MBCT

Improve Bipolar Disorder with Few Adverse Complications with Mindfulness

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Improve Bipolar Disorder with Few Adverse Complications with Mindfulness

 

By John M. de Castro, Ph.D.

 

“[Mindfulness-Based Cognitive Therapy] in [bipolar disorder] is associated with improvements in cognitive functioning and emotional regulation, reduction in symptoms of anxiety depression and mania symptoms.” – Sanja Bojic

 

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

 

Bipolar disorder affects about 1% of the population throughout the world at any time. But about 3% to 10% of the population may experience it sometime during their lives. It is usually treated with drugs. But these medications are not always effective and can have difficult side effects. This disorder has generally been found to be very difficult to treat with psychotherapy. Hence, there is a great need for alternative treatments.

 

Mindfulness practices and treatments have been shown to be effective for major mental disorders, including  depression and anxiety disorders and to improve the regulation of emotions.  Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior. But whether MBCT may produce adverse events that may worsen bipolar disorder has not been well investigated.

 

In today’s Research News article “Adverse or therapeutic? A mixed-methods study investigating adverse effects of Mindfulness-Based Cognitive Therapy in bipolar disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8568103/ ) Hanssen and colleagues recruited patients who were diagnosed with bipolar disorder and provided them with 8 weekly 2.5-hour group sessions of Mindfulness-Based Cognitive Therapy (MBCT) along with home practice. The patients completed weekly self-reports of adverse events; “any meditation related-effects that occurred during the course of MBCT, which patients indicated as having a negative valence or negative impact on daily functioning”. Patients who reported adverse events received structured interviews regarding the events.

 

They found that 38% of the patients reported at least one adverse event. These included in order of frequency reported self-related doubts, depression, anxiety, agitation, re-experiencing of traumatic affect, derealization, distrust, mania, depersonalization, unusual bodily sensations, and visual hallucinations. Over the course of Mindfulness-Based Cognitive Therapy (MBCT) treatment the number of patients reporting adverse events declined and the number of adverse events per patient declined. There were no serious adverse events leading to hospitalization or permanent damage. More than half of the patients found the adverse events challenging but thought that they were actually a beneficial part of their therapeutic process and the development of mindfulness skills.

 

This is important research as adverse events during mindfulness training even in normal individuals can produce adverse events. In seriously mentally ill individuals like those with bipolar disorder adverse event are quite common. So, understanding the nature and consequences of these events is important in calculating the risk-reward of engaging in therapy. It appears that even in these seriously mentally ill patients that the adverse events are generally mild and perceived as aiding in the therapeutic process. This suggests that the risks of therapy for these patients are small and the potential rewards great.

 

So, improve bipolar disorder with few adverse complications with mindfulness.

 

“medication can help people with bipolar disorder in the short term, and that meditation is helpful in promoting a more balanced mood over a longer period of time.” – Anthony Watt

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Hanssen, I., Scheepbouwer, V., Huijbers, M., Regeer, E., Lochmann van Bennekom, M., Kupka, R., & Speckens, A. (2021). Adverse or therapeutic? A mixed-methods study investigating adverse effects of Mindfulness-Based Cognitive Therapy in bipolar disorder. PloS one, 16(11), e0259167. https://doi.org/10.1371/journal.pone.0259167

 

Abstract

Background

Mindfulness-Based Interventions (MBIs) are widely used in clinical and non-clinical populations, but little attention has been given to potential adverse effects (AEs).

Aims

This study aimed to gain insight in the prevalence and course of AEs during Mindfulness-Based Cognitive Therapy (MBCT) for patients with bipolar disorder (BD).

Method

The current mixed-methods study was conducted as part of a RCT on (cost-) effectiveness of MBCT in 144 patients with BD (Trial registered on 25th of April 2018, ClinicalTrials.gov, NCT03507647). During MBCT, occurrence of AEs was monitored prospectively, systematically, and actively (n = 72). Patients who reported AEs were invited for semi-structured interviews after completing MBCT (n = 29). Interviews were analysed with directed content analysis, using an existing framework by Lindahl et al.

Results

AEs were reported by 29 patients, in seven of whom the experiences could not be attributed to MBCT during the interview. AEs were reported most frequently up to week 3 and declined afterwards. Baseline anxiety appeared to be a risk factor for developing AEs. Seven existing domains of AEs were observed: cognitive, perceptual, affective, somatic, conative, sense of self, and social. Influencing factors were subdivided into predisposing, precipitating, perpetuating, and mitigating factors. With hindsight, more than half of patients considered the reported AEs as therapeutic rather than harmful.

Conclusions

Although the occurrence of AEs in MBCT for patients with BD is not rare, even in this population with severe mental illness they were not serious or had lasting bad effects. In fact, most of them were seen by the patients as being part of a therapeutic process, although some patients only experienced AEs as negative.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8568103/

 

Improve Food Related Cognitive Processing in Patients with Eating Disorders with Mindfulness

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Improve Food Related Cognitive Processing in Patients with Eating Disorders with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Practicing mindfulness techniques has proven to be extremely helpful in aiding individuals to understand the driving forces behind their eating disorder.” – Greta Gleissner

 

Around 30 million people in the United States of all ages and genders suffer from an eating disorder: either anorexia nervosa, bulimia, or binge eating disorder. 95% of those who have eating disorders are between the ages of 12 and 26. Eating disorders are not just troubling psychological problems, they can be deadly, having the highest mortality rate of any mental illness. Two example of eating disorders are binge eating disorder (BED) and bulimia nervosa (BN). BED involves eating a large amount of food within a short time-period while experiencing a sense of loss of control over eating. BN involves binge-eating and purging (e.g., self-induced vomiting, compensatory exercise).

 

Eating disorders can be difficult to treat because eating is necessary and cannot be simply stopped as in smoking cessation or abstaining from drugs or alcohol. One must learn to eat appropriately not stop. So, it is important to find methods that can help prevent and treat eating disorders. Contemplative practices, mindfulness, and mindful eating have shown promise for treating eating disorders. It is not known however, what processes are affected by mindfulness training to improve eating disorders.

