MBCT

Improve Mindfulness’ Benefits for Cancer Survivors with Smart-Messaging

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Improve Mindfulness’ Benefits for Cancer Survivors with Smart-Messaging

 

By John M. de Castro, Ph.D.

 

“Cancer is a traumatic event that changes a person’s life. Utilizing mindfulness tools can provide peace and hope. Practicing mindfulness on a daily basis can assist with long term effects of happiness and positivity.” – Erin Murphy-Wilczek

 

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

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. Mindfulness-Based Cognitive Therapy (MBCT) consists of mindfulness training and Cognitive Behavioral Therapy (CBT). During therapy the patient is trained to investigate and alter aberrant thought patterns underlying their reactions to cancer. MBCT has been found to help relieve the symptoms of cancer survivors. It makes sense to explore ways to improve the effectiveness of MBCT for cancer patients.

 

In today’s Research News article “Using smart-messaging to enhance mindfulness-based cognitive therapy for cancer patients: A mixed methods proof of concept evaluation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004102/ ) Wells and colleagues evaluated whether providing text message reminders could enhance the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for the relief of anxiety and depression in cancer patients. They recruited adult cancer patients with mild to moderate anxiety and/or depression and provided them with 8 weekly sessions of MBCT along with 40 minutes daily home practice. The patients could refuse messaging or opt to receive text messages 3 times per week reminding them of their home practice and could request up to 9 more messages per week. They were measured before and after each session and 1 month after the completion of the training for depression, anxiety, and general mental health.

 

They found that 87% of the patients receiving smart messaging completed the 8-week Mindfulness-Based Cognitive Therapy (MBCT) program while only 38% of the non-messaging patients completed the MBCT program. Both groups had significant reductions in anxiety and depression that were maintained 1 month after treatment. But the smart messaging group had significantly greater reductions in depression.

 

This is a proof of concept study which demonstrated that smart messaging could be effectively used in conjunction with Mindfulness-Based Cognitive Therapy (MBCT). The results, though, need to be interpreted with great caution. The patients decided whether to receive the messages or not and very different patients might have opted in compared those that refused the messaging. These differences in the groups could account for the observed differences in participation and depression. But this study establishes that this smart messaging method is feasible with cancer patients with suggestions of improved impact of the therapy. A randomized controlled trial is now needed.

 

So, improve mindfulness’ benefits for cancer survivors with smart-messaging.

 

“It turns out that some of the most difficult elements of the cancer experience are very well-suited to a mindfulness practice.” – Linda Carlson

 

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

 

Wells, C., Malins, S., Clarke, S., Skorodzien, I., Biswas, S., Sweeney, T., Moghaddam, N., & Levene, J. (2020). Using smart-messaging to enhance mindfulness-based cognitive therapy for cancer patients: A mixed methods proof of concept evaluation. Psycho-oncology, 29(1), 212–219. https://doi.org/10.1002/pon.5256

 

Abstract

Objective

Depression and anxiety lead to reduced treatment adherence, poorer quality of life, and increased care costs amongst cancer patients. Mindfulness‐based cognitive therapy (MBCT) is an effective treatment, but dropout reduces potential benefits. Smart‐message reminders can prevent dropout and improve effectiveness. However, smart‐messaging is untested for MBCT in cancer. This study evaluates smart‐messaging to reduce dropout and improve effectiveness in MBCT for cancer patients with depression or anxiety.

Methods

Fifty‐one cancer patients attending MBCT in a psycho‐oncology service were offered a smart‐messaging intervention, which reminded them of prescribed between‐session activities. Thirty patients accepted smart‐messaging and 21 did not. Assessments of depression and anxiety were taken at baseline, session‐by‐session, and one‐month follow‐up. Logistic regression and multilevel modelling compared the groups on treatment completion and clinical effectiveness. Fifteen post‐treatment patient interviews explored smart‐messaging use.

Results

The odds of programme completion were eight times greater for patients using smart‐messaging compared with non‐users, controlling for age, gender, baseline depression, and baseline anxiety (OR = 7.79, 95% CI 1.75 to 34.58, p = .007). Smart‐messaging users also reported greater improvement in depression over the programme (B = ‐2.33, SEB = .78, p = .004) when controlling for baseline severity, change over time, age, and number of sessions attended. There was no difference between groups in anxiety improvement (B = ‐1.46, SEB = .86, p = .097). In interviews, smart‐messaging was described as a motivating reminder and source of personal connection.

Conclusions

Smart‐messaging may be an easily integrated telehealth intervention to improve MBCT for cancer patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004102/

 

Improve Depression in International Students with Positive Coping with Mindfulness

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Improve Depression in International Students with Positive Coping with Mindfulness

 

“with practice, meditation can help many people control how they react to the stress and anxiety that often leads to depression,” – John Denninger

 

By John M. de Castro, Ph.D.

 

Depression affects over 6% of the population. It is common in college students. There is a lot of pressure on college students to excel so that they can get the best jobs after graduation. This can lead to stress, anxiety and depression which can impede the student’s physical and mental health, well-being, and school performance. International students face the additional stress of being immersed in an alien culture and being separated from family and friends. 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. It is important to determine if mindfulness training can help to relieve depression in international college students.

 

In today’s Research News article “The Mediating Effects of Coping Style on the Effects of Breath Count Mindfulness Training on Depressive Symptoms among International Students in China.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7474765/ ) Gu and colleagues recruited foreign college students in china and randomly assigned them to receive no treatment, but encouraged to exercise, or 8-weeks for 2-hours per week of either normal college counseling or Mindfulness-Based Cognitive Therapy (MBCT) program that emphasized attention to the breath. They were measured before and after training for depression, life events including family life, work and study life, and family and friends’ life, and positive and negative coping. In addition, saliva samples were taken and assayed for cortisol levels.

