Reduce Stress and Improve Healthcare Worker Well-Being with Mindfulness

June 21, 2021 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“The therapeutic applications of mindfulness are considerable and its impact on clinical practice itself appears to be profound. Indeed, several commentators characterize mindfulness as inciting nothing short of a revolution in the way we conduct our mental lives both within the clinic and without.” – Matias P. Raski

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It is estimated that over 45% of healthcare workers experience burnout. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout, in fact, it is a threat to the entire healthcare system. Currently, over a third of healthcare workers report that they are looking for a new job. Hence, burnout contributes to the shortage of doctors and nurses.

Preventing burnout has to be a priority. Unfortunately, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout. So, it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices have been shown to reduce the psychological and physiological responses to stress and improve well-being. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, improving sleep and reduce stress.

In today’s Research News article “Reducing stress and promoting well-being in healthcare workers using mindfulness-based cognitive therapy for life.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903308/ ) Strauss and colleagues recruited healthy adult healthcare workers 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) along with 40 minutes of daily practice. 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. MBCT was developed specifically to treat depression. For this study it was modified to be more appropriate for the general population. The participants were measured before and after training for attendance and practice amounts, stress, anxiety, depression, mental well-being, burnout, presenteeism, compassion, and mindfulness.

They found that in comparison to baseline and the wait-list control group after Mindfulness-Based Cognitive Therapy (MBCT) there were significant increases in mindfulness, mental well-being, and self-compassion, and significant decreases in anxiety, depression, and stress. They also found that the greater the increases in mindfulness and self-compassion produced by MBCT the greater the increase in mental well-being and the decrease in stress.

These findings are similar to those found in previous research with different groups that Mindfulness training increases well-being and self-compassion, and decreases anxiety, depression, and stress. Hence, mindfulness training improves the psychological well-being of healthcare workers. This should help protect them against burnout and increase their resilience in the face of high workplace stress.

So, reduce stress and improve healthcare worker well-being with mindfulness.

“As we become more adept at dwelling in the living presence of our own experience, we begin to connect more deeply with patients, as well as co-workers and family members. Mindfulness practice provides a simple and practical way to recapture the calling of healing.” – Penn Medicine

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

Strauss, C., Gu, J., Montero-Marin, J., Whittington, A., Chapman, C., & Kuyken, W. (2021). Reducing stress and promoting well-being in healthcare workers using mindfulness-based cognitive therapy for life. International journal of clinical and health psychology : IJCHP, 21(2), 100227. https://doi.org/10.1016/j.ijchp.2021.100227

Background/Objective

Healthcare workers play a critical role in the health of a nation, yet rates of healthcare worker stress are disproportionately high. We evaluated whether mindfulness-based cognitive therapy for life (MBCT-L), could reduce stress in healthcare workers and target a range of secondary outcomes. Method: This is the first parallel randomised controlled trial of MBCT-L. Participants were NHS workers, who were randomly assigned (1:1) to receive either MBCT-L or wait-list. The primary outcome was self-reported stress at post-intervention. Secondary variables were well-being, depression, anxiety, and work-related outcomes. Mixed regressions were used. Mindfulness and self/other-compassion were explored as potential mechanisms of effects on stress and wellbeing. Results: We assigned 234 participants to MBCT-L (n = 115) or to wait-list (n = 119). 168 (72%) participants completed the primary outcome and of those who started the MBCT-L 73.40% (n = 69) attended the majority of the sessions. MBCT-L ameliorated stress compared with controls (B = 2.60, 95% CI = 1.63‒3.56; d = -0.72; p < .0001). Effects were also found for well-being, depression and anxiety, but not for work-related outcomes. Mindfulness and self-compassion mediated effects on stress and wellbeing. Conclusions: MBCT-L could be an effective and acceptable part of a wider healthcare workers well-being and mental health strategy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903308/

Relieve Maternal Perinatal Depression with Smartphone-Based Mindfulness Training

June 4, 2021 psyjdc Leave a comment

Relieve Maternal Perinatal Depression with Smartphone-Based Mindfulness Training

By John M. de Castro, Ph.D.

“the ideal treatment plan for perinatal depression and anxiety often includes mindfulness techniques.” – Edith Gettes

The period of pregnancy is a time of intense physiological and psychological change. Anxiety, depression, and fear are quite common during pregnancy. More than 20 percent of pregnant women have an anxiety disorder, depressive symptoms, or both during pregnancy. The psychological health of pregnant women has consequences for fetal development, birthing, and consequently, child outcomes. Depression during pregnancy is associated with premature delivery and low birth weight.

In addition, immediately after birth it is common for the mother to experience mood swings including what has been termed “baby blues,” a sadness that may last for as much as a couple of weeks. But some women experience a more intense and long-lasting negative mood called postpartum depression. This occurs usually 4-6 weeks after birth in about 15% of births; about 600,000 women in the U.S. every year. For 50% of the women the depression lasts for about a year while about 30% are still depressed 3 years later.

Hence, it is clear that there is a need for methods to treat depression, and anxiety during the perinatal period. Since the fetus can be negatively impacted by drugs, it would be preferable to find a treatment that did not require drugs. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy and to relieve postpartum depression.

The vast majority of the mindfulness training techniques, however, require a trained teacher. The participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with busy employee schedules and at locations that may not be convenient. As an alternative, apps for smartphones have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. But the question arises as to the effectiveness of these apps and their ability to relieve depression during the perinatal period.