 

In today’s Research News article “Mindfulness-based cognitive therapy added to usual care improves eating behaviors in patients with bulimia nervosa and binge eating disorder by decreasing the cognitive load of words related to body shape, weight, and food.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8668447/ ) Sala and colleagues recruited adult participants who were diagnosed with either bulimia nervosa or binge eating disorder. They were on a wait-list for 8 weeks and then received weekly 2-hour sessions over 8 weeks 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 and exacerbate psychological symptoms. They were measured before and after therapy for mindfulness, eating behaviors, anxiety, and depression. In addition, the participants were presented cards printed in various colors with either neutral words or food related words and asked to name the color of the word as quickly as possible.

 

After Mindfulness-Based Cognitive Therapy (MBCT) there were significant improvements in mindfulness, anxiety, depression and eating behaviors, including nonreactivity, cognitive restraint, disinhibition, and hunger. In addition, the reaction times to food-related words was significantly shorter after MBCT. Path analysis revealed that MBCT affected eating behavior indirectly by altering the responses to the food-related words.

 

These results are interesting, but the study lacked a comparison (control) condition limiting the strength of the conclusions. But previous controlled research has demonstrated that mindfulness training improves eating disorders. So, the present results are likely due to the effects of Mindfulness-Based Cognitive Therapy (MBCT) and not to potential confounding variables.

 

The present study, though, has an interesting new finding. Mindfulness-Based Cognitive Therapy (MBCT) appears to affect the cognitive processing involved with eating. This includes nonreactivity, cognitive restraint, disinhibition, and hunger. These changes predict more healthful eating behavior and a reduction in disordered eating. In addition, MBCT affected these cognitive processes only indirectly by altering responses to food-related cues (words). This suggests that MBCT improves eating disorders by changing the thought processes in response to food cues. In other words, mindfulness improves eating disorders by altering how the individual processes information related to food. This interesting finding needs further research.

 

So, improve food related cognitive processing in patients with eating disorders with mindfulness.

 

“increasing mindful awareness of internal experiences and automatic patterns could be effective for the improvement of self-acceptance and emotional regulation, thereby reducing the problematic eating behaviors.” – Jinyue Yu

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Sala, L., Gorwood, P., Vindreau, C., & Duriez, P. (2021). Mindfulness-based cognitive therapy added to usual care improves eating behaviors in patients with bulimia nervosa and binge eating disorder by decreasing the cognitive load of words related to body shape, weight, and food. European psychiatry : the journal of the Association of European Psychiatrists, 64(1), e67. https://doi.org/10.1192/j.eurpsy.2021.2242

 

Abstract

Background

This study aimed to investigate the effectiveness of mindfulness-based cognitive therapy (MBCT) as a complementary approach in patients with bulimia nervosa (BN) or binge eating disorder (BED), and to assess how the reduction of the cognitive load of words related to eating disorders (ED) could constitute an intermediate factor explaining its global efficacy.

Methods

Eighty-eight women and men participated in clinical assessments upon inscription, prior to and following 8-week group MBCT. Mindfulness skills were assessed using the five facet mindfulness questionnaire; eating behaviors were assessed using the Three Factor Eating Questionnaire (TFEQ); comorbid pathologies were assessed using the beck depression index and the state-trait anxiety inventory. The cognitive load of words associated with ED was assessed through a modified version of the Stroop color naming task.

Results

Mindfulness skills improved significantly (p < .05) after group MBCT. The improvement of TFEQ scores was accompanied by reduced levels of depressive mood and trait anxiety. The positive impact of MBCT on TFEQ score was directly related to an improvement of the performance in the Stroop task.

Conclusions

MBCT represents an interesting complementary therapy for patients with either BN or BED, at least when cognitive and behavioral domains are concerned. Such efficacy seems to be mediated by the reduction of the cognitive load associated with ED stimuli, which offers a possible explanation of how MBCT could reduce binge-eating behaviors. Other studies are needed, in independent centers, to focus more directly on core symptoms and long-term outcome.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8668447/

 

Reduce Depression with Mindfulness Training in Primary Care

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Reduce Depression with Mindfulness Training in Primary Care

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

The most commonly used mindfulness technique for the treatment of depression is Mindfulness-Based Cognitive Therapy (MBCT).  MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. MBCT has been shown to be as effective as antidepressant drugs in relieving the symptoms of depression and preventing depression reoccurrence and relapse. In addition, it appears to be effective as either a supplement to or a replacement for these drugs. The research, however, has been performed in controlled settings. So, there is a need to determine if it’s effective in real world applications such as in primary care.

 

In today’s Research News article “The Effectiveness of Mindfulness-Based Cognitive Therapy in Primary Care and the Role of Depression Severity and Treatment Attendance.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8628140/ ) Elices and colleagues recruited patients through primary care physicians who had participated in Mindfulness-Based Cognitive Therapy (MBCT) for mental health issues. MBCT involved 8 weekly 2.5-hour sessions and included daily home practice. The patients were measured for personality, and depression.

 

They found that after Mindfulness-Based Cognitive Therapy (MBCT) patients who were in the normal range for depression prior to therapy had small but significant reductions in depression while those who were classified as either mildly, moderately, or severely depressed prior to therapy had large and significant reductions in depression. Hence, in real world applications, .MBCT significantly reduced depression regardless of the initial state of depression.

 

Mindfulness training has been repeatedly shown to reduce depression in a wide range of ill and healthy participants. But most of the research involved systematic controlled research. The present study shows that even in the messy and uncontrolled situation of real world primary care applications, Mindfulness-Based Cognitive Therapy (MBCT) is very effective treatment for depression.

 

So, reduce depression with mindfulness training in primary care.

