MBCT

Prevent Depression Relapse and Lessen Residual Symptoms with Mindfulness

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Prevent Depression Relapse and Lessen Residual Symptoms with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Through mindfulness, individuals start to see their thoughts as less powerful. These distorted thoughts – such as “I always make mistakes” or “I’m a horrible person” – start to hold less weight. We ‘experience’ thoughts and other sensations, but we aren’t carried away by them. We just watch them come and go.” – William Marchand

 

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 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 be applied when the typical treatments fail. 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 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,.  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.

 

In today’s Research News article “Mindfulness Based Cognitive Therapy for Residual Depressive Symptoms and Relapse Prophylaxis.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4706736/

Segal and colleagues reviewed the recent published research literature on the effectiveness of MBCT for depression, remission, and residual symptoms. They indicate that the current research provides evidence that MBCT acts to alter neural structures that are involved in depressive symptoms including increased activations in the insula and prefrontal cortex, which are involved in interoceptive awareness and emotion regulation, processes deficient in depressed individuals. They also report that MBCT has been found to be as effective or perhaps more effective than antidepressant drugs in relieving depression, preventing relapse, and decreasing residual symptoms.

 

The published recent research suggests that MBCT might have its benefits for depression by lowering worry and rumination which are major contributors to depression. MBCT has also been shown to be effective for other mood disorders and for eating disorders, medically ill populations, such as cancer or diabetes, and pain management. In addition, these effects have been shown to occur regardless of whether MBCT is delivered in face-to-face group formats or individually on-line.

 

Hence, the research indicates that MBCT is a highly effective treatment of depression, relapse prevention, and residual symptoms, for other mood disorders, for medical diseases, and for pain. It has been shown to be safe with few if any adverse effects, and can be delivered with cost-effective on-line programs. Much of its effectiveness appears to be from cognitive changes, making the patient more mindful of the present moment and reconfiguring errant thought processes producing reductions in worry and rumination. Thus, a clear case is building that MBCT should be one of the primary treatments used especially for depression.

 

So, prevent depression relapse and lessen residual symptoms with mindfulness.

 

“mindfulness meditation “helps individuals step back from the ruminative thinking processes widely found to underlie a depressive episode.” – “Lara Fielding

 

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

Segal, Z. V., & Walsh, K. M. (2016). Mindfulness Based Cognitive Therapy for Residual Depressive Symptoms and Relapse Prophylaxis. Current Opinion in Psychiatry, 29(1), 7–12. http://doi.org/10.1097/YCO.0000000000000216

 

Key Points

Data from multiple RCTs indicates that MBCT is effective in preventing relapse and reducing residual symptoms in patients with recurrent depression who are in clinical remission.

Studies of the mechanisms of change in MBCT point to reductions in rumination and increases in metacognitive awareness as being consistently associated with clinical benefits

In an effort to reduce barriers to care, MBCT has been adapted for online delivery – Mindful Mood Balance – with early data suggesting good patient engagement and outcomes.

Mindfulness meditation is associated with increased activations in the insula and prefrontal cortex, neurological changes that parallel behavioural changes in interoceptive awareness and emotion regulation.

 

Abstract

Purpose of review

This article reviews the recent evidence for mindfulness based cognitive therapy (MBCT) for patients with residual depressive symptoms or in remitted patients at increased risk for relapse.

Recent findings

Randomized controlled trials have shifted focus from comparing MBCT with treatment-as-usual to comparing MBCT against interventions. These studies have provided evidence for the efficacy of MBCT on par with maintenance antidepressant pharmacotherapy and leading to a relative reduction of risk on the order of 30–40%. Perhaps fuelled by these data, recent efforts have focused on extending MBCT to novel populations, such as acutely depressed patients, those diagnosed with health anxiety, social anxiety, fibromyalgia, or multiple chemical sensitivities as well migrating MBCT to online platforms so that it is more widely available. Neuroimaging studies of patients in structured therapies which feature mindfulness meditation, have reported findings that parallel behavioural changes, such as increased activation in brain regions subsuming self-focus and emotion regulation (prefrontal cortex) and interoceptive awareness (insula).

Summary

The current evidence base for MBCT is strongest for its application as a prophylactic intervention or for residual depressive symptoms, with early data suggesting additional indications outside the mood disorders. Future work will need to address dose-effect relationships between mindfulness practice and clinical benefits as well as establishing the rates of uptake for online MBCT so that its benefits can be compared to in-person groups. Additionally, validating current or novel neural markers of MBCT treatment response will allow for patient matching and optimization of treatment response.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4706736/

 

Improve Treatment Resistant Depression with Mindfulness

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Improve Treatment Resistant Depression with Mindfulness

 

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. 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 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.

 

Being depressed and not responding to treatment (Treatment Resistant Depression) 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 be applied when the typical treatments fail. 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. In order to identify the best possible treatment, it is particularly important to investigate MBCT’s efficacy for Treatment Resistant Depression relative to other treatments that place equivalent demands upon the patients.

 

In today’s Research News article “A Randomized Controlled Trial of Mindfulness-Based Cognitive Therapy for Treatment-Resistant Depression.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4756643/

Eisendrath and colleagues compared the relative efficacy of MBCT to a structurally equivalent active comparison condition, a Health-Enhancement Program. They recruited adults who were diagnosed with Major Depressive Disorder who were taking antidepressant medication. They were encouraged to continue their antidepressant medication while participating in the study. They were randomly assigned, stratified by gender, to receive 8-weeks of either standard Mindfulness Based Cognitive Therapy (MBCT) treatment or the Health-Enhancement Program. Both groups met once a week for 2 ¼ hours and were assigned 45 minutes of homework 6 days per week. The MBCT program included training in skills to identify cognitive distortions and to disengage from depression-focused ruminative thinking patterns, body scans, sitting meditations, three-minute breathing spaces, and mindful movement. The Health-Enhancement Program included aerobic exercise, functional movement, music therapy, and dietary education. The participants were evaluated for depression levels, and expectancies of treatment effects before and after treatment and mid-treatment (4-weeks).

