MBSR

Improve Symptoms of Chronic Heart Failure with Mindfulness

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Improve Symptoms of Chronic Heart Failure with Mindfulness

 

By John M. de Castro, Ph.D.

 

“On the surface, heart failure seems to be a purely physical problem. The heart muscle is too weak, or too stiff, to pump enough blood to meet the body’s demands.  . .. But it’s an emotional and psychological problem, too, that can lead to depression, anxiety, and grief. These not only cast a pall on daily life, but they can make heart failure worse as well. A program based on the practice of mindfulness helps ease depression and improve symptoms of heart failure.” – Harvard Heart Letter

 

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. Congestive heart failure (CHF) is a major type of cardiovascular disease. “CHF is a chronic progressive condition that affects the pumping power of your heart muscles. While often referred to simply as “heart failure,” CHF specifically refers to the stage in which fluid builds up around the heart and causes it to pump inefficiently” (Healthline).

 

There are myriads of treatments that have been developed to treat Heart Failure including a variety of surgical procedures and medications. Importantly, lifestyle changes have proved to be quite effective. These include quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Contemplative practices, such as meditation, tai chi and yoga, have been shown to be helpful for heart health. In addition, mindfulness practices have also been shown to be helpful for producing the kinds of other lifestyle changes needed such as smoking cessation, weight reduction, and stress reduction.

 

In today’s Research News article “Effects of a mindfulness-based intervention on symptoms and signs in chronic heart failure: A feasibility study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5751854/ ), Norman and colleagues recruited patients diagnosed with chronic heart failure and randomly assigned them to receive either treatment as usual or to participate in an additional mindfulness-based intervention. The intervention was based upon Mindfulness-Based Stress Reduction (MBSR) program with additional psychoeducation based upon Mindfulness-Based Cognitive Therapy (MBCT) and consisted of meditation, yoga, and body scan. They met in 2-hour group sessions once a week for 8 weeks with additional daily home practice. The participants were measured before and after training for fatigue, sleep, heart failure symptoms and their severity, functional capacity, resting heart and respiration rate, and body size.

 

They found compared to baseline and control participants, those that participated in the mindfulness intervention had significantly less fatigue, unsteadiness/dizziness, and improved physical functioning, including less breathlessness during activities and greater walking distance. Hence, mindfulness practice was found to improve the symptoms of heart failure.

 

This was a small study and needs to be followed up with a larger controlled clinical trial with an active control group, e.g. exercise, and longer-term follow-up. But, this initial study is encouraging. Although no component analysis was performed to identify which elements of the complex mindfulness intervention were effective for which symptoms, it can be speculated that the exercise provided by the yoga practice and the stress reduction provided by the mindfulness practice were responsible for the improvements in the symptoms of heart failure.

 

So, improve symptoms of chronic heart failure with mindfulness.

 

“a significant part of the link between mindfulness and cardiovascular health was attributable to mindful people feeling a greater sense of control and less depression, which is thought to lead to more heart-friendly behaviors.” Adam Hoffman

 

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

 

Jonna Norman, Michael Fu, Inger Ekman, Lena Björck, Kristin Falk. Effects of a mindfulness-based intervention on symptoms and signs in chronic heart failure: A feasibility study. Eur J Cardiovasc Nurs. 2018 Jan; 17(1): 54–65. Published online 2017 Jun 22. doi: 10.1177/1474515117715843

 

Abstract

Aims:

Despite treatment recommended by guidelines, many patients with chronic heart failure remain symptomatic. Evidence is accumulating that mindfulness-based interventions (MBIs) have beneficial psychological and physiological effects. The aim of this study was to explore the feasibility of MBI on symptoms and signs in patients with chronic heart failure in outpatient clinical settings.

