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Improve Psychological Well-Being with Mindfulness Regardless of the Amount of Practice

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Improve Psychological Well-Being with Mindfulness Regardless of the Amount of Practice

 

By John M. de Castro, Ph.D.

 

“No matter what stage of life you are in, the goal of meditating is to find that silence within you, of letting go of external stressors, and accessing calm, tranquility, and feeling that all is well from within. You will reap the benefits of feeling better. And when you feel better, you can be your best self.” – Carol Melnick

 

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 illnesses. It appears to be beneficial across ages, from children 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. With impacts so great it is important to know how to optimize the development of mindfulness. But it is unclear exactly what kind and how much of training is essential to producing maximum benefits.

 

In today’s Research News article “Adherence to Practice of Mindfulness in Novice Meditators: Practices Chosen, Amount of Time Practiced, and Long-Term Effects Following a Mindfulness-Based Intervention.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419774/), Ribeiro and colleagues recruited healthy older adults, aged 50 to 80 years, who had not engaged in mindfulness practices and were moderately stressed. They were randomly assigned to either a wait-list control group or to receive a 6-week mindfulness training based upon the Mindfulness-Based Cognitive Therapy (MBCT) program. They met once a week for 60-90 minutes and were instructed to practice at home for 30-45 minutes daily. They were measured before and after training and 8 weeks later for neuroticism, perceived stress, expectancy, mindfulness, quality of life, depression, and adherence to mindfulness practice.

 

They found that the participants continued meditation after the training averaging 23 minutes per day for 76% of days and 8 weeks later significantly less averaging 16 minutes per day for 55% of days. Their preferred practice was body scan meditation, followed by sitting meditation and the most popular sitting meditation was breath following. In comparison to the baseline and the wait-list control group, mindfulness practice produced significant improvements in well-being including reductions in perceived stress, depression, and neuroticism and increases in mindfulness and the quality of life. These effects persisted from the end of training to the 8-week follow-up. There were no significant effects of expectancy, amount of practice, or type of practice on the results.

 

These results are similar to previous reports that mindfulness practice reduces perceived stress, depression, and neuroticism and increases in mindfulness and quality of life that continue beyond the end of training. Unlike previous research, however, they did not find any influence of the types, amounts, or patterns of practice on well-being. This may be due to a ceiling effects as the adherence and amount of practice was relatively high. It could also be due to the age of participants. Future studies may clarify these possibilities. Nevertheless, it is clear that mindfulness practice improves well-being in older adults.

 

So, improve psychological well-being with mindfulness regardless of the amount of practice.

 

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

 

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

 

Ribeiro, L., Atchley, R. M., & Oken, B. S. (2017). Adherence to Practice of Mindfulness in Novice Meditators: Practices Chosen, Amount of Time Practiced, and Long-Term Effects Following a Mindfulness-Based Intervention. Mindfulness, 9(2), 401–411.

 

Abstract

In this study, we objectively tracked the duration, frequency, and the preferred practices chosen by novice mindfulness practitioners following a mindfulness meditation (MM) intervention. A sample of 55 mildly stressed participants, aged 50 to 80 years old, underwent an individual 6-week MM intervention and had their guided meditation home practice electronically recorded during the intervention and the 8-week post-intervention period. Participants’ psychological well-being was assessed through self-report measures of mindfulness, quality of life, and symptoms of depression and stress. Results evidenced a high adherence to practice, with an average of ~23 minutes per day during the intervention and ~16 minutes per day in the follow-up period. Body scan, sitting meditation, and breathing space were the most popular meditation practices among participants. Our results showed significant alterations in self-reported measures over time, suggesting improvements in stress and overall quality of life. Changes in the self-report measures did not correlate with MM practice time, which suggests that other psychological phenomena, including quality of meditation practice, influence these outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419774/

 

Improve Mental Health in Older Adults with Mental Health Problems with Mindfulness

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Improve Mental Health in Older Adults with Mental Health Problems with Mindfulness

 

By John M. de Castro, Ph.D.

 

“You can think of emotional regulation like stopping a train—it works better if you can stop before the train (your emotions) starts rolling too fast.  It also helps when your brakes work immediately, without interference. Mindfulness lets you know right away that you need to stop and keeps thoughts and emotions from interfering.” – University of Minnesotta

 

As we age, there are systematic progressive declines in every system in the body, the brain included. This includes our mental abilities and results in impairments in memory, attention, and problem-solving ability. Aging also results in changes in mental health. Depression is very common in the elderly. The elderly cope with increasing loss of friends and family, deteriorating health, as well as concerns regarding finances on fixed incomes. In addition, many elderly experience withdrawal and isolation from social interactions producing increased loneliness, worry and anxiety.

 

Mindfulness appears to be effective for an array of psychological issues that occur with aging. It has also been shown to be beneficial in slowing or delaying physical and mental decline with aging. and improve cognitive processes. It has also been shown to reduce anxiety, worry, and depression and improve overall mental health. But not everyone responds to mindfulness training with improvement. Identifying who will respond and who won’t is important in determining the best treatment option for each individual.

 

In today’s Research News article “Predictors of Improvements in Mental Health From Mindfulness Meditation in Stressed Older Adults.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5802968/ ), Oken and colleagues recruited generally healthy, meditation naïve, older individuals aged 50 to 85 years who reported high levels of perceived stress. They were randomly assigned to a wait-list control group or to receive a 6-week program of Mindfulness-Based Cognitive Therapy (MBCT) including home practice. MBCT training occurred once a week for 60 to 90 minutes and 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.