 

They found that MBCT, in comparison to the Health-Enhancement Program produced a significantly greater reduction in depression (36.6% vs. 25.3%). In addition, MBCT treatment had a significantly greater proportion of patients respond to treatment. MBCT also produced higher, albeit not significantly different, rates of depression remission (22.4%). The two groups did not differ in their expectations that treatment would be successful, suggesting equivalent placebo effects. Hence, MBCT, was found to be superior to a structurally equivalent Health-Enhancement Program treatment in reducing depression in patients with Treatment Resistant Depression (TRD).

 

These are exciting results and strengthen the case that Mindfulness Based Cognitive Therapy (MBCT) is an effective treatment for the very difficult to treat Treatment Resistant Depression. MBCT uses mindfulness training and cognitive training to allow the patients to reprogram their thought patterns and how they interpret experiences, recognizing that their thoughts are only, just that, thoughts and not reflective of their selves. They learn to experience their emotions but adaptively react to them, seeing them as simply experiences that come and go. This helps them release rumination about past and future problems and focus on the present. This appears to go to the core of the psychological aspects of the disorder and greatly enhance the patient’s ability to cope with their depression.

 

So, improve treatment resistant depression with mindfulness.

 

“MBCT enables people to relate mindfully to the self and with others. The key, it seems, lies in the way MBCT enhances relationships: Less stress about relationships in turn helps prevent future episodes of depression.” – Emily Nauman

 

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

Eisendrath, S. J., Gillung, E., Delucchi, K. L., Segal, Z. V., Nelson, J. C., McInnes, L. A., … Feldman, M. D. (2016). A Randomized Controlled Trial of Mindfulness-Based Cognitive Therapy for Treatment-Resistant Depression. Psychotherapy and Psychosomatics, 85(2), 99–110. http://doi.org/10.1159/000442260

 

Abstract

Background

Due to the clinical challenges of treatment-resistant depression (TRD), we evaluated the efficacy of Mindfulness-Based Cognitive Therapy (MBCT) relative to a structurally equivalent active comparison condition as adjuncts to treatment-as-usual (TAU) pharmacotherapy in TRD.

Methods

This single site, randomized controlled trial compared 8-week courses of MBCT and the Health-Enhancement Program (HEP), comprising physical fitness, music therapy and nutritional education, as adjuncts to TAU pharmacotherapy for outpatient adults with TRD.

The primary outcome was change in depression severity, measured by percent reduction in total score on the 17-item Hamilton Depression Rating Scale (HAM-D17), with secondary depression indicators of treatment response and remission.

Results

We enrolled 173 adults, mean length of current depressive episode was 6.8 years (sd = 8.9). At the end of 8-week treatment, a multivariate analysis showed that relative to the HEP condition, the MBCT condition was associated with a significantly greater mean percent reduction on the HAM-D17 (36.6% versus 25.3%; p=.01) and a significantly higher rate of treatment responders (30.3% versus 15.3%; p=.03). Although numerically superior for MBCT than for HEP, the rates of remission did not significantly differ between treatments (22.4% versus 13.9%; p=.15). In these models, state anxiety, perceived stress, and the presence of personality disorder had adverse effects on outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4756643/

Feel Depressed About a Disease, Try Mindfulness

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Feel Depressed About a Disease, Try Mindfulness

 

By John M. de Castro, Ph.D.

 

“Depression can be the dead hand of the past. Our longing for what we’re missing has a hold on us. If we feel helpless about our situation and don’t feel we can change it, we are likely to remain depressed. If we can mobilize our feelings of hopefulness, if we see that hope is justified and act on it, then our mood will improve.” – James Gordon

 

Clinically diagnosed depression is the most common form of mental illness, affecting over 6% of the population. In general, it involves feelings of sadness, emptiness or hopelessness, irritability or frustration, loss of interest or pleasure in most or all normal activities, sleep disturbances, tiredness and lack of energy, anxiety, agitation, feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things that aren’t your responsibility, suicidal thoughts, and suicide attempts or completed suicide. Needless to say, individuals with depression are miserable and need help.

 

There are numerous causes of depression, one being coping with a chronic physical disease. Indeed, between 9% to 23% of people diagnosed with a chronic physical disease become depressed. Although, there have been many studies of treatments for depression, there are very few that target just patients with physical diseases and comorbid depression. Mindfulness-Based Cognitive Therapy (MBCT) was developed specifically to treat depression and has been found to reduce depression alone or in combination with anti-depressive drugs.  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. Hence, it is reasonable to study the effects of MBCT on patients who suffer with chronic physical disease and comorbid depression.

 

In today’s Research News article “Group and Individual Mindfulness-Based Cognitive Therapy (MBCT) Are Both Effective: a Pilot Randomized Controlled Trial in Depressed People with a Somatic Disease.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1479247762099145/?type=3&theater

or see summary below or view the full text of the study at:

http://link.springer.com/article/10.1007/s12671-016-0575-z

Schroevers and colleagues recruited adults, 18 to 70 years of age who have been diagnosed with a chronic physical disease and comorbid depression. They were randomly assigned to receive 8-weeks, 60-minutes, once a week, with home practice, of Mindfulness-Based Cognitive Therapy (MBCT) administered either individually or in a group of 8-12 patients. Before and after treatment and 3-months later the patients completed measures of depression, anxiety, positive well-being, mindfulness, and self-compassion.

 

They found that, regardless of whether MBCT was administered individually or in a group format, produced clinically significant improvements in depression, anxiety, positive well-being, mindfulness, and self-compassion. The sizes of the effects were large and they were maintained at 3-month follow-up. These results are encouraging and extend the range of applications of MBCT for depression to those who are depressed due to a chronic physical condition. They also suggest that using the much more efficient and cost effective group treatment method does not produce any reduction in benefits.

 

It should be mentioned that there was no control condition. So, the results have to be interpreted cautiously. Nevertheless, these kinds of effects have been demonstrated previously with randomized controlled clinical trials with depressed patients. These have demonstrated effectiveness reducing depression, and anxiety, and increasing positive well-being, mindfulness, and self-compassion So, it would seem reasonable to conclude that the effects observed with patients with chronic physical disease and comorbid depression were due to MBCT treatment and not a confounding factor.

 

So, if you feel depressed about a disease, try mindfulness.