Methods:

A prospective feasibility study. Fifty stable but symptomatic patients with chronic heart failure, despite optimized guideline-recommended treatment, were enrolled at baseline. In total, 40 participants (median age 76 years; New York Heart Association (NYHA) classification II−III) adhered to the study. Most patients (n=17) were randomized into MBI, a structured eight-week mindfulness-based educational and training programme, or controls with usual care (n=16). Primary outcome was self-reported fatigue on the Fatigue severity scale. Secondary outcomes were self-reported sleep quality, unsteadiness/dizziness, NYHA functional classification, walking distance in the six-minute walk test, and heart and respiratory rates. The Mann–Whitney U test was used to analyse median sum changes from baseline to follow-up (week 10±1).

Results:

Compared with usual care (zero change), MBI significantly reduced the self-reported impact of fatigue (effect size −8.0; p=0.0165), symptoms of unsteadiness/dizziness (p=0.0390) and breathlessness/tiredness related to physical functioning (NYHA class) (p=0.0087). No adverse effects were found.

Conclusions:

In stable but symptomatic outpatients with chronic heart failure, MBI alleviated self-reported symptoms in addition to conventional treatment. The sample size is small and further studies are needed, but findings support the role of MBI as a feasible complementary option, both clinically and as home-based treatment, which might contribute to reduction of the symptom burden in patients diagnosed with chronic heart failure.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5751854/

Improve Heart Disease with Mindfulness

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Improve Heart Disease with Mindfulness

 

By John M. de Castro, Ph.D.

 

“it is not the stress in our life, but the reaction to stress that is so potentially harmful to our health, including cardiovascular health. Hence, being in a potentially very stressful profession, meditation and relaxation techniques are extremely important and useful to minimize these unhealthy reactions to stress.” – Joon Sup Lee

 

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. But the safest effective treatments are lifestyle changes. These include quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Cardiac rehabilitation programs for patients recovering from a heart attack, emphasize these lifestyle changes. Unfortunately, for a variety of reasons, 60% of cardiac patients decline participation, making these patients at high risk for another attack.

 

Other safe and effective 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 be helpful for producing the kinds of lifestyle changes needed to prevent heart disease such as smoking cessation, weight reduction, and stress reduction. Although death from heart disease is decreasing in men it is actually increasing in women. So, there is a need to study the effectiveness of mindfulness practice for the treatment of cardiovascular disease in women.

 

In today’s Research News article “Impact of Mindfulness Based Stress Reduction Therapy on Myocardial Function and Endothelial Dysfunction in Female Patients with Microvascular Angina.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5762694/ ), Kim and colleagues recruited women who were diagnosed with microvascular angina which is “heart disease that affects the heart’s smallest coronary artery blood vessels. Causes of microvascular angina: Spasms within the walls of these very small arterial blood vessels causes reduced blood flow to the heart muscle leading to a type of chest pain referred to as microvascular angina.” (American Heart Association). The women were provided with an 8-week, 2.5 hour once-a-week program of Mindfulness-Based Stress Reduction (MBSR) which includes of meditation, yoga, and body scan practices and on hour per day of home practice. Participants were measured for heart function and stress parameters before and after the 8-week practice.

 

Kim and colleagues found that following the 8-week MBSR program there was a marked and significant decrease in most stress parameters including somatization, compulsivity, interpersonal sensitivity, depression, anxiety, phobic anxiety, paranoid ideation, and psychoticism. Importantly there were improvements in cardiovascular functions including a decrease in systolic blood pressure and improvements in heart left ventricular function and heart arterial blood vessel function. Additionally, they found that the greater the reduction in the stress parameters the greater the improvements in heart function.

 

Conclusions from this study must be tempered as there wasn’t a comparison group included in the study, only females were examined, and no short- or long-term follow-up was included. But previous research has clearly established that mindfulness training, including MBSR, produces significant reductions in the psychological and physiological responses to stress and improves cardiovascular function. These prior findings combined with the present findings makes the case that MBSR reduces stress response which in turn improves cardiovascular function. This is very important for the promotion of longevity and well being in everyone but particularly for patients with cardiovascular disease.