 

They found that in general international college students had mild levels of depression and that the higher the levels of depression the greater the problems with life events and the lower the coping ability. They found that both mindfulness training and normal counseling, but not exercise, resulted in significant reductions in depression and cortisol levels. In addition, those students who had positive coping styles had greater reductions in depression after mindfulness training than either of the other groups.

 

That mindfulness training can reduce depression, especially with or Mindfulness-Based Cognitive Therapy (MBCT) has been well documented in prior research. Additionally, it found that students with positive coping styles benefited the most from the therapy. Additionally, it found that students with positive coping styles benefited the most from the therapy. In addition, mindfulness training reduced cortisol levels suggesting a reduction in stress levels in these students. Again, mindfulness training has been previously been shown to reduce cortisol levels and stress. The contribution of the present study is that it demonstrates that mindfulness training is effective in reducing stress and depression in international students.

 

It is interesting that MBCT training was no more effective than traditional college counseling. MBCT training was specifically developed to treat depression. So, it is surprising that it was not superior to normal counselling. It is possible that since the students were only mildly depressed in the first place there was limited ability to show improvement creating a floor effect. Indeed, depression index levels at the end of training indicated no depression was present at all following training. Perhaps if the students were more depressed to start with, MBCT training would have a greater opportunity to demonstrate superiority. Nevertheless, it is clear that mindfulness training can reduce the depression found in international students especially in students who have strong positive coping ability.

 

So, improve depression in international students with positive coping with mindfulness.

 

“Depression makes someone more likely to react to life’s setbacks with negative, judgmental thinking, which can lower their mood and trigger a new episode. Mindfulness helps create mental space around these thoughts, enabling people at risk to observe, with kindness, the patterns of the mind that might otherwise drag them down.” – Ed Halliwell

 

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

 

Gu, S., Li, Y., Liang, F., Feng, R., Zeng, Z., & Wang, F. (2020). The Mediating Effects of Coping Style on the Effects of Breath Count Mindfulness Training on Depressive Symptoms among International Students in China. Neural plasticity, 2020, 8859251. https://doi.org/10.1155/2020/8859251

 

Abstract

Mindfulness training has gained popularity in the scientific field and has been proposed as an efficient way for emotional regulation. Mindfulness-based cognitive therapy (MBCT) is designed especially for depressive people in reducing risk of depression relapse and is recommended in national guidelines as a treatment choice for relapse prevention in recurrent depression. The aim of the current study was to investigate the effects of mindfulness training on depressive symptoms of international students and probe into the mediating role of mindfulness in stressful events and depression. In addition, we introduced a new kind of mindfulness training, the breathing exercise-based mindfulness training, which is based on the integration of Buddhism and Daoism. Self-report questionnaires assessing the coping style, abnormal depressive behavior, and stressful live events were completed in 260 international students in China (mean age = 21.4 years). The results showed that (1) many international students showed depression symptoms, (2) stressful life events play a completely mediating role in the initiation of depression and anxiety, and (3) mindfulness training for 8 weeks significantly reduced the depressive symptoms, and it was also related to a positive coping style. This study has certain theoretical significance in exploring the mechanism of the occurrence and development of depression among international students and provides useful tools for this special group of international students. In addition, the international students can also learn Chinese culture through the training. These findings indicate that mindfulness training and positive coping style are interrelated with treating depressive symptoms for international students.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7474765/

 

Improve Mental Health with Mindfulness

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Improve Mental Health with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is recommended as a treatment for people with mental ill-health as well as those who want to improve their mental health and wellbeing.” – Mental Health Foundation

 

Over the last several decades, research and anecdotal experiences have accumulated an impressive evidential case that the development of mindfulness has positive benefits for the individual’s mental, physical, and spiritual life. Mindfulness appears to be beneficial both for healthy people and for people suffering from a myriad of mental and physical illnesses. It appears to be beneficial across ages, from children, to adolescents, to the elderly. And it appears to be beneficial across genders, personalities, race, and ethnicity. The breadth and depth of benefits is unprecedented. There is no other treatment or practice that has been shown to come anyway near the range of mindfulness’ positive benefits.

 

There is a vast array of techniques for the development of mindfulness. It is important to establish the most efficacious techniques and their dosages for the treatment of common mental illnesses. It is particularly important, for reasons of affordability, to employ techniques that qualify for insurance reimbursement.

 

In today’s Research News article “Insurance-Reimbursable Mindfulness for Safety-Net Primary Care Patients: A Pilot Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7009938/ ) Gawande and colleagues recruited adults with a non-severe mental health diagnosis and randomly assigned them to receive either a high or low dose mindfulness training. The high dose training consisted of 8 weeks of twice a week 1-hour mindfulness trainings along with daily 30-45 minutes of home practice. The mindfulness training was adapted from Mindfulness-Based Cognitive Therapy (MBCT) including meditation, trauma-informed practices, and self-compassion training. The low dose mindfulness training consisted of a single 60-minute introduction to mindfulness and encouragement to practice mindfulness. They were measured before and after training for anxiety, depression, perceived stress, disease self-efficacy, mindfulness, self-compassion, and perceived control of disease.