 

The participants were measured before and after treatment and 2 months later for perceived stress, life experience stressors, neuroticism, positive and negative emotions, depression, health-related quality of life, sleep quality, fatigue, self-efficacy, and mindfulness. The researchers separated the participants by their response to the treatment with responders (half the participants) showing significant improvement in mental health.

 

They found that the responders had poorer mental health at the beginning (baseline) including greater levels of negative emotions, lower health related quality of life, and greater fatigue. One interpretive difficulty here is a phenomenon called regression to the mean. This occurs when extremes are selected. On retest they are almost always significantly better. It is possible that the observed effects were not due to the treatment but to people who were struggling getting spontaneously better.

 

These results, however, suggest that MBCT training is best suited to older individuals who have existing mental health issues and is little value to those who are relatively stable psychologically. This makes sense and implies that MBCT training is not particularly useful for psychologically healthy individuals but can help those with difficulties.

 

So, improve mental health in older adults with mental health problems 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 also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Oken, B. S., Goodrich, E., Klee, D., Memmott, T., & Proulx, J. (2018). Predictors of Improvements in Mental Health From Mindfulness Meditation in Stressed Older Adults. Alternative therapies in health and medicine, 24(1), 48-55.

 

Abstract

Context

The benefits of a mindfulness meditation (MM) intervention are most often evidenced by improvements in self-rated stress and mental health. Given the physiological complexity of the psychological stress system, it is likely that some people benefit significantly, while others do not. Clinicians and researchers could benefit from further exploration to determine which baseline factors can predict clinically significant improvements from MM.

Objectives

The study intended to determine: (1) if the baseline measures for participants who significantly benefitted from MM training were different from the baseline measures of participants who did not and (2) whether a classification analysis using a decision-tree, machine-learning approach could be useful in predicting which individuals would be most likely to improve.

Design

The research team performed a secondary analysis of a previously completed randomized, controlled clinical trial.

Setting

Oregon Health & Science University and participants’ homes.

Participants

Participants were 134 stressed, generally healthy adults from the metropolitan area of Portland, Oregon, who were 50 to 85 years old.

Intervention

Participants were randomly assigned either to a six-week MM intervention group or to a waitlist control group, who received the same MM intervention after the waitlist period.

Outcome Measures

Outcome measures were assessed at baseline and at two-month follow-up intervals. A responder was defined as someone who demonstrated a moderate, clinically significant improvement on the Mental Health Component (MHC) of the SF-36, Short Form Health-related Quality of Life (SF-36), ie, a change ≥4. The MHC had demonstrated the greatest effect size in the primary analysis of the above-mentioned randomized, controlled clinical trial. Potential predictors were demographic information and baseline measures related to stress and affect. Univariate statistical analyses were performed to compare the values of predictors in the responder and nonresponder groups. In addition, predictors were chosen for a classification analysis using a decision tree approach.

Results

Of the 134 original participants, 121 completed the MM intervention. As defined above, 61 were responders and 60 were nonresponders. Analyses of the baseline measures demonstrated significant differences between the 2 groups in several measures: (1) the Positive and Negative Affect Schedule negative sub-scale (PANAS-neg), (2) the SF-36 MHC, and (3) the SF-36 Energy/Fatigue, with clinically worse scores being associated with greater likelihood of being a responder. Disappointingly, the decision-tree analyses were unable to achieve a classification rate of better than 65%.

Conclusions

The differences in predictor variables between responders and nonresponders to an MM intervention suggested that those with worse mental health at baseline were more likely to improve. Decision-tree analysis was unable to usefully predict who would respond to the intervention.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5802968/

 

Improve Executive and Emotional Control of Grief with Mindfulness

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Improve Executive and Emotional Control of Grief with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness for grief is not about whitewashing your pain, or “getting over” your loss. It is about learning how to stay present, cultivate compassion, and make wise choices that will help you cope with this new normal known as life after loss.” – Heather Stang

 

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, loss of employment etc. Exactly what transpires depends upon the individual and the nature of the loss. It involves physical, emotional, psychological and cognitive processes. Not everyone grieves in the same way but there have been identified four general stages of grief, shock and denial, intense concern, despair and depression, and recovery. These are normal and healthy. But, 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. This would seem to be an ideal treatment protocol to treat intense grief.

 

In today’s Research News article “Mindfulness Improves Emotion Regulation and Executive Control on Bereaved Individuals: An fMRI Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360180/ ), Huang and colleagues recruited participants who had lost a significant relative within the last 4 years and self-reported intense unresolved grief. They completed an 8-week, once a week for 2.5 hours Mindfulness-Based Cognitive Therapy (MBCT) treatment including daily, 30-40 minute, home practice. The participants were measured before and after treatment for grief, anxiety, depression, and emotion regulation.

 

The participants also underwent 3 brain scanning sessions with functional Magnetic Resonance Imaging (fMRI). During 2 of the sessions they performed a numerical Stroop task in which they were to report which of 2 numerals was larger. In one session they were to ignore the physical size of the numeral and only report on the numerically larger numeral. In the second session they were to ignore the numerical magnitude of the numeral and only report on the physically larger numeral. This task measures cognitive interference and executive control.

 

They found that after MBCT treatment there were large and highly significant increases in mindfulness and emotion regulation and decreases in grief, anxiety, and depression. They also found that after treatment the higher the level of mindfulness the lower the levels of grief, anxiety, and depression. In addition, the participants after treatment were significantly better at ignoring irrelevant stimuli and respond faster in the Stroop task. This suggests reduced negative emotionality and improved cognitive control.