 

“Most of us have issues that we find hard to let go and mindfulness can help us deal with them more productively. We can ask: ‘Is trying to solve this by brooding about it helpful, or am I just getting caught up in my thoughts?’ Awareness of this kind also helps us notice signs of stress or anxiety earlier and helps us deal with them better.” – Mark Williams

 

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 Twitter @MindfulResearch

 

Study Summary

Schroevers, M.J., Tovote, K.A., Snippe, E. et al. Group and Individual Mindfulness-Based Cognitive Therapy (MBCT) Are Both Effective: a Pilot Randomized Controlled Trial in Depressed People with a Somatic Disease. Mindfulness (2016) 7: 1339. doi:10.1007/s12671-016-0575-z

 

Abstract

Depressive symptoms are commonly reported by individuals suffering from a chronic medical condition. Mindfulness-based cognitive therapy (MBCT) has been shown to be an effective psychological intervention for reducing depressive symptoms in a range of populations. MBCT is traditionally given in a group format. The aim of the current pilot RCT was to examine the effects of group-based MBCT and individually based MBCT for reducing depressive symptoms in adults suffering from one or more somatic diseases. In this study, 56 people with a somatic condition and comorbid depressive symptoms (i.e., Beck Depression Inventory-II [BDI-II] ≥14) were randomized to group MBCT (n = 28) or individual MBCT (n = 28). Patients filled out questionnaires at three points in time (i.e., pre-intervention, post-intervention, 3 months follow-up). Primary outcome measure was severity of depressive symptoms. Anxiety and positive well-being as well as mindfulness and self-compassion were also assessed. We found significant improvements in all outcomes in those receiving group or individual MBCT, with no significant differences between the two conditions regarding these improvements. Although preliminary (given the pilot nature and lack of control group), results suggest that both group MBCT and individual MBCT are associated with improvements in psychological well-being and enhanced skills of mindfulness and self-compassion in individuals with a chronic somatic condition and comorbid depressive symptoms. Our findings merit future non-inferiority trials in larger samples to be able to draw more firm conclusions about the effectiveness of both formats of MBCT.

http://link.springer.com/article/10.1007/s12671-016-0575-z

Reduce the Psychological Distress Produced by Chronic Pain with Mindfulness

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Reduce the Psychological Distress Produced by Chronic Pain with Mindfulness

 

By John M. de Castro, Ph.D.

 

“When it comes to chronic pain, the key is learning to live with it rather than vainly trying to avoid or eradicate it; a regular meditation practice is the best ongoing foundation for working with pain.” – Christiane Wolf

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have common chronic pain conditions. It has to be kept in mind that pain is an important signal that there is something wrong or that damage is occurring. This signals that some form of action is needed to mitigate the damage. This is an important signal that is ignored at the individual’s peril. So, in dealing with pain, it’s important that pain signals not be blocked or prevented. They need to be perceived. But, methods are needed to mitigate the psychological distress produced by chronic pain.

 

The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the patients ability to cope with the pain. Pain is affected by the mind. The perception of pain can be amplified by the emotional reactions to it and also by attempts to fight or counteract it. Pain perception can be reduced by aerobic exercise and mental states, including placebo effects, attention, and conditioning. Additionally, mindfulness has been shown to reduce both chronic and acute pain and are safe. Mindfulness may be an effective treatment to be used in combination with other treatments. Hence, it is important to study mindfulness practice effects on chronic pain and the psychological distress it produces.

 

In today’s Research News article “A 13-Weeks Mindfulness Based Pain Management Program Improves Psychological Distress in Patients with Chronic Pain Compared with Waiting List Controls.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1473967172627204/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5037934/

Andersen and Vægter recruited patients with chronic non-malignant pain who entered a pain clinic for treatment and a control group on the waiting list for treatment at the clinic. Both groups received medical treatment as usual, but the intervention group in addition received a 13-week Mindfulness-Based Cognitive Behavior Therapy (MBCT) program. Therapy was conducted once a week in a 2.5-hour session, combined with homework assignments supported with written and recorded materials. Patients were measured for pain intensity, pain catastrophizing, pain acceptance, anxiety, depression, mindfulness, and psychological distress prior to and after treatment.

 

It was found that the Mindfulness-Based Cognitive Behavior Therapy (MBCT) program produced a significant decrease in depression, anxiety, psychological distress, and pain catastrophizing, and an increase in pain acceptance and mindfulness. There were no significant changes in pain intensity. The change in mindfulness and also in pain acceptance were highly correlated with the reduction in psychological distress. Hence, MBCT reduced the psychological impact of chronic pain without changing the perception of pain. It appears to do so by increasing mindfulness and pain acceptance.

 

These are interesting results that suggest that Mindfulness-Based Cognitive Behavior Therapy (MBCT) is a safe and effective adjunct treatment for patients with chronic pain. The fact that MBCT improved mindfulness is expected as mindfulness training is targeted to do just that. The fact that MBCT also improves pain acceptance is also expected as Cognitive Behavioral Therapy is targeted to do so. In addition, mindfulness training and MBCT have been shown to reduce anxiety, depression, and worry and catastrophizing. So, the results would be expected. But, it is always important to confirm even expected outcomes.

 

So, reduce the psychological distress produced by chronic pain with mindfulness.

 

“It is still early days in terms of understanding why meditation can be so helpful in coping with pain, although the ancient origins of meditation in the different yoga and contemplative traditions suggests that people have known of these benefits for hundreds of years.” – Jean Byrne

 

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 Twitter at @MindfulResearch

 

Study Summary

Andersen, T. E., & Vægter, H. B. (2016). A 13-Weeks Mindfulness Based Pain Management Program Improves Psychological Distress in Patients with Chronic Pain Compared with Waiting List Controls. Clinical Practice and Epidemiology in Mental Health : CP & EMH, 12, 49–58. http://doi.org/10.2174/1745017901612010049

 

Abstract

Background:: Eradication of pain is seldom an option in chronic pain management. Hence, mindfulness meditation has become popular in pain management.

Objective: This pilot study compared the effect of a 13-weeks cognitive behavioural therapy program with integrated mindfulness meditation (CBTm) in patients with chronic non-malignant pain with a control condition. It was hypothesised that the CBTm program would reduce pain intensity and psychological distress compared to the control condition and that level of mindfulness and acceptance both would be associated with the reduction in pain intensity and psychological distress.

Methods: A case-control design was used and data were collected from a convenience sample of 70 patients with chronic non-malignant pain. Fifty patients were consecutively recruited to the CBTm intervention and 20 patients matched waiting list controls. Assessments of clinical pain and psychological distress were performed in both groups at baseline and after 13 weeks.

