beginner and 2 as advanced. The lack of effect of teacher competence may also be due to the fact that MBCT programs are highly standardized and scripted by the treatment protocol and that patients are supplied with prerecorded materials for home practice. Nevertheless, the results suggest that only modest teacher competence and training is sufficient, with a standardized program, to produce maximal results.

 

So, it appears that Mindfulness-Based Cognitive Therapy is effective regardless of teacher competence.

 

“MBCT teaches people to pay attention to the present moment, rather than worrying about the past or the future, and to let go of the negative thoughts that can tip them over into depression. It also gives people a greater awareness of their own body, helping them to identify the signs of oncoming depression and ward off the episode before it starts.” – BeMindful

 

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

 

Huijbers, M. J., Crane, R. S., Kuyken, W., Heijke, L., van den Hout, I., Donders, A. R. T., & Speckens, A. E. M. (2017). Teacher Competence in Mindfulness-Based Cognitive Therapy for Depression and Its Relation to Treatment Outcome. Mindfulness, 8(4), 960–972. http://doi.org/10.1007/s12671-016-0672-z

 

Abstract

As mindfulness-based cognitive therapy (MBCT) becomes an increasingly mainstream approach for recurrent depression, there is a growing need for practitioners who are able to teach MBCT. The requirements for being competent as a mindfulness-based teacher include personal meditation practice and at least a year of additional professional training. This study is the first to investigate the relationship between MBCT teacher competence and several key dimensions of MBCT treatment outcomes. Patients with recurrent depression in remission (N = 241) participated in a multi-centre trial of MBCT, provided by 15 teachers. Teacher competence was assessed using the Mindfulness-Based Interventions: Teaching Assessment Criteria (MBI:TAC) based on two to four randomly selected video-recorded sessions of each of the 15 teachers, evaluated by 16 trained assessors. Results showed that teacher competence was not significantly associated with adherence (number of MBCT sessions attended), possible mechanisms of change (rumination, cognitive reactivity, mindfulness, and self-compassion), or key outcomes (depressive symptoms at post treatment and depressive relapse/recurrence during the 15-month follow-up). Thus, findings from the current study indicate no robust effects of teacher competence, as measured by the MBI:TAC, on possible mediators and outcome variables in MBCT for recurrent depression. Possible explanations are the standardized delivery of MBCT, the strong emphasis on self-reliance within the MBCT learning process, the importance of participant-related factors, the difficulties in assessing teacher competence, the absence of main treatment effects in terms of reducing depressive symptoms, and the relatively small selection of videotapes. Further work is required to systematically investigate these explanations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506231/

Improve Fatigue and Multiple Sclerosis Psychological Symptoms with Mindfulness

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Improve Fatigue and Multiple Sclerosis Psychological Symptoms with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness may help people better respond to stress by fostering healthier coping strategies. For example, study participants who reported higher levels of mindfulness were less likely to rely on coping strategies, such as denial, disengagement and self-blame. They were also more likely to use more-positive strategies, such as information gathering, planning and seeking out social support. Mindfulness practice appears to be a safe, drug-free approach to coping with stress and anxiety, which may in turn help reduce your MS symptoms.” – Amit Sood

 

Multiple Sclerosis (MS) is a progressive demyelinating disease which attacks the coating on the neural axons which send messages throughout the body and nervous system. It affects about 2 million people worldwide and about 400,000 in the U.S. It is most commonly diagnosed in people between the ages of 20 and 50 years.  Unfortunately, there is no cure for multiple sclerosis. There are a number of approved medications that are used to treat MS but are designed to lessen frequency of relapses and slow the progression of the disease, but they don’t address individual symptoms.

 

Although there is a progressive deterioration, MS is not fatal with MS patients having about the same life expectancy as the general population. Hence, most MS sufferers have to live with the disease for many years. So, quality of life becomes a major issue. Quality of life with MS is affected by fatigue, cognitive decrements, physical impairment, depression, and poor sleep quality. There is a thus a critical need for safe and effective methods to help relieve the symptoms of MS and improve quality of life. Mindfulness has been previously shown to improve depression, sleep quality, cognitive impairments, emotion regulation, and fatigue. It has also been shown to improve the symptoms of multiple sclerosis.