 

The researchers observed that after treatment during the cognitive task there was a decrease in activity in the cingulate cortex. These areas are involved in what is termed the Default Mode Network which becomes active during mind wandering and self-referential thinking. In other words, the brain areas associated with a lack of attention to the task at hand became less active. This suggests that there was greater attention to the present moment after MBCT training.

 

Long-term intense grief can be very harmful to the psychological and physical well-being of the individual. The present findings suggest that MBCT practice may be an effective treatment. It appears to reduce the negative emotions and improve the ability to regulate them in grieving individuals. It appears to do so, by altering the brain systems associated with mind wandering. It is during mind wandering where rumination occurs that tends to exacerbate anxiety and depression. So, the brain changes produced by MBCT treatment tend to keep the individual focused on the present lowering the impact of the past on their emotional state.

 

So, improve executive and emotional control of grief with mindfulness.

 

“Mindfulness reminds us that pain and sorrow, like all else, are impermanent.  Does this mean grief goes away completely?  Of course not.   But it does mean that it will change shape and form, it will ebb and flow, some days it will hurt like hell and some days you will start to smile.  It means that our grief, like everything else, is impermanent and ever-changing.  Once we accept this, even if only on a rational level, some of the need to avoid our grief starts to diminish.  We can stop believing it is permanent and will never change, even when we feel it will last forever.  We can start noticing and accepting our grief for what it really is and the small changes every day in our experiences.’ – WYG

 

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., Hsu, L. M., Tsai, J. S., Huang, C. M., Chao, Y. P., Hwang, T. J., … Wu, C. W. (2019). Mindfulness Improves Emotion Regulation and Executive Control on Bereaved Individuals: An fMRI Study. Frontiers in human neuroscience, 12, 541. doi:10.3389/fnhum.2018.00541

 

Abstract

The grief of bereavement is recognized as a severe psychosocial stressor that can trigger a variety of mental and physical disorders, and the long-lasting unresolved grief has a detrimental effect on brain functionality. Literature has documented mindfulness-based cognitive therapy (MBCT) as an efficient treatment for improving well-being, specifically related to the mood and cognition, in a variety of populations. However, little attention has been devoted to neural mechanisms with regard to bereaved individuals’ cognition after MBCT intervention. In this study, we recruited 23 bereaved participants who lost a significant relative within 6 months to 4 years to attend 8-week MBCT course. We used self-reporting questionnaires to measure emotion regulation and functional magnetic resonance imaging (fMRI) with the numerical Stroop task to evaluate the MBCT effect on executive control among the bereaved participants. The self-reported questionnaires showed improvements on mindfulness and reductions in grief, difficulties in emotion regulation, anxiety, and depression after the MBCT intervention. The fMRI analysis demonstrated two scenarios: (1) the activity of the fronto-parietal network slightly declined accompanied with significant improvements in the reaction time of incongruent trials; (2) the activities in the posterior cingulate cortex and thalamus were positively associated with the Texas Revised Inventory of Grief, implying emotional interferences on cognitive functions. Results indicated that MBCT facilitated the executive control function by alleviating the emotional interferences over the cognitive functions and suggested that the 8-week MBCT intervention significantly improved both executive control and emotion regulation in bereaved individuals.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360180/

 

Improve the Symptoms of Obsessive-Compulsive Disorder with Mindfulness

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Improve the Symptoms of Obsessive-Compulsive Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“most OCD sufferers I know who practice mindfulness find it very helpful in fighting their disorder. To be able to focus on what is really happening in any given moment, as opposed to dwelling on the past or anticipating the future, takes away the power of OCD.” – Janet Singer

 

Obsessive-Compulsive Disorder (OCD) sufferer have repetitive anxiety producing intrusive thoughts (obsessions) that result in repetitive behaviors to reduce the anxiety (compulsions). In a typical example of OCD, the individual is concerned about germs and is unable to control the anxiety that these thoughts produce. Their solution is to engage in ritualized behaviors, such as repetitive cleaning or hand washing that for a short time relieves the anxiety. The obsessions and compulsions can become so frequent that they become a dominant theme in their lives. Hence OCD drastically reduces the quality of life and happiness of the sufferer and those around them. About 2% of the population, 3.3 million people in the U.S., are affected at some time in their life. Fortunately, OCD can be treated and Mindfulness training has been shown to be effective in treating OCD.

 

In today’s Research News article “New-wave behavioral therapies in obsessive-compulsive disorder: Moving toward integrated behavioral therapies.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343420/ ), Manjula and colleagues review and summarize the published research literature on new treatments for Obsessive-Compulsive Disorder (OCD). They included in their review studies involving two mindfulness treatment techniques; Mindfulness-Based Cognitive Therapy (MBCT) and Acceptance and Commitment Therapy (ACT).

 

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. Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that focuses on the individual’s thoughts, feelings, and behaviors and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

They find that the literature reports that both MBCT and ACT are successful in treating adults and children with Obsessive-Compulsive Disorder (OCD) symptoms and produces improvements in anxiety, depression, experiential avoidance, believability, the need to respond to obsessions, obsessions, and compulsions. These benefits were found to be sustained 6 months later. But the authors caution that the studies are often performed with small numbers of participants and often have methodological problems. They conclude that the present research is promising but larger better controlled trials need to be performed especially with comparisons to other therapies for OCD that do not include mindfulness training.

 

So, improve the symptoms of obsessive-compulsive disorder with mindfulness.