 

The most common disorders were anxiety disorders in 37% and depression in 32% of the participants. They found that in comparison to baseline the high dose mindfulness group had significant reductions in anxiety, depression, and perceived stress and significant increases in disease self-efficacy, mindfulness, and self-compassion. The low dose mindfulness group had only a significant reduction in perceived stress. The high dose mindfulness group had significant greater increases in mindfulness and self-compassion and decreases in anxiety than the low dose group. Importantly, the high dose mindfulness intervention was accepted for reimbursement by insurance companies.

 

The study is important in that it demonstrated that insurance would cover the high dose treatment. This is important for making the treatment affordable for insured clients. The study demonstrated as have a variety of other research studies that mindfulness training produces significant reductions in anxiety, depression, and perceived stress and significant increases in disease self-efficacy, mindfulness, and self-compassion. But the study had a unique control condition of a low dose mindfulness training. The high dose intervention produced significant improvements in mental illness disease symptoms that were for the most part better than those of the low dose. This establishes that participant expectancies and positive biases toward mindfulness training cannot account for the improvements. It also demonstrates that greater doses of mindfulness training produce greater benefits for patients with non-severe mental health issues.

 

So, improve mental health with mindfulness.

 

“The research is strong for mindfulness’ positive impact in certain areas of mental health, including stress reduction, emotion and attention regulation, reduced rumination, for reducing mild to moderate depression and anxiety, and preventing depressive relapse.” – Kelle Walsh

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Gawande, R., Pine, E., Griswold, T., Creedon, T., Vallejo, Z., Rosenbaum, E., Lozada, A., & Schuman-Olivier, Z. (2019). Insurance-Reimbursable Mindfulness for Safety-Net Primary Care Patients: A Pilot Randomized Controlled Trial. Mindfulness, 10(9), 1744–1759. https://doi.org/10.1007/s12671-019-01116-8

 

Abstract

Objectives:

Mindfulness is effective for reducing anxiety and depression and increasing chronic disease self-management. An accessible, insurance-reimbursable model for implementation in patient-centered medical homes within US healthcare systems has promise for patients with multi-morbid conditions. Clarifying both the dose needed to impact anxiety, depression and self-management, and the design requirements for accessible primary care implementation, is essential.

Methods:

We tested feasibility, acceptability, and effectiveness of Mindfulness Training for Primary Care (MTPC), an 8-week, referral-based, insurance-reimbursable mindfulness program integrated within primary care, compared with a Low-Dose Comparator (LDC), consisting of a 60-minute mindfulness introduction plus referral to community and digital resources. Outcome measures were assessed at baseline and 8 weeks. MTPC is trauma-informed, incorporates mindfulness-oriented behavior change skills, and is designed to target anxiety, depression, stress, and chronic illness selfmanagement. Participants schedule a PCP visit to co-create a self-management action plan during week 6.

Results:

Primary care providers (PCP) referred 344 patients over 14 months. Eighty-one participants with DSM-V anxiety disorders, depressive disorders, trauma- and stress-related disorders participated in this pilot randomized-controlled comparative effectiveness trial [MTPC (n=54); LDC (n=27)]. These data suggest that MTPC was more effective than LDC for reducing anxiety (p=0.01), enhancing mindfulness (p=0.02) and self-compassion (p=0.001), and for catalyzing selfmanagement behavior change through action plan initiation (OR=4.34, p=0.03).

Conclusions:

MTPC was successfully integrated into a health system, was billed to insurance, and was acceptable to a diverse primary care population. Replication with a larger study and further accessibility adaptations are needed to confirm and expand these pilot results.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7009938/

 

Improve Bipolar Disorder with Mindfulness-Based Cognitive Therapy

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Improve Bipolar Disorder with Mindfulness-Based Cognitive Therapy

 

By John M. de Castro, Ph.D.

 

“Bipolar disorder can be complicated by stress, and having bipolar disorder is stressful in itself. Relaxation techniques such as meditation can reduce the stress you experience from bipolar disorder, which can help you keep your mood in check.” – Timothy Legg

 

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 been 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.

 

It would seem appropriate to summarize what has been learned about the efficacy of Mindfulness-Based Cognitive Therapy (MBCT) for the treatment of bipolar disorder. In today’s Research News article “Mindfulness-based cognitive therapy for bipolar disorder: A systematic review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7448295/) Lovas and colleagues review and summarize the published research studies of the effectiveness of MBCT for the treatment of bipolar disorder. They identified 13 published research studies.

 

They report that the published research studies found that Mindfulness-Based Cognitive Therapy (MBCT) significantly reduced depressive symptoms of patients with bipolar disorder while not eliciting symptoms of mania. MBCT appears to also reduce anxiety and suicidality. It appears to reduce depressive symptoms and improve mood by decreasing rumination, repetitive negative thoughts. It also appeared to improve attentional control, broadening present moment awareness from a focus on negative thoughts. In addition, it appears to create reappraisal, such that the patients were able to reappraise their negative thoughts as just thoughts and not facts. The improvements in depressive symptoms were found to be related to the amount of home practice during MBCT training.

 

These are promising results suggesting that Mindfulness-Based Cognitive Therapy (MBCT) is a safe and effective treatment for the depressive symptoms of bipolar disorder. But the authors report that the published research studies were generally of low research quality and underpowered to discern statistically significant effects. So, better designed and larger studies need to be conducted before firm conclusions regarding benefits can be reached.

 

So, improve bipolar disorder with Mindfulness-Based Cognitive Therapy.

