Strengthen Character with Mindfulness

September 30, 2019February 23, 2023 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“Mindfulness opens the door to who we are, and character strengths are what is behind that door.” – Ryan Niemiec

Personality characteristics are thought to be relatively permanent traits that form an individual’s distinctive character. Engaging in mindfulness training has been shown to have a large number of beneficial effects on the psychological, emotional, and physical health of the individual and is helpful in the treatment of mental and physical illness. It also appears to be associated with healthy personality characteristics. Character strengths are group of positive personality characteristics that are highly valued such as “creativity, curiosity, open-mindedness, love of learning, perspective, bravery, perseverance, zest, love, social intelligence, forgiveness, self-regulation, appreciation of beauty, gratitude, hope, and spirituality.” This suggests that mindfulness may be associated with and may improve these character strengths.

In today’s Research News article “The Mutual Support Model of Mindfulness and Character Strengths.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6647542/), Pang and Ruch recruited participants online and had them complete an online questionnaire measuring mindfulness and 24 character strengths. They found that the higher the mindfulness scores the higher the character strengths. They then separated the participants in those who meditated and those who didn’t. They found that the meditators had significantly higher levels of mindfulness, and the character strengths of spirituality, gratitude, appreciation of beauty, curiosity, love of learning, curiosity, hope, bravery, leadership, zest, perspective, self-regulation, and humor.

In a second study they recruited adults and randomly assignee them to a wait-list control condition or to receive Mindfulness-Based Stress Reduction (MBSR) program. The MBSR program consists of 8 weekly 2-hour group sessions involving meditation, yoga, body scan, and discussion. The participants are also encouraged to perform daily practice. They were measured before and after training and 1, 3, and 6 months later for mindfulness and the 24 character strengths. They found that in comparison to baseline and the wait-list controls, after training and the follow-up measures the participants who received MBSR training had significantly higher levels of mindfulness, love, appreciation of beauty, gratitude, spirituality, zest, and bravery.

The 2 studies suggest that mindfulness is associated with character strengths and increasing mindfulness with MBSR training produces enduring increases in the levels of these strengths. The character strengths that were most associated with mindfulness, hope, bravery, curiosity, social intelligence, zest, love, perspective, and gratitude, have been shown to be associated with greater life satisfaction. This underscores the contribution of mindfulness to psychological health and happiness.

So, strengthen character with mindfulness.

“The combination of practicing mindfulness with a focus on character strengths helps us to open the door to avenues to self growth. With improved awareness of our character strengths we can more easily overcome common obstacles that emerge when developing mindfulness and serve to “supercharge” both mindful living and formal mindfulness meditation.” – Susan Kuz

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

Pang, D., & Ruch, W. (2019). The Mutual Support Model of Mindfulness and Character Strengths. Mindfulness, 10(8), 1545–1559. doi:10.1007/s12671-019-01103-z

Abstract

Objectives

Numerous studies have confirmed robust relationships between general well-being and mindfulness or character strengths, respectively, but few have examined associations between mindfulness and character strengths. Two studies were carried out to explore these relationships comprehensively in the framework of the Values in Action (VIA) classification of character strengths.

Methods

In study 1, participants (N = 1335) completed validated assessments of mindfulness and character strengths, and the relationship between the two was investigated in a broad online sample. In study 2, the effect of a mindfulness training on specific character strengths was investigated using a randomized-control design (N = 42).

Results

The results of study 1 confirmed positive relationships between mindfulness and character strengths and further identified a list of character strengths that might overlap with mindfulness—i.e., creativity, curiosity, open-mindedness, love of learning, perspective, bravery, perseverance, zest, love, social intelligence, forgiveness, self-regulation, appreciation of beauty, gratitude, hope, and spirituality. The findings of study 2 provided further support for the hypothesis that mindfulness training could help cultivate certain character strengths. Compared with participants in the waitlist control condition, those who attended an 8-week mindfulness-based training program showed significant increases in the strengths of love, appreciation of beauty, gratitude, and spirituality, and a trend toward significant increases in the strengths of zest and bravery.

Conclusions

The results provide initial evidence for a mutual support model of mindfulness and character strengths.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6647542/

Reduce Stress and Improve the Psychological Health of Teachers with Mindfulness

September 28, 2019 psyjdc Leave a comment

Reduce Stress and Improve the Psychological Health of Teachers with Mindfulness

By John M. de Castro, Ph.D.

“mindfulness training for teachers can help them cope better with stress on the job while also making the classroom environment more productive for learning.” – Jill Suttie

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

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

In today’s Research News article “Mixed-methods evaluation comparing the impact of two different mindfulness approaches on stress, anxiety and depression in school teachers.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615820/), Todd and colleagues recruited primary and secondary school teachers who were attending mindfulness courses of Mindfulness-Based Stress Reduction (MBSR) or .b Foundations. The MBSR program consists of 8 weekly 2-hour group sessions involving meditation, yoga, body scan, and discussion. The teachers are also encouraged to perform daily practice. The .b Foundations program consists of 8 weekly 1.5-hour group sessions involving mindfulness training in a classroom setting. The teachers are similarly encouraged to perform daily practice. They were measured before and after training for anxiety, depression, perceived stress, and completed semi-structured interviews.

They found that teachers who participated in the Mindfulness-Based Stress Reduction (MBSR) program had significant reductions in anxiety, depression, and perceived stress, while the teachers who participated in the .b Foundations program had significant reductions in anxiety and perceived stress, but not depression. The qualitative interviews revealed that both programs were found to be acceptable and a good experience and having profound impacts with no significant differences between the programs.

The weaknesses of this study were that there wasn’t a no-treatment or active control group and participants were not randomly assigned to conditions. As such the benefits of the training could have been due to subject expectancy effects, Hawthorne effects, experimenter bias, or just the effects of attending a social group for 8 weeks. But a large number of previous better controlled studies have shown that mindfulness training improves anxiety, depression, and perceived stress. So, it is likely that the reductions seen in the present study were due to the mindfulness training.

So, reduce stress and improve the psychological health of teachers with mindfulness.