 

So, improve heart disease with mindfulness,

 

“an analysis of 23 controlled trials into heart disease determined that psychosocial interventions (such as meditation, breathing exercises, and physical relaxation techniques) improved the outcomes when they were added to cardiac rehabilitation programmes for patients with CHD.” – British Heart Foundation

 

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

 

Bong Joon Kim, In Suk Cho, Kyoung Im Cho. Impact of Mindfulness Based Stress Reduction Therapy on Myocardial Function and Endothelial Dysfunction in Female Patients with Microvascular Angina. J Cardiovasc Ultrasound. 2017 Dec; 25(4): 118–123. Published online 2017 Dec 29. doi: 10.4250/jcu.2017.25.4.118

 

Abstract

Background

Mindfulness-based stress reduction (MBSR) is a structured group program that employs mindfulness meditation to alleviate suffering associated with physical, psychosomatic, and psychiatric disorders. In this study, we investigate the impact of MBSR on left ventricular (LV) and endothelial function in female patients with microvascular angina.

Methods

A total of 34 female patients (mean age 52.2 ± 13.8 years) diagnosed with microvascular angina underwent a MBSR program with anti-anginal medication for 8 weeks. The global longitudinal strain (GLS) of the LV was used as a parameter to assess myocardial function and reactive brachial flow-mediated dilatation (FMD) was used to assess endothelial function. Symptoms were analyzed by the Symptom Checklist 90 Revised to determine emotional stress. Changes in GLS and FMD between baseline and post-MBSR were analyzed.

Results

After 8 weeks of programmed MBSR treatment, stress parameters were significantly decreased. In addition, GLS (−19.5 ± 2.1% vs. −16.6 ± 2.5%, p < 0.001) and reactive FMD significantly improved (8.9 ± 3.0% vs. 6.9 ± 2.6%, p = 0.005) after MBSR compared to baseline. The changes in GLS correlated to changes in FMD (r = 0.120, p = 0.340) and with the changes in most stress parameters.

Conclusion

MBSR has beneficial impacts on myocardial and endothelial function in female patients with microvascular angina.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5762694/

 

Improve Pain Responding in Adolescents with Mindfulness

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Improve Pain Responding in Adolescents with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness was a significant predictor of both real-world and experimental pain outcomes. Adolescents who were more mindful tended to experience less interference in their day-to-day life as a result of pain. Additionally, . . . more mindful adolescents reported less intense pain and a higher level of pain tolerance.” – Mark Petter

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. Sadly, about a quarter to a third of children experience chronic pain. It has to be kept in mind that pain is an important signal that there is something wrong or that damage is occurring. This signals that some form of action is needed to mitigate the damage. This is an important signal that is ignored at the individual’s peril. So, in dealing with pain, it’s important that pain signals not be blocked or prevented. They need to be perceived. But, methods are needed to mitigate the psychological distress produced by chronic pain.

 

The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and prescription opioid overdoses kill more than 14,000 people annually. The use of drugs in adolescents is even more complicated and potentially directly harmful or could damage the developing brain. So, there is a great need to find safe and effective ways to lower the psychological distress and improve adolescents’ ability to cope with the pain.

 

Pain involves both physical and psychological issues. The stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. So, reducing the emotional reactions to pain may be helpful in pain management. There is an accumulating volume of research findings to demonstrate that mind-body therapies have highly beneficial effects on the health and well-being of humans. These include meditation, yoga, tai chi, qigong, biofeedback, progressive muscle relaxation, guided imagery, hypnosis, acupuncture, and deep breathing exercises. Mindfulness practices have been shown to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. Indeed, mindfulness practices are effective in treating pain in adults. But there is very little systematic study of the application of these practices for the treatment of chronic pain in adolescents.