In today’s Research News article “Effectiveness of Smartphone-Based Mindfulness Training on Maternal Perinatal Depression: Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7875700/ ) Sun and colleagues recruited pregnant women who were diagnosed with depression and randomly assigned them to receive 8-weeks of either health consultation or mindfulness training. Mindfulness training occurred in 8 weekly sessions delivered on a smartphone app. The training was Mindfulness-Based Cognitive Therapy (MBCT) modified for pregnant women. Health consultation also occurred via smartphone app. They were measured before during, and after training, 10 weeks later, and 6-months after delivery for depression, anxiety symptoms, perceived stress, positive and negative emotions, sleep-related problems, fatigue, memory, and fear of childbirth. There was a 52% completion rate for the trainings.

They found that after training the mindfulness group had significantly lower levels of depression and anxiety and significantly higher levels of positive emotions but these were not maintained 6 months after delivery. The mindfulness group also had a significantly higher rate of depression symptom remission. Hence the smartphone-based mindfulness training improved the psychological health of the pregnant women.

These findings replicate previous findings that mindfulness training reduces anxiety and depression in non-pregnant individuals and relieves maternal anxiety and depression during pregnancy. The strength of the current study was that these effects were produced by mindfulness training with a smartphone app. This is important as this training is highly scalable at minimal cost and so can be made available to virtually all pregnant women who want it. Hence, it may be able to reduce the psychological misery that occurs in many women during the perinatal period, making pregnancy a happier time for the women and produce better outcoms for the infant.

So, relieve maternal perinatal depression with smartphone-based mindfulness training.

“the risk of having moderate depressive symptoms was reduced by nearly 90% in participants receiving the MMT [Mindfulness] intervention.” – Ruta Nonacs

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

Sun, Y., Li, Y., Wang, J., Chen, Q., Bazzano, A. N., & Cao, F. (2021). Effectiveness of Smartphone-Based Mindfulness Training on Maternal Perinatal Depression: Randomized Controlled Trial. Journal of medical Internet research, 23(1), e23410. https://doi.org/10.2196/23410

Abstract

Background

Despite potential for benefit, mindfulness remains an emergent area in perinatal mental health care, and evidence of smartphone-based mindfulness training for perinatal depression is especially limited.

Objective

The objective of this study was to evaluate the effectiveness of a smartphone-based mindfulness training intervention during pregnancy on perinatal depression and other mental health problems with a randomized controlled design.

Methods

Pregnant adult women who were potentially at risk of perinatal depression were recruited from an obstetrics clinic and randomized to a self-guided 8-week smartphone-based mindfulness training during pregnancy group or attention control group. Mental health indicators were surveyed over five time points through the postpartum period by online self-assessment. The assessor who collected the follow-up data was blind to the assignment. The primary outcome was depression as measured by symptoms, and secondary outcomes were anxiety, stress, affect, sleep, fatigue, memory, and fear.

Results

A total of 168 participants were randomly allocated to the mindfulness training (n=84) or attention control (n=84) group. The overall dropout rate was 34.5%, and 52.4% of the participants completed the intervention. Mindfulness training participants reported significant improvement of depression (group × time interaction χ24=16.2, P=.003) and secondary outcomes (χ24=13.1, P=.01 for anxiety; χ24=8.4, P=.04 for positive affect) compared to attention control group participants. Medium between-group effect sizes were found on depression and positive affect at postintervention, and on anxiety in late pregnancy (Cohen d=0.47, –0.49, and 0.46, respectively). Mindfulness training participants reported a decreased risk of positive depressive symptom (Edinburgh Postnatal Depression Scale [EPDS] score>9) compared to attention control participants postintervention (odds ratio [OR] 0.391, 95% CI 0.164-0.930) and significantly higher depression symptom remission with different EPDS reduction scores from preintervention to postintervention (OR 3.471-27.986). Parity did not show a significant moderating effect; however, for nulliparous women, mindfulness training participants had significantly improved depression symptoms compared to nulliparous attention control group participants (group × time interaction χ24=18.1, P=.001).

Conclusions

Smartphone-based mindfulness training is an effective intervention in improving maternal perinatal depression for those who are potentially at risk of perinatal depression in early pregnancy. Nulliparous women are a promising subgroup who may benefit more from mindfulness training.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7875700/

Improve Psychological Well-Being in Cancer Survivors with Online Mindfulness-Based Cognitive Therapy (MBCT)

May 27, 2021 psyjdc Leave a comment

Improve Psychological Well-Being in Cancer Survivors with Online Mindfulness-Based Cognitive Therapy (MBCT)

By John M. de Castro, Ph.D.

“both MBCT and eMBCT interventions reduced fear of cancer recurrence and rumination, and increased mental health–related quality of life, mindfulness skills, and positive mental health.” – Félix Compen

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis.

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatigue, stress, sleep disturbance, fear, and anxiety and depression. Mindfulness-Based Cognitive Therapy (MBCT) is a well-established therapy that involves mindfulness training and cognitive therapy to change maladaptive thought processes. MBCT has been found to be effective in reducing the residual psychological issues that are common in cancer survivors.

But the vast majority of the mindfulness training techniques require a trained therapist. This results in costs that many parents can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with parents’ busy schedules and at locations that may not be convenient. As an alternative, mindfulness trainings over the internet have been developed. These have tremendous advantages in making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. So, it makes sense to explore the effectiveness of internet-based Mindfulness-Based Cognitive Therapy (iMBCT) in treating the psychological symptoms of cancer survivors.

In today’s Research News article “Internet-delivered Mindfulness-Based Cognitive Therapy for anxiety and depression in cancer survivors: Predictors of treatment response.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7843453/ ) Nissen and colleagues recruited adult breast and prostrate cancer survivors and randomly assigned them to a wait-list control condition or to receive internet-based Mindfulness-Based Cognitive Therapy (iMBCT); consisting of 8 1-week modules. They were measured before and after training and 6 months later for mindfulness, self-compassion, anxiety, depression, and therapy related working reliance.