 

“mindfulness-based cognitive therapy (MBCT) may help individuals with bipolar disorder prevent depressive episodes and has lasting benefits to the brain and cognition.” – BP Magazine

 

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

 

Lovas, D. A., & Schuman-Olivier, Z. (2018). Mindfulness-based cognitive therapy for bipolar disorder: A systematic review. Journal of affective disorders, 240, 247–261. https://doi.org/10.1016/j.jad.2018.06.017

 

Abstract

Background:

Persisting high levels of relapse, morbidity and mortality in bipolar disorder (BD) in spite of first-line, evidence-based psychopharmacology has spurred development and research on adjunctive psychotherapies. Mindfulness-based cognitive therapy (MBCT) is an emerging psychotherapy that has shown benefit in related and comorbid conditions such as major depressive, anxiety, and substance disorders. Furthermore, neurocognitive studies of MBCT suggest that that may have effects on some of the theorized pathophysiological processes in BD.

Methods:

We conducted a systematic literature review using PsychINFO and PubMed databases to identify studies reporting clinical and/or neurocognitive findings for MBCT for BD.

Results:

This search revealed 13 articles. There was a wide range in methodological quality and most studies were underpowered or did not present power calculations. However, MBCT did not appear to precipitate mania, and there is preliminary evidence to support a positive effect on anxiety, residual depression, mood regulation, and broad attentional and frontal-executive control.

Limitations:

As meta-analysis is not yet possible due to study heterogeneity and quality, the current review is a narrative synthesis, and therefore net effects cannot be estimated.

Conclusions:

MBCT for BD holds promise, but more high-quality studies are needed in order to ascertain its clinical efficacy. Recommendations to address the limitations of the current research are made.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7448295/

 

Reduce Anxiety and Depression in Cancer Patients with Mindfulness

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Reduce Anxiety and Depression in Cancer Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Practicing mindfulness can assist with uncertainty about the future, depression, fear of recurrence and anxiety as well as mitigate physical symptoms such as fatigue, pain, and sleep disturbance.” – Erin Murphy-Wilczek

 

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

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress,  sleep disturbance, fear, and anxiety and depression. There has been considerable research conducted on the effectiveness of mindfulness practices in treating the psychological issues associated with cancer. So, it makes sense to step back and summarize what has been learned about the effectiveness of mindfulness in treating anxiety in cancer patients.

 

In today’s Research News article “Association of Mindfulness-Based Interventions With Anxiety Severity in Adults With Cancer: A Systematic Review and Meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7414391/) Oberoi and colleagues review, summarize, and perform a meta-analysis of the published research on the effectiveness of mindfulness in reducing anxiety in adult cancer patients. They found 28 published trials. The most common forms of mindfulness treatment were Mindfulness-Based Stress Reduction (MBSR) (13 studies) and Mindfulness-Based Cognitive Therapy (MBCT) (6 studies).

 

They report that the published research found that mindfulness training reduced anxiety and depression and increased quality of life over the short and medium term (up to 6 months post-treatment) with moderate effect sizes. The reduction in anxiety and depression may be responsible for the improvement in the patients’ quality of life. But 2 trials had longer term follow up measures (over 6 months) and did not find significant reductions. The fact that the effects do not appear to last beyond 6 months suggests that continued mindfulness practice or periodic booster sessions may be needed.

 

Fighting cancer is very stressful and amplifies negative emotions like anxiety and depression. The stress produced by these emotions can in turn interfere with the body’s ability to fight the cancer. So, treating these negative emotional states may be very important not only for the individual’s mental health but also to their physical well-being. So, mindfulness training may be important to the overall health of the cancer patient by reducing anxiety and depression.

 

So, reduce anxiety and depression in cancer patients with mindfulness.

 

“In summary, results show promise for mindfulness-based interventions to treat common psychological problems such as anxiety, stress, and depression in cancer survivors and to improve overall quality of life.” – Linda Carlson

 

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

 

Oberoi, S., Yang, J., Woodgate, R. L., Niraula, S., Banerji, S., Israels, S. J., Altman, G., Beattie, S., Rabbani, R., Askin, N., Gupta, A., Sung, L., Abou-Setta, A. M., & Zarychanski, R. (2020). Association of Mindfulness-Based Interventions With Anxiety Severity in Adults With Cancer: A Systematic Review and Meta-analysis. JAMA network open, 3(8), e2012598. https://doi.org/10.1001/jamanetworkopen.2020.12598

 

Abstract

Importance

Mindfulness-based interventions (MBIs), grounded in mindfulness, focus on purposely paying attention to experiences occurring at the present moment without judgment. MBIs are increasingly used by patients with cancer for the reduction of anxiety, but it remains unclear if MBIs reduce anxiety in patients with cancer.

Objective

To evaluate the association of MBIs with reductions in the severity of anxiety in patients with cancer.

Data Sources

Systematic searches of MEDLINE, Embase, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and SCOPUS were conducted from database inception to May 2019 to identify relevant citations.

Study Selection

Randomized clinical trials (RCTs) that compared MBI with usual care, waitlist controls, or no intervention for the management of anxiety in cancer patients were included. Two reviewers conducted a blinded screening. Of 101 initially identified studies, 28 met the inclusion criteria.

Data Extraction and Synthesis

Two reviewers independently extracted the data. The Cochrane Collaboration risk-of-bias tool was used to assess the quality of RCTs, and the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline was followed. Summary effect measures were reported as standardized mean differences (SMDs) and calculated using a random-effects model.

Main Outcomes and Measures

Our primary outcome was the measure of severity of short-term anxiety (up to 1-month postintervention); secondary outcomes were the severity of medium-term (1 to ≤6 months postintervention) and long-term (>6 to 12 months postintervention) anxiety, depression, and health-related quality of life of patients and caregivers.