“When administrators call you, you never know what they want. It could be a parent is upset with you, or you forgot something. I used to rush to meetings, grab a seat, and jump in. Now, I practice mindful walking. I think about where I’m going. When I arrive, I’m not revved up. I’m able to receive criticism or conversation without being triggered.” – Nicole Willheimer

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

Todd, C., Cooksey, R., Davies, H., McRobbie, C., & Brophy, S. (2019). Mixed-methods evaluation comparing the impact of two different mindfulness approaches on stress, anxiety and depression in school teachers. BMJ open, 9(7), e025686. doi:10.1136/bmjopen-2018-025686

Strengths and limitations of this study

This study is unique as there are currently no published studies comparing the two mindfulness courses in terms of acceptability, experience and effects on stress, anxiety and depression, despite current roll-out.
Strengths lie in the mixed-methods approach used to explore differences between .b and Mindfulness-Based Stress Reduction.
Limitations lie in the numbers lost to follow-up, with future research needed to explore this further.

Abstract

Objectives

This study compared the impact of two different 8-week mindfulness based courses (.b Foundations and Mindfulness-Based Stress Reduction (MBSR)), delivered to school teachers, on quantitative (stress, anxiety and depression) and qualitative (experience, acceptability and implementation) outcomes.

Design

A mixed-methods design was employed. Matched-paired t-tests were used to examine change from baseline, with imputation conducted to account for those lost to follow-up. Qualitative methods involved 1:1 semistructured interviews (n=10). Thematic analysis was used to explore differences in experience between courses.

Setting

Courses took place in UK primary schools or nearby leisure centres, 1:1 interviews took place via telephone.

Participants

44/69 teachers from schools in the UK were recruited from their attendance at mindfulness courses (.b and MBSR).

Interventions

Participants attended either an MBSR (experiential style learning, 2 hours per week) or .b Foundations (more classroom focused learning, 1.5 hours per week) 8-week mindfulness course.

Outcome measures

Stress (Perceived Stress Scale), anxiety and depression (Hospital Anxiety and Depression Scale) were evaluated in both groups at baseline (n=44), end of intervention (n=32) and 3-month follow-up (n=19).

Results

Both courses were associated with significant reductions in stress (.b 6.38; 95% CI 1.74 to 11.02; MBSR 9.69; 95% CI 4.9 to 14.5) and anxiety (.b 3.36; 95% CI 1.69 to 5.0; MBSR 4.06; 95% CI 2.6 to 5.5). MBSR was associated with improved depression outcomes (4.3; 95% CI 2.5 to 6.11). No differences were found in terms of experience and acceptability. Four main themes were identified including preconceptions, factors influencing delivery, perceived impact and training desires/practical application.

Conclusion

.b Foundations appears as beneficial as MBSR in anxiety and stress reduction but MBSR may be more appropriate for depression. Consideration over implementation factors may largely improve the acceptability of mindfulness courses for teachers. Further research with larger samples is needed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615820/

Mindfulness Therapies May Be Cost-Effective for the Treatment of Mental Illness

August 31, 2019October 24, 2019 psyjdc Leave a comment

Mindfulness Therapies May Be Cost-Effective for the Treatment of Mental Illness

By John M. de Castro, Ph.D.

“[Mindfulness] is a cost-saving alternative to treatment as usual over the trial duration from both a healthcare and a societal perspective for patients with a diagnosis of depression, anxiety or stress and adjustment disorders.” – Sanjib Saha

There has developed a large volume of research findings supporting the effectiveness of mindfulness training for the treatment of mental illnesses. Effectiveness has been documented for a wide variety of psychological disorders including anxiety, depression, stress responses, obsessive-compulsive disorder, eating disorders, addictions, and major mental illnesses. But there is little understanding of the cost-effectiveness of these mindfulness trainings. So, it is important take a serious look at the costs of implementing these therapies in comparison to the healthcare savings produced and/or the costs of other treatments of similar effectiveness.

In today’s Research News article “Are acceptance and mindfulness-based interventions ‘value for money’? Evidence from a systematic literature review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6588093/), Duarte and colleagues review and summarize the published studies of the cost-effectiveness of acceptance and mindfulness-based interventions. The following acceptance and mindfulness-based interventions were identified: Mindfulness Based Cognitive Therapy (MBCT), Mindfulness-Based Stress Reduction (MBSR) , Dialectical Behavior Therapy (DBT), Acceptance and Commitment Therapy (ACT), mindfulness‐based relapse prevention (MBRP), and other mindfulness meditation and mindfulness training. They identified 10 published studies.

They reported that the published studies found mixed results depending on the type of economic analysis and the comparator condition. In general, they report that acceptance and mindfulness-based interventions are mildly cost-effective for the treatment of depression, emotional unstable personality disorder, and general mental health conditions. It is clear, however, that this issue needs to be further studied.

In an age of high healthcare costs, it is important to perform economic analyses of treatments. Before widespread implementation of a treatment it is important to know that the costs of implementing the treatments are less than the healthcare savings produced. Various acceptance and mindfulness-based interventions can be expensive to implement and the savings produced hard to evaluate. So, the analysis has produced ambiguous results. One way to improve the cost-effectiveness of acceptance and mindfulness-based interventions is to implement the therapies online or with smartphone technologies. This markedly reduces the costs while maintaining effectiveness.

So, mindfulness therapies may be cost-effective for the treatment of mental illness.

“MBSR reduced costs to society by $724 per year in comparison to usual care, and reduced healthcare costs to payers by $982; it also increased participants’ quality-adjusted life years.” – Patricia Herman

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

Duarte, R., Lloyd, A., Kotas, E., Andronis, L., & White, R. (2019). Are acceptance and mindfulness-based interventions ‘value for money’? Evidence from a systematic literature review. The British journal of clinical psychology, 58(2), 187–210. doi:10.1111/bjc.12208

Abstract

Objectives

Acceptance and mindfulness‐based interventions (A/MBIs) are recommended for people with mental health conditions. Although there is a growing evidence base supporting the effectiveness of different A/MBIs for mental health conditions, the economic case for these interventions has not been fully explored. The aim of this systematic review was to identify and appraise all available economic evidence of A/MBIs for the management of mental health conditions.