Results: The CBTm program reduced depression, anxiety and pain-catastrophizing compared with the control group. Increased level of mindfulness and acceptance were associated with change in psychological distress with the exception of depression, which was only associated with change in level of mindfulness. Surprisingly, changes in level of mindfulness did not correlate with changes in acceptance.

Conclusions: The results indicate that different mechanisms are targeted with cognitive behavioural therapy and mindfulness. The finding that changes in level of mindfulness did not correlate with changes in acceptance may indicate that acceptance is not a strict prerequisite for coping with pain related distress.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5037934/

 

Improve Mental Health with Mindfulness

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By John M. de Castro, Ph.D.

 

“Mindfulness-Based Cognitive Therapy (MBCT) is designed to help people who suffer repeated bouts of depression and chronic unhappiness. It combines the ideas of cognitive therapy with meditative practices and attitudes based on the cultivation of mindfulness. The heart of this work lies in becoming acquainted with the modes of mind that often characterize mood disorders while simultaneously learning to develop a new relationship to them.” – MBCT.com

 

About one out of every five people suffers from a mental disorder. In the U.S. that amounts to over 44 million people. For the U.S. adults about 1.1% live with schizophrenia, 2.6% with bipolar disorder.  6.9% with major depression, 18.1% with anxiety disorders, and 3% with substance use disorders. This places a tremendous burden on the individual, their families, and the health care system. Obviously there is a critical need to find safe, effective, and affordable treatments for these disorders.

 

Mindfulness training has been shown to be helpful in treating many of these disorders, including schizophrenia, depression, anxiety, and substance abuse. One form of therapy that includes mindfulness training is Mindfulness-Based Cognitive Therapy (MBCT). It was developed specifically to treat depression and has been found to reduce depression alone or in combination with antidepressive drugs. 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. It has proved so effective for depression that it has also begun to be applied to a variety of other mental disorders.

 

In today’s Research News article “Effects of mindfulness-based cognitive therapy on mental disorders: a systematic review and meta-analysis of randomised controlled trials..” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1444323605591561/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5030069/

Galante and colleagues review the published research literature on the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for a variety of mental disorders. They found 11 published randomized controlled trials 10 of which compared MBCT to treatment as usual. There were only a sufficient number of studies to perform a meta-analysis for depression, depression relapse rates, and anxiety. They found that overall the research has demonstrated significant treatment effects for MBCT for the reduction in anxiety and depression. Importantly, MBCT had long-term beneficial effects as evidenced by a significant lowering of the relapse rates from depression on average by 40%.

 

These are important findings that strongly support the application of MBCT for the treatment of depression and anxiety disorders. The effects were not only robust but lasting, still being significantly better then treatment as usual a year after the end of treatment. It is unfortunate that there were not a greater number of studies of the effectiveness of MBCT for other mental disorders. This underscores the need for more research into the application of MBCT to disorders other than anxiety and depression. It has such powerful and lasting effects on anxiety and depression that it would be predicted that it would also be effective for other disorders.

 

It is not known exactly how MBCT relieves anxiety and depression. But, it can be speculated that MBCT, by shifting attention away from the past or future to the present moment, interrupts the kinds of thinking that are characteristic of and support anxiety and depression. These include rumination about past events, worry about future events, and catastrophizing about potential future events. Mindfulness has been shown to interrupt rumination, worry, and catastrophizing and focus the individual on what is transpiring in the present. By interrupting these forms of thinking that support anxiety and depression, shifting attention to the present moment where situations are actually manageable, mindfulness may disrupt depression. MBCT also improves the ability to see thoughts as objects of awareness and not something personal. This may be the most important change to improve anxiety and depression. This changes the relationship of the patients with their thoughts, making them less personal and thereby easier to cope with and change.

 

So, improve mental health 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

 

Study Summary

Galante, J., Iribarren, S. J., & Pearce, P. F. (2013). Effects of mindfulness-based cognitive therapy on mental disorders: a systematic review and meta-analysis of randomised controlled trials. Journal of Research in Nursing : JRN, 18(2), 133–155. http://doi.org/10.1177/1744987112466087

 

Key points for policy, practice and research

  • Patients with recurrent depression (three episodes or more) treated with additive MBCT have on average 40% fewer relapses at one year of follow-up compared to patients undergoing treatment as usual.
  • Improvements in depression and anxiety with additive MBCT were significant at one year of follow-up but unstable in sensitivity analyses.
  • More studies with active control groups and long-term follow-ups are needed to better understand the specific effects of MBCT.
  • Depression is a symptom that is present in many conditions. More high quality RCTs are needed to evaluate MBCT in populations with varying depression severity as well as diagnosis with multiple co-morbidities.

Abstract

Objective: Mindfulness-based cognitive therapy (MBCT) is a programme developed to prevent depression relapse, but has been applied for other disorders. Our objective was to systematically review and meta-analyse the evidence on the effectiveness and safety of MBCT for the treatment of mental disorders.

Methods: Searches were completed in CENTRAL, MEDLINE, EMBASE, LILACS, PsychINFO, and PsycEXTRA in March 2011 using a search strategy with the terms ‘mindfulness-based cognitive therapy’, ‘mindfulness’, and ‘randomised controlled trials’ without time restrictions. Selection criteria of having a randomised controlled trial design, including patients diagnosed with mental disorders, using MBCT according to the authors who developed MBCT and providing outcomes that included changes in mental health were used to assess 608 reports. Two reviewers applied the pre-determined selection criteria and extracted the data into structured tables. Meta-analyses and sensitivity analyses were completed.

Results:Eleven studies were included. Most of them evaluated depression and compared additive MBCT against usual treatment. After 1 year of follow-up MBCT reduced the rate of relapse in patients with three or more previous episodes of depression by 40% (5 studies, relative risk [95% confidence interval]: 0.61 [0.48, 0.79]). Other meta-analysed outcomes were depression and anxiety, both with significant results but unstable in sensitivity analyses. Methodological quality of the reports was moderate.

Conclusion: Based on this review and meta-analyses, MBCT is an effective intervention for patients with three or more previous episodes of major depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5030069/

 

 

Decrease Distress from Hearing Voices with Mindfulness

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By John M. de Castro, Ph.D.