They found that at baseline the higher the levels of self-compassion and the mindfulness facets of describing, non-judging, and acting with awareness, the lower the levels of anxiety and depression. Mindfulness-Based Cognitive Therapy (iMBCT) resulted in significant decreases in anxiety and depression. The amount of decrease in anxiety was related to the baseline depression level with the most depressed participants having the greatest reductions, while the amount of decrease in depression was related to the baseline self-compassion level with the participants with the highest levels of self-compassion having the greatest reductions. Neither mindfulness, therapy related working reliance, nor were related to the improvements.

These are interesting results that replicate previous findings of mindfulness training producing improvements in depression and anxiety in cancer patients, and that mindfulness training over the internet is effective in improving cancer patients. The primary intent of the research, though, was to examine predictors of patient responsiveness to the therapy. The results here were disappointing as only baseline self-compassion was related to depression improvements and only baseline depression was related to improvements in anxiety. Regardless, it is clear that mindfulness training can be successfully implemented over the internet and it is effective in improving the levels of anxiety and depression in cancer survivors.

So, improve psychological well-being in cancer survivors with online Mindfulness-Based Cognitive Therapy (iMBCT).

“I love being more mindful. Instead of waiting for the flowers to come out, I go out in the garden and see what is happening now. I am happier. Things still get difficult at times and when they do, I do my practice.” – MBCT Patient

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

Nissen, E. R., Zachariae, R., O’Connor, M., Kaldo, V., Jørgensen, C. R., Højris, I., Borre, M., & Mehlsen, M. (2021). Internet-delivered Mindfulness-Based Cognitive Therapy for anxiety and depression in cancer survivors: Predictors of treatment response. Internet interventions, 23, 100365. https://doi.org/10.1016/j.invent.2021.100365

Abstract

Background

The present study investigates possible predictors of treatment response in an Internet-delivered Mindfulness-Based Cognitive Therapy (iMBCT) intervention with therapist support. This iMBCT program, a fully online delivered intervention with asynchronous therapist support, has previously been shown to be efficacious in reducing symptoms of anxiety and depression in women treated for breast cancer and men treated for prostate cancer.

Methods

Eighty-two breast- and prostate cancer survivors experiencing psychological distress received 8 weeks of therapist-guided iMBCT. Primary outcomes were improvement in anxiety and depression scores from baseline to post-treatment and from baseline to six-months follow-up. Clinical predictors included levels of depression and anxiety at the time of screening and at baseline, as well as time since diagnosis. Demographic predictors included age and educational level. Therapy-related predictors included working alliance, self-compassion, and five facets of mindfulness. Mixed Linear Models were employed to test the prediction effects over time.

Results

Higher levels of baseline depression were associated with increased treatment response in anxiety at post-treatment, and lower levels of self-compassion were associated with increased treatment response in depression at post-treatment. None of the proposed predictors significantly predicted treatment response at six-months follow-up.

Conclusion

The findings suggest that iMBCT can be provided for cancer survivors regardless of their age, educational level, and time since diagnosis (up to five years) and that therapeutic alliance is not crucial for treatment response. We did not identify characteristics predicting treatment response, although many factors were tested. Still, other characteristics may be predictors, and given the relatively small sample size and a large number of statistical tests, the results should be interpreted with caution.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7843453/

Mindfulness-Based Therapies Benefits are Greatly Affected by Social Factors in Therapy

May 26, 2021 psyjdc Leave a comment

Mindfulness-Based Therapies Benefits are Greatly Affected by Social Factors in Therapy

By John M. de Castro, Ph.D.

“Designed to deliberately focus a person’s attention on the present experience in a way that is non-judgmental, mindfulness-based interventions, whether offered individually or in a group setting, may offer benefit to people seeking therapy for any number of concerns.” – Manuel A. Manotas

Psychotherapy is an interpersonal transaction. Its effectiveness in treating the ills of the client is to some extent dependent upon the chemistry between the therapist and the client, termed the therapeutic alliance. Research has demonstrated that there is a positive relationship with moderate effect sizes between treatment outcomes and the depth of the therapeutic alliance.

There are also other factors that may be important for successful therapy. The client’s engagement in the process as well as the therapists interpersonal skills may also be important ingredients in producing successful therapeutic outcomes. There are also important social factors present particularly when the therapy is provided in groups. In addition, formal and informal practice effects are involved. There is little known, however, of the role of these components of therapy on the effectiveness of treatment for mental health issues such as depression.

In today’s Research News article “The Contribution of Common and Specific Therapeutic Factors to Mindfulness-Based Intervention Outcomes.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874060/ ) Canby and colleagues recruited patients diagnosed with mild to severe depression and randomly assigned them to receive once a week for 8 weeks, 3 hour sessions of either focused meditation, open monitoring meditation or Mindfulness-Based Cognitive Therapy (MBCT) which contains both focused and open monitoring meditation practices. Before and after the 8-weeks of practice and 3 months later they were measured for empathy, therapeutic alliance, formal and informal mindfulness practices, depression, anxiety, stress, mindfulness, and group therapeutic factors in group therapy: instillation of hope, secure emotional expression, awareness of relational impact, and social learning. Finally, they received structured interviews exploring mindfulness practices and impact of treatment.

They found that the over treatment and follow-up the groups had significantly increased mindfulness and significantly decreased anxiety, depression and stress. They found that the higher the ratings of the instructors. the ratings of the groups and the amounts of formal meditation practice the greater the changes. In general, the instructor and group factors had stronger relationships to the psychological improvements than the amount of formal meditation and the amount of informal meditation practice had no relationship with the improvements. The analysis of the structured interviews indicated that the participants found the instructor and group factors including bonding, instilling hope, and expressing feelings were important to their improvements.