 

“mindfulness is really for anyone who wants to stop feeling like what is going on inside their mind is a burden.  It’s hard to imagine anyone with OCD who would wish to continue feeling that way.” – John Hershfield

 

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

 

Manjula, M., & Sudhir, P. M. (2019). New-wave behavioral therapies in obsessive-compulsive disorder: Moving toward integrated behavioral therapies. Indian journal of psychiatry, 61(Suppl 1), S104-S113.

 

Abstract

New-wave behavioral therapies in obsessive-compulsive disorders (OCDs) comprise of third-wave therapies and newer cognitive therapies (CTs). This review covers outcome studies published in English until December 2017. A total of forty articles on mindfulness-based CT, metacognitive therapy, acceptance and commitment therapy, and danger ideation reduction therapy in the form of single-case studies, case series, open-label trials, two-group comparison studies, and randomized controlled studies were included. Results show that studies on these therapies are limited in number. Methodological limitations including lack of active control groups, randomized controlled trials, small sample sizes, and short follow-up periods were also noted. However, the available literature demonstrates the feasibility and utility of these therapies in addressing the issues unresolved by exposure and response prevention (ERP) and cognitive behavior therapy (CBT). These therapies were often combined with traditional ERP and CBT based on the profile and response of the client; hence, it is unclear whether they can be used as standalone therapies in the larger segment of the OCD population. Supplementary use of these strategies alongside established therapies could provide better utilization of resources. In view of the need for such integration, further research is warranted. The use of sound methodologies and establishing the mechanism of action of these therapies would assist in choosing the techniques for integration.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343420/

 

Improve Prisoner Mental Health with Mindfulness

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Improve Prisoner Mental Health with Mindfulness

 

By John M. de Castro, Ph.D.

 

“It is truly within the reach of anyone to create an environment in which kindness and resilience can flourish. Even the most powerless among us—prisoners—have the ability to live mindfully and treat others with kindness and respect. In doing so, they are able to improve life and build resilience not just for themselves, but for other inmates, guards, and in fact everyone in their community.” – Doug Carnine

 

Around 2 ¼ million people are incarcerated in the United States. Even though prisons are euphemistically labelled correctional facilities very little correction actually occurs. This is supported by the rates of recidivism. About three quarters of prisoners who are released commit crimes and are sent back to prison within 5-years. The lack of actual treatment for the prisoners leaves them ill equipped to engage positively in society either inside or outside of prison. Hence, there is a need for effective treatment programs that help the prisoners while in prison and prepares them for life outside the prison.

 

Contemplative practices are well suited to the prison environment. Mindfulness training teaches skills that may be very important for prisoners. In particular, it puts the practitioner in touch with their own bodies and feelings. It improves present moment awareness and helps to overcome rumination about the past and negative thinking about the future. It’s been shown to be useful in the treatment of the effects of trauma and attention deficit disorder. It also relieves stress and improves overall health and well-being. Finally, mindfulness training has been shown to be effective in treating depression, anxiety, and anger. It has also been shown to help overcome trauma in male prisoners.

 

In today’s Research News article “The Effects of Mindfulness Training on Emotional Health in Chinese Long-Term Male Prison Inmates.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345534/ ), Xu and colleagues recruited healthy prisoners and randomly assigned them to either a wait-list control condition or to receive a 6-week program of a modified version of Mindfulness-Based Cognitive Therapy (MBCT). It was modified by replacing depression discussions with yoga practice. MBCT training occurred once a week for 2.5 hours and included practice on the prisoners own time. The mindfulness training involved 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. The prisoners were measured before and after training for anxiety, depression, mindfulness, and mood.

 

They found that at the time of pretest the higher the prisoner’s level of mindfulness the lower their levels of anxiety, depression, tension-anxiety, depression-dejection, anger-hostility, confusion-bewilderment, and total mood disturbance. They also found that in comparison to baseline and the wait-list control group the mindfulness training group had significant improvements in mindfulness, anxiety, depression, tension-anxiety, depression-dejection, anger-hostility, confusion-bewilderment, or total mood disturbance.

 

These are interesting results that suggest that Mindfulness-Based Cognitive Therapy (MBCT) significantly improve the mental health of prisoners. This is important as better mental health may lead to better adjustment to life in prison and to life after release. This may lead to lower recidivism.

 

So, improve prisoner mental health with mindfulness.

 

“By working with both prisoners and correctional facilities professionals, mindfulness programs systematically transform the impact of our criminal justice system. Through cultivating greater awareness and compassion, mindfulness “encourages a shift away from fear-based and often anti-social or criminal strategies for meeting needs” – Prison Mindfulness Institute

 

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

 

Xu, W., Jia, K., Liu, X., & Hofmann, S. G. (2016). The Effects of Mindfulness Training on Emotional Health in Chinese Long-Term Male Prison Inmates. Mindfulness, 7(5), 1044-1051.

 

Abstract

Long-term imprisonment can cause severe emotional problems, which in turn can trigger behavioral problems, self-harm, and suicide. Mindfulness-based intervention can enhance emotional health. This study investigated the effects of a 6-week mindfulness training program on the emotional health of long-term male Chinese prison inmates. Forty long-term male prisoners completed a pretest and posttest, with 19 in the mindfulness training group and 21 in the waitlist control group. The treatment group showed a significant improvement in mindfulness level, anxiety, depression, tension-anxiety, depression-dejection, anger-hostility, confusion-bewilderment, and total mood disturbance. Implications and limitations of this study were discussed. These results support the use of a mindfulness-based intervention to enhance the emotional health of long-term male prison inmates.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345534/

 

Reduce Anxiety and Depression with Mindfulness

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Reduce Anxiety and Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Being unwilling to experience negative thoughts, feelings, or sensations is often the first link in a mental chain that can lead to automatic, habitual, and critical patterns of mind becoming re-established. By accepting unpleasant experiences, we can shift our attention to opening up to them. Thus, “I should be strong enough” shifts to “Ah, fear is here,” or “Judgment is present.”—Zindel Segal,

 

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. Meditation practice has been found to improve the regulation of emotions and reduce difficult emotional states such as anxiety and depression.