Methods

Eight electronic bibliographic databases (MEDLINE, MEDLINE In‐Process & Other Non‐Indexed Citations, EMBASE, Web of Science, NHS Economic Evaluation Database (EED), Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment (HTA) database, and EconLit) were searched for relevant economic evaluations published from each database’s inception date until November 2017. Study selection, quality assessment, and data extraction were carried out according to published guidelines.

Results

Ten relevant economic evaluations presented in 11 papers were identified. Seven of the included studies were full economic evaluations (i.e., costs and effects assessed), and three studies were partial economic evaluations (i.e., only costs were considered in the analysis). The A/MBIs that had been subjected to economic evaluation were acceptance and commitment therapy (ACT), dialectical behaviour therapy (DBT), mindfulness‐based cognitive therapy (MBCT), and mindfulness‐based stress reduction (MBSR). In terms of clinical presentations, the evaluation of cost‐effectiveness of A/MBIs has been more focused on depression and emotional unstable personality disorder with three and four economic evaluations, respectively. Three out of seven full economic evaluations observed that A/MBIs were cost‐effective for the management of mental health conditions. Nevertheless, the heterogeneity of included populations, interventions, and economic evaluation study types limits the extent to which firm conclusions can currently be made.

Conclusion

This first substantive review of economic evaluations of A/MBIs indicates that more research is needed before firm conclusions can be reached on the cost‐effectiveness of A/MBIs for mental health conditions.

Practitioner points

The findings of the review provide information that may be relevant to mental health service commissioners and decision‐makers as all economic evidence available on acceptance and mindfulness‐based interventions for mental health conditions is summarized.

Evidence relating to the cost‐effectiveness and cost‐saving potential of acceptance and mindfulness‐based interventions is focused mainly on depression and emotional unstable personality disorder to date.

Heterogeneity in the specific forms of acceptance and mindfulness‐based interventions may limit generalizability of the findings.

The number of health economic evaluations relating to acceptance and mindfulness‐based interventions remains relatively small. Further research in this area is required.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6588093/

Improve Quality of Life in Women with Ovarian Removal with Mindfulness

August 29, 2019September 24, 2019 psyjdc Leave a comment

Improve Quality of Life in Women with Ovarian Removal with Mindfulness

By John M. de Castro, Ph.D.

“midlife women with higher mindfulness scores experienced fewer menopausal symptoms. These findings suggest that mindfulness may be a promising tool to help women reduce menopausal symptoms and overall stress.” – Richa Sood

Women who carry genetic markers, BRCA1 or BRCA2 mutation, have a very high risk of developing ovarian cancer. Often as a preventative measure, women opt to have their ovaries and fallopian tubes surgically removed (salpingo-oophorectomy). A consequence of this procedure is to produce the onset of menopausal symptoms. These include hot flashes, (n + Add New Category ight) sweats, vaginal dryness, loss of sexual desire, and pain during intercourse. Hormone treatments may reduce the symptom intensity but do not eliminate them.

Hence, there is a need to find alternative treatment to help relieve these troubling symptoms following ovary removal. Mindfulness training has been shown to help reduce the symptoms of natural meonpause. But it is not known whether mindfulness training might also help alleviate these symptoms in women after surgical removal of the ovaries.

In today’s Research News article “Mindfulness-based stress reduction for menopausal symptoms after risk-reducing salpingo-oophorectomy (PURSUE study): a randomised controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6587763/), van Driel and colleagues recruited women who carried the BRCA1 or BRCA2 mutation and had undergone surgical removal of their ovaries and fallopian tubes before the age of 52 years. They continued care as usual and were randomly assigned to receive an 8-week program of Mindfulness-Based Stress Reduction (MBSR) or no additional treatment. The MBSR program met for 2.5 hours once a week along with 30-45 minutes of daily home practice and consisted of discussion, meditation, yoga, and body scan practices. The women were measured before and after MBSR and 3 and 9 months later for menopausal-specific quality of life, sexual function, and sexual distress.

They found that in comparison to baseline and the usual care control group, the group that received MBSR training had significantly improved menopausal-specific quality of life, including improved vasomotor (i.e. burden caused by hot flushes, night sweats, and sweating in general) and physical symptoms (e.g. burden caused by stamina reduction, aches, and urination frequency) quality of life. These improvements were found immediately after MBSR training and 9 months later. No significant improvements were found for sexual function or distress.

In women

The study results suggest that MBSR training is a safe and effective treatment to produce long-term improvements in the menopausal quality of life in women who carry the BRCA1 or BRCA2 mutation and had undergone surgical removal of their ovaries and fallopian tubes. MBSR consists of a package of practices. It will remain for future research to determine which of these practices or which combination of practices are necessary and sufficient to produce the benefits.

So, improve quality of life in women with ovarian removal with mindfulness.

“Mindfulness cannot entirely remove the symptoms of menopause, but it can help you deal with them in a calmer and more compassionate way – and self compassion boosts mental health. Learning these simple techniques to focus our awareness, relax the body, and ride out the storm, (whether the storm is physical or emotional) can pay great dividends’” – Karita Cullen

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

van Driel, C., de Bock, G. H., Schroevers, M. J., & Mourits, M. J. (2019). Mindfulness-based stress reduction for menopausal symptoms after risk-reducing salpingo-oophorectomy (PURSUE study): a randomised controlled trial. BJOG : an international journal of obstetrics and gynaecology, 126(3), 402–411. doi:10.1111/1471-0528.15471

Abstract

Objective

To assess the short‐ and long‐term effects of mindfulness‐based stress reduction (MBSR) on the resulting quality of life, sexual functioning, and sexual distress after risk‐reducing salpingo‐oophorectomy (RRSO).

Design

Randomised controlled trial.

Setting

A specialised family cancer clinic of the university medical center Groningen.

Population

Sixty‐six women carriers of the BRCA1/2 mutation who developed at least two moderate‐to‐severe menopausal symptoms after RRSO.