 

“Mindfulness-based cognitive therapy is a group program that is generally used to delay or prevent recurrence of major depression, but can also ameliorate acute depressive syndromes and symptoms.” – Zindel Segal,

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Elices, M., Pérez-Sola, V., Pérez-Aranda, A., Colom, F., Polo, M., Martín-López, L. M., & Gárriz, M. (2021). The Effectiveness of Mindfulness-Based Cognitive Therapy in Primary Care and the Role of Depression Severity and Treatment Attendance. Mindfulness, 1–11. Advance online publication. https://doi.org/10.1007/s12671-021-01794-3

 

Abstract

Objectives

Evidence suggests the efficacy of mindfulness-based cognitive therapy (MBCT) to prevent depression relapse and decrease depressive symptoms during the acute phase. However, the effectiveness of MBCT in real-world heterogeneous samples treated in clinical health settings, including primary care, has received little attention. This study had two aims: (1) to evaluate the effectiveness of MBCT delivered in primary care considering pre-treatment depression scores and (2) to explore the role of participants’ characteristics on symptom improvement.

Methods

Data were obtained from 433 individuals who received MBCT. Participants completed the Personality Inventory for ICD-11 (PiCD) pretreatment and the Beck Depression Inventory (BDI-II) pre- and post-treatment.

Results

Sixty percent presented moderate-to-severe depression according to scores on the BDI-II, 18.1% presented mild depression, and 21.7% were in the non-depressed range. The severity of pre-treatment depressive symptoms was associated with outcomes. Most individuals who lacked depressive symptoms at baseline remained in the non-clinical range after the treatment. Those in the severe group benefited the most from the intervention, since 35.6% were considered recovered. Rates of deterioration ranged from 2.1 to 2.7%, depending on the depression-baseline scores. Depression severity at the entrance, attendance, and age, but not personality traits, appear to be related to symptom improvement.

Conclusions

According to our results, MBCT can be effectively and safely delivered in primary care.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8628140/

 

Improve Anxiety Disorders with Mindfulness

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Improve Anxiety Disorders with Mindfulness

 

By John M. de Castro, Ph.D.

 

“[Anxiety Disorders] primarily involves unrelenting worry. With meditation, you can learn to accept those worries without letting them upset you, which is likely to diminish your stress.” – Arlin Cuncic

 

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

 

In today’s Research News article “A systematic review and meta-analysis of acceptance- and mindfulness-based interventions for DSM-5 anxiety disorders.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8516851/ ) Haller and colleagues review, summarize, and perform a meta-analysis on the published research on the effectiveness of mindfulness-based therapies for anxiety disorders. They identified 23 randomized controlled trials including a total of 1815 patients with anxiety disorders; Generalized Anxiety Disorder, Social Anxiety Disorder, and mixed anxiety diagnoses. Twelve studies employed Acceptance and Commitment Therapy (ACT), 3 ones Mindfulness-Based Cognitive Therapy (MBCT), and 8 ones Mindfulness-Based Stress Reduction (MBSR).

 

They report that the published research studies found that Acceptance and Commitment Therapy (ACT), Mindfulness-Based Cognitive Therapy (MBCT), and Mindfulness-Based Stress Reduction (MBSR) in comparison to treatment as usual produced significant reduction in anxiety either based on clinician or patient reports and also depression in these patients. ACT appeared to have superior effects, followed by MBCT, and lastly MBSR. These effects, however, were no longer significant at follow up 6- and 12-months after the interventions.

 

This analysis of the published research suggests that mindfulness-based therapies are effective in relieving anxiety and depression in patients with anxiety disorders. But they appear to be only effective over the short term. More work needs to be done to optimize the effectiveness of these therapies and to identify how to make the effects longer lasting.

 

So, improve anxiety disorders with mindfulness.

 

“Mindfulness counters the overthinking and hypervigilance of anxiety. When we’re anxious, our minds are full of ruminations about the past and worries about the future, and the more anxiety pulls us away from the present moment, the more stressed and unhappy we are.  . . mindfulness offers a break from the worries and fears of anxiety.” – Tanya Peterson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Haller, H., Breilmann, P., Schröter, M., Dobos, G., & Cramer, H. (2021). A systematic review and meta-analysis of acceptance- and mindfulness-based interventions for DSM-5 anxiety disorders. Scientific reports, 11(1), 20385. https://doi.org/10.1038/s41598-021-99882-w

 

Abstract

This meta-analysis systematically reviewed the evidence on standardized acceptance-/mindfulness-based interventions in DSM-5 anxiety disorders. Randomized controlled trials examining Acceptance and Commitment Therapy (ACT), Mindfulness-Based Cognitive Therapy (MBCT), and Mindfulness-Based Stress Reduction (MBSR) were searched via PubMed, Central, PsycInfo, and Scopus until June 2021. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for primary outcomes (anxiety) and secondary ones (depression and quality of life). Risk of bias was assessed using the Cochrane tool. We found 23 studies, mostly of unclear risk of bias, including 1815 adults with different DSM-5 anxiety disorders. ACT, MBCT and MBSR led to short-term effects on clinician- and patient-rated anxiety in addition to treatment as usual (TAU) versus TAU alone. In comparison to Cognitive Behavioral Therapy (CBT), ACT and MBCT showed comparable effects on both anxiety outcomes, while MBSR showed significantly lower effects. Analyses up to 6 and 12 months did not reveal significant differences compared to TAU or CBT. Effects on depression and quality of life showed similar trends. Statistical heterogeneity was moderate to considerable. Adverse events were reported insufficiently. The evidence suggests short-term anxiolytic effects of acceptance- and mindfulness-based interventions. Specific treatment effects exceeding those of placebo mechanisms remain unclear.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8516851/

Reduce Fatigue and Depression in Patients with Multiple Sclerosis with Mindfulness

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Reduce Fatigue and Depression in Patients with Multiple Sclerosis with Mindfulness

 

By John M. de Castro, Ph.D.

 

“the pragmatic resiliency skills of mindfulness training may be beneficial in helping to mitigate unpleasant and unpredictable mental and physical symptoms that are associated with an MS diagnosis.” – Rachel M. Gilbertson

 

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. But 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. Mindfulness practices have been shown to improve the symptoms of multiple sclerosis.