Results

This meta-analysis included 28 RCTs enrolling 3053 adults with cancer. None of the trials were conducted in children. Mindfulness was associated with significant reductions in the severity of short-term anxiety (23 trials; 2339 participants; SMD, −0.51; 95% CI, −0.70 to −0.33; I2 = 76%). The association of mindfulness with short-term anxiety did not vary by evaluated patient, intervention, or study characteristics. Mindfulness was also associated with the reduction of medium-term anxiety (9 trials; 965 participants; SMD, −0.43; 95% CI, −0.68 to −0.18; I2 = 66%). No reduction in long-term anxiety was observed (2 trials; 403 participants; SMD, −0.02; 95% CI, −0.38 to 0.34; I2 = 68%). MBIs were associated with a reduction in the severity of depression in the short term (19 trials; 1874 participants; SMD, −0.73; 95% CI; −1.00 to −0.46; I2 = 86%) and the medium term (8 trials; 891 participants; SMD, −0.85; 95% CI, −1.35 to −0.35; I2 = 91%) and improved health-related quality of life in patients in the short term (9 trials; 1108 participants; SMD, 0.51; 95% CI, 0.20 to 0.82; I2 = 82%) and the medium term (5 trials; 771 participants; SMD, 0.29; 95% CI, 0.06 to 0.52; I2 = 57%).

Conclusions and Relevance

In this study, MBIs were associated with reductions in anxiety and depression up to 6 months postintervention in adults with cancer. Future trials should explore the long-term association of mindfulness with anxiety and depression in adults with cancer and determine its efficacy in more diverse cancer populations using active controls.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7414391/

 

Reduce Depression in Vindictive/Self‐Centered Depressed Patients with Mindfulness

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Reduce Depression in Vindictive/Self‐Centered Depressed Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“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

 

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. Problematic interpersonal styles, such as submissive and hostile styles are characteristics of patients with chronic depression. It is possible that MBCT has differential effectiveness for depression, in patient’s with certain interpersonal problems and not others.

 

In today’s Research News article “Patients’ interpersonal problems as moderators of depression outcomes in a randomized controlled trial comparing mindfulness-based cognitive therapy and a group version of the cognitive-behavioral analysis system of psychotherapy in chronic depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318258/) Probst and colleagues recruited participants with a current, long-term, at least 2 years, major depressive disorder. They all received their treatment as usual. They were randomly assigned to receive either no additional treatment, or to receive 8 weeks, once a week, for 2.5 hours group sessions of either Mindfulness-Based Cognitive Therapy (MBCT), or cognitive behavioral analysis system of psychotherapy (CBASP). They were measured before and after treatment and 6 months later for depression, interpersonal problems including domineering/controlling; vindictive/self‐centered; cold/distant; socially inhibited/avoidant; nonassertive; overly accommodating/exploitable; self‐sacrificing/overly nurturant; and intrusive/needy.

 

They found that both treatments significantly reduced depression levels. But patients who were high in vindictive/self‐centered interpersonal problems benefited more (had a greater reductions in depression) from Mindfulness-Based Cognitive Therapy (MBCT), than from cognitive behavioral analysis system of psychotherapy (CBASP). Conversely, patients who were high in nonassertive interpersonal problems benefited more (had a greater reductions in depression) from cognitive behavioral analysis system of psychotherapy (CBASP) than from MBCT.

 

Vindictive/self‐centered individuals are frequently egocentric and hostile in dealing with others. Mindfulness training has been shown to produce decentering and lower hostility. So, it makes sense that Mindfulness-Based Cognitive Therapy (MBCT) would be particularly effective with these patients. On the other hand, nonassertive patients have difficulty expressing their needs to others and cognitive behavioral analysis appears to work better for them.

 

There are a number of different types of therapy for depression. So, the results of the present study are very useful. They suggest that knowing the particular interpersonal problems a patient has can help to select the form of therapy that will be maximally beneficial for them. Mindfulness-Based Cognitive Therapy (MBCT) appears to work best for vindictive/self‐centered depressed patients reducing their egocentricity and hostility.

 

So, reduce depression in vindictive/self‐centered depressed patients with mindfulness.

 

“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 also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Probst, T., Schramm, E., Heidenreich, T., Klein, J. P., & Michalak, J. (2020). Patients’ interpersonal problems as moderators of depression outcomes in a randomized controlled trial comparing mindfulness-based cognitive therapy and a group version of the cognitive-behavioral analysis system of psychotherapy in chronic depression. Journal of clinical psychology, 76(7), 1241–1254. https://doi.org/10.1002/jclp.22931

 

Abstract

Objectives

Interpersonal problems were examined as moderators of depression outcomes between mindfulness‐based cognitive therapy (MBCT) and cognitive behavioral analysis system of psychotherapy (CBASP) in patients with chronic depression.

Methods

Patients received treatment‐as‐usual and, in addition, were randomized to 8‐weeks of MBCT (n = 34) or 8‐weeks of CBASP (n = 34). MBCT and CBASP were given in a group format. The Hamilton depression rating scale (HAM‐D) was the primary and the Beck Depression Inventory (BDI‐II) the secondary outcome. The subscales of the Inventory of interpersonal problems (IIP‐32) were moderators. Multilevel models were performed.

Results

Higher scores on the “vindictive/self‐centered” subscale were associated with a better outcome in MBCT than in CBASP (HAM‐D: p < .01; BDI‐II: p < .01). Higher scores on the “nonassertive” subscale were associated with a better outcome in CBASP than in MBCT (HAM‐D: p < .01; BDI‐II: p < .01).