Methods

Women were randomised to an 8‐week MBSR training programme or to care as usual (CAU).

Main outcome measures

Change in the Menopause‐Specific Quality of Life Questionnaire (MENQOL), the Female Sexual Function Index, and the Female Sexual Distress Scale, administered from baseline at 3, 6, and 12 months. Linear mixed modelling was applied to compare the effect of MBSR with CAU over time.

Results

At 3 and 12 months, there were statistically significant improvements in the MENQOL for the MBSR group compared with the CAU group (both P = 0.04). At 3 months, the mean MENQOL scores were 3.5 (95% confidence interval, 95% CI 3.0–3.9) and 3.8 (95% CI 3.3–4.2) for the MBSR and CAU groups, respectively; at 12 months, the corresponding values were 3.6 (95% CI 3.1–4.0) and 3.9 (95% CI 3.5–4.4). No significant differences were found between the MBSR and CAU groups in the other scores.

Conclusion

Mindfulness‐based stress reduction was effective at improving quality of life in the short‐ and long‐term for patients with menopausal symptoms after RRSO; however, it was not associated with an improvement in sexual functioning or distress.

Tweetable abstract

Mindfulness improves menopause‐related quality of life in women after risk‐reducing salpingo‐oophorectomy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6587763/

Improve Weight-Related Eating Behaviors with a Mindfulness App

June 24, 2019 psyjdc Leave a comment

Improve Weight-Related Eating Behaviors with a Mindfulness App

By John M. de Castro, Ph.D.

“a slower, more thoughtful way of eating could help with weight problems and maybe steer some people away from processed food and unhealthy choices.” – Harvard Health

Eating is produced by two categories of signals. Homeostatic signals emerge from the body’s need for nutrients, is associated with feelings of hunger, and usually work to balance intake with expenditure. Non-homeostatic eating, on the other hand, is not tied to nutrient needs or hunger but rather to the environment and or to the pleasurable and rewarding qualities of food. These cues can be powerful signals to eat even when there is no physical need for food.

Mindful eating involves paying attention to eating while it is occurring, including attention to the sight, smell, flavors, and textures of food, to the process of chewing and may help reduce intake by affecting the individual’s response to non-homeostatic cues for eating. Indeed, high levels of mindfulness are associated with lower levels of obesity. Hence, mindful eating may counter non-homeostatic eating.

Mindfulness training programs over the internet and with smartphone apps have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. These online and smartphone app trainings have been shown to be effective. It is not known if a mindful eating smartphone app may be effective in reducing body weight and weight-related eating behaviors.

In today’s Research News article “The Mindfulness App Trial for Weight, Weight-Related Behaviors, and Stress in University Students: Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6479283/), Lyzwinski and colleagues recruited college students and randomly assigned them to receive apps for their smartphones for either mindfulness or a self-monitoring diet and exercise diary for an 11 week period. The mindfulness app consisted of body scan, diaphragmatic breathing, observing the breath, loving kindness meditation, concentration meditation, choiceless awareness mindfulness meditation, and Hatha yoga all adapted from the Mindfulness-Based Stress Reduction (MBSR) program. The students were measured before and after the 11-week training for body size, physical activity, eating behavior, mindful eating, mindfulness, perceived stress, and participant retention and adherence.

They found in comparison to baseline and to the diet and exercise diary group, the mindfulness group had significant increases in mindfulness and mindful eating, and significant decreases in emotional eating, uncontrolled eating, and perceived stress levels. The diet and exercise diary group had significantly higher levels of exercise. There were no significant changes in body size for either group. 80% of the participants completed the program and of the mindfulness app group only 14% reported completing all modules, while 61% reported sporadic use, and 23% reported using it very seldom.

The results are encouraging and suggest that the mindfulness smartphone app is a feasible and acceptable method of increasing mindfulness and improving weight-related eating behaviors. Although retention is good, adherence was not. The students recruited, though, were not particularly motivated to lose weight or practice mindfulness. Perhaps, a more motivated group of participants would have resulted in better adherence. There also may be a need to modify the app to make participation more interesting and fun.

The fact there no changes in weight were observed was no surprising as the 11-week period is short to detect significant changes in weight. A long-term study is needed here. In addition, maintaining a diet and exercise diary has been shown to reduce food intake and increase exercise. A comparison of the mindfulness app to a group participating in nutrition education ap might be better able to demonstrate changes in body size. Regardless, the results are encouraging and suggest that an app, training students in mindfulness, may be a convenient and inexpensive means to develop better eating habits.

So, improve weight-related eating behaviors with a mindfulness App.

“Increased mindful eating has been shown to help participants gain awareness of their bodies, be more in tune to hunger and satiety, recognize external cues to eat, gain self compassion, decrease food cravings, decrease problematic eating, and decrease reward-driven eating.” – Carolyn Dunn

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

Lyzwinski, L. N., Caffery, L., Bambling, M., & Edirippulige, S. (2019). The Mindfulness App Trial for Weight, Weight-Related Behaviors, and Stress in University Students: Randomized Controlled Trial. JMIR mHealth and uHealth, 7(4), e12210. doi:10.2196/12210

Abstract

Background

University students are at risk of weight gain during their studies. Key factors related to weight gain in this population include unhealthy weight-related behaviors because of stress. Mindfulness holds promise for weight management. However, there has not been any previous trial that has explored the effectiveness of a student-tailored mindfulness app for stress, weight-related behaviors, and weight. There is limited evidence that current mindfulness apps use evidence-based mindfulness techniques. A novel app was developed that combined evidence-based, mindfulness-based stress reduction and mindful eating (ME) techniques that were tailored to university students, with student-relevant themes for targeting weight behaviors, weight, and stress.

Objectives

The aim of this study was to test the effectiveness, acceptability, and feasibility of a student-tailored mindfulness app for weight, weight-related behaviors, and stress. Testing this app in a rigorous randomized controlled trial (RCT) for these outcomes is a novelty and contribution to this emerging field.