 

A characterizing feature of anxiety disorders is recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Indeed, Mindfulness practices have been shown to be quite effective in relieving anxiety. Anxiety often co-occurs with depression and mindfulness training is also effective for treating depression. Anxiety disorders and depression have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. So, there is a need to develop alternative treatments. Since mindfulness- based treatments are relatively new, it makes sense to step back and summarize what is known regarding the effectiveness of mindfulness training for anxiety disorders and for depression.

 

In today’s Research News article “Mindfulness-Based Interventions for Anxiety and Depression. The Psychiatric clinics of North America.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5679245/ ), Hofmann and Gomez review and summarize the published research literature on the effectiveness of mindfulness training for the relief of anxiety and depression.

 

They report that randomized controlled trials found that Mindfulness-Based interventions including the Mindfulness-Based Stress Reduction (MBSR), the Mindfulness-Based Cognitive Therapy (MBCT), Dialectical Behavior Therapy, and Acceptance and Commitment Therapy treatment programs were “moderately-to-largely effective at reducing anxiety and depression symptom severity among individuals with a broad range of medical and psychiatric conditions.” They also report that these programs are effective whether provided in person or over the internet. They are consistently more effective than health education, relaxation training, and supportive psychotherapy, but equivalently effective as Cognitive Behavioral Therapy (CBT).

 

Hence, accumulating controlled research has built a strong case for the use of Mindfulness-Based Interventions for the treatment of anxiety and depression. Since, these treatments are generally safe and effective with little if any side effects, they would appear to be preferable to pharmacological treatments.

 

So, reduce anxiety and depression with mindfulness.

 

“Mindfulness keeps us focused on the present, and helps us meet challenges head on while we appreciate all our senses absorb. On the contrary, focus on the future contributes to anxiety, while perseveration on the past feeds depression. Far too often when we look to the future, we ask ourselves, “What if,” and the answer we give ourselves is often a prediction of a negative result.” – Vincent Fitzgerald

 

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

 

Hofmann, S. G., & Gómez, A. F. (2017). Mindfulness-Based Interventions for Anxiety and Depression. The Psychiatric clinics of North America, 40(4), 739-749.

 

Key Points

  • Research on mindfulness-based interventions (MBIs) for anxiety and depression has increased exponentially in the past decade. The most common include Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT).
  • MBIs have demonstrated efficacy in reducing anxiety and depression symptom severity in a broad range of treatment-seeking individuals.
  • MBIs consistently outperform non-evidence-based treatments and active control conditions, such as health education, relaxation training, and supportive psychotherapy.
  • MBIs also perform comparably to cognitive-behavioral therapy (CBT). The treatment principles of MBIs for anxiety and depression are compatible with those of standard CBT.

Synopsis

This article reviews the ways in which cognitive and behavioral treatments for depression and anxiety have been advanced by the application of mindfulness practices. Research on mindfulness-based interventions (MBIs) has increased exponentially in the past decade. The most common include Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT). MBIs have demonstrated efficacy in reducing anxiety and depression symptom severity in a broad range of treatment-seeking individuals. MBIs consistently outperform non-evidence-based treatments and active control conditions, such as health education, relaxation training, and supportive psychotherapy. MBIs also perform comparably to cognitive-behavioral therapy (CBT). The treatment principles of MBIs for anxiety and depression are compatible with those of standard CBT.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5679245/

 

Mindfulness Improves Depression by Affecting Trait Anxiety

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Mindfulness Improves Depression by Affecting Trait Anxiety

 

By John M. de Castro, Ph.D.

 

“When you become aware of the present moment, you gain access to resources you may not have had before. You may not be able to change a situation, but you can mindfully change your response to it. You can choose a more constructive and productive way of dealing with stress rather than a counterproductive or even destructive way of dealing with it.” – Mindful

 

A characterizing feature of anxiety disorders is recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Indeed, Mindfulness practices have been shown to be quite effective in relieving anxiety. Anxiety often co-occurs with depression. Mindfulness training is also effective for treating depression. Anxiety disorders and depression have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders and for depression either alone or in combination with other therapies. The fact that anxiety and depression occur together so often suggests that they may be linked and mindfulness training may affect that linkage.

 

In today’s Research News article “The Factorial Structure of Trait Anxiety and Its Mediating Effect Between Mindfulness and Depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6212471/ ), Wang and colleagues recruited college students with depression and measured before and after training for trait anxiety, depression and mindfulness. A second set of students were provided with an 8-week program of Mindfulness-Based Cognitive Therapy (MBCT). It met once a week for 2.5 hours.  MBCT was developed specifically to treat depression. It involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. These students were measured before and after training for trait anxiety, depression and mindfulness.

 

They then performed a factor analysis of the trait anxiety scale from the untreated group of students and identified two distinct factors; Trait Anxiety Present and Trait Anxiety Absent. They found that the higher the level of mindfulness the lower the levels of depression and both of the trait anxiety factors. In addition, the higher the levels of both of the trait anxiety factors, the higher the levels of depression. So, trait anxiety and depression covaried and mindfulness was associated with lower levels of these psychological issues. In a mediation analysis they discovered that the association of mindfulness with lower depression was mediated by the two trait anxiety factors. In other words, mindfulness was associated with lower trait anxiety and this was in turn associated with lower levels of depression.