 

In today’s Research News article “Mindfulness-based cognitive therapy severely fatigued multiple sclerosis patients: A waiting list controlled study.” See summary below or view the full text of the study at: https://www.medicaljournals.se/jrm/content/html/10.2340/16501977-2237, Hoogerwerf and colleagues recruited patients with multiple sclerosis and kept them on a waiting list for 10 weeks and then provided them with 10 weeks of Mindfulness-Based Cognitive Therapy (MBCT) in groups of 12. 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. They were measured at baseline after the 10-week waiting period, after treatment and 3 months later for fatigue, mindfulness, anxiety, depression, quality of life, sleeping problems, daily cognitive mistakes, catastrophizing, coping styles, and cognitive ability.

 

They found that during the 10-week waiting period symptoms generally did not significantly change, but after the MBCT training there were significant improvements in fatigue, mindfulness, anxiety, depression, daily cognitive mistakes, catastrophizing, and emotion focused coping styles. These improvements were sustained at the 3-month follow-up. Hence, MBCT training appeared to produce marked and lasting improvements in the psychological symptoms of multiple sclerosis. There is a need to repeat this study with a stronger randomized controlled clinical trial. The positive results make a compelling case for such a trial.

 

Mindfulness training has been shown to produce improvements in fatigue, emotion regulation, anxiety, depression, cognitive performance, coping strategies, worry and catastrophizing, and of course mindfulness. The present study confirms that these benefits also accrue to patients with multiple sclerosis and are maintained. This suggests that MBCT training or other mindfulness trainings may be helpful in relieving the symptoms of this life-long progressive neurological disease. This will hopefully allow them to cope better with their disease and generally make their lives better

 

So, improve fatigue and multiple sclerosis psychological symptoms with mindfulness.

 

“Studies in multiple sclerosis, these have shown that mindfulness can improve quality of life and help people cope better with their MS. The studies also found that it decreased stress, anxiety and depression.” – MS Trust

 

 

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

 

Hoogerwerf AEW, Bol Y, Lobbestael J, Hupperts R, van Heugten CM. Mindfulness-based cognitive therapy severely fatigued multiple sclerosis patients: A waiting list controlled study. J Rehabil Med. 2017 Jun 8. doi: 10.2340/16501977-2237

 

Abstract

BACKGROUND:

Fatigue is the most common symptom in multiple sclerosis. Evidence-based treatment options are scarce.

OBJECTIVE:

To study the feasibility and potential effectiveness of mindfulness-based cognitive therapy in severely fatigued multiple sclerosis patients.

METHODS:

Non-randomized pilot study with a wai-ting list control period including 59 multiple sclerosis patients with severe fatigue.

PRIMARY OUTCOME MEASURE:

fatigue severity subscale of the Checklist Individual Strength-20. Secondary measures: Hospital Anxiety and Depression Scale, Life Satisfaction Questionnaire, subscale sleep of the Symptom Checklist-90, Cognitive Failure Questionnaire, Fatigue Catastrophizing Scale, Coping Inventory of Stressful Situations, and Five Facet Mindfulness Questionnaire-Short Form. Measurements were taken before treatment (double baseline), after treatment, and at follow-up (3 months).

RESULTS:

Adherence rate was 71%. Eight out of 10 participants who completed the intervention were satisfied with the intervention. Significant time effects were found for 7 out of 11 outcome measures (p = 0.006 to < 0.001). The effect size was moderate for all outcome measures that were significant post-treatment and/or at follow-up (Ƞ² = 0.10-0.17). Improvements were maintained at follow-up. Of the completers, 46% showed a clinically relevant change regarding fatigue.

CONCLUSION:

Mindfulness-based cognitive therapy is feasible in severely fatigued multiple sclerosis patients and has positive results in the reduction of severe fatigue and several psychological factors.

https://www.medicaljournals.se/jrm/content/html/10.2340/16501977-2237

Improve Anxiety in Adolescents with Mindfulness

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Improve Anxiety in Adolescents with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness also helps us to get to know our real self which is never a bad thing! People suffering from social anxiety are often marred by an exaggerated perception of their shortcomings which leads them to believe that they are inadequate and that everybody must be noticing. Practicing mindfulness based cognitive therapy will help them to reestablish a more realistic self-image.” – Kyle MacDonald

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. Anxiety Disorders affects about 3.1% of the U.S. population. Severe anxiety affects about 6% of adolescents. Physically, anxiety sufferers will often show excessive fatigue, irritability, muscle tension or muscle aches, trembling, feeling twitchy, being easily startled, trouble sleeping, sweating, nausea, diarrhea or irritable bowel syndrome, and headaches.