 

In today’s Research News article “Mindfulness training during brief periods of hospitalization in multiple sclerosis (MS): beneficial alterations in fatigue and the mediating role of depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8499486/ ) Sauder and colleagues recruited patients diagnosed with Multiple Sclerosis (MS) who also had symptoms of fatigue and depression during a brief (>5-day) hospital stay. During their hospital stay the patients were administered daily 45-minute mindfulness training based upon Mindfulness-Based Cognitive Therapy (MBCT). They were measured before and after the hospital stay for depression, fatigue, rumination, mindfulness, cognition, and attention.

 

They found that in comparison to baseline after training there were significant increases in mindfulness and distraction techniques to cope with a negative mood and significant decreases in depression, general fatigue, and physical fatigue. Further, they found that the greater the increases in mindfulness the greater the reductions in fatigue and depression. A mediation analysis revealed that mindfulness decreased fatigue indirectly by reducing depression that in turn reduced fatigue.

 

The study lacked a control, comparison, condition and as such caution must be exercised in interpreting the results. But mindfulness has been previously demonstrated in controlled studies to reduce fatigue and depression in a wide variety of people. So, the effects of mindfulness reported here were probably due to mindfulness causing the improvements. What is new here is that mindfulness reduces depression and in turn fatigue in patients with Multiple Sclerosis (MS). The patients also had a significant increase in the coping strategy of using distraction during negative mood states. This suggests that mindfulness training helps them to learn to distract themselves from depression and this may be the mechanism whereby mindfulness reduces depression.

 

Depression and fatigue greatly reduce the patients’ ability to conduct their lives, reducing their quality of life, So, improving depression and fatigue can be very beneficial to these patients. This suggests that mindfulness training should be recommended for patients with Multiple Sclerosis (MS).

 

So, reduce fatigue and depression in patients with multiple sclerosis with mindfulness.

 

“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

 

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

 

Sauder, T., Hansen, S., Bauswein, C., Müller, R., Jaruszowic, S., Keune, J., Schenk, T., Oschmann, P., & Keune, P. M. (2021). Mindfulness training during brief periods of hospitalization in multiple sclerosis (MS): beneficial alterations in fatigue and the mediating role of depression. BMC neurology, 21(1), 390. https://doi.org/10.1186/s12883-021-02390-7

 

Abstract

Objectives

Persons with MS (PwMS) are frequently affected by fatigue and depression. Mindfulness-based interventions may reduce these symptoms in PwMS and consequently their application has been extended to various settings. Only few efforts have been made to explore effects of short-term mindfulness training during brief periods of hospitalization. In the current study, the feasibility and potential effects of short-term mindfulness training on depression, fatigue, rumination and cognition were explored in PwMS in an acute-care hospital setting. Based on previous work, it was further examined whether the relation between trait mindfulness and fatigue prior to and following the intervention was mediated by depression and whether a mediation effect was also observable throughout the intervention.

Methods

A short-term mindfulness training protocol was developed, tailored to the requirements of the acute-care setting. Subsequently, 30 PwMS were recruited sequentially and received mindfulness training during the routine clinical process (median duration in hospital: eight days, number of sessions: four). Participants completed relevant self-report measures (depression, fatigue, rumination) and a neuropsychological assessment before and after training.

Results

Participants reported significantly increased trait mindfulness and decreased depression and fatigue following the intervention. Respective change scores were highly correlated so that increased trait mindfulness was associated with decreased symptoms. In the rumination domain, patients reported a tendency for an increased adaptive ability to engage in distractive behavior during arising negative mood. Other measures of trait rumination and cognition remained relatively stable. Results of the mediation analyses indicated that depression mediated the negative relationship between trait mindfulness and fatigue symptoms at pre and post assessments. With regards to the change scores, an association between mindfulness and cognitive fatigue ceased to be significant when depression was controlled, albeit in this case, the mediation effect did not reach significance.

Conclusion

Results of the current study indicate that short-term mindfulness training during brief periods of hospitalization may be beneficial for PwMS. They further complement previous work by identifying depression as a potential mediator of the antagonistic relationship between mindfulness and fatigue. Based on the current exploratory study, future trials are warranted to address this mechanism of mindfulness training in more detail.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8499486/

 

Mindfulness Improves the Psychological Well-Being of Teachers in Non-Western Societies

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Mindfulness Improves the Psychological Well-Being of Teachers in Non-Western Societies

 

By John M. de Castro, Ph.D.

 

“Teachers who practice “mindfulness” are better able to reduce their own levels of stress and prevent burnout.” – Dee DiGioia

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. This often produces burnout; fatigue, cynicism, emotional exhaustion, and professional inefficacy. Teachers experience burnout at high rates. Roughly a half a million teachers out of a workforce of three million, leave the profession each year and the rate is almost double in poor schools compared to affluent schools. Indeed, nearly half of new teachers leave in their first five years.

 

Burnout frequently results from emotional exhaustion. This exhaustion not only affects the teachers personally, but also the students, as it produces a loss of enthusiasm, empathy, and compassion. Regardless of the reasons for burnout or its immediate presenting consequences, it is a threat to schools and their students. In fact, it is a threat to the entire educational systems as it contributes to the shortage of teachers. Hence, methods of reducing stress and improving teacher psychological health needs to be studied.

 

Mindfulness techniques are gaining increasing attention for the treatment of the symptoms of stress and burnout. They have been demonstrated to be helpful in reducing the psychological and physiological responses to stress and for treating and preventing burnout in a number of work environments including schools. But most of the research focuses on teachers in Western societies. There is a need to study if mindfulness is equally effective in Eastern societies.

 

In today’s Research News article “Effectiveness and Mechanisms of Mindfulness Training for School Teachers in Difficult Times: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8443903/ ) Tsang and colleagues recruited elementary and secondary school teachers in Hong Kong and randomly assigned them to either a wait-list or to receive 8 weekly 90-minute sessions of mindfulness training along with home practice. The mindfulness training was based upon the Mindfulness-Based Stress Reduction (MBSR) and the Mindfulness-Based Cognitive Therapy (MBCT) programs. They were measured before and after training and two months later for mindfulness, general health, insomnia, stress, positive and negative emotions, life satisfaction, emotion regulation, and mindfulness in teaching.