Conclusions

If these results can be replicated in larger trials, MBCT should be preferred to CBASP in chronically depressed patients being vindictive/self‐centered, whereas CBASP should be preferred to MBCT in chronically depressed patients being nonassertive.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318258/

 

Improve Fertility with Mindfulness

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Improve Fertility with Mindfulness

 

By John M. de Castro, Ph.D.

 

“those who participate in a mind-body wellness program are 32% more likely to become pregnant!” – Michelle Anne

 

Infertility is primarily a medical condition due to physiological problems. It is quite common. It is estimated that in the U.S. 6.7 million women, about 10% of the population of women are infertile. Infertility can be more than just a medical issue. It can be an emotional crisis for many couples, especially for the women. Couples attending a fertility clinic reported that infertility was the most upsetting experience of their lives. Women with infertility reported feeling as anxious or depressed as those diagnosed with cancer, hypertension, or recovering from a heart attack.

 

Mindfulness training been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail. This is especially true for Mindfulness-Based Cognitive Therapy (MBCT) which was specifically developed to treat depression. MBCT has been shown to be effective in treating infertility. At this point it’s useful to step back and summarize what has been learned about mindfulness training and infertility.

 

In today’s Research News article “Application of Mindfulness-Based Psychological Interventions in Infertility.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7295259/), Patel and colleagues review and summarize the published scientific research of the effectiveness of mindfulness training in treating infertility. They identified 9 published research studies.

 

They report that the research found that mindfulness training decreases anxiety, depression, stress, and anger, and increases well-being and quality of life of infertile women. These enhance the self-efficacy of women coping with infertility. Mindfulness training also has been found to reduce emotional stress and stress hormones and improve sleep and immune function all of which are known to play an important role in infertility. These all lead to increased conception rates.

 

The psychological and emotional issues that result from infertility produce a negative spiral, where infertility increases emotional dysfunction, which in turn lessens the likelihood of conception, which increases emotionality and so on. Mindfulness training appears to interrupt this cycle by improving the psychological and physical well-being of infertile women. This allows the women to relax and better cope with the issues surrounding infertility. This in turn improves their likelihood of conception. Hence, mindfulness training should be recommended for infertile women.

 

So, improve fertility with mindfulness.

 

“mindfulness becomes the perfect antidote for the paradoxical land mines infertility presents. Mindfulness starts from the perspective that you are whole and complete already, regardless of flaws or imperfections. It is based on the concept of original goodness: your essential nature is good and pure. Proceeding from this vantage point gives you freedom from the bondage of inadequacy and insecurity.” – Janetti Marotta

 

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

 

Patel, A., Sharma, P., & Kumar, P. (2020). Application of Mindfulness-Based Psychological Interventions in Infertility. Journal of Human Reproductive Sciences, 13(1), 3–21. https://doi.org/10.4103/jhrs.JHRS_51_19

 

Abstract

Living mindfully helps one gain a deeper understanding into realities of life. It enables people to witness suffering, desire, attachments, and impermanence without any fear, anxiety, anger, or despair. This is considered the hallmark of true psychological insight. As a skill, mindfulness can be inculcated by anyone. Mindfulness helps in attending, getting aware and understanding experiences in a compassion and open-minded way. Research suggests that applying mindfulness in daily life has been known to tame our emotional mind and enabled people to perceive things “as they are” without ascribing expectations, judgments, cynicism, or apprehensions to them. This review unravels the therapeutic power of mindfulness meditation in the context of infertility distress. It serves to integrate the evidence on the effectiveness of mindfulness-based psychological interventions to improve the emotional well-being and biological outcomes in Infertility.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7295259/

 

Reduce the Risk of Major Depression Relapse with Mindfulness

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Reduce the Risk of Major Depression Relapse with Mindfulness

 

By John M. de Castro, Ph.D.

 

“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.

 

Relapsing into depression 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.

 

There has been considerable research demonstrating that Mindfulness-Based Cognitive Therapy (MBCT) is effective in treating depression.  In today’s Research News article “The effects of mindfulness-based cognitive therapy on risk and protective factors of depressive relapse – a randomized wait-list controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275325/), Schanche and colleagues investigate the ability of  MBCT to reduce risk factors associated with relapse in patients with major depressive disorder.

 

They recruited adult patients diagnosed with major depressive disorder who had at least 3 depressive episodes and who were currently in remission. They were randomly assigned to be on a wait list or to receive 8 weekly 2-hour sessions of Mindfulness-Based Cognitive Therapy (MBCT). They were measured before and after training for rumination, emotion regulation, anxiety, self-compassion, mindfulness, and depression.

 

They found that in comparison to baseline and the wait-list group after Mindfulness-Based Cognitive Therapy (MBCT) there were significant reductions in rumination, anxiety, emotional reactivity to stress and depression and significant increases in emotion regulation, self-compassion and mindfulness. Hence, MBCT significantly improved the psychological well-being of these patients.

 

These are interesting results that suggest that Mindfulness-Based Cognitive Therapy (MBCT) produces a reduction in the types of negative emotional symptoms that could promote a depressive relapse and an increase in factors that could promote resistance to relapse especially the ability to effectively cope with their emotions and compassion for themselves. Mindfulness training has been repeatedly shown in the past to reduce rumination, anxiety, emotional reactivity to stress and depression and increase emotion regulation and self-compassion. The present study demonstrates that these benefits occur in patients in remission from major depressive disorder. This suggests that MBCT is effective in improving the major depressive disorder patients psychological state in a way that suggests that they would be resistant to relapse in the future.

 

So, reduce the risk of major depression relapse with mindfulness.