 

Anxiety disorders in adults have generally been treated with drugs. It has been estimated that 11% of women in the U.S. are taking anti-anxiety medications. But, there are considerable side effects and these drugs are often abused. The drugs are also not appropriate for children and adolescents with developing nervous systems. 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 in adults. Mindfulness training has also been shown to produce changes in the nervous system. It is not known, however, what changes in the nervous system underlie the effect of MBCT on anxiety.

 

In today’s Research News article “Neural Function Before and After Mindfulness-Based Cognitive Therapy in Anxious Adolescents at Risk for Developing Bipolar Disorder.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4876535/, Strawn and colleagues examine the effects of Mindfulness-Based Cognitive Therapy (MBCT) on the nervous systems of youth with high levels of anxiety. They recruited children and adolescents, aged 9 to 16 years, who were diagnosed with an anxiety disorder and who were at risk for developing bipolar disorder. They were treated with a 12-week program of MBCT. Before and after the treatment they were measured for anxiety, clinical symptoms, and mindfulness and also underwent functional Magnetic Resonance (f-MRI) brain scans while performing a continuous processing task with emotional and neutral distractors.

 

They found that following MBCT there was a significant increase in activity of the insula, lentiform nucleus, and thalamus, and anterior cingulate cortex with the presentation of emotional pictures. So, MBCT produces changes in the brains of children and adolescents similar to those seen in adults. They also found that the greater the reduction in anxiety resulting from MBCT the greater the decrease in activity of the insula and anterior cingulate cortex.

 

The insula and the anterior cingulate cortex have been shown to be involved in emotional processing and MBCT is aimed at altering the thought processes revolving around the interpretations of emotions. So, the changes in the functional activity of these structures following MBCT are commensurate with the changes in emotionality. Hence, MBCT appears to change the brains of children and adolescents with anxiety disorders to improve emotional processing.

 

It should be noted that this was a pilot study with a very small number of participants and no control group. So, the findings must be interpreted with caution. But the findings are sufficiently interesting to justify conducting a larger randomized clinical trial in the future.

 

“If you have unproductive worries, you can train yourself to experience those thoughts completely differently. ‘You might think ‘I’m late, I might lose my job if I don’t get there on time, and it will be a disaster!’ Mindfulness teaches you to recognize, ‘Oh, there’s that thought again. I’ve been here before. But it’s just that—a thought, and not a part of my core self,‘” – Elizabeth Hoge

 

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

 

Strawn, J. R., Cotton, S., Luberto, C. M., Patino, L. R., Stahl, L. A., Weber, W. A., … DelBello, M. P. (2016). Neural Function Before and After Mindfulness-Based Cognitive Therapy in Anxious Adolescents at Risk for Developing Bipolar Disorder. Journal of Child and Adolescent Psychopharmacology, 26(4), 372–379. http://doi.org/10.1089/cap.2015.0054

 

Abstract

Objective: We sought to evaluate the neurophysiology of mindfulness-based cognitive therapy for children (MBCT-C) in youth with generalized, social, and/or separation anxiety disorder who were at risk for developing bipolar disorder.

Methods: Nine youth (mean age: 13 ± 2 years) with a generalized, social, and/or separation anxiety disorder and a parent with bipolar disorder completed functional magnetic resonance imaging (fMRI) while performing a continuous processing task with emotional and neutral distractors (CPT-END) prior to and following 12 weeks of MBCT-C.

Results: MBCT-C was associated with increases in activation of the bilateral insula, lentiform nucleus, and thalamus, as well as the left anterior cingulate while viewing emotional stimuli during the CPT-END, and decreases in anxiety were correlated with change in activation in the bilateral insula and anterior cingulate during the viewing of emotional stimuli (p < 0.05, uncorrected; p < 0.005 corrected; cluster size, 37 voxels).