 

In today’s Research News article “I Learned to Let Go of My Pain”. The Effects of Mindfulness Meditation on Adolescents with Chronic Pain: An Analysis of Participants’ Treatment Experience.” (See summary below or view the full text of the study at:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5742755/ ), Ruskin and colleagues recruited adolescents between the ages of 12 to 18 years who suffered from chronic pain. They provided the adolescents with an 8-week program or Mindfulness-Based Stress Reduction (MBSR) modified for adolescents, including meditation, yoga, and body scan, but with reduced expectation for home practice and shortened sessions. One week after the end of the program the youths were asked about their satisfaction with the program and participated in focus groups to provide feedback, evaluations, and suggestions regarding the program. The groups discussions were transcribed and a content analysis performed.

 

The participants rated their satisfaction program at 8.29 out of 10, suggesting a high degree of satisfaction. Ruskin and colleagues found that the “Qualitative analysis of focus group transcripts revealed six main themes: Mindfulness Skills, Supportive Environment, Group Exercises, Empowerment, Program Expectations, and Logistics.”

 

In terms of the mindfulness category the participants reported that the program improved their awareness of the present moment, their ability to let go of their pain, their ability to cope with the emotions produced by the pain, and increased their overall emotional well-being and happiness. In addition, they reported that the mindfulness skills transferred to other aspects of their life such as work, and became a part of how they normally viewed the world.

 

In terms of the supportive environment, the participants reported that the group developed a sense of openness and trust, provided emotional support and made them feel less alone. They also reported that being able to discuss their pain issues with others who were also suffering was very beneficial. In terms of the group exercises, the participants reported that the “weather report”, reporting on their current state with the group was very helpful, that focusing on the pain in meditation was helpful. In terms of empowerment, the participants felt that the program did not actually ease their pain but empowered them to take actions to cope with it and not let it interfere with their activities. In terms of the program expectations, they reported that they had great misconceptions of mindfulness at the beginning believing it to be uninteresting and dumb and some reported that they thought the program would actually lower their pain levels. Finally,

in terms of the logistics, the meeting room was too sterile and needed to be decorated in a more interesting fashion, there needed to be more meetings, and they liked working with other adolescents with chronic pain.

 

Hence, the participants viewed the program very positively as improving their ability to appreciate and stay in the present moment and better cope with the emotional and practical consequences of their pain. That the practice was conducted in a group of other adolescents with chronic pain was viewed as an important and helpful characteristic of the program. In other words, they were pleased and felt the program was helpful to them in dealing with their pain.

 

These results must be interpreted carefully. They should be viewed as constructive feedback on the program and nothing more. More empirical evidence is needed to reach firm conclusions regarding the programs efficacy. But, the results are suggestive that more systematic studies are warranted as mindfulness training may be very helpful to adolescents in coping with chronic pain.

 

 “Mindful meditation can have profound effects for those who suffer from chronic pain. This simple practice seems to be able to change a patient’s perception of pain, making it less intense. . . . consistent meditation helped patients locate and turn down the “volume knob” on sensations. Often pain sufferers are unable to focus on anything but their pain, which increases their perception of it.” – Pain Doctor

 

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

 

Danielle Ruskin, Lauren Harris, Jennifer Stinson, Sara Ahola Kohut, Kathryn Walker, Erinn McCarthy. I Learned to Let Go of My Pain”. The Effects of Mindfulness Meditation on Adolescents with Chronic Pain: An Analysis of Participants’ Treatment Experience. Children (Basel) 2017 Dec; 4(12): 110. Published online 2017 Dec 15. doi: 10.3390/children4120110

 

Abstract

Chronic pain can lead to significant negative outcomes across many areas of life. Recently, mindfulness-based interventions (MBIs) have been identified as potentially effective tools for improved pain management among adolescents living with pain. This study aimed to explore the experience of adolescents who participated in an eight-week mindfulness group adapted for adolescents with chronic pain (MBI-A), and obtain their feedback and suggestions on group structure and content. A mixed method design was used employing qualitative data from focus groups and data from a satisfaction questionnaire. Focus group data were transcribed and analyzed using inductive simple descriptive content analysis. Of the total participants (n = 21), 90% (n = 19) provided feedback by completing satisfaction questionnaires and seventeen (n = 17) of those also participated across two focus groups. Analysis of the focus group transcripts uncovered six themes: mindfulness skills, supportive environment, group exercises (likes and dislikes), empowerment, program expectations, and logistics. Participants reported positive experiences in the MBI-A program, including support received from peers and mindfulness skills, including present moment awareness, pain acceptance, and emotion regulation. Group members suggested increasing the number of sessions and being clearer at outset regarding a focus on reduction of emotional suffering rather than physical pain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5742755/