 

In the second group of students they found that MBCT training resulted in significantly lower levels of depression and both trait anxiety factors. Importantly, after MBCT training the mediational relationship of mindfulness to trait anxiety to depression was still present. So, the training lowered levels of anxiety and depression but did not change their relationships with mindfulness, with trait anxiety changes associated with the changes in depression.

 

These results are interesting and suggest a high degree of relationship between trait anxiety and depression. This could represent a conceptual overlap in that both involve rumination regarding past events. On the other hand, it could indicate that anxiety and depression are separate but linked. Perhaps, feeling chronic anxiety may lead to depression. This would explain the mediation analysis wherein high mindfulness is associate with low anxiety and this tends to relieve depression.

 

So, mindfulness improves depression by affecting trait anxiety.

 

“mindfulness-based practices have proved to be helpful in promoting mental well-being, especially by reducing the symptoms of depression and anxiety in various populations. For people with medicine noncompliance issues or people unwilling to start formal psychotherapy, mindfulness-based therapies could be a beneficial alternative to consider.” Han Ding

 

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

 

Wang, T., Li, M., Xu, S., Jiang, C., Gao, D., Wu, T., Lu, F., Liu, B., … Wang, J. (2018). The Factorial Structure of Trait Anxiety and Its Mediating Effect Between Mindfulness and Depression. Frontiers in psychiatry, 9, 514. doi:10.3389/fpsyt.2018.00514

 

Abstract

Background: Increasing studies have found that high trait anxiety is a key susceptibility phenotype that causes depression. Mindfulness-based interventions can target on dealing with depressogenic vulnerability effectively. Evidence indicates that trait anxiety could affect the trajectory of anti-depressive psychotherapy, and play an important role in the relationship between mindfulness and depression. Furthermore, related studies have found that trait anxiety could involve factors beyond anxiety and be a two-factor construct instead of one-dimensional concept. This viewpoint provides a new prospective for exploring the pathways of the two factors of trait anxiety in the complex relationship and further understand the potential mechanism of vulnerable personality mediated the link of mindfulness and depression.

Methods: A cross-sectional survey and a preliminary intervention study were conducted. Thousand two hundred and sixty-two subjects completed a set of self-reported questionnaires that evaluated trait anxiety, mindfulness, and depressive symptoms. Twenty-Three eligible participants with depression were recruited to attend mindfulness-based cognitive training for eight weeks. The same questionnaires were completed 1 week before the training and 6 months after the training. Factor analysis was performed on the 1262-subject sample to explore and confirm the factorial structure of trait anxiety. In addition, mediating effect analysis was conducted in the two studies to test whether two factors of trait anxiety were mediators of the relationship between mindfulness and depression.

Results: The exploratory factor analysis extracted two dimensions of trait anxiety, namely, trait anxiety-present factor (TA-P) and trait anxiety-absent factor (TA-A). And confirmatory factor analysis showed that the fit of the two-factor model was acceptable. Both TA-P and TA-A were significantly negatively correlated with mindfulness and positively correlated with depression, and they played a mediating role between mindfulness and depression. The two factors of trait anxiety had multiple mediating effects on the relationship between mindfulness and depression, and the mediating effect of the TA-P factor was stronger than that of the TA-A factor.

Conclusion: Our results demonstrated a two-factor model of trait anxiety in the Chinese population. TA-P and TA-A played a multiple mediating role in the relationship between mindfulness and depression. The findings provide new perspectives for psychological interventions to treat depression for people with susceptible personalities. Aiming to reduce negative emotional tendencies (TA-P factor) and enhance positive cognition (TA-A factor) may achieve the early prevention and efficient treatment of depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6212471/

 

Improve Bipolar Disorders in Low and Middle Income Countries with Mindfulness

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Improve Bipolar Disorders in Low and Middle Income Countries with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness-based cognitive therapy appears to have lasting benefits for people with bipolar disorder, , , incorporating mindfulness practices and mindful breathing into daily life on a regular basis was associated with better prevention of depressive relapse.” – Mahesh Agrawal

 

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. 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 for the treatment of depression and has been shown to be very effective.

 

There are a number of alternative treatments including mindfulness that have been shown to be effective for bipolar disorder in developed affluent countries. But bipolar disorder knows no borders. Countries with less affluent citizens are just as likely to suffer from bipolar disorder but may react differently to these treatments. Hence, there is a need to assesses the effectiveness of these alternative treatments on bipolar disorder in middle and low income countries.

 

In today’s Research News article “Psychological interventions for bipolar disorder in low- and middle-income countries: systematic review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6127962/ ), Demissie and colleagues review and summarize the published research literature on the effectiveness of alternative treatments for bipolar disorder in countries with middle to low general income levels. They examined randomized controlled research studies that employed “any psychological intervention delivered either face to face (individual or group format) or online.” These included psychoeducation, family therapy, Cognitive Behavioral Therapy (CBT), or Mindfulness-Based Cognitive Therapy (MBCT).

 

They identified 18 studies 15 of which included psychoeducation, 2 CBT and 1 MBCT. They report that psychoeducation was effective in preventing relapse and improving treatment adherence while CBT was effective in prolonging the period of remission. All three intervention types were effective in reducing psychiatric symptoms and MBCT was also effective in promoting emotion regulation and mindfulness.