 

“MBCT and CT attempt to reduce the risk of relapse by promoting different skill sets. CT promotes challenging dysfunctional thinking and increasing physical activity level. MBCT promotes nonjudgmental monitoring of moment-by-moment experience, and decentering from thoughts or seeing thoughts as transient mental phenomena and not necessarily valid.” – American Mindfulness Research Association

 

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

 

Elisabeth Schanche, Jon Vøllestad, Endre Visted, Julie Lillebostad Svendsen, Berge Osnes, Per Einar Binder, Petter Franer, Lin Sørensen. The effects of mindfulness-based cognitive therapy on risk and protective factors of depressive relapse – a randomized wait-list controlled trial. BMC Psychol. 2020; 8: 57. Published online 2020 Jun 5. doi: 10.1186/s40359-020-00417-1

 

Abstract

Background

The aim of this randomized wait-list controlled trial was to explore the effects of Mindfulness–Based Cognitive Therapy (MBCT) on risk and protective factors for depressive relapse within the domains of cognition, emotion and self-relatedness.

Methods

Sixty-eight individuals with recurrent depressive disorder were randomized to MBCT or a wait-list control condition (WLC).

Results

Completers of MBCT (N = 26) improved significantly on measures assessing risk and protective factors of recurrent depression compared to WLC (N = 30) on measures of rumination (d = 0.59, p = .015), emotion regulation (d = 0.50, p = .028), emotional reactivity to stress (d = 0.32, p = .048), self-compassion (d = 1.02, p < .001), mindfulness (d = 0.59, p = .010), and depression (d = 0.40, p = .018). In the Intention To Treat sample, findings were attenuated, but there were still significant results on measures of rumination, self-compassion and depression.

Conclusions

Findings from the present trial contribute to evidence that MBCT can lead to reduction in risk factors of depressive relapse, and strengthening of factors known to be protective of depressive relapse. The largest changes were found in the domain of self-relatedness, in the form of large effects on the participants’ ability to be less self-judgmental and more self-compassionate.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275325/

 

Mindfulness Training Changes Patients’ Relationship to Tinnitus and Improves Symptoms

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Mindfulness Training Changes Patients’ Relationship to Tinnitus and Improves Symptoms

 

By John M. de Castro, Ph.D.

 

“It hasn’t affected the tinnitus… It’s the way I think about it and the way I deal with it… knowing that in just a few moments it won’t be as bad… you have to accept that it’s there, you have to.” – Study Participant

 

Tinnitus is one of the most common symptoms to affect humanity. People with tinnitus live with a phantom noise that can range from a low hiss or ringing to a loud roar or squeal which can be present constantly or intermittently. It can have a significant impact on people’s ability to hear, concentrate, or even participate in everyday activities. The vast majority of people with tinnitus have what is known as subjective tinnitus. This is caused by unknown problems somewhere in the auditory system; the inner, middle, or outer ear, the part of the brain that translates nerve signals as sounds, or the auditory nerves.

 

Approximately 25 million to 50 million people in the United States experience it to some degree. Approximately 16 million people seek medical attention for their tinnitus, and for up to two million patients, debilitating tinnitus interferes with their daily lives. There are a number of treatments for tinnitus including, counseling, sound therapy, drugs, and even brain stimulation. Unfortunately, none of these treatments is very effective. Mindfulness practices have been shown to be effective in treating Tinnitus. How learning to be mindful affects tinnitus is unknown.

 

In today’s Research News article “I Wasn’t at War With the Noise: How Mindfulness Based Cognitive Therapy Changes Patients’ Experiences of Tinnitus.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2020.00483/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1313244_69_Psycho_20200428_arts_A), Marks and colleagues recruited adults with tinnitus who participated in a study of the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for tinnitus. They were questioned with semi-structured interviews on the MBCT program and its effects on themselves and their tinnitus. The interview responses were analyzed with Interpretative Phenomenological Analysis.

 

The previous study that the subjects participated in demonstrated that Mindfulness-Based Cognitive Therapy (MBCT) significantly reduced tinnitus severity, catastrophizing, and fear and significantly increased their acceptance of tinnitus. The participants responses in the structured interviews were found to reflect 4 different themes. First, they reported that they learned to relate to tinnitus in a new way, specifically to cease fighting and attempting to control their tinnitus and instead to allow and accept it and turn toward it. Second, MBCT reduced their emotional distress and improved their well-being. Third, MBCT improved their relationships with others and themselves increasing understanding and compassion. Finally, MBCT improved attitudes that supported change including open mindedness, motivation, and balancing realism with gentleness.

 

These results suggest that Mindfulness-Based Cognitive Therapy (MBCT) improved tinnitus symptoms by changing the subjects attitudes and perspective. This is exactly what MBCT is designed to do. MBCT involves mindfulness training 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. It would appear from the participants’ reports that the training indeed was effective in changing how they experienced and related to their tinnitus and this, in turn, improved their symptoms.

 

So, mindfulness training changes patients’ relationship to tinnitus and improves symptoms.

 

“the rest of me has benefitted… You can’t catastrophize over everything else but manage it with your tinnitus. So it’s holistic… the big thing is the not catastrophizing…” – Study Participant

 

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

 

Marks E, Smith P and McKenna L (2020) I Wasn’t at War With the Noise: How Mindfulness Based Cognitive Therapy Changes Patients’ Experiences of Tinnitus. Front. Psychol. 11:483. doi: 10.3389/fpsyg.2020.00483

 

Abstract

Objectives: Intrusive tinnitus is a challenging, life-changing experience for which traditional medical treatment does not yet have a cure. However, Mindfulness Based Cognitive Therapy for tinnitus (MBCT-t) is effective in reducing tinnitus-related distress, disability and intrusiveness. It is a priority to understand patients’ experience of MBCT-t and active processes which they regarded as underpinning the changes they experienced. Semi-structured interviews were conducted 6 months after participants had completed MBCT as part of a randomized controlled trial (RCT), with a focus on exploring their experiences of the course, what they felt had changed and how they felt such changes had occurred.