 

“The mindfulness-based psychoeducation group reported significantly greater improvements in psychiatric symptoms, psychosocial functioning, insight into illness/treatment and duration of readmissions to hospital.” – Wai Chien

 

Hearing voices (auditory hallucinations) is seen as a prime symptom of psychosis and is considered a first rank symptom of schizophrenia. Neuroimaging has demonstrated that the voices that people hear are experienced as if there were a real person talking to them with the same brain areas becoming active during voice hearing as during listening to actual speech. So, it would appear that voice hearers are actually experiencing voices.

 

Hearing voices, however, is not always indicative of psychosis. Around 2% – 4% of the population reports hearing voices. But, only about a third of voice hearers are considered psychotic. On the other hand, about two thirds of voice hearers are quite healthy and function well. They cope effectively with the voices they’re hearing, do not receive the diagnosis of psychosis, and do not require psychiatric care. The differences between people with psychoses and healthy people who hear voices, is not in the form but the content of the heard speech. Non-psychotic individuals hear voices both inside and outside their head just like the psychotic patients but either the content is positive or the individual feels positive about the voice or that they are in control of it. By contrast the psychotic patients are frightened of the voices, the voices are more malevolent, and they feel less control over them.

 

Mindfulness has been shown to be negatively related to the distress felt by the individual about hearing voices, such that the higher the level of mindfulness, the lower the level of distress. But, it has not been demonstrated that increasing mindfulness with training can produce decreases in distress. Cognitive Behavioral Therapy (CBT) has been shown repeatedly to help relieve the symptoms of psychosis. So, it would seem reasonable to test the ability of a mindfulness based form of CBT to relieve the distress produced by hearing voices.

 

In today’s Research News article “Group mindfulness-based intervention for distressing voices: A pragmatic randomised controlled trial.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1443292212361367/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4967452/

Chadwick and colleagues recruited participants who had reported hearing voices at least over the last year. The participants were randomly assigned to receive either treatment as usual or a Mindfulness-Based Cognitive Therapy (MBCT) program administered in a group format, weekly for 1.5 hours over 12 weeks. Before and after therapy and 6 months later the participants were measured for auditory hallucinations, anxiety, depression, and psychological distress. They found that the participants who received MBCT had significantly lower depression levels after treatment and 6 months later. In addition, the therapy produced a significant decrease in the distress felt about hearing voices and the participants perceived ability to control the voices.

 

These are interesting results that replicate the frequent finding that MBCT is effective in reducing depression. In addition, MBCT did not affect the severity of the voices heard. Rather it changed how people felt about the voices reducing how distressful they were to the individual and how well they felt that they could control them. So, MBCT doesn’t cause the voices to be heard differently, rather it simply helps the individuals to suffer less from the voices they hear. Being in the present moment may allow the voice hearer to feel more in control and to simply hear the voices without associating them with past or future problems making them much less distressful.

 

So, decrease distress from hearing voices with mindfulness.

 

“mindfulness with individuals with psychosis can facilitate a decrease in overall symptoms, and can promote a reduction in subjective distress and the believability of symptoms. Mindfulness has also been shown to provide participants with a sense of calm and relaxation, while also instilling a sense of power over their experience. Thus, mindfulness-based treatment interventions may be an effective adjunctive treatment approach for individuals with psychotic illnesses.” – Kolina Delgado

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Chadwick, P., Strauss, C., Jones, A.-M., Kingdon, D., Ellett, L., Dannahy, L., & Hayward, M. (2016). Group mindfulness-based intervention for distressing voices: A pragmatic randomised controlled trial. Schizophrenia Research, 175(1-3), 168–173. http://doi.org/10.1016/j.schres.2016.04.001

 

Abstract

Group Person-Based Cognitive Therapy (PBCT) integrates cognitive therapy and mindfulness to target distinct sources of distress in psychosis. The present study presents data from the first randomised controlled trial investigating group PBCT in people distressed by hearing voices. One-hundred and eight participants were randomised to receive either group PBCT and Treatment As Usual (TAU) or TAU only. While there was no significant effect on the primary outcome, a measure of general psychological distress, results showed significant between-group post-intervention benefits in voice-related distress, perceived controllability of voices and recovery. Participants in the PBCT group reported significantly lower post-treatment levels of depression, with this effect maintained at six-month follow-up. Findings suggest PBCT delivered over 12 weeks effectively impacts key dimensions of the voice hearing experience, supports meaningful behaviour change, and has lasting effects on mood.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4967452/

 

 

Reduce Anxiety and Depression in Pregnancy with Mindfulness

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By John M. de Castro, Ph.D.

 

“research is beginning to show how mindfulness decreases depression and anxiety during pregnancy and boosts positive emotions.” – Mindful

 

Depression occurring after delivery of a baby is well known, documented and discussed. Less well known but equally likely is intense depression and anxiety during pregnancy. But, between 14% and 23% of women suffer from some form of depression and between 5% to 16% of women experience an anxiety disorder during pregnancy. Intense anxiety and depression are difficult to deal with 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 torment.

 

Without treatment, prenatal depression can pose a serious threat to a mother-to-be, who may stop taking care of herself or, in extreme cases, become suicidal. This can even cause a woman to want to terminate her pregnancy. There are no statistics on the matter but it has been speculated that prenatal depression can lead to abortion. Anxiety during depression is also a serious threat being associated with more health problems during pregnancy, postpartum depression and anxiety, and premature birth.

 

Prenatal depression and anxiety are often not recognized or diagnosed. When it is, the typical treatment is drugs. But these drugs are often ineffective and frequently have troublesome side effects and may not be safe during pregnancy. So, alternative treatments are needed. Mindfulness training may be an answer. Meditation and yoga practices have been shown to help improve mental and physical health during pregnancy. This is encouraging as mindfulness training has many benefits and is completely safe, even during pregnancy. Hence, it is important to further research the potential beneficial effects of mindfulness training during pregnancy.

 

In today’s Research News article “The Effect of Mindfulness-integrated Cognitive Behavior Therapy on Depression and Anxiety among Pregnant Women: a Randomized Clinical Trial.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1417100888313833/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5045953/

Yazdanimehr and colleagues investigate the effectiveness of mindfulness training for anxiety and depression during pregnancy. They recruited women who were 1 to 6 months pregnant and randomly assigned them to receive treatment as usual (control) or Mindfulness-Based Cognitive Therapy (MBCT). Treatment was delivered over 8 weeks with 1.5 hour sessions occurring once a week. Depression and anxiety were measured before and after treatment and followed up 1 month later.