 

These studies suggest that alternative treatments are effective in treating bipolar disorder in middle and low income countries as they are in affluent countries. Psychoeducation appears well studied and effective. There were, however, only 2 studies with CBT and only 1 with MBCT. They suggest efficacy. But much more research is needed particularly comparing the different adjunctive treatments to determine which produce the greatest improvements alone or in combination with drugs.

 

So, improve bipolar disorders in low and middle income countries with psychoeducation, cognitive therapy, or mindfulness.

 

“Even though it’s not a cure for bipolar disorder, meditation can help you relax and reduce stress. It can also help you disengage from stressful or anxious thoughts, and better control your mood.” – Anthony Watt

 

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

 

Demissie, M., Hanlon, C., Birhane, R., Ng, L., Medhin, G., & Fekadu, A. (2018). Psychological interventions for bipolar disorder in low- and middle-income countries: systematic review. BJPsych open, 4(5), 375-384. doi:10.1192/bjo.2018.46

 

Abstract

Background

Adjunctive psychological interventions for bipolar disorder have demonstrated better efficacy in preventing or delaying relapse and improving outcomes compared with pharmacotherapy alone.

Aims

To evaluate the efficacy of psychological interventions for bipolar disorder in low- and middle-income countries.

Method

A systematic review was conducted using PubMed, PsycINFO, Medline, EMBASE, Cochrane database for systematic review, Cochrane central register of controlled trials, Latin America and Caribbean Center on Health Science Literature and African Journals Online databases with no restriction of language or year of publication. Methodological heterogeneity of studies precluded meta-analysis.

Results

A total of 18 adjunctive studies were identified: psychoeducation (n = 14), family intervention (n = 1), group cognitive–behavioural therapy (CBT) (n = 2) and group mindfulness-based cognitive therapy (MBCT) (n = 1). In total, 16 of the 18 studies were from upper-middle-income countries and none from low-income countries. All used mental health specialists or experienced therapists to deliver the intervention. Most of the studies have moderately high risk of bias. Psychoeducation improved treatment adherence, knowledge of and attitudes towards bipolar disorder and quality of life, and led to decreased relapse rates and hospital admissions. Family psychoeducation prevented relapse, decreased hospital admissions and improved medication adherence. CBT reduced both depressive and manic symptoms. MBCT reduced emotional dysregulation.

Conclusions

Adjunctive psychological interventions alongside pharmacotherapy appear to improve the clinical outcome and quality of life of people with bipolar disorder in middle-income countries. Further studies are required to investigate contextual adaptation and the role of non-specialists in the provision of psychological interventions to ensure scalability and the efficacy of these interventions in low-income country settings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6127962/

 

Decrease Depressive Rumination with Mindfulness

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Decrease Depressive Rumination with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Rumination starts off as a dim light that we stop putting energy into, allowing it to get darker and darker until we can’t see anymore.” – Laura Meyer

 

Worry (concern about the future) and rumination (repetitive thinking about the past) are associated with mental illness, particularly depression. Mindfulness training been shown to be an effective treatment for depression and its recurrence 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 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. These include rumination. It is possible that ruminative thinking is reduced by MBCT and this, in turn, is responsible for the effectiveness of MBCT in reducing depression.

 

In today’s Research News article “Mindfulness-based interventions for the treatment of depressive rumination: 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/PMC6220915/ ), Perestelo-Perez and colleagues review, summarize, and perform a meta-analysis of the published research studies on the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) on ruminative thinking for patients with at least one major depressive episode. They found 11 published research studies that were either randomized controlled studies or pseudorandomized controlled studies comparing MBCT to treatment as usual for depression.

 

They report that the literature finds that MBCT significantly reduces ruminative thinking with moderate effect size and that this effect is still present one month later. Five of the studies performed a meditation analysis and reported that the reductions in rumination significantly mediated the effectiveness MBCT on depression. Hence, MBCT appears to reduce the levels of repetitive thinking about the past and this is responsible, in part, for MBCT’s ability to reduce depression.

 

Mindfulness training focuses the mind on the present moment, reducing the influence of memories of the past and projections about the future. So, it would seem to be unsurprising that Mindfulness-Based Cognitive Therapy (MBCT) would reduce the frequency with which the mind is focused on memories of the past (rumination). In addition, since depression is characterized by rumination it is also unsurprising that MBCT would effectively reduce depression.

 

So, decrease depressive rumination with mindfulness

 

“Know that practicing is an act of self care and helps stop the cycle of rumination and cultivates more patience, compassion, and peace. Mindfulness is not a panacea for depression, but it’s a good foundation for preventing relapse.” – Elisha Goldstein

 

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

 

Perestelo-Perez, L., Barraca, J., Peñate, W., Rivero-Santana, A., & Alvarez-Perez, Y. (2017). Mindfulness-based interventions for the treatment of depressive rumination: Systematic review and meta-analysis. International journal of clinical and health psychology : IJCHP, 17(3), 282-295.