Conclusions: MBCT-C treatment in anxious youth with a familial history of bipolar disorder is associated with increased activation of brain structures that subserve interoception and the processing of internal stimuli—functions that are ostensibly improved by this treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4876535/

Improve resilience in Spouses of Schizophrenia Patients with Mindfulness

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Improve resilience in Spouses of Schizophrenia Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Most of life’s stressors are subjective and with mindfulness (seeing things as they are in this present moment), we have the ability to respond with wisdom vs. react in a harmful way. When we see our thoughts and feelings clearly and can offer compassion for the hardship we are experiencing, we increase our resilience.” – Carley Hauck

 

Psychological well-being is sometimes thought of as a lack of mental illness. But, it is more than just a lack of something. It is a positive set of characteristics that lead to happy, well-adjusted life. These include the ability to be aware of and accept one’s strengths and weaknesses, to have goals that give meaning to life, to truly believe that your potential capabilities are going to be realized, to have close and valuable relations with others, the ability to effectively manage life issues especially daily issues, and the ability to follow personal principles even when opposed to society. But, stress can interfere with the individual’s ability to achieve these goals.  When highly stressed, resilience is required to cope with the stress and continue on the path to psychological well-being.

 

Schizophrenia is the most common form of psychosis, affecting about 1% of the population worldwide. In many cases it is so debilitating that institutionalization is required. But, the symptoms of psychoses often do not appear until early adulthood. So, many carry on relatively normal lives including marriage prior to the onset of debilitating symptoms. This can result in wives having to cope with the institutionalization of their husbands, having to live alone, replace lost income, and withstand the societal stigma of having a mentally ill spouse. The resultant stress can exacerbate an already difficult situation.

 

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 increase resilience in the wives of institutionalized individuals with schizophrenia. In today’s Research News article “The Efficacy of Mindfulness-Based Cognitive Therapy on Resilience among the Wives of Patients with Schizophrenia.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449888/,  Solati recruited wives whose husbands were diagnosed with schizophrenia and institutionalized and randomly assigned them to a no-treatment control group or to receive and 8-week, once a week for 90 minutes, program of 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 difficult emotions. The women were measured before and after training for resilience.

 

They found that following the intervention the women who received Mindfulness-Based Cognitive Therapy (MBCT) had a significant, 10%, increase in resilience in comparison to the control group. There is a need to conduct a randomized controlled trial with an active control condition to verify these findings. Nevertheless, mindfulness training appeared to improve resilience. This suggests that MBCT may assist wives whose husbands are diagnosed with schizophrenia and institutionalized to better cope with the resultant stress. This may better equip the women to withstand their difficulties and retain their own well-being.

 

So, improve resilience in spouses of schizophrenia patients with mindfulness.

 

“The emotional soup that follows a stressful event can whip up negative stories about yourself or others that goes on and on, beyond being useful. Mindfulness reduces this rumination and, if practiced regularly, changes your brain so that you’re more resilient to future stressful events.” – Shamash Alidina

 

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

 

Solati, K. (2017). The Efficacy of Mindfulness-Based Cognitive Therapy on Resilience among the Wives of Patients with Schizophrenia. Journal of Clinical and Diagnostic Research : JCDR, 11(4), VC01–VC03. http://doi.org/10.7860/JCDR/2017/23101.9514

 

Abstract

Introduction

The wives of patients with schizophrenia experience high levels of stress due to their spouses’ disease, which leads to certain problems and decreased adaptability and efficiency in them.

Aim

This study investigated the efficacy of Mindfulness-Based Cognitive Therapy (MBCT) on resilience in schizophrenia patients.

Materials and Methods

In this quasi-experimental study, 40 wives of patients with schizophrenia (20 assigned to experimental group and 20 to control group) whose husbands were kept in rehabilitation centers for mental disorders were enrolled according to convenience sampling. In the experimental group, the therapeutic protocol of MBCT was conducted. Accordingly, the patients were encouraged to process the experiences in a non-judgmental manner as they have been formed, and to change their relationship with and embrace challenging thoughts and feelings. Meanwhile, the control group underwent no intervention. The research instrument was Connor-Davidson Resilience Scale. Data were analysed by ANCOVA in SPSS 16.

Results

At post-test, mean resilience score of the experimental group (77.95±4.71) was much higher than that of the control group (71.75±5.81). There was a significant difference in the mean resilience score at post-test between the experimental and control groups (p<0.05).

Conclusion

Training MBCT strategies was effective on resilience in the wives of schizophrenia patients. Therefore, this approach can be incorporated into mental health-related interventions for the families of patients with psychiatric disorders such as schizophrenia.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449888/

Remove Mental Sets to Improve Depression with Mindfulness

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Remove Mental Sets to Improve Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“This new evidence for mindfulness-based cognitive therapy … is very heartening. While MBCT is not a panacea, it does clearly offer those with a substantial history of depression a new approach to learning skills to stay well in the long-term.” – Willem Kuyken

 

Depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. It is also generally episodic, coming and going. Some people only have a single episode but most have multiple reoccurrences of depression. Depression can be difficult to treat and it’s 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. Additionally, drugs often have troubling side effects and can lose effectiveness over time. So, it is imperative that safe and effective treatments be identified that can be applied as stand-alone treatments or applied when the typical treatments fail and/or when side effects are unacceptable.