These results are interesting replicate previous findings of mindfulness-based therapies produce improvements in anxiety, depression, and stress. The results suggest that mindfulness-based therapies have complex effects and changes in mindfulness may be less important than the social environment produced by the instructor and the group. These social factors may account for a large proportion of the benefits to the participants. These results are important as they suggest that empathizing the social interactions involved in therapy may improve the impact of the therapy on the patients’ psychological well-being.

So, mindfulness-based therapies benefits are greatly affected by social factors in therapy.

“Mindfulness’ strength is in helping us to see more clearly, by giving us the room to not be so quickly reactive. And over time the event does not have to jump to emotional distress, like a grasshopper leaping over a stream.” – Barry Boyce

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

Canby, N. K., Eichel, K., Lindahl, J., Chau, S., Cordova, J., & Britton, W. B. (2021). The Contribution of Common and Specific Therapeutic Factors to Mindfulness-Based Intervention Outcomes. Frontiers in psychology, 11, 603394. https://doi.org/10.3389/fpsyg.2020.603394

Abstract

While Mindfulness-Based Interventions (MBIs) have been shown to be effective for a range of patient populations and outcomes, a question remains as to the role of common therapeutic factors, as opposed to the specific effects of mindfulness practice, in contributing to patient improvements. This project used a mixed-method design to investigate the contribution of specific (mindfulness practice-related) and common (instructor and group related) therapeutic factors to client improvements within an MBI. Participants with mild-severe depression (N = 104; 73% female, M age = 40.28) participated in an 8-week MBI. Specific therapeutic factors (formal out-of-class meditation minutes and informal mindfulness practice frequency) and social common factors (instructor and group ratings) were entered into multilevel growth curve models to predict changes in depression, anxiety, stress, and mindfulness at six timepoints from baseline to 3-month follow-up. Qualitative interviews with participants provided rich descriptions of how instructor and group related factors played a role in therapeutic trajectories. Findings indicated that instructor ratings predicted changes in depression and stress, group ratings predicted changes in stress and self-reported mindfulness, and formal meditation predicted changes in anxiety and stress, while informal mindfulness practice did not predict client improvements. Social common factors were stronger predictors of improvements in depression, stress, and self-reported mindfulness than specific mindfulness practice-related factors. Qualitative data supported the importance of relationships with instructor and group members, involving bonding, expressing feelings, and instilling hope. Our findings dispel the myth that MBI outcomes are exclusively the result of mindfulness meditation practice, and suggest that social common factors may account for much of the effects of these interventions. Further research on meditation should take into consideration the effects of social context and other common therapeutic factors.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874060/

Focused Meditation has Superior Effectiveness for Emotional Disorders

May 14, 2021 psyjdc Leave a comment

Focused Meditation has Superior Effectiveness for Emotional Disorders

By John M. de Castro, Ph.D.

“meditation can help you relax and reduce stress. It can also help you disengage from stressful or anxious thoughts, and better control your mood.” – Healthline

Meditation training has been shown to improve health and well-being. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. As a result, meditation training has been called the third wave of therapies. One problem with understanding meditation effects is that there are, a wide variety of meditation techniques and it is not known which work best for affecting different psychological areas.

There are a number of different types of meditation. Classically they’ve been characterized on a continuum with the degree and type of attentional focus. In focused attention meditation, the individual practices paying attention to a single meditation object, often the breath. In open monitoring meditation, the individual opens up awareness to everything that’s being experienced including thoughts regardless of its origin. Mindfulness-Based Cognitive Therapy (MBCT) employs both focused and open monitoring meditation and also Cognitive Behavioral Therapy (CBT). During therapy the patient is trained to investigate and alter aberrant thought patterns. It is important to understand which form of meditation training works best for which conditions.

In today’s Research News article “The contributions of focused attention and open monitoring in mindfulness-based cognitive therapy for affective disturbances: A 3-armed randomized dismantling trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802967/ ) Cullen and colleagues recruited adults with mild-moderate depression and anxiety and randomly assigned them to an 8-week program of one of three meditation types; focused meditation, open monitoring meditation, or their combination as occurs in Mindfulness-Based Cognitive Therapy (MBCT). They were measured before training and weekly over the 8-week program and 12 weeks later for depression, stress, and anxiety.

They found that all three meditation programs produced significant improvements in depression, stress, and anxiety at the end of training and 12 weeks later. But Mindfulness-Based Cognitive Therapy (MBCT) and focused meditation produced significantly greater reductions in anxiety at the 12-week follow-up than open monitoring meditation. During training statistically significant improvements in depression, stress, and anxiety occurred first for focused meditation, followed by MBCT, and last by open monitoring meditation.

These are interesting results that again demonstrate the efficacy of meditation training in improving depression, stress, and anxiety. They also found that the training in both focused and open monitoring meditation as occurs in Mindfulness-Based Cognitive Therapy (MBCT) did not produce superior results to the individual meditation types. Finally, they show the focused meditation may be superior to open monitoring meditation in relieving depression, stress, and anxiety. The participants who practiced focused meditation improved faster and at follow up had lower levels of anxiety than those who practiced open monitoring meditation.

The reason for the differences in the effectiveness of the different meditation types is unknown. But focused meditation may be simpler and easier to learn and practice than open monitoring meditation. Also, open monitoring meditation by having the practitioner open up awareness to everything that’s being experienced may allow for anxiety, stress, and depression to more easily arise during the session. Future research should investigate these possibilities.

So, focused meditation has superior effectiveness for emotional disorders.

“Within just a week or two of regular meditation, you should see a noticeable change in your mood and stress level. “People will start to feel some inner peace and inner poise, even in the midst of their busy lives,” – Burke Lennihan.