Methods

A 2-arm RCT of an 11-week duration was undertaken at the University of Queensland. Students were either randomized to the mindfulness app (n=45) or to a behavioral self-monitoring electronic diary (e-diary; n=45) for diet and exercise. Analysis of covariance was used to compare differences in weight, stress, mindfulness, ME, physical activity, and eating behaviors between both groups.

Results

Neither the mindfulness app group nor the e-diary group lost weight and there were no differences between the groups at follow-up. The mindfulness app group had significantly lower stress levels (P=.02) (adherers only), lower emotional eating (P=.02), and uncontrolled eating (P=.02) as well as higher mindfulness (P≤.001) and ME levels overall (P≤.001). The e-diary group had higher metabolic equivalents of moderate activity levels (P≤.01). However, the effect sizes were small. Regular adherence to mindfulness exercises in the app was low in the group. The majority of students (94%) liked the app and found it to be acceptable. Compared with other exercises, the most helpful reported meditation was the short breathing exercise observing the breath (39.4% [13/33] preferred it).

This was the first RCT that tested a mindfulness app for weight and weight-related behaviors in students. The modest level of user adherence likely contributes to the lack of effect on weight loss. However, there was a small, albeit promising, effect on weight-related eating behavior and stress.

Conclusions

A mindfulness app demonstrated effectiveness for stress, eating behaviors, mindfulness, and ME, but the effect sizes were small. Future studies should be conducted over longer periods of time and with greater participant compliance.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6479283/

Mindfulness Training and Cognitive Therapy Improves Social Anxiety Disorder

June 22, 2019 psyjdc Leave a comment

Mindfulness Training and Cognitive Therapy Improves Social Anxiety Disorder

By John M. de Castro, Ph.D.

“Using mindfulness, we can begin to notice what happens in the body when anxiety is present and develop strategies to empower clients to “signal safety” to their nervous system. Over time, clients feel empowered to slow down their response to triggers, manage their body’s fear response (fight-or-flight) and increase their ability to tolerate discomfort.” – Jeena Chi

It is a common human phenomenon that being in a social situation can be stressful and anxiety producing. Most people can deal with the anxiety and can become quite comfortable. But many do not cope well and the anxiety is overwhelming, causing the individual to withdraw. Social Anxiety Disorder (SAD) is characterized by a persistent, intense, and chronic fear of being watched and judged by others and feeling embarrassed or humiliated by their actions. This fear may be so severe that it interferes with work, school, and other activities and may negatively affect the person’s ability to form relationships.

Anxiety disorders have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for anxiety. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders including Social Anxiety Disorder (SAD). Mindfulness-Based Stress Reduction (MBSR) and also Cognitive Behavioral Therapy (CBT) have been shown to be effective in treating Social Anxiety Disorder (SAD).

In today’s Research News article “Emotional clarity and attention to emotions in cognitive behavioral group therapy and mindfulness-based stress reduction for social anxiety disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5879018/), Butler and colleagues recruited patients diagnosed with Social Anxiety Disorder (SAD) and a healthy control group and randomly assigned them to receive 12 weekly 2.5 hour sessions of either Cognitive Behavioral Group Therapy (CBGT) or Mindfulness-Based Stress Reduction (MBSR) or to a wait-list control condition. They were measured before and after treatment and 12 months later for emotional clarity, attention to emotions, and social anxiety.

They found that at baseline the patients with Social Anxiety Disorder (SAD) had significantly greater social anxiety and lower emotional clarity than the healthy controls. After treatment the patients who had received either MBSR or CBGT had significantly higher levels of emotional clarity than the wait-list controls. The effect remained 12 months later. They also found that the greater the changes in emotional clarity observed after treatment and at the 12-month follow-up, the greater the improvement in Social Anxiety Disorder (SAD). There were no significant effects on attention to emotions.

Emotional clarity is an aspect of emotional regulation which involves the ability to identify the emotion that is being experienced. The results suggest that this ability is enhanced by both Cognitive Behavioral Group Therapy (CBGT) and Mindfulness-Based Stress Reduction (MBSR) and that this improvement is related to the treatments ability to improve the symptoms of Social Anxiety Disorder (SAD). This is in line with the repeated finding that mindfulness training improves emotion regulation. The results further refine this understanding by identifying emotional clarity and not attention to emotions as the component of emotional regulation that’s important for improvements in SAD. So, being more sensitive to what is the identity of the emotion being experienced is helpful in dealing with social anxiety, but paying more attention to emotions is not. This further suggests that treatment focusing on emotional clarity may be even more effective in treating SAD.

So, improve social anxiety disorder with mindfulness training or cognitive therapy.

“The power of a mindfulness practice, however, may come in the realization that one can live a meaningful life even with social anxiety. Schjerning, who participated in Fleming and Kocovski’s group, says that he still feels nervous in social situations but now feels compassion — not judgment — for himself, and sees that “I can be more the person I want to be.” – Jason Drwal

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

Butler, R. M., Boden, M. T., Olino, T. M., Morrison, A. S., Goldin, P. R., Gross, J. J., & Heimberg, R. G. (2018). Emotional clarity and attention to emotions in cognitive behavioral group therapy and mindfulness-based stress reduction for social anxiety disorder. Journal of anxiety disorders, 55, 31–38. doi:10.1016/j.janxdis.2018.03.003

Highlights

We examined emotional clarity (EC) and attention to emotion in patients with social anxiety disorder (SAD).

Patients demonstrated lower levels of EC than healthy controls.
Cognitive-behavioral group therapy increased EC more than a waitlist.
Mindfulness-based stress reduction did not increase EC more than a waitlist.
Changes in emotional clarity predicted changes in social anxiety.
Analyses involving attention to emotions were not significant.