 

One of the characterizing features of depression is aberrant thought processes. The thinking of individuals with depression is often fraught with rumination, repeated reflection on troubling past events, and inability to suppress irrelevant thoughts or expectancies. These ruminative and irrelevant thoughts can produce an inaccurate and dark interpretation of reality. That these thought processes may be at the core of depression is evidenced by the fact that altering them with cognitive behavioral therapy is quite effective in relieving depression.

 

Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and is also effective for the prevention of its recurrence. The combination of mindfulness training with cognitive behavioral therapy is a technique called Mindfulness-Based Cognitive Therapy (MBCT). It was specifically developed to treat depression. 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 depression. MBCT has been found to reduce depression alone or in combination with anti-depressive drugs and can even be effective even in the cases where drugs fail,.

 

In today’s Research News article “Mindfulness-based cognitive therapy for depressed individuals improves suppression of irrelevant mental-sets,” see summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5357295/

Greenberg and colleagues investigate the thought processes of depressed individuals, the effects of Mindfulness-Based Cognitive Therapy (MBCT) on these thought processes and the relationship of the altered thought processes to the relief of depression. They recruited mildly to moderately depressed adults and randomly assigned them to either receive treatment as usual or 8-weeks of MBCT. They were measured before and after treatment for depression, rumination, and suppression of mental set. This latter measure involved measuring the ability of the participants to move from a rule used repeatedly to solve a simple comparison problem (mental set) to a new one. For example, they were asked to indicate if one to three objects varied in a characteristic, e.g. amount. After repeated trials in which amount was the relevant characteristic, without knowledge of the participants, it was changed to another characteristic smoothness. How long it took the participant to recognize the change to the new rule and begin responding to it was measured.

 

They found, as many previous studies, that Mindfulness-Based Cognitive Therapy (MBCT) produced large and significant relief of depression. Importantly, they also found that MBCT resulted in faster recognition of and response to the changed rule. In other words the MBCT treated participants had improved suppression of mental set. In addition, they found that the greater the improvement in suppressing mental sets the greater the relief of depression. These results strongly suggest that altering thought processes produced by MBCT are at the root of its ability to relieve depression.

 

It has been long suspected that changes in thinking were important for treating depression. The results of the present study provide strong evidence that this is true. They also suggest that being able to move from a single method of thinking to more flexible thinking may be a key. Depressed individuals interpret events in a way that reinforces their depression. By improving their ability to interpret events in different, more realistic, ways, MBCT interrupts the cycle of thinking that maintains the depression and thereby relives the depression.

 

So, remove mental sets to improve depression with mindfulness.

 

“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

 

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

Greenberg, J., Shapero, B. G., Mischoulon, D., & Lazar, S. W. (2017). Mindfulness-based cognitive therapy for depressed individuals improves suppression of irrelevant mental-sets. European Archives of Psychiatry and Clinical Neuroscience, 267(3), 277–282. http://doi.org/10.1007/s00406-016-0746-x

 

Abstract

An impaired ability to suppress currently irrelevant mental-sets is a key cognitive deficit in depression. Mindfulness-based cognitive therapy (MBCT) was specifically designed to help depressed individuals avoid getting caught in such irrelevant mental-sets. In the current study, a group assigned to MBCT plus treatment-as-usual (n = 22) exhibited significantly lower depression scores and greater improvements in irrelevant mental-set suppression compared to a wait-list plus treatment-as-usual (n = 18) group. Improvements in mental-set-suppression were associated with improvements in depression scores. Results provide the first evidence that MBCT can improve suppression of irrelevant mental-sets and that such improvements are associated with depressive alleviation.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5357295/

Improve Loneliness and Quality of Life with Women with HIV with Mindfulness

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Improve Loneliness and Quality of Life with Women with HIV with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness-Based Therapies had a long-term effect on stress and both a short- and long-term effect on depression in people living with an HIV infection.” – Yang Yang

 

More than 35 million people worldwide and 1.2 million people in the United States are living with HIV infection. In 1996, the advent of the protease inhibitor and the so-called cocktail changed the prognosis for HIV. Since this development, a 20-year-old individual, infected with HIV, can now expect to live on average to age 69. Hence, living with HIV is a long-term reality for a very large group of people.