 

They found that the women receiving MBCT had significant improvements in both depression (46%) and anxiety (45%) at the end of treatment and at one month follow-up while there were no significant change for the control participants. Mindfulness-Based Cognitive Therapy (MBCT) was developed specifically to treat depression. So, its effectiveness with the women is not surprising. It develops mindfulness and works to alter thought patterns to interpret experiences objectively without reference to negative or self-deprecating beliefs. This training is very effective for the relief of depression and also anxiety.

 

The fact that MBCT had such large effects with this vulnerable population is particularly encouraging. By relieving anxiety and depression in these pregnant women it should be helping to insure a better pregnancy, more full term births, and less problems postnatally. This suggests that MBCT could be a very valuable treatment and perhaps a recommended practice for pregnant women.

 

So, reduce anxiety and depression in pregnancy with mindfulness.

 

“Pregnancy and childbirth are great crash-courses for motherhood. For nine months, you are increasingly required to be in your body. Labor and childbirth may be the time when you are most in touch with your body-the most embodied any of us will ever be-though not necessarily in a very comfortable way. This doesn’t end when the baby is born. Learning how to be present and grounded in your body even in the face of discomfort is a great skill to cultivate now and for the rest of your life as a mother.” – 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

 

Study Summary

Yazdanimehr, R., Omidi, A., Sadat, Z., & Akbari, H. (2016). The Effect of Mindfulness-integrated Cognitive Behavior Therapy on Depression and Anxiety among Pregnant Women: a Randomized Clinical Trial. Journal of Caring Sciences, 5(3), 195–204. http://doi.org/10.15171/jcs.2016.021

 

Abstract

Introduction: Pregnancy can be associated with different psychological problems such as depression and anxiety. These problems are often neglected and left untreated. This study aimed to examine the effect of mindfulness-integrated cognitive behavior therapy on depression and anxiety among pregnant women.

Methods: A convenient sample of 80 pregnant women were selected. Participants were randomly allocated to either the experimental or the control groups. Participants in the experimental group received mindfulness-integrated cognitive behavior therapy while women in the control group only received routine prenatal care services. A demographic questionnaire, the Edinburgh Postnatal Depression Scale, and the Beck Anxiety Inventory were used for data collection. Descriptive statistics measures such as frequency, mean, and standard deviation as well as the repeated-measures analysis of variance test were used for data analysis.

Results: After the study intervention, the mean scores of anxiety and depression in the experimental group were significantly lower than the control group.

Conclusion: Mindfulness-integrated cognitive behavior therapy can significantly alleviate pregnant women’s depression and anxiety. So implementation of this method alongside with other prenatal care services is recommended.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5045953/

 

Cost Effectively Treat Recurrent Depression with Mindfulness

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By John M. de Castro, Ph.D.

 

“Depression is not only the most common mental illness, it’s also one of the most tenacious. Up to 80 percent of people who experience a major depressive episode may relapse. Drugs may lose their effectiveness over time, if they work at all. But a growing body of research is pointing to an intervention that appears to help prevent relapse by altering thought patterns without side effects: mindfulness-based cognitive therapy, or MBCT”. – Stacy Lu

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. 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 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.

 

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 be applied when the typical treatments fail. 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. Hence, MBCT is a promising alternative treatment. As such, it is important to further investigate its effectiveness. But, costs are also important, so determining the cost-effective of MBCT is also very important.

 

In today’s Research News article “Mindfulness-based cognitive therapy for recurrent major depression: A ‘best buy’ for health care?” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1408935652463690/?type=3&theater

or see summary below, Shawyer and colleagues recruited adults who were in remission from verified Major Depressive Disorder and engaged them in a continuous self-monitoring of depression. They were then randomly assigned them to either receive no-treatment or 8 weeks of 2 hour, once a week, Mindfulness-Based Cognitive Therapy (MBCT) with once a month optional booster sessions for 3 months. They measured days depressed, patient quality of life, and the economic costs of disability and treatment, before and after treatment and 14 and 24 months later.

 

They found that over the two years of the study that the patients receiving MBCT had significantly fewer days (44%) with depression than control patients regardless of whether treatment was performed in primary or secondary care facilities. This resulted in major cost savings, with the yearly costs for mental health treatment for the MBCT treated patients 32% lower and overall health care costs 24% lower than control patients. Hence, Mindfulness-Based Cognitive Therapy (MBCT) was found to be not only an effective treatment for reoccurrence of major depression, but also a cost-effective treatment.

 

MBCT uses mindfulness training and cognitive training to allow the patients to reprogram their thought patterns and how they interpret experiences, recognizing that their thoughts are only, just that, thoughts and not reflective of their selves. They learn to experience their emotions but adaptively react to them, seeing them as simply experiences that come and go. The results of today’s Research News study demonstrates, as have a number of other studies, that this approach is effective for the treatment of recurrent depression. But, in today’s cost conscious medical environment, the study, importantly, demonstrated that MBCT also reduces health care costs. Hence, MBCT improves major depression cost-effectively.

 

So, cost effectively treat recurrent depression with mindfulness.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

“Through mindfulness, individuals start to see their thoughts as less powerful. These distorted thoughts – such as “I always make mistakes” or “I’m a horrible person” – start to hold less weight. We ‘experience’ thoughts and other sensations, but we aren’t carried away by them. We just watch them come and go.” – William Marchand

 

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

 

Study Summary

Frances Shawyer, Joanne C Enticott, Mehmet Özmen, Brett Inder,and Graham N Meadows Mindfulness-based cognitive therapy for recurrent major depression: A ‘best buy’ for health care? Aust N Z J Psychiatry, October 2016; vol. 50, 10: pp. 1001-1013., first published on April 19, 2016

 

Abstract

Objective: While mindfulness-based cognitive therapy is effective in reducing depressive relapse/recurrence, relatively little is known about its health economic properties. We describe the health economic properties of mindfulness-based cognitive therapy in relation to its impact on depressive relapse/recurrence over 2 years of follow-up.