 

They found that in comparison to baseline and the wait-list group, the teachers who had received mindfulness training had significantly higher levels of mindfulness, general health, positive emotions, life satisfaction, emotion regulation, and mindfulness in teaching and significantly lower levels of insomnia, stress, and negative emotions that were maintained at the 2-month follow-up measurement. In addition, a mediation analysis demonstrated that mindfulness was associated with well-being directly and indirectly via emotion regulation such that mindfulness was associated with increased emotion regulation that was in turn associated with increased well-being. Similarly, mindfulness was associated with mindfulness in teaching directly and indirectly via well-being such that mindfulness was associated with increased well-being that was in turn associated with increased mindfulness in teaching.

 

The present study had a passive control condition, wait-list, and this leaves a number of potential confounding explanations of the results such as placebo effects, attentional effects, and experimenter bias. But a large amount of previous controlled research has demonstrated that mindfulness training produces increases in health, positive emotions, emotion regulation, and life satisfaction, and decreases in insomnia, stress, and negative emotions. So, the present benefits are likely due to the mindfulness training.

 

The findings are important as they demonstrate that teachers in an Eastern society were benefited by mindfulness training to the same extent and in the same ways as teachers in Western societies. Thus, the effects of mindfulness training appear to be universal, regardless of culture. The findings also demonstrate that mindfulness training has direct and indirect effects on well-being that similarly effects mindfulness in teaching. All of this suggests that mindfulness training improves the psychological well-being of teachers which likely makes them happier and more effective teachers.

 

So, mindfulness improves the psychological well-being of teachers in non-western societies

 

“Through yoga, mindfulness and social-emotional learning exercises, educators . . .  learned strategies to help reduce stress, prioritize self-care, cultivate resilience and enhance their well-being.” – Wendy McMahon

 

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

 

Tsang, K., Shum, K. K., Chan, W., Li, S. X., Kwan, H. W., Su, M. R., Wong, B., & Lam, S. F. (2021). Effectiveness and Mechanisms of Mindfulness Training for School Teachers in Difficult Times: A Randomized Controlled Trial. Mindfulness, 1–12. Advance online publication. https://doi.org/10.1007/s12671-021-01750-1

 

Abstract

Objectives

Research in recent years has shown that mindfulness-based interventions can enhance teachers’ mental and physical health. However, the existing studies were predominantly conducted in Western, educated, industrialized, rich, and democratic (WEIRD) societies. As a randomized controlled trial in a non-WEIRD society, the present study examined the effectiveness and mechanisms of mindfulness training for Hong Kong teachers in difficult times.

Methods

Teachers from primary and secondary schools (n = 186) were randomly assigned to mindfulness training (eight-week .b Foundations) or waitlist control condition. They completed online self-report surveys on measures of well-being, emotion management, and mindfulness in teaching at baseline, post-intervention, and two-month follow-up.

Results

The intervention group reported significantly higher levels of life satisfaction, positive affect, general health, along with significantly lower levels of insomnia, stress, and negative affect than the control group at post-test and two-month follow-up. The effect sizes were medium to large (ηp2 = 0.06 to 0.14). More importantly, teachers’ baseline well-being had a significant moderating effect on the intervention effectiveness. Those with a lower baseline in well-being benefitted more than their counterparts with a higher baseline. In addition, teachers’ emotion management was found to be the mediator through which mindfulness training enhanced teachers’ well-being. Such improvement in well-being also predicted higher levels of mindfulness in teaching.

Conclusions

This study provides evidence on the efficacy of mindfulness training for teachers beyond WEIRD societies. It suggests the universality and practicality of mindfulness training in enhancing teachers’ well-being and reducing their distress in difficult times.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8443903/

 

Improve Worker’s Psychological Wellbeing and Work Engagement and Performance with Mindfulness

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Improve Worker’s Psychological Wellbeing and Work Engagement and Performance with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness impacts the individual holistically. This impact translates quickly into the workplace and appears as shifts in the approach to work, in changes in mindsets and in being present more, among others, opening the possibility for employees to impact the bottom line through these changes.” – Fabiola Fajardo

 

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

 

To help overcome unhappiness, stress, and burnout, mindfulness practices have been implemented in the workplace. Indeed, mindfulness practices have been shown to markedly reduce the physiological and psychological responses to stress. As a result, it has become very trendy for business to incorporate meditation into the workday to help improve employee well-being, health, and productivity. These programs attempt to increase the employees’ mindfulness at work and thereby reduce stress.

 

In today’s Research News article “Differential Effects of Mindfulness-Based Intervention Programs at Work on Psychological Wellbeing and Work Engagement.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.715146/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1741394_a0P58000000G0YfEAK_Psycho_20210930_arts_A ) Calcagni and colleagues recruited “white collar” workers and randomly assigned them to receive either mindfulness training based upon the Mindfulness-Based Cognitive Therapy (MBCT) program or to a wait-list control condition. The mindfulness training occurred in either 6 weekly 2-hour sessions of 3 weekly 4-hour sessions along with daily home practice. They were measured before and 1-week after training for mindfulness, psychological well-being, work engagement, work performance, and perceived stress.

 

They found that in comparison to baseline and the wait-list control group, the mindfulness group had significantly lower levels of perceived stress and significantly higher levels of mindfulness, including the describe, acting with awareness, and no-reactivity subscales. They also had significantly higher levels of psychological well-being, including the positive relations, autonomy, and environmental mastery subscales. For work engagement they found significantly higher levels for the mindfulness group including the vigor and absorption subscales. Finally, after training the mindfulness group had significantly higher levels of work performance including the in-role and extra-role subscales.

 

It appears that mindfulness training of “white collar” workers produces improved psychological well-being, engagement with work and job performance. These results are similar to those observed in previous research in a wide variety of contexts and participants including improves well-being and work engagement and performance. So, mindfulness training is an effective method to improve the work and psychological health of “white collar” workers. These results suggest that mindfulness training would reduce the likelihood of burnout and improve retention of workers. This provides support for mindfulness training in work environments.

 

So, improve worker’s psychological wellbeing and work engagement and performance with mindfulness.