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

Cullen, B., Eichel, K., Lindahl, J. R., Rahrig, H., Kini, N., Flahive, J., & Britton, W. B. (2021). The contributions of focused attention and open monitoring in mindfulness-based cognitive therapy for affective disturbances: A 3-armed randomized dismantling trial. PloS one, 16(1), e0244838. https://doi.org/10.1371/journal.pone.0244838

Abstract

Objective

Mindfulness-based cognitive therapy (MBCT) includes a combination of focused attention (FA) and open monitoring (OM) meditation practices. The aim of this study was to assess both short- and long-term between- and within-group differences in affective disturbance among FA, OM and their combination (MBCT) in the context of a randomized controlled trial.

Method

One hundred and four participants with mild to severe depression and anxiety were randomized into one of three 8-week interventions: MBCT (n = 32), FA (n = 36) and OM (n = 36). Outcome measures included the Inventory of Depressive Symptomatology (IDS), and the Depression Anxiety Stress Scales (DASS). Mixed effects regression models were used to assess differential treatment effects during treatment, post-treatment (8 weeks) and long-term (20 weeks). The Reliable Change Index (RCI) was used to translate statistical findings into clinically meaningful improvements or deteriorations.

Results

All treatments demonstrated medium to large improvements (ds = 0.42–1.65) for almost all outcomes. While all treatments were largely comparable in their effects at post-treatment (week 8), the treatments showed meaningful differences in rapidity of response and pattern of deteriorations. FA showed the fastest rate of improvement and the fewest deteriorations on stress, anxiety and depression during treatment, but a loss of treatment-related gains and lasting deteriorations in depression at week 20. OM showed the slowest rate of improvement and lost treatment-related gains for anxiety, resulting in higher anxiety in OM at week 20 than MBCT (d = 0.40) and FA (d = 0.36), though these differences did not reach statistical significance after correcting for multiple comparisons (p’s = .06). MBCT and OM showed deteriorations in stress, anxiety and depression at multiple timepoints during treatment, with lasting deteriorations in stress and depression. MBCT showed the most favorable pattern for long-term treatment of depression.

Conclusions

FA, OM and MBCT show different patterns of response for different dimensions of affective disturbance.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802967/

Further Improve Health Care Professionals’ Mental Health with Supplemental Mindfulness Training

May 6, 2021 psyjdc Leave a comment

Further Improve Health Care Professionals’ Mental Health with Supplemental Mindfulness Training

By John M. de Castro, Ph.D.

Preventing the negative psychological consequences of stress in healthcare professionals has to be a priority. Contemplative practices have been shown to reduce the psychological and physiological responses to stress and improve well-being. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, and improving sleep. Once mindfulness has been established it is not known if additional mindfulness training will produce greater benefits.

In today’s Research News article “The Interpersonal Mindfulness Program for Health Care Professionals: a Feasibility Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7447696/ ) Bartels-Velthui and colleagues recruited health care professionals who had already received mindfulness training with either Mindfulness-Based Stress Reduction (MBSR) or Mindfulness-Based Cognitive Therapy (MBCT). The participants in the training group were further treated with an Interpersonal Mindfulness Course. This course was designed for participants who had already received mindfulness training to deepen mindful presence, empathy and compassion with other people. The course met for 9-weekly, 2.5-hour sessions combined with 45 to 60 minutes of daily home practice. All participants were measured before and after training for the feasibility and acceptability of the program, mindfulness, self-compassion, empathy, stress, and quality of life.

They found that the program was feasible as all participants completed the program and acceptable as 88% report the program to be highly relevant and would recommend it to others. They found that compared to baseline and the control group the participants who received the additional mindfulness training had significant improvements in self-compassion, empathy and compassion fatigue.

These are very interesting findings in that health care professionals who had already received mindfulness training had further increases in self-compassion, empathy and compassion fatigue when provided a program designed to improve mindfulness with other people. It is well known that mindfulness training improves self-compassion, empathy and compassion fatigue. These findings, though, suggests that these improvements can be strengthened with further training. In addition, the improvements were in characteristics that would tend to reduce health care professional burnout. The fact that the program emphasized being mindful of other people suggests that the health care workers would be have more empathy and understanding in treating their patients.

So, further improve health care professionals’ mental health with supplemental mindfulness training.

“mindfulness can result in decreased burnout and improved well-being. Mindfulness is a useful way of cultivating self-kindness and compassion, including by bringing increased awareness to and acceptance of those things that are beyond our control.” – Kate Fitzpatrick

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

Bartels-Velthuis, A. A., van den Brink, E., Koster, F., & Hoenders, H. (2020). The Interpersonal Mindfulness Program for Health Care Professionals: a Feasibility Study. Mindfulness, 1–10. Advance online publication. https://doi.org/10.1007/s12671-020-01477-5

Abstract

Objectives

There are a number of mindfulness-based programs (MBPs) that have demonstrated effectiveness for patients and health care professionals. The Interpersonal Mindfulness Program (IMP) is a relatively new MBP, developed to teach those with prior mindfulness training to deepen their mindful presence, empathy and compassion in the interpersonal domain. The aim of the present study was to examine the feasibility of using the IMP with mental health care workers and assessing its effects on levels of mindfulness, self-compassion, empathy, stress and professional quality of life when compared with the control group participants.

Methods

The IMP training consisted of nine weekly 2.5-h sessions and daily home practice (45–60 min). Twenty-five participants (mean age, 51.4 years) with mindfulness experience participated in the training. Twenty-two individuals in the control group (mean age, 47.5 years) were recruited from those who had followed a mindfulness training before. Feasibility of the IMP was assessed in the training participants in six domains. All study participants completed self-report questionnaires before and after the training.