 

Abstract

Background/Objective: This systematic review aims to evaluate the effect of interventions based on the mindfulness and/or acceptance process on ruminative thoughts, in patients with depression. Method:Electronic searches in Medline, Embase, Cochrane Central, PsycInfo, and Cinahl until December 2016, in addition to hand-searches of relevant studies, identified eleven studies that fulfilling inclusion criteria. Results: A meta-analysis of the effect of the intervention compared to usual care showed a significant and moderate reduction of ruminative thoughts (g = −0.59, 95% CI: −0.77, −0.41; I2 = 0%). Furthermore, findings suggest that mindfulness/acceptance processes might mediate changes in rumination, and that they in turn mediate in the clinical effects of interventions. A meta-analysis of three studies that compared the intervention to other active treatments (medication, behavioral activation and cognitive-behavioral therapy, respectively) showed no significant differences. Conclusions: Mindfulness-based cognitive therapy compared to usual care, produces a significant and moderate reduction in rumination. This effect seems independent of the treatment phase (acute or maintenance) or the number of past depressive episodes, and it was maintained one month after the end of treatment. However, further controlled studies with real patients that compare the most commonly used cognitive-behavioral techniques to treat ruminative thoughts to the acceptance and mindfulness techniques are needed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6220915/

 

Reduce Treatment-Resistant Depression with Mindfulness

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Reduce Treatment-Resistant Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“MBCT is a major achievement. Based on a coherent body of experimental work, the treatment has proven its worth in reducing the recurrence of depression and, as a consequence, changing the future prospects of numerous people whose lives are blighted by repeated episodes of this disabling condition.“ – David Clark

 

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

 

Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering. Mindfulness training 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.

 

The most commonly used mindfulness technique for the treatment of depression is Mindfulness-Based Cognitive Therapy (MBCT).  MBCT was developed specifically to treat depression. It involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. MBCT has been shown to be as effective as antidepressant drugs in relieving the symptoms of depression and preventing depression reoccurrence and relapse. In addition, it appears to be effective as either a supplement to or a replacement for these drugs.

 

In today’s Research News article “Mindfulness-based cognitive therapy for patients with chronic, treatment-resistant depression: A pragmatic randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6175087/ ), Cladder-Micus and colleagues recruited adult patients with current depression who had failed to respond to antidepressant drug treatment. All participants continued with treatment as usual including antidepressant medication, psychological treatment, support by a psychiatric nurse, or day‐hospital treatment. Half of the participants were randomly assigned to receive 8 weeks, 2,5 hour once a week, of group based Mindfulness-Based Cognitive Therapy (MBCT). They were measured before and after treatment and 3 and 6 months later for depressive symptoms, remission, rumination, quality of life, mindfulness, and self-compassion.

 

They found that the addition of Mindfulness-Based Cognitive Therapy (MBCT) to treatment as usual resulted in decreased depressive symptoms which was significant only for participants who completed the program. There was a 42% remission rate for the MBCT group that was significantly better than the 22% rate in the treatment as usual group. The MBCT group also had significantly improved mindfulness and self-compassion.

 

These results are impressive and corroborate previous findings that MBCT is an effective treatment for depression and its recurrence and even in the cases where drugs fail. Depressed patients are suffering and if the depression isn’t lifted by drug treatments, the suffering becomes chronic. The fact that MBCT can help these treatment resistant patients, reducing depressive symptoms and producing remissions in greater numbers of patients, should not be underestimated. Since suicide is a real possibility in these patients, MBCT may not only be reducing suffering but actually saving lives,

 

So, reduce treatment-resistant depression with mindfulness.

 

“MBCT was developed for people with recurring episodes of depression or unhappiness, to prevent relapse. It has been proven effective in patients with major depressive disorder who have experienced at least three episodes of depression.” – Psychology Today

 

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

Abstract

Cladder-Micus, M. B., Speckens, A., Vrijsen, J. N., T Donders, A. R., Becker, E. S., & Spijker, J. (2018). Mindfulness-based cognitive therapy for patients with chronic, treatment-resistant depression: A pragmatic randomized controlled trial. Depression and anxiety, 35(10), 914-924.

 

Background

Chronic and treatment‐resistant depressions pose serious problems in mental health care. Mindfulness‐based cognitive therapy (MBCT) is an effective treatment for remitted and currently depressed patients. It is, however, unknown whether MBCT is effective for chronic, treatment‐resistant depressed patients.

Method

A pragmatic, multicenter, randomized‐controlled trial was conducted comparing treatment‐as‐usual (TAU) with MBCT + TAU in 106 chronically depressed outpatients who previously received pharmacotherapy (≥4 weeks) and psychological treatment (≥10 sessions).

Results

Based on the intention‐to‐treat (ITT) analysis, participants in the MBCT + TAU condition did not have significantly fewer depressive symptoms than those in the TAU condition (–3.23 [–6.99 to 0.54], d = 0.35, P = 0.09) at posttreatment. However, compared to TAU, the MBCT + TAU group reported significantly higher remission rates (χ 2(2) = 4.25, φ = 0.22, P = 0.04), lower levels of rumination (–3.85 [–7.55 to –0.15], d = 0.39, P = 0.04), a higher quality of life (4.42 [0.03–8.81], d = 0.42, P = 0.048), more mindfulness skills (11.25 [6.09–16.40], d = 0.73, P < 0.001), and more self‐compassion (2.91 [1.17–4.65], d = 0.64, P = 0.001). The percentage of non‐completers in the MBCT + TAU condition was relatively high (n = 12, 24.5%). Per‐protocol analyses revealed that those who completed MBCT + TAU had significantly fewer depressive symptoms at posttreatment compared to participants receiving TAU (–4.24 [–8.38 to –0.11], d = 0.45, P = 0.04).

Conclusion

Although the ITT analysis did not reveal a significant reduction in depressive symptoms of MBCT + TAU over TAU, MBCT + TAU seems to have beneficial effects for chronic, treatment‐resistant depressed patients in terms of remission rates, rumination, quality of life, mindfulness skills, and self‐compassion. Additionally, patients who completed MBCT showed significant reductions in depressive symptoms. Reasons for non‐completion should be further investigated.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6175087/