 

“Mindfulness-based practices can improve workers’ health and reduce employers’ costs by ameliorating the negative effect of stress on workers’ health.” – Diana Kachan

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Calcagni CC, Salanova M, Llorens S, Bellosta-Batalla M, Martínez-Rubio D and Martínez Borrás R (2021) Differential Effects of Mindfulness-Based Intervention Programs at Work on Psychological Wellbeing and Work Engagement. Front. Psychol. 12:715146. doi: 10.3389/fpsyg.2021.715146

 

Two different mindfulness-based interventions were deployed in a sample of white-collar workers to explore the differential effects on different facets of mindfulness, dimensions of psychological wellbeing, work engagement, performance, and stress of a participant. A total of 28 participants completed one of the different programs, and their results were compared between groups and against 27 participants randomly allocated to a waiting list control group. Results suggest both mindfulness intervention programs were successful at increasing the levels of psychological wellbeing, work engagement, and performance of the participants, as well as decreasing their levels of stress. Significant differences were found between the two programs in all outcome variables. Results suggest that brief and customized mindfulness interventions at work are as successful as lengthier programs.

https://www.frontiersin.org/articles/10.3389/fpsyg.2021.715146/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1741394_a0P58000000G0YfEAK_Psycho_20210930_arts_A

 

Improve Well-Being of Healthy Individuals with Mindfulness

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Improve Well-Being of Healthy Individuals with Mindfulness

 

By John M. de Castro, Ph.D.

 

“engaging in mindfulness meditation cultivates our ability to both focus and broaden our attention, which is a practical way to elicit psychological well-being.” – Jennifer Wolkin

 

The primary focus of the majority of research on mindfulness has been on its ability to treat mental illness and negative emotional states such as anxiety, depression, and perceived stress. As such, it has been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. But mindfulness training has also been shown to improve health and well-being in healthy individuals.

 

The most commonly used mindfulness technique for the treatment of depression is Mindfulness-Based Cognitive Therapy (MBCT).  MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. MBCT was developed to treat mental illness. So, it is not known if it can improve the well-being of healthy individuals.

 

In today’s Research News article “Effectiveness of Mindfulness-Based Cognitive Therapy for Improving Subjective and Eudaimonic Well-Being in Healthy Individuals: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.700916/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1714167_a0P58000000G0YfEAK_Psycho_20210831_arts_A ) Kosugi and colleagues recruited healthy adults and randomly assigned them to either a wait-list control condition or to receive 8 weekly, 2-hour group sessions of Mindfulness-Based Cognitive Therapy (MBCT). They were measured before, during, and after training and 8 weeks later for satisfaction with life, flourishing, positive and negative experiences, self-esteem, mindfulness, self-compassion, resilience, anxiety, depression, perceived stress, presenteeism, interoceptive awareness, and quality of life.

 

They found that in comparison to baseline and the wait-list control group, the group that received Mindfulness-Based Cognitive Therapy (MBCT) had significant increases in satisfaction with life, interoceptive awareness, mindfulness, self-compassion, resilience, and work productivity that were maintained 8 weeks after the end of training. Hence, MBCT produced significant improvements in the psychological states of healthy adults. So, MBCT is not only effective in improving the mental health of individuals with mental problems but also can increase the positive psychological states in healthy individuals.

 

This study had a passive comparison (control) condition. This leaves open the possibility that the results were affected by participant expectancies (placebo), experimenter bias, or attentional (Hawthorne) effects. Future research should compare Mindfulness-Based Cognitive Therapy (MBCT) treatment to an active control condition, e.g. exercise to eliminate the possible confounding variables.

 

So, improve well-being of healthy individuals with mindfulness.

 

“The practice of mindfulness is an effective means of enhancing and maintaining optimal mental health and overall well-being, and can be implemented in every aspect of daily living.” – Rezvan Ameli

 

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

 

Kosugi T, Ninomiya A, Nagaoka M, Hashimoto Z, Sawada K, Park S, Fujisawa D, Mimura M and Sado M (2021) Effectiveness of Mindfulness-Based Cognitive Therapy for Improving Subjective and Eudaimonic Well-Being in Healthy Individuals: A Randomized Controlled Trial. Front. Psychol. 12:700916. doi: 10.3389/fpsyg.2021.700916

 

Objectives: Better subjective and eudaimonic well-being fosters better health conditions. Several studies have confirmed that mindfulness-based interventions are effective for improving well-being; however, the samples examined in these studies have been limited to specific populations, and the studies only measured certain aspects of well-being rather than the entire construct. Additionally, few studies have examined the effect of mindfulness-based cognitive therapy on well-being. The present study examines the feasibility of mindfulness-based cognitive therapy and its effectiveness for improving subjective and eudaimonic well-being among community residents.

Methods: The study design featured an 8-week randomized, waiting-list controlled, parallel-group study. 8 weekly mindfulness classes, followed by 2 monthly classes, were provided for healthy individuals aged 20–65 years who had a Satisfaction with Life Scale score of ≤ 24 indicating average to low cognitive aspect of subjective well-being. This trial was registered with the University Hospital Medical Information Network Clinical Trials Registry (ID: UMIN000031885, URL: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000036376).

Results: The results showed that cognitive aspect of subjective well-being and mindfulness skills were significantly improved at 8 weeks, and this effect was enhanced up to the end of the follow-up period. Positive affective aspect of subjective and eudaimonic well-being were significantly improved at 16 weeks.

Conclusions: Eight weeks of mindfulness-based cognitive therapy with a 2-month follow-up period improves cognitive and affective aspects of subjective and eudaimonic well-being in healthy individuals. The order of improvement was cognitive, positive affective, and eudaimonic well-being. To verify these findings, multi-center randomized controlled trials with active control groups and longer follow-up periods are warranted.

https://www.frontiersin.org/articles/10.3389/fpsyg.2021.700916/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1714167_a0P58000000G0YfEAK_Psycho_20210831_arts_A

 

Relieve Insomnia in Older Adults with Tai Chi or Exercise

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Relieve Insomnia in Older Adults with Tai Chi or Exercise

 

By John M. de Castro, Ph.D.