Results

The IMP training was considered highly acceptable and very useful. The training had a significant positive effect on self-compassion, empathy and compassion fatigue, but no effect on mindfulness, stress and compassion satisfaction. Five participants reported some mild adverse reactions.

Conclusions

The IMP training appears feasible for health care professionals and seems to induce some positive effects. A few mild adverse effects were reported. Further research on the effectiveness and possible mechanisms of change of the IMP training in larger samples is needed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7447696/

Change the Brain to Improve Emotion Regulation in Bereaved Individuals with Mindfulness

April 13, 2021 psyjdc Leave a comment

Change the Brain to Improve Emotion Regulation in Bereaved Individuals with Mindfulness

By John M. de Castro, Ph.D.

“It takes a boat load of self-compassion to allow oneself to feel whatever it is you are feeling at any given time, without judgment, without comparison relative to another’s explicit portrayal of their own process. In this way, to grieve is to be mindful of our thoughts and feelings.” – Jennifer Wolkin

Grief is a normal, albeit complex, process that follows a loss of a significant person or situation in one’s life. This can involve the death of a loved one, a traumatic experience, termination of a relationship, relationship to a long-missing person, etc. Exactly what transpires depends upon the individual and the nature of the loss. It involves physical, emotional, psychological and cognitive processes. In about 15% of people grief can be overly intense or long and therapeutic intervention may become necessary.

Mindfulness practices have been found to help with coping with loss and its consequent grief. 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 is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. Mindfulness training has been shown to change the size, activity and connectivity of brain structures. Hence, MBCT may reduce grief by altering the brain.

In today’s Research News article “Mindfulness-based cognitive therapy on bereavement grief: Alterations of resting-state network connectivity associate with changes of anxiety and mindfulness.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7775995/ ) Huang and colleagues recruited adults who had lost a first degree relative within the last 4 years and had unresolved grief. The patients received an 8-week program of Mindfulness-Based Cognitive Therapy (MBCT). They met weekly for 2.5 hours and were encouraged to practice for 45 minutes daily at home. They were measured before and after the training for grief, generalized anxiety, depression, emotion regulation, and mindfulness. After training they underwent brain functional Magnetic Resonance Imaging (fMRI) at rest and while viewing pictures of faces with either neutral or negative emotional expressions.

They found that in comparison to baseline, after Mindfulness-Based Cognitive Therapy (MBCT) the participants had significant increases in mindfulness, particularly the describing and non-reacting mindfulness facets, and emotion regulation and significant decreases in grief, anxiety, and depression. The brain connectivity as revealed in the fMRI scans changed after MBCT training with decreased connectivity within the Default Mode Network of the brain and connectivity between the Auditory, Visual, Salience, and frontal-parietal networks during rest but not emotion arousal. In addition, the connectivity between the subcortical caudate with the cortex correlated positively with mindfulness and emotion regulation and negatively with anxiety.

The Default Mode Network is thought to underly mind wandering and self-referential thinking. So, the decreases in connectivity may signal heightened present moment awareness. In addition, the changes in the connectivity between cortical areas were negatively related to emotion regulation while the connectivity between cortical and subcortical areas were positively related to emotion regulation. This suggests that MBCT training decreased effects of external perception on emotion regulation while increasing the effects of internal sensations.

It should be noted that there wasn’t a comparison, control, condition. So, the passage of time, participant expectancy effects, attentional effects, or experimenter bias may have been responsible for the observed changes. Nevertheless, the results suggest that MBCT training for bereaved patients improves their mental health and reduces grief. The brain scans suggest that the training altered the brain to increase present moment awareness and dependence of the person’s internal state in regulating emotions.

So, change the brain to improve emotion regulation in bereaved individuals with mindfulness.

“Mindfulness practice is not meant to minimize that pain or to convince people that everything is OK, but rather to help you recognize the reality of your circumstances, and to do so in a nonjudgmental and self-compassionate way.” – Stephanie Pritchard

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

Huang, F. Y., Hsu, A. L., Chao, Y. P., Shang, C. M., Tsai, J. S., & Wu, C. W. (2020). Mindfulness-based cognitive therapy on bereavement grief: Alterations of resting-state network connectivity associate with changes of anxiety and mindfulness. Human brain mapping, 42(2), 510–520. Advance online publication. https://doi.org/10.1002/hbm.25240

Abstract

Bereavement, the experience of losing a loved one, is one of the most catastrophic but inevitable events in life. It causes grief and intense depression‐like sadness. Recent studies have revealed the effectiveness and proficiency of mindfulness‐based cognitive therapy (MBCT) in emotional regulation among bereavement populations. MBCT improves the well‐being of the bereaved by enhancing cognitive performances. Regarding the neural correlates of bereavement grief, previous studies focused on the alleviation of emotion–cognition interferences at specific brain regions. Here, we hypothesized that the bereavement grief fundamentally triggers global alterations in the resting‐state brain networks and part of the internetwork connectivity could be reformed after MBCT intervention. We recruited 19 bereaved individuals who participated the 8‐week MBCT program. We evaluated (a) the large‐scale changes in brain connectivity affected by the MBCT program; as well as (b) the association between connectivity changes and self‐rated questionnaire. First, after MBCT, the bereaved individuals showed the reduction of the internetwork connectivity in the salience, default‐mode and fronto‐parietal networks in the resting state but not under emotional arousal, implying the alleviated attention to spontaneous mind wandering after MBCT. Second, the alterations of functional connectivity between subcortical (e.g., caudate) and cortical networks (e.g., cingulo‐opercular/sensorimotor) were associated with the changes of the mindfulness scale, the anxiety and the emotion regulation ability. In summary, MBCT could enhance spontaneous emotion regulation among the bereaved individuals through the internetwork reorganizations in the resting state.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7775995/

Improve Major Depression in the Real World with Mindfulness

April 12, 2021 psyjdc Leave a comment

Improve Major Depression in the Real World with Mindfulness

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. 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 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 is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail. 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. MBCT has been found to be effective in treating depression.