Method: Non-depressed adults with a history of three or more major depressive episodes were randomised to mindfulness-based cognitive therapy + depressive relapse active monitoring (n = 101) or control (depressive relapse active monitoring alone) (n = 102) and followed up for 2 years. Structured self-report instruments for service use and absenteeism provided cost data items for health economic analyses. Treatment utility, expressed as disability-adjusted life years, was calculated by adjusting the number of days an individual was depressed by the relevant International Classification of Diseases 12-month severity of depression disability weight from the Global Burden of Disease 2010. Intention-to-treat analysis assessed the incremental cost–utility ratios of the interventions across mental health care, all of health-care and whole-of-society perspectives. Per protocol and site of usual care subgroup analyses were also conducted. Probabilistic uncertainty analysis was completed using cost–utility acceptability curves.

Results: Mindfulness-based cognitive therapy participants had significantly less major depressive episode days compared to controls, as supported by the differential distributions of major depressive episode days (modelled as Poisson, p < 0.001). Average major depressive episode days were consistently less in the mindfulness-based cognitive therapy group compared to controls, e.g., 31 and 55 days, respectively. From a whole-of-society perspective, analyses of patients receiving usual care from all sectors of the health-care system demonstrated dominance (reduced costs, demonstrable health gains). From a mental health-care perspective, the incremental gain per disability-adjusted life year for mindfulness-based cognitive therapy was AUD83,744 net benefit, with an overall annual cost saving of AUD143,511 for people in specialist care.

Conclusion: Mindfulness-based cognitive therapy demonstrated very good health economic properties lending weight to the consideration of mindfulness-based cognitive therapy provision as a good buy within health-care delivery.

http://anp.sagepub.com.ezproxy.shsu.edu/content/50/10/1001.full

Improve Sexual Function with Mindfulness

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By John M. de Castro, Ph.D.

 

“A key factor in having better sex is actually being there when you’re having it. Being there not just physically — being fully present, in thought, word and deed. it’s about really showing up and tuning in, to the moment, yourself and your partner.” –  Marsha Lucas

 

Problems with sex are very common, but, with the exception of male erectile dysfunction, driven by the pharmaceutical industry, it is rarely discussed and there is little research. The Puritanical attitudes toward sex in the U.S., in particular, produce inhibitions toward overt explorations of the issues surrounding sex. But, these problems have a major impact on people’s lives and deserve far more attention. 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. It is amazing that such an important human behavior is can be problematic for so many people without an outcry for more study and research.

 

Problems with sex with women can involve reduced sex drive, difficulty becoming aroused, vaginal dryness, lack of orgasm and decreased sexual satisfaction. Sexual function in women involves many different systems in the body, including physical, psychological and hormonal factors. So, although, female sexual dysfunction is often caused by physical/medical problems, it is also frequently due to psychological issues. This implies that it many cases may be treated with activities that are effective in working with psychological problems. Mindfulness trainings have been shown to improve a variety of psychological issues including emotion regulation, stress responses, trauma, fear and worry, anxiety, and depression, and self-esteem. So, perhaps mindfulness training could help resolve psychological issues that might be affecting sexual behavior. Hence, it would make sense to investigate the effectiveness of mindfulness training as a treatment for female sexual dysfunction.

 

In today’s Research News article “A Pilot Study of Eight-Session Mindfulness-Based Cognitive Therapy Adapted for Women’s Sexual Interest/ Arousal Disorder.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1396097427080846/?type=3&theater

or see summary below. Paterson, Handy, and Brotto recruited women who were diagnosed with Sexual Interest/Arousal Disorder (SIAD) and provided for them an 8-week program of group Mindfulness-Based Cognitive Therapy adapted for sexual issues (MBCT-S). This program included mindfulness training, cognitive therapy, and sex therapy. Before and after treatment they were assessed for sexual interest, sex-related distress, overall sexual function, mindfulness, self-compassion, interoceptive awareness, depression, rumination, anxiety, and treatment expectations. They found that following treatment the women had significant improvements in overall sexual function (26%), sexual desire (60%), sex-related distress (20%). There were also significant improvements in mindfulness, interoceptive awareness, depression, rumination, and anxiety. In addition, they found that the improvement in overall sexual function was due, in part, to the treatment producing increased mindfulness and self-compassion, and decreased depression. So, MBCT-S improved the psychological and sexual health of the women.

 

These are interesting and potentially important preliminary findings. This was a small trial without a control condition, so conclusions need to be tempered with the understanding that the significant differences between before and after treatment may be due to experimental contamination including placebo effects. In addition, it cannot be determined if the effects may have been produced by any kind of therapy and not necessarily MBCT-S. Indeed, before the therapy commenced that participants expressed moderate expectations of treatment success, suggesting significant subject expectancy effects that could make any program appear successful. But, regardless, the outcomes were compelling enough to justify performing a large randomized controlled trial.

 

Nevertheless, the results may indicate that mindfulness based therapy tailored for sexual dysfunction may be a safe and effective means to treat Sexual Interest/Arousal Disorder (SIAD). Sex is very important in relationships and, to some extent, bonding and holding partners together. It can also be very important for the individual’s mental and physical well-being and feelings of self-worth. So, addressing sexual issues is important for the health of the individual and the family and these results suggest that MBCT-S may be a safe and effective treatment.

 

So, improve sexual function with mindfulness.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

“Sexual health is an integral component of quality of life and sexual dysfunction impacts mood, well-being, relationship satisfaction, and many domains of quality of life. Improvements in sexual functioning can positively impact each of these domains.” – Lori Brotto

 

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

 

Study Summary

Laurel Q. P. Paterson, Ariel B. Handy & Lori A. Brotto (2016): A Pilot Study of Eight-Session Mindfulness-Based Cognitive Therapy Adapted for Women’s Sexual Interest/ Arousal Disorder, The Journal of Sex Research, DOI: 10.1080/00224499.2016.1208800

 

Abstract

While few treatment options exist for low sexual desire and arousal, the most common sexual dysfunction in women, a growing body of research supports the efficacy of mindfulness-based approaches. The mechanisms underlying improvements, and whether they are due to mindfulness practice or other treatment components, are unclear. As a result, we designed and pilot-tested an eight-session group mindfulness-based cognitive therapy for sexuality (MBCT-S) program that includes more extensive practice of mindfulness skills and closely aligns with the evidence-based MBCT program for depression and anxiety. A total of 26 women (mean age 43.9, range 25 to 63) with a diagnosis of sexual interest/arousal disorder participated in eight weekly group sessions, before and after which they completed validated questionnaires. The majority of women attended all sessions and completed the recommended at-home mindfulness exercises. Compared to baseline, women reported significant improvements in sexual desire, overall sexual function, and sex-related distress, regardless of treatment expectations, relationship duration, or low desire duration. Depressed mood and mindfulness also significantly improved and mediated increases in sexual function. These pilot data suggest that eight-session MBCT-S is feasible and significantly improves sexual function, and provide the basis for a larger randomized-controlled trial (RCT) with a longer follow-up period.