 

“Tai Chi significantly improved sleep quality in both healthy adults and patients with chronic health conditions, which suggests that Tai Chi may be considered as an alternative behavioral therapy in the treatment of insomnia.” – Gown Raman

 

Modern society has become more around-the-clock and more complex producing considerable pressure and stress on the individual. The advent of the internet and smart phones has exacerbated the problem. The resultant stress can impair sleep. Indeed, it is estimated that over half of Americans sleep too little due to stress. As a result, people today sleep 20% less than they did 100 years ago. Not having a good night’s sleep has adverse effects upon the individual’s health, well-being, and happiness. It has been estimated that 30 to 35% of adults have brief symptoms of insomnia, 15 to 20% have a short-term insomnia disorder, and 10% have chronic insomnia

 

Insomnia is more than just an irritant. Sleep deprivation is associated with decreased alertness and a consequent reduction in performance of even simple tasks, decreased quality of life, increased difficulties with memory and problem solving, increased likelihood of accidental injury including automobile accidents, and increased risk of dementia and Alzheimer’s disease. It also can lead to anxiety about sleep itself. This is stressful and can produce even more anxiety about being able to sleep. About 4% of Americans revert to sleeping pills. But these do not always produce high quality sleep and can have problematic side effects. So, there is a need to find better methods to treat insomnia. Mindfulness-based practices have been reported to improve sleep amount and quality and help with insomnia.

 

Tai Chi is an ancient mindfulness practice involving slow prescribed movements. It is gentle and completely safe, can be used with the elderly and sickly, is inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, it can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Indeed, studies have shown that Tai Chi practice is effective in improving sleep. But Tai Chi is both a mindfulness practice and an exercise. It is unclear whether its effects on insomnia are due to the exercise provided or the mindfulness practice.

 

In today’s Research News article “). Effects of Tai Chi or Exercise on Sleep in Older Adults With Insomnia: A Randomized Clinical Trial.” (See summary below or view the full text of the study at: ) Siu and colleagues recruited older sedentary adults over 60 years of age who were diagnosed with chronic insomnia and randomly assigned them to receive either treatment as usual, or 12 weeks of 3 weekly 1-hour sessions of  exercise, or Tai Chi practice. Exercise consisted of brisk walking and muscle strengthening. Tai Chi practice consisted of the 24 form Yang style Tai Chi. They were measured before and after treatment and 24 months later for objective sleep quality with actigraphy and subjectively for remission of insomnia, insomnia treatment response, perceived sleep quality, insomnia severity, self-reported sleep parameters, and the use of hypnotic medication.

 

They found that in comparison to baseline and the usual care group, the actigraphy and Tai Chi groups had significant improvements in objective sleep measures of sleep efficiency, sleep onset, wake time after sleep onset, and number of awakenings, and subjective measures of remission of insomnia, perceived sleep quality, insomnia severity, and lower use of hypnotic medications. Importantly, these improvements were still present 2 years later.

 

Hence, both objective and subjective measures of sleep revealed that both exercise and Tai Chi practice produced moderate significant and enduring improvements in sleep in older adults with insomnia. The fact that exercise and Tai Chi practice produced equivalent benefits suggests that the ability of Tai Chi practice to improve sleep is due to the exercise provided by the practice and not to the mindfulness aspects of the practice.

 

So, relieve insomnia in older adults with tai chi or exercise.

 

“TCC [Tai Chi Chih] produce clinically meaningful improvements in insomnia.” – Michael Irwin

 

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

 

Siu, P. M., Yu, A. P., Tam, B. T., Chin, E. C., Yu, D. S., Chung, K. F., Hui, S. S., Woo, J., Fong, D. Y., Lee, P. H., Wei, G. X., & Irwin, M. R. (2021). Effects of Tai Chi or Exercise on Sleep in Older Adults With Insomnia: A Randomized Clinical Trial. JAMA network open, 4(2), e2037199. https://doi.org/10.1001/jamanetworkopen.2020.37199

 

Key Points

Question

Can tai chi improve sleep as effectively as conventional exercise in older adults with insomnia?

Findings

In this randomized clinical trial using data collected from 320 older adults, both tai chi and conventional exercise were associated with improved sleep. Both interventions were equally effective in improving various actigraphy-assessed sleep parameters, and these beneficial effects remained persistent 24 months after the intervention with no significant differences between the 2 intervention groups.

Meaning

Given that tai chi is an accepted form of physical activity among older people because of its gentle, low-impact exercises, it can represent an alternative approach to fulfill the physical activity recommendations for improving sleep for individuals who are averse to conventional exercise.

Abstract

Importance

Previous studies that have shown tai chi to improve sleep were mainly based on subjective assessments, which might have produced results confounded by self-reporting bias.

Objective

To compare the effectiveness of tai chi for improving sleep in older adults with insomnia with conventional exercise and a passive control group using actigraphy-based objective measurements.

Design, Setting, and Participants

This randomized, 3-arm, parallel group, assessor-masked clinical trial was conducted at a single research unit in Hong Kong between August 2014 and August 2018. Eligible participants, aged 60 years or older and with chronic insomnia, were randomly allocated into tai chi training, exercise, and control groups.

Interventions

12-week tai chi training, 12-week conventional exercise, and no intervention control.

Main Outcomes and Measures

Primary outcomes were measures taken from actigraphy sleep assessment. Secondary outcomes included remission of insomnia, insomnia treatment response, Pittsburgh Sleep Quality Index score, Insomnia Severity Index score, and self-reported sleep using a 7-day sleep diary. Assessments were performed at baseline, end of the intervention (postintervention), and 24 months after the intervention (follow-up). Data analysis was performed from September 2018 to August 2020.