Most of the research studies that have examined the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for depression were conducted in controlled laboratory settings. But the real world of therapeutic interventions are less consistent and much more complex and messy. This raises the question as to how effective MBCT may be for the treatment of major depression in real world.

In today’s Research News article “The effectiveness of mindfulness-based cognitive therapy for major depressive disorder: evidence from routine outcome monitoring data.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7745235/ ) Geurts and colleagues recruited patients with major depressive disorder who had received treatment with Mindfulness-Based Cognitive Therapy (MBCT). Their psychiatric diagnosis was recorded and before and after treatment they completed measures of mindfulness, depression, worry, and self-compassion.

They found that after treatment the patients had significant increases in mindfulness and self-compassion and significant decreases in depression and worry. The also found that the greater the increases in mindfulness and self-compassion and decreases in worry, the greater the decreases in depression. They found that having a job mattered as those patients who had employment had significantly greater reductions in depression than the unemployed.

These findings are in line with those in more controlled lab studies of significant improvements in major depressive disorder produced by Mindfulness-Based Cognitive Therapy (MBCT). The importance of the present studies is that they demonstrate that similar improvement occur in real world clinical settings. Finally, they suggest that MBCT may increase mindfulness and self-compassion and decrease worry and these improvements are associated with greater relief of depression.

So, improve major depression in the real world with mindfulness.

“Still, there are a handful of key areas — including depression, chronic pain, and anxiety — in which well-designed, well-run studies have shown benefits for patients engaging in a mindfulness meditation program, with effects similar to other existing treatments.” – Alvin Powell

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

Geurts, D., Compen, F. R., Van Beek, M., & Speckens, A. (2020). The effectiveness of mindfulness-based cognitive therapy for major depressive disorder: evidence from routine outcome monitoring data. BJPsych open, 6(6), e144. https://doi.org/10.1192/bjo.2020.118

Abstract

Background

Meta-analyses show efficacy of mindfulness-based cognitive therapy (MBCT) in terms of relapse prevention and depressive symptom reduction in patients with major depressive disorder (MDD). However, most studies have been conducted in controlled research settings.

Aims

We aimed to investigate the effectiveness of MBCT in patients with MDD presenting in real-world clinical practice. Moreover, we assessed whether guideline recommendations for MBCT allocation in regard to recurrence and remission status of MDD hold in clinical practice.

Method

This study assessed a naturalistic cohort of patients with (recurrent) MDD, either current or in remission (n = 765), who received MBCT in a university hospital out-patient clinic in The Netherlands. Outcome measures were self-reported depressive symptoms, worry, mindfulness skills and self-compassion. Predictors were MDD recurrence and remission status, and clinical and sociodemographic variables. Outcome and predictor analyses were conducted with linear regression.

Results

MBCT adherence was high (94%). Patients with a lower level of education had a higher chance of non-adherence. Attending more sessions positively influenced improvement in depressive symptoms. Depressive symptoms significantly reduced from pre- to post-MBCT (Δ mean = 7.7, 95%CI = 7.0–8.5, Cohen’s d = 0.75). Improvement of depressive symptoms was independent from MDD recurrence and remission status. Unemployed patients showed less favourable outcomes. Worry, mindfulness skills and self-compassion all significantly improved. These improvements were related to changes in depressive symptoms.

Conclusions

Previous efficacy results in controlled research settings are maintained in clinical practice. Results illustrate that MBCT is effective in routine clinical practice for patients suffering from MDD, irrespective of MDD recurrence and remission status.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7745235/

Improve Mental and Physical Health in Anxious, Depressed Patients with Mindfulness and Qigong

March 25, 2021 psyjdc Leave a comment

Improve Mental and Physical Health in Anxious, Depressed Patients with Mindfulness and Qigong

By John M. de Castro, Ph.D.

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

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

Recently, it has been found that mindfulness training can be effective for anxiety disorders. Mindfulness has also been shown to be effective for depression. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression and has been shown to be very effective. In addition, mind-body practices such as qigong have also been shown to be effective for anxiety and depression. Recently, qigong practice has been combined with Cognitive Behavioral Therapy (CBT) to treat anxiety and depression. The relative efficacy of MBCT and qigong-Based Cognitive Therapy has not been tested.

In today’s Research News article “A randomized controlled trial on the comparative effectiveness of mindfulness-based cognitive therapy and health qigong-based cognitive therapy among Chinese people with depression and anxiety disorders.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7734764/ ) Chan and colleagues recruited adults who had been diagnosed with either an anxiety disorder or depression and randomly assigned them to either a no-treatment control condition or to receive 8 weekly 2 hour sessions of either Mindfulness-Based Cognitive Therapy (MBCT) or Qigong-Based Cognitive Therapy (a combination of Qigong practice along with Cognitive Behavioral Therapy). They were measured before and after training and 8 weeks later for physical and mental health, anxiety, depression, perceived stress, sleep quality, and self-efficacy.

They found that in comparison to baseline and the no-treatment control, the participants who received either Mindfulness-Based Cognitive Therapy (MBCT) or Qigong-Based Cognitive Therapy had significantly reduced anxiety, depression, and perceived stress, and significantly increased sleep quality and self-efficacy. These improvements were either sustained or even greater still at the 8-week follow-up. The decreases in anxiety and depression were significantly greater in the Qigong group than in the MBCT group. But the MBCT group had significantly greater improvements in overall mental health than the Qigong group while the Qigong group had significantly greater improvements in physical health than the MBCT group.