Abstract

We examined (1) differences between controls and patients with social anxiety disorder (SAD) in emotional clarity and attention to emotions; (2) changes in emotional clarity and attention to emotions associated with cognitive-behavioral group therapy (CBGT), mindfulness-based stress reduction (MBSR), or a waitlist (WL) condition; and (3) whether emotional clarity and attention to emotions moderated changes in social anxiety across treatment. Participants were healthy controls (n = 37) and patients with SAD (n=108) who were assigned to CBGT, MBSR, or WL in a randomized controlled trial. At pretreatment, posttreatment, and 12-month follow-up, patients with SAD completed measures of social anxiety, emotional clarity, and attention to emotions. Controls completed measures at baseline only. At pretreatment, patients with SAD had lower levels of emotional clarity than controls. Emotional clarity increased significantly among patients receiving CBGT, and changes were maintained at 12-month follow-up. Emotional clarity at posttreatment did not differ between CBGT and MBSR or between MBSR and WL. Changes in emotional clarity predicted changes in social anxiety, but emotional clarity did not moderate treatment outcome. Analyses of attention to emotions were not significant. Implications for the role of emotional clarity in the treatment of SAD are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5879018/

Improve Mental Well-Being with Mindfulness

June 20, 2019 psyjdc Leave a comment

Improve Mental Well-Being with Mindfulness

By John M. de Castro, Ph.D.

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

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 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. They include a variety of forms of meditation, yoga, mindful movements, contemplative prayer, and combinations of practices. Some are recommended to be practiced for years while others are employed for only a few weeks. Regardless of the technique, they all appear to develop and increase mindfulness. One particularly effective mindfulness training program is Mindfulness-Based Stress Reduction (MBSR). The MBSR program consists of 8 weekly group sessions involving meditation, yoga, body scan, and discussion. The patients are also encouraged to perform daily practice. It is unclear, however, exactly how the state of mindfulness of the participants at the beginning of training affect the effects of the MBSR program.

In today’s Research News article “The many facets of mindfulness and the prediction of change following mindfulness-based stress reduction (MBSR)” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5815955/), Gawrysiak and colleagues recruited participants in an 8-week, one 2.5-hour session per week of Mindfulness-Based Stress Reduction (MBSR) program. They were measured before and after treatments for perceived stress, positive and negative emotions, mindfulness, and decentering.

They found that in comparison to baseline, after the MBSR program there were large significant improvements in all measures including increases in mindfulness, positive emotions, and decentering and decreases in negative emotions, and perceived stress. They then examined the relationship of the levels of mindfulness facets at baseline and the changes in emotions and stress produced by the MBSR program. They found that in general, participants with high levels of mindfulness facets of awareness, acceptance, and decentering had significantly greater increases in positive emotions and decreases in negative emotions. On the other hand, participants with low levels of acceptance, and decentering had significantly greater decreases in stress, negative emotions.

These results clearly demonstrate that participating in an MBSR program produces improved mindfulness, emotional health, and stress reduction. These are in line with a number of previous findings that mindfulness training improves emotions and perceived stress levels. But, the results regarding baseline mindfulness facets on emotions and stress are complex and a bit counterintuitive. They suggest that participants who are already high in awareness, acceptance, and decentering benefited the most in regards to their emotions from the MBSR program. While, those low in acceptance, and decentering benefited the most in regards to their perceived stress levels. More research is needed to better understand these complex relationships.

So, improve mental well-being with mindfulness.

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

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Gawrysiak, M. J., Grassetti, S. N., Greeson, J. M., Shorey, R. C., Pohlig, R., & Baime, M. J. (2017). The many facets of mindfulness and the prediction of change following mindfulness-based stress reduction (MBSR). Journal of clinical psychology, 74(4), 523–535. doi:10.1002/jclp.22521

Abstract

Objectives

Mindfulness-Based Stress Reduction (MBSR) promotes numerous psychological benefits, but few studies have identified for whom MBSR is most effective. The current study tested the hypothesis that lower baseline mindfulness invites more “room to grow” and, thus, predicts greater improvement during MBSR.

Design

We examined three facets of mindfulness (awareness, acceptance, decentering), among 131 MBSR participants prior to enrollment, to test the hypothesis that lower baseline mindfulness predicts greater improvements in perceived stress, positive affect (PA), and negative affect (NA) following MBSR.

Results

Lower acceptance and decentering predicted greater decreases in perceived stress. Higher awareness, acceptance, and decentering predicted greater increases in PA. Higher awareness predicted greater reductions in NA. Lower decentering predicted greater reductions in NA.

Conclusions

Findings partly supported the hypothesis that lower baseline mindfulness predicts greater improvement following MBSR and emphasize the importance of assessing multiple mindfulness facets given their unique, contrasting relations to outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5815955/

Improve the Psychological State of Heart Disease Patients with Mindfulness

June 10, 2019 psyjdc Leave a comment

Improve the Psychological State of Heart Disease Patients with Mindfulness

By John M. de Castro, Ph.D.

“Not only can meditation improve how your heart functions, but a regular practice can enhance your outlook on life and motivate you to maintain many heart-healthy behaviors, like following a proper diet, getting adequate sleep, and keeping up regular exercise,” – John Denninger

Cardiovascular disease is the number one killer, claiming more lives than all forms of cancer combined. “Heart disease is the leading cause of death for both men and women. About 610,000 people die of heart disease in the United States every year–that’s 1 in every 4 deaths. Every year about 735,000 Americans have a heart attack.” (Centers for Disease Control). A myriad of treatments has been developed for heart disease including a variety of surgical procedures and medications. In addition, lifestyle changes have proved to be effective including quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Unfortunately, for a variety of reasons, 60% of heart failure patients decline participation, making these patients at high risk for another attack.

Safe and effective alternative treatments for cardiovascular disease are contemplative practices, such as meditation, tai chi, and yoga, have also been shown to be helpful for heart health. These practices have also been shown to reduce the physiological and psychological responses to stress and to be helpful for producing the kinds of lifestyle changes needed to prevent heart disease such as smoking cessation, and weight reduction. They have also been shown to be effective in maintaining cardiovascular health and the treatment of cardiovascular disease. Hence it is reasonable to continue studying the effects of mindfulness training on patients with cardiovascular disease.

In today’s Research News article “Effectiveness of mindfulness-based stress reduction program on quality of life in cardiovascular disease patients.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465573/), Jalali and colleagues recruited patients with cardiovascular disease and randomly assigned them either to a wait-list control or to receive and 8-week program of Mindfulness-Based Stress Reduction (MBSR) that includes body scan and focused meditations, yoga practice, and discussion. Training occurred once a week for 2.5 hours and included daily home practice. They were measured before and after training and 3 months later for self-efficacy and their health.