Methods: Nine participants took part and Interpretative Phenomenological Analysis (IPA) was used to analyze the interview transcripts.

Results: Four overarching themes emerged: (1) Relating to Tinnitus in a New Way, (2) Holistic Benefits, (3) Connection, Kindness and Compassion, and (4) Factors Supporting Engagement and Change.

Conclusion: All participants reported benefits from MBCT-t, based on a radically new relationship with tinnitus. It was no longer characterized by “fighting it” and was instead based on “allowing” tinnitus to be present. Changes were supported by the development of open, stable, present-moment awareness and attitudes of equanimity, kindness, and compassion. Practices encouraging focus on sound (including tinnitus) were challenging, but essential to learning this new way of being with tinnitus. MBCT-t had a huge range of benefits including reduced distress and enhanced wellbeing. The group nature of MBCT-t was an integral part of the therapeutic process. A number of clinical and research implications are discussed.

https://www.frontiersin.org/articles/10.3389/fpsyg.2020.00483/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1313244_69_Psycho_20200428_arts_A

 

Reduce the Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) with Mindfulness

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Reduce the Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Normally I would have lost my keys and then gone tearing through the house looking for them. ( . . . ) And then ( . . . ) completely losing yourself in that. And these days that just doesn’t happen anymore. When I lose something now it’s more like, “okay, then let’s just look for it,” and I go and stand calmly in my room and then at some point I find it.” – Study Participant

 

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

 

There are indications that mindfulness practices may be an effective treatment for ADHD. It makes sense that it should be, as the skills and abilities strengthened by mindfulness practices are identical to those that are defective in ADHD,  attention, impulse control, executive function, emotion control, and mood improvement. In addition, unlike drugs, they are relatively safe interventions that have minimal troublesome side effects. Mindfulness-Based Cognitive Therapy (MBCT) is a mindfulness practice that contains Cognitive Behavioral Therapy (CBT) and assigned homework. During therapy the patient is trained in mindfulness and to investigate and alter aberrant thought patterns.

 

In today’s Research News article “The Feasibility, Effectiveness, and Process of Change of Mindfulness-Based Cognitive Therapy for Adults With ADHD: A Mixed-Method Pilot Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081523/), Janssen and colleagues recruited adults diagnosed with ADHD who had completed an 8-week program of Mindfulness-Based Cognitive Therapy (MBCT). Training occurred in weekly 2.5-hour sessions along with 30 minutes per day of home practice. They were measured before and after training for mindfulness, Attention Deficit Hyperactivity Disorder (ADHD) symptoms, behavioral regulation, metacognition, self-compassion, general functioning, and health status. They also participated in a focus group 3 months after training.

 

Only 16% of the patients failed to complete training. They found that in comparison to baseline, following Mindfulness-Based Cognitive Therapy (MBCT) training there were significant increases in mental health, self-compassion, total executive functioning, including metacognition including the self-monitor, working memory, plan/organize, task monitor and organization of materials subscales and significant reductions in total ADHD symptoms, including inattention and hyperactive-impulsive symptoms. The analysis of the focus group data indicated that the participants believed that they improved due to increased ability to self-regulate.

 

Although this study did not have a comparison, control, condition, the results are similar to those found in prior controlled studies that mindfulness training improves the symptoms of Attention Deficit Hyperactivity Disorder (ADHD). The study demonstrated that Mindfulness-Based Cognitive Therapy (MBCT) training was feasible and acceptable for the treatment of adult patients with ADHD and that the treatment improved their symptoms, mental health, cognitive ability, and the patients’ ability to regulate their own behavior.

 

So, reduce the symptoms of Attention Deficit Hyperactivity Disorder (ADHD) with mindfulness.

 

“I can spend the whole day in a haze, but when we focus consciously on our breathing, I’m able to turn it around. I also have that during meetings or discussions. If I’ve had enough at a certain point and I notice my mind wandering off, I think about the breathing and I’m able to be more present again.” – Study Participant

 

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

 

Janssen, L., de Vries, A. M., Hepark, S., & Speckens, A. (2020). The Feasibility, Effectiveness, and Process of Change of Mindfulness-Based Cognitive Therapy for Adults With ADHD: A Mixed-Method Pilot Study. Journal of attention disorders, 24(6), 928–942. https://doi.org/10.1177/1087054717727350

 

Abstract

Objective: Mindfulness-Based Cognitive Therapy (MBCT) is a promising psychosocial intervention for adult ADHD. The feasibility and effectiveness of an adapted MBCT program is explored, together with the possible process of change. Method: Mixed-method study with 31 ADHD patients participating in an adapted MBCT program. Self-report questionnaires on ADHD symptoms, executive functioning, mindfulness skills, self-compassion, patient functioning, and health status were administered before and after MBCT. Semi-structured interviews were conducted with 24 patients. Results: A modest drop-out of n = 5 (16%) was found. MBCT resulted in a significant reduction of ADHD symptoms and improvements of executive functioning, self-compassion, and mental health. Qualitative analysis provided insight in facilitators and barriers participants experienced, and their process of change. Conclusion: The adapted MBCT program seemed to be feasible for adults with ADHD and preliminary evidence for the effectiveness is shown. An adequately powered Randomized Controlled Trial (RCT) is needed to further examine the effectiveness of MBCT for ADHD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081523/