These are interesting results and to my knowledge the first direct comparison of the effects of Mindfulness-Based Cognitive Therapy (MBCT) and Qigong-Based Cognitive Therapy on patients with anxiety and depression. MBCT has been previously established to significantly improve anxiety, depression, perceived stress, sleep, and self-efficacy and Qigong has similarly been established to significantly improve anxiety, depression, perceived stress, sleep, and self-efficacy. So, the improvements observed in the current study relative to the no-treatment group are expected. What is new is the findings that MBCT is superior for the improvement of mental health while Qigong is superior for the improvement of physical health in patients with diagnosed anxiety and depression.

So, improve mental and physical health in anxious, depressed patients with mindfulness and qigong.

“depression and anxiety scores were significantly decreased after participation in an 8-week mindfulness group therapy for depressive and anxious people.” – Tora Takahashi

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

Chan, S., Chan, W., Chao, J., & Chan, P. (2020). A randomized controlled trial on the comparative effectiveness of mindfulness-based cognitive therapy and health qigong-based cognitive therapy among Chinese people with depression and anxiety disorders. BMC psychiatry, 20(1), 590. https://doi.org/10.1186/s12888-020-02994-2

Abstract

Background

The goal of this study was to investigate treatment outcome and related intervention processes of mindfulness-based cognitive therapy versus health qigong-based cognitive therapy versus waitlist control among individuals with mood disorders.

Methods

A total of 187 individuals with mood disorders were randomized and allocated into mindfulness-based cognitive therapy, health qigong-based cognitive therapy, or waitlist control groups. All participants were assessed at three time points with regard to depressive and anxiety symptoms, physical and mental health status, perceived stress, sleep quality, and self-efficacy. Linear mixed models analysis was used to test the individual growth model by studying the longitudinal data.

Results

Mindfulness-based cognitive therapy and health qigong-based cognitive therapy both produced greater improvements on all outcome measures as compared with waitlist control. Relatively, more reductions of mood symptoms were observed in the health qigong-based cognitive therapy group as compared with the mindfulness-based cognitive therapy group. Health qigong-based cognitive therapy is more conducive to physical health status whereas mindfulness-based cognitive therapy has more favorable mental health outcomes. Individual growth curve models indicated that alterations in perceived stress was the common predictor of mood changes in both intervention groups.

Conclusions

The predominant emphasis on physical health in health qigong-based cognitive therapy makes it more acceptable and effective than mindfulness-based cognitive therapy as applied in Chinese individuals with mood disorders. The influence of Chinese culture is discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7734764/

Reduce Current Depressive Symptoms with Mindfulness

March 8, 2021 psyjdc Leave a comment

Reduce Current Depressive Symptoms with Mindfulness

By John M. de Castro, Ph.D.

“Depression is not only the most common mental illness, it’s also one of the most tenacious. . . 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. 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. 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).

Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail. 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. MBCT has been found to be effective in treating depression. The research is accumulating. So, it makes sense to take a look at what has been learned.

In today’s Research News article “Mindfulness-based cognitive therapy for the treatment of current depressive symptoms: a meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6687569/ ) Goldberg and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials of the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for current depression. They identified 13 published controlled studies.

They report that the published studies found that Mindfulness-Based Cognitive Therapy (MBCT) produced significant improvements in depressive symptoms when compared to non-specific control conditions; those that did not suggest therapeutic effects. On the other hand, compared to control conditions in which the condition was portrayed as therapeutic, MBCT produced equivalent reductions in depressive symptoms. They also report that the improvements do not last and were no longer present at follow-ups as long as 6 months post-treatment.

The results suggest that Mindfulness-Based Cognitive Therapy (MBCT) is a safe and effective treatment for current depressive symptoms. But it does not appear to be superior to other therapies and does not have lasting efficacy. This suggests that further research needs to be performed to determine what are the components of therapy that produce improvements and which do not. They also suggest that booster treatments periodically after the primary treatment may be needed to maintain effectiveness.

So, reduce current depressive symptoms with mindfulness.

“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.” – MBCT.com

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Goldberg, S. B., Tucker, R. P., Greene, P. A., Davidson, R. J., Kearney, D. J., & Simpson, T. L. (2019). Mindfulness-based cognitive therapy for the treatment of current depressive symptoms: a meta-analysis. Cognitive behaviour therapy, 48(6), 445–462. https://doi.org/10.1080/16506073.2018.1556330

Abstract

Mindfulness-based cognitive therapy (MBCT) appears to be a promising intervention for the prevention of relapse in major depressive disorder, but its efficacy in patients with current depressive symptoms is less clear. Randomized clinical trials of MBCT for adult patients with current depressive symptoms were included (k = 13, N = 1,046). Comparison conditions were coded based on whether they were intended to be therapeutic (specific active controls) or not (non-specific controls). MBCT was superior to non-specific controls at post-treatment (k = 10, d = 0.71, 95% CI [0.47, 0.96]), although not at longest follow-up (k = 2, d = 1.47, [−0.71, 3.65], mean follow-up = 5.70 months across all studies with follow-up). MBCT did not differ from other active therapies at post-treatment (k = 6, d = 0.002, [−0.43, 0.44]) and longest follow-up (k = 4, d = 0.26, [−0.24, 0.75]). There was some evidence that studies with higher methodological quality showed smaller effects at post-treatment, but no evidence that effects varied by inclusion criterion. The impact of publication bias appeared minimal. MBCT seems to be efficacious for samples with current depressive symptoms at post-treatment, although a limited number of studies tested the long-term effects of this therapy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6687569/