 

People living with HIV infection experience a wide array of physical and psychological symptoms which decrease their perceived quality of life. The symptoms include muscle aches, anxiety, depression, weakness, fear/worries, difficulty with concentration, concerns regarding the need to interact with a complex healthcare system, stigma, loneliness, and the challenge to come to terms with a new identity as someone living with HIV. Hence, patients with HIV infection, even when controlled with drugs, have a reduction in their quality of life.  There is thus a need to find methods to improve the quality of life in people who are living with HIV infection.

 

Mindfulness has been shown to improve psychological and physical well-being in people suffering from a wide range of disorders including depression and anxiety. It has also been shown that mindfulness is associated with psychological well-being and lower depression in patients with HIV infection. Integrated Yoga is a contemplative practice is a mindfulness practice that includes postures, breathing practices, relaxation techniques, and meditation. It has been shown to reduce anxiety and depression in in patients with HIV infection. So, it would stand to reason that other mindfulness practices would be beneficial for people who are living with HIV infection.

 

In today’s Research News article “The effectiveness of mindfulness-based cognitive therapy on quality of life and loneliness of women with HIV.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319288/

Samhkaniyan and colleagues recruited women infected with HIV and randomly assigned them to a no-treatment control or to receive 8 weeks of Mindfulness-Based Cognitive Therapy (MBCT), administered once weekly for 2 hours. They were measured before and after the 8-week intervention for loneliness and quality of life, including body health, emotional care, community relationships, and environmental health.

 

They found that the Mindfulness-Based Cognitive Therapy (MBCT) group had significant improvements in all measure in comparison to baseline and the control group, with significant improvements in loneliness, overall quality of life and each quality of life component, body health, emotional care, community relationships, and environmental health. Hence, MBCT appears to be an effective treatment for the psychological issues of loneliness and perceived quality of life in women diagnosed with HIV.

 

MBCT contains both mindfulness practice and also cognitive therapy that is designed to change faulty thought processes. Mindfulness training has been shown to relieve loneliness and lead to improvement in quality of life with a myriad of different conditions. Also, loneliness is an interpretation of the environmental conditions and the altered thinking produced by MBCT may well be responsible for the effect. A more mundane explanation is that the social contacts involved in receiving MBCT by themselves relieve loneliness and improve quality of life. A randomized controlled clinical trial with an active control group is needed to distinguish between these alternative explanations.

 

So, improve loneliness and quality of life with women with HIV with mindfulness.

 

“Given the stress-reduction benefits of mindfulness meditation training, there can be health protective effects not just in people with HIV but in folks who suffer from daily stress,” – David Creswell

 

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

Samhkaniyan, E., Mahdavi, A., Mohamadpour, S., & Rahmani, S. (2015). The effectiveness of mindfulness-based cognitive therapy on quality of life and loneliness of women with HIV . Journal of Medicine and Life, 8(Spec Iss 4), 107–113.

 

Abstract

Objective: The present study investigated the performance of Mindfulness according to the Cognitive approach on the Quality of Life and Loneliness of women with HIV.

Methods: This research is a semi-experimental with pretest-posttest and check team, which was conducted in winter, 2014. In this research, 24 positive HIV women in Tehran were selected by volunteers sampling method and were stochastically related to either the control team (n = 12) or the MBCT groups (n = 12) and, the World Health Organization quality of life survey and the University of California Los Angeles loneliness scale were administrated as pretest. The MBCT team got eight sessions of mindfulness according to the cognitive theory and the check team got no intervention. At the end, the post-test was administrated to two groups and, covariance method was used for data analysis by SPSS-20 software.

Findings: The results of the present study indicated that there were clear variations among the test groups check group and MBCT (p < 0.001). Therefore, Mindfulness-based Cognitive theory increased the mean quality of life and decreased loneliness.

Conclusion: The findings indicated that the Mindfulness-based Cognitive therapy increased the quality of life and decreased loneliness in positive HIV women. Therefore, in order to modify the quality of life and loneliness in these cases, attention to these variables during clinical trials with the goal of an appropriate intervention, will be beneficial.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319288/