They found that compared to baseline and the wait-list control group, the group that received the program of Mindfulness-Based Stress Reduction (MBSR) had significantly increased self-efficacy and quality of life that persisted 3 months after treatment. Hence. MBSR training appears to be safe, effective, and lasting treatment that is very helpful for patients with cardiovascular disease, improving self-efficacy and quality of life.

The improved self-efficacy is very important. It suggests that the patients feel better able to control their health. It suggests that they are more willing to take control of their lives to improve their health. It is well known that changes in lifestyle are very important for the treatment of cardiovascular disease. So, improved self-efficacy would predict that the patients would be more likely to adopt and maintain these lifestyle changes. This would inevitably lead to an improved health and quality of life.

So, improve the psychological state of heart disease patients with mindfulness.

“Given the proven role of stress in heart attacks and coronary artery disease, effective meditation would be appropriate for almost all patients with coronary artery disease.” – Joon Sup Lee

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

Jalali, D., Abdolazimi, M., Alaei, Z., & Solati, K. (2019). Effectiveness of mindfulness-based stress reduction program on quality of life in cardiovascular disease patients. International journal of cardiology. Heart & vasculature, 23, 100356. doi:10.1016/j.ijcha.2019.100356

Abstract

Introduction

Cardiovascular disease is one of the most fatal physical illnesses that impose many financial losses on societies every year.

Aim

This study was to investigate the effectiveness of a mindfulness-based stress reduction (MBSR) program on self-efficacy and quality of life in patients with cardiovascular disease.

Material and methods

The samples of this clinical trial were 60 patients who were selected by convenience sampling from patients were diagnosed, clinically interviewed by a cardiologist and randomized to two groups; experimental and control, and then completed Sherer et al. General Self-Efficacy Scale and 36-item Short Form Survey three times; pre-test, post-test, and after 3 months of follow-up. MBSR Program includes the methods that patients learn to calm their minds and body to help them cope with disease that was based on self-efficacy and quality of life. Data analysis was performed by the SPSS v22 using t-test and ANOVA.

Results

The results show that the mean pre-test scores of self-efficacy and quality of life of patients were not significantly different between the experimental and control groups (P > 0.05). However, the mean scores of the two variables were found to be significantly different between the experimental group and the control group on the post-test and follow-up as the research hypotheses were examined (P < 0.01). So that the means of self-efficacy were 60.80 ± 5.91 and 60.40 ± 7.03 and quality of life were 103.80 ± 9.35 and 101.10 ± 9.13 at post-test and 3 months later respectively in experimental group.

Conclusion

Self-efficacy and quality of life of cardiovascular patients could be improved by providing an MBSR program.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465573/

Relieve Stress and Burnout in Primary Care Physicians with Mindfulness

April 29, 2019 psyjdc Leave a comment

Relieve Stress and Burnout in Primary Care Physicians with Mindfulness

By John M. de Castro, Ph.D.

“Dealing with sick, scared, suffering and dying patients is draining all by itself. Throw in distraction by negative emotions like worry, anger, frustration, righteous indignation … and you can easily double the energy drain. . . With an effective mindfulness practice you can notice when you are distracted by thoughts and feelings and release them quickly and effectively — without judging yourself in the process.” – Dike Drummond

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

Preventing burnout has to be a priority. Unfortunately, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout, so it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, and improving sleep. On the front lines of medical practice are the primary care physicians. It is thus important to assess the effectiveness of mindfulness in reducing stress and burnout in these physicians.

In today’s Research News article “Effects of mindfulness training on perceived stress, self-compassion, and self-reflection of primary care physicians: a mixed-methods study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348323/ ), Wietmarschen and colleagues recruited primary care physicians and provided them with an 8-week Mindfulness-Based Stress Reduction (MBSR) program that includes body scan and focused meditations, yoga practice, and discussion that was modified for physicians’ needs. Training occurred once a week for 2.5 hours and included daily home practice. The physicians were measured before and after the training and 6 months later for perceived stress, self-compassion, and self-reflection ability. A subset of these physicians was also interviewed 3 months after training.

They found that immediately after training the physicians has significantly lower perceived stress and significantly improved self-compassion and self-reflection. Six months later the improvements in perceived stress and self-compassion were still large and highly significant. The interviews revealed that “participation in the mindfulness training made the participants more aware of their own feelings and thoughts, and better able to accept situations, experience more peacefulness, and have more openness to the self and others.”

It needs to be recognized that the study did not contain a control group for comparison leaving open a number of potentially confounding factors. But, prior published randomized controlled trials have demonstrated that mindfulness training markedly reduces stress and burnout. So, the present results are most likely due to the effects of MBSR training.

These are important findings as burnout is a threat to medical careers and the quality of health care. The fact, that a relatively brief training can have lasting effects on the well-being of primary care physicians suggests that mindfulness training should be routinely included in physician training and continuing education.

So, relieve stress and burnout in primary care physicians with mindfulness.

“mindfulness can be thought of as ‘preventive medicine’ for future doctors, helping them cultivate a way of being that may foster healing and growth in their own lives as well as skills to effectively help others heal and grow in the future.” – Shauna Shapiro

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

van Wietmarschen, H., Tjaden, B., van Vliet, M., Battjes-Fries, M., & Jong, M. (2018). Effects of mindfulness training on perceived stress, self-compassion, and self-reflection of primary care physicians: a mixed-methods study. BJGP open, 2(4), bjgpopen18X101621. doi:10.3399/bjgpopen18X101621

Abstract

Background

Primary care physicians are subjected to a high workload, which can lead to stress and a high incidence of burnout. A mindfulness training course was developed and implemented for primary care physicians to better cope with stress and improve job functioning.

Aim

To gain insight into the effects of the mindfulness training on perceived stress, self-compassion, and self-reflection of primary care physicians.

Design & setting

A pragmatic mixed-methods pre–post design in which physicians received 8 weeks of mindfulness training.