 

Get Parents Out of the Dumps with Mindfulness

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By John M. de Castro, Ph.D.

 

“a lot of the work is about learning to make peace with our imperfections. Because we’re going to do things that are going to land our kids in therapy, we’re gonna do things that hurt our kids. We can beat ourselves up. But if, instead, we were able to make peace with our imperfections and begin to regulate our emotional state, we can be calmer and more present for our kids and cultivate some self-compassion.” – Elisha Goldstein

 

Clinically diagnosed depression is the most common form of mental illness, affecting over 6% of the population. In general, it involves feelings of sadness, emptiness or hopelessness, irritability or frustration, loss of interest or pleasure in most or all normal activities, sleep disturbances, tiredness and lack of energy, anxiety, agitation, feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things that aren’t your responsibility, suicidal thoughts, and suicide attempts or completed suicide. Needless to say individuals with depression are miserable and need help.

 

Depression does not occur in isolation. When an individual in a family is depressed, it affects all of the members of the family. When it is a parent, it affects how the child is raised and what he/she experiences during the formative years. This can have long-lasting effects on the child. So, it is important to study how depression affects childrearing and the child and what are the factors that might mitigate or eliminate the effects of parental depression on the child. Mindfulness training has been shown to both reduce depression and to improve parenting. Mindfulness-Based Cognitive Therapy (MBCT) was developed specifically to treat depression and has been found to reduce depression alone or in combination with antidepressive drugs.  Hence, it is reasonable to study the effects of MBCT on parents who suffer with depression and their children.

 

In today’s Research News article “Manual Development and Pilot Randomised Controlled Trial of Mindfulness-Based Cognitive Therapy Versus Usual Care for Parents with a History of Depression.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/pb.627681673922429.-2207520000.1480075619./1392058374151418/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010613/

Mann and colleagues recruited parents with children who were attending an outpatient depression clinic and randomly assigned them to either continue with treatment as usual or receive a form of Mindfulness-Based Cognitive Therapy that was adapted for parents (MBCT-P). They were measured before therapy and 4 and 9 months after for depression, parental stress, mindfulness, self-compassion, and the children’s behavior. They found that the Mindfulness-Based Cognitive Therapy for parents (MBCT-P) treatment program in comparison to treatment as usual significantly reduced depression and improved mindfulness and self-compassion at 9-months after treatment. They also found that there were significantly fewer behavior problems with the children.

 

These are very interesting and promising results. They suggest that this newly developed Mindfulness-Based Cognitive Therapy for parents (MBCT-P) program is a safe, effective, and long lasting treatment for parental depression which, in turn, leads to improved behavior in the children. It should be noted that this was a small pilot trial and the results need to be confirmed with a larger number of participants before making firm conclusions. But, the fact that significant results were obtained from such a small sample suggests that the effects of MBCT-P are robust.

 

That MBCT-P relieved depression and improved mindfulness and self-compassion should be expected given the large array of research demonstrating the effectiveness of Mindfulness-Based Cognitive Therapy for depression. It is an important, but not surprising, consequence of MBCT-P that the children’s behavior was improved. It can be speculated that with the depression relived the parents are better able to engage with their children and be more effective and mindful parents. Future research should investigate precisely what changes occur in parenting behaviors after MBCT-P training and how they affect the children.

 

So, get parents out of the dumps with mindfulness.

 

“Mindfulness helps parents emerge from autopilot and end ineffective habits, Bertin said. For instance, instead of getting frustrated and yelling at your child during a homework session – like you might usually do — you’re able to pause and observe your feelings, and act in a calmer, and perhaps more effective way.” – Mark Bertin

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Mann, J., Kuyken, W., O’Mahen, H., Ukoumunne, O. C., Evans, A., & Ford, T. (2016). Manual Development and Pilot Randomised Controlled Trial of Mindfulness-Based Cognitive Therapy Versus Usual Care for Parents with a History of Depression. Mindfulness, 7(5), 1024–1033. http://doi.org/10.1007/s12671-016-0543-7

 

Abstract

Parental depression can adversely affect parenting and children’s development. We adapted mindfulness-based cognitive therapy (MBCT) for parents (MBCT-P) with a history of depression and describe its development, feasibility, acceptability and preliminary estimates of efficacy. Manual development involved interviews with 12 parents who participated in MBCT groups or pilot MBCT-P groups. We subsequently randomised 38 parents of children aged between 2 and 6 years to MBCT-P plus usual care (n = 19) or usual care (n = 19). Parents were interviewed to assess the acceptability of MBCT-P. Preliminary estimates of efficacy in relation to parental depression and children’s behaviour were calculated at 4 and 9 months post-randomisation. Levels of parental stress, mindfulness and self-compassion were measured. Interviews confirmed the acceptability of MBCT-P; 78 % attended at least half the sessions. In the pilot randomised controlled trial (RCT), at 9 months, depressive symptoms in the MBCT-P arm were lower than in the usual care arm (adjusted mean difference = −7.0; 95 % confidence interval (CI) = −12.8 to −1.1; p = 0.02) and 11 participants (58 %) in the MBCT-P arm remained well compared to 6 (32 %) in the usual care arm (mean difference = 26 %; 95 % CI = −4 to 57 %; p = 0.02). Levels of mindfulness (p = 0.01) and self-compassion (p = 0.005) were higher in the MBCT-P arm, with no significant differences in parental stress (p = 0.2) or children’s behaviour (p = 0.2). Children’s behaviour problems were significantly lower in the MBCT-P arm at 4 months (p = 0.03). This study suggests MBCT-P is acceptable and feasible. A definitive trial is needed to test its efficacy and cost effectiveness.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010613/