Results

A total of 320 participants (mean [SD] age, 67.3 [6.8] years; mean [SD] insomnia duration, 124.4 [134.5] months; 256 [80.0%] women) were randomly allocated into control (110 participants), exercise (105 participants), and tai chi (105 participants) groups and included in the data analysis. Compared with the control group, the exercise and tai chi groups showed improved sleep efficiency (exercise vs control: adjusted mean difference, +3.5%; 95% CI, 1.8-5.2; P < .001; tai chi vs control: adjusted mean difference, +3.4%; 95% CI, 1.6-5.1; P < .001) and reductions of wake time after sleep onset (exercise vs control: −17.0 minutes; 95% CI, −24.9 to −9.0; P < .001; tai chi vs control: −13.3 minutes; 95% CI, −21.3 to −5.2; P = .001) and number of awakenings (exercise vs control: −2.8 times; 95% CI, −4.0 to −1.6; P < .001; tai chi vs control: −2.2 times; 95% CI, −3.5 to −1.0; P < .001) as assessed by actigraphy at postintervention; although there were no significant differences between the exercise and tai chi groups. The actigraphy-assessed beneficial effects were maintained in both intervention groups at follow-up.

Conclusions and Relevance

Conventional exercise and tai chi improved sleep and the beneficial effects sustained for 24 months, although the absolute improvements in sleep parameters were modest. Improvements in objective sleep parameters were not different between the tai chi and exercise groups, suggesting that tai chi can be an alternative approach for managing insomnia.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7885034/

 

Reduce Stigma and Perceived Devaluation in Patients with Schizophrenia with Mindfulness

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Reduce Stigma and Perceived Devaluation in Patients with Schizophrenia with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Stigma is the number one reason people do not seek help; therefore, efforts to reduce stigma are crucial to increasing people’s help-seeking behaviors.” – Sami Boomgarden

 

Stigma is a view that a distinguishing characteristic makes the individual less acceptable to others. This can lead to discrimination where stigmatized people are treated negatively either directly with ugly remarks such as “crazy” or “weird” or indirectly by being avoided or marginalized by others. This can produce fewer work opportunities, harassment, bullying, problems with insurance, and loneliness. The social isolation can even lead to early mortality. Stigma can lead to low self-esteem and self-stigmatization in which the individual adopts those negative stereotypes and as a result there is a loss of self-efficacy This leads to the individual ceasing trying to make things better, thinking “why try?”

 

Mindfulness promotes non-judgmental awareness in which the individual perceives things just as they are without labelling or making value judgements about them. It also promotes the ability to adaptively cope with emotions and reduces worry and rumination. These can be useful in overcoming stigmas and their effects, especially self-stigmas. So, mindfulness may buffer the individual from the effects of stigma and self-stigmatization in severe mental illnesses such as schizophrenia. Mindfulness-Based Cognitive Therapy (MBCT) involves the combination of mindfulness training and cognitive behavioral therapy. It contains sitting, walking and body scan meditations, and cognitive therapy that is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. Hence, MBCT may be particularly effective in reducing stigma in patients diagnosed with schizophrenia.

 

In today’s Research News article “Effects of Mindfulness-Based Cognitive Therapy on Stigma in Female Patients With Schizophrenia.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8342917/ ) Tang and colleagues recruited patients diagnosed with schizophrenia and randomly assigned them to either receive 8 weeks of Mindfulness-Based Cognitive Therapy (MBCT) or to a treatment as usual control condition. They were measured before and after treatment for mindfulness, insight and treatment attitudes, and stigma including subscales measuring perceived devaluation-discrimination, stigma-coping orientation, and stigma-related feeling.

 

They found that in comparison to baseline and the control group, the participants who received Mindfulness-Based Cognitive Therapy (MBCT) had significantly higher levels of mindfulness and insight and treatment attitudes, and significantly lower levels of stigma, including perceived devaluation-discrimination and stigma-coping orientation. They also found that the higher the levels of mindfulness after treatment the lower the levels of stigma and the higher the levels of insight and treatment attitudes.

 

Stigma involves “shame, evaluative thoughts, and fear of enacted stigma that results from individuals’ identification with a stigmatized group”. Stigma is an impediment to successful treatment of mental illnesses and improvement of social function. In fact, many patients high in stigma refuse treatment all together. The findings of the present study suggest that mindfulness training can help patients diagnosed with schizophrenia overcome stigma and as a result improve their attitudes toward treatment. As a result, mindfulness training may improve the patient’s prognosis and make successful treatment more likely.

 

So, reduce stigma and perceived devaluation in patients with schizophrenia with mindfulness.

 

“mindfulness-based psychoeducation was effective in reducing stigma in patients with schizophrenia.” – Emine Yılmaz

 

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

 

Tang, Q., Yang, S., Liu, C., Li, L., Chen, X., Wu, F., & Huang, X. (2021). Effects of Mindfulness-Based Cognitive Therapy on Stigma in Female Patients With Schizophrenia. Frontiers in psychiatry, 12, 694575. https://doi.org/10.3389/fpsyt.2021.694575

 

Abstract

Mindfulness-based cognitive therapy (MBCT) has been increasingly recognized as effective in different mental illnesses, but these effects are limited in schizophrenia. For patients with schizophrenia, stigma is one of the most negative factors that affects treatment, rehabilitation and social function. This research aimed to determine the effects of MBCT on stigma in patients with schizophrenia. In total, 62 inpatients with schizophrenia were recruited and randomly assigned to the experimental group or control group. The experimental group received an 8-week MBCT intervention, and the control group were treated as usual. Link’s Stigma Scales (with three subscales, including perceived devaluation-discrimination (PDD), stigma-coping orientation, and stigma-related feeling), Five Facet Mindfulness Questionnaire (FFMQ), and Insight and Treatment Attitudes Questionnaire (ITAQ) were used to collect data before and after intervention. After intervention, the post-test score of PDD, stigma-coping orientation, FFMQ, and ITAQ were significantly different between the experimental group and the control group. In the experimental group, the PDD and stigma-coping orientation scores significantly decreased, and FFMQ and ITAQ scores increased remarkably (P < 0.05). In addition, correlation analysis revealed a significant negative correlation between mindfulness and stigma. MBCT was effective in reducing stigma in patients with schizophrenia, which mainly manifested as changes in the patients’ perception of stigma as well as the withdrawal and avoidance caused by schizophrenia. Enhancing mindfulness will help reduce the stigma level. MBCT is worthy of promotion and application in patients with schizophrenia.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8342917/