Method

Participants completed validated questionnaires on perceived stress (Perceived Stress Scale [PSS]), self-compassion (Self-Compassion Scale [SCS]), and self-reflection (Groningen Reflection Ability Scale [GRAS]) before the training, directly after, and 6 months later. Semi-structured interviews were conducted with six participants after the training and a content analysis was performed to gain in depth understanding of experiences.

Results

A total of 54 physicians participated in the study. PSS was reduced (mean difference [MD] -4.5, P<0.001), SCS improved (MD = 0.5, P<0.001), and GRAS improved (MD = 3.3, P<0.001), directly after the 8-week training compared with before training. Six months later, PSS was still reduced (MD = -2.9, P = 0.025) and SCS improved (MD = 0.7, P<0.001). GRAS did not remain significant (MD = 2.5, P = 0.120). Qualitative analysis revealed four themes: being more aware of their own feelings and thoughts; being better able to accept situations; experiencing more peacefulness; and having more openness to the self and others.

Conclusion

Mindfulness training might be an effective approach for improving stress resilience, self-compassion, and self-reflection in primary care physicians.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348323/

Mindfulness Practice Quality not Quantity Predicts Psychological Improvement

April 12, 2019April 12, 2019 psyjdc Leave a comment

Mindfulness Practice Quality not Quantity Predicts Psychological Improvement

By John M. de Castro, Ph.D.

“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

There is a vast array of techniques for the development of mindfulness. They include a variety of forms of meditation, yoga, mindful movements, contemplative prayer, and combinations of practices. Some are recommended to be practiced for years while others are employed for only a few weeks. Regardless of the technique, they all appear to develop and increase mindfulness. One particularly effective mindfulness training program is Mindfulness-Based Stress Reduction (MBSR). The MBSR program consists of 8 weekly group sessions involving meditation, yoga, body scan, and discussion. The patients are also encouraged to perform daily practice. It is unclear, however, exactly whether it is the quantity or the quality of practice that is essential to producing maximum benefits.

In today’s Research News article “The secret ingredient in mindfulness interventions? A case for practice quality over quantity.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333205/ ), Goldberg and colleagues recruited adults for a “Quit Smoking Trial” and had them participate in an 8 week, once a week for 1.5 hours, mindfulness training program based upon the Mindfulness-Based Stress Reduction (MBSR) program but targeting smoking cessation. They also practiced at home for 30 minutes per day. In addition, for the first 4 weeks they also received nicotine patches. They were measured before and after the program and 5 months later for smoking, mindfulness, psychological functioning, emotion regulation, negative emotions, and quality of life. At each of the 8 practice sessions the participants also reported on the amount of time they practiced during the week and quality of these practices. The measure of practice quality was “composed of two dimensions: perseverance (e.g., “During practice, I attempted to return to my present-moment experience, whether unpleasant, pleasant, or neutral”) and receptivity (e.g., “During practice I was actively avoiding or ‘pushing away’ certain experiences”).”

They found that after treatment there was a significant relationship between practice time and the change in practice quality and the psychological functioning of the individuals with small to moderate effect sizes. In particular, the greater the amount of time spent practicing and also the greater the change in the quality of practice, the greater the improvement in psychological function in the participants. At the 5-month follow-up, however, only the change in quality of practice was associated with improved psychological function. Neither the amount of time spent practicing or the quality of practice was associated with smoking cessation at the end of treatment or 5 months later.

These results are interesting and suggest the importance of quality of practice in influencing the effectiveness of mindfulness practice on the psychological function of the individual. The quality measure components of perseverance and receptivity reflect exactly what is taught in mindfulness training where the meditator is asked to return to mindfulness whenever they detect mind wandering and to simply let things be as they are without attempts to change or control them. How well these skills are mastered, as evidenced by their change over the 8 weeks of training appears to be very important for maintaining the benefits.

This is an unusual study as most research on mindfulness training do not measure either amount or quality of the trained practice, while only a few, monitor the amount of time spent practicing. The current study underlines the importance of measuring quality. It appears to be important for assessing benefits but also may be used to examine practice methods that maximize the quality and quantity of practice and their importance for their benefits.

“Mindfulness is an important part of mental wellbeing; it can help us take stock of the fast-paced world around us and understand our emotions and feelings better. Practising mindfulness regularly can help reduce stress and improve mood; it can also help people to become more emotionally alert, to listen more attentively, communicate more clearly, and can increase self-awareness and the awareness of others.” – Fit for Work

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Goldberg, S. B., Del Re, A. C., Hoyt, W. T., & Davis, J. M. (2014). The secret ingredient in mindfulness interventions? A case for practice quality over quantity. Journal of counseling psychology, 61(3), 491-7.

Abstract

As mindfulness-based interventions become increasingly widespread, interest has grown in better understanding which features of these treatments produce beneficial effects. The present study examined the relative contribution of mindfulness practice time and practice quality in predicting psychological functioning (negative affect, emotion regulation, quality of life, mindfulness). Data were drawn from a randomized clinical trial of mindfulness training for smokers and assessed outcomes at posttreatment (n = 43) and 5-month follow-up (n = 38). The intervention included instruction in mindfulness techniques targeted to smoking cessation and relapse prevention and was composed of 10 group meetings over 8 weeks. Data from 8 treatment groups were used. Mindfulness practice quality was measured weekly over the course of treatment, and multilevel modeling was used to estimate trajectories of change in practice quality. The measure of practice quality was shown to be valid and reliable, with change in practice quality predicting change in psychological functioning at both posttreatment (β= .31, 95% CI =[0.04, 0.56], p = .022) and follow-up (β= .45 [0.16, 0.73], p = .002), even when controlling for practice time. Practice time predicted outcomes at posttreatment (β= .31 [0.05, 0.57], p = .019) but not at follow-up (β= .16 [[H11002]0.14, 0.47], p = .293). Neither practice time nor change in practice quality predicted smoking abstinence at 1 month or 6 months postquit. Results support the importance of practice quality as a relevant aspect of mindfulness interventions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333205/