Improve Cancer Survivor Quality of Life with Exercise or Mindfulness

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Improve Cancer Survivor Quality of Life with Exercise or Mindfulness

 

By John M. de Castro, Ph.D.

 

“One of the main reasons people with cancer use meditation is to help them to feel better. Meditation can reduce anxiety and stress. It might also help control problems such as: pain, difficulty sleeping, tiredness, feeling sick, high blood pressure.” – Cancer Research UK

 

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

 

But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. It is estimated that 15 million adults and children with a history of cancer are alive in the United States today. But, surviving cancer carries with it a number of problems. “Physical, emotional, and financial hardships often persist for years after diagnosis and treatment. Cancer survivors are also at greater risk for developing second cancers and other health conditions.” National Cancer Survivors Day.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. In today’s Research News article “Review of systematic reviews of non-pharmacological interventions to improve quality of life in cancer survivors.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5719270/ ), Duncan and colleagues summarize the published scientific reviews of randomized controlled trials on the effects of non-drug interventions on the quality of life of adult cancer survivors. The interventions included fell into a number of categories including physical (e.g. aerobic exercise, yoga), psychological education,  peer support, and mind-body therapies (Mindfulness-Based Stress Reduction (MBSR), cognitive behavioral therapy (CBT), psychotherapy, relaxation training).

 

They discovered 21 published reviews of 362 randomized controlled trials. They found that the literature supported the efficacy of aerobic exercise, yoga, cognitive behavioral therapy (CBT), and Mindfulness-Based Stress Reduction (MBSR) in improving the quality of life in cancer survivors. Hence, published scientific randomized controlled trials of non-drug treatment approaches demonstrate that the quality of life of cancer survivors can be improved with exercise, CBT, and mindfulness practices such as MBSR and yoga.

 

It was not reported how these practices might improve quality of life in cancer survivors. But, it can be speculated that because cancer treatments are physically demanding and of themselves produce physical debilitation, that exercise is a useful countermeasure to help overcome the physical losses occurring in treatment. It can also be speculated that mindfulness training may be helpful by improving the survivor’s ability to regulate the emotions produced by a cancer diagnosis and its treatment. These include anxiety, depression, fear, catastrophizing etc. By improving the ability to feel these emotions but react to them adaptively and thereby not amplifying them, the survivors may help to improve their emotional well-being and as a result their quality of life.

 

So, improve cancer survivor quality of life with exercise or mindfulness.

 

“We already know that psychosocial interventions like mindfulness meditation will help you feel better mentally, but now for the first time we have evidence that they can also influence key aspects of your biology,” – Linda Carlson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Duncan, M., Moschopoulou, E., Herrington, E., Deane, J., Roylance, R., Jones, L., … Bhui, K. (2017). Review of systematic reviews of non-pharmacological interventions to improve quality of life in cancer survivors. BMJ Open, 7(11), e015860. http://doi.org/10.1136/bmjopen-2017-015860

 

Strengths and limitations of this study

  • This is a systematic review of reviews and evidence synthesis of non-pharmacological interventions in cancer survivors.
  • Longer term studies are needed and studies of greater methodological quality that adopt similar reporting standards.
  • Definitions of survivor varied and more studies are needed for different types of cancer, and specifically for patients who have poor quality of life.
  • More studies are needed that investigate educational, online and multidisciplinary team-based interventions.
  • This review has some limitations in the methodology. Studies not in English and grey literature were not included. This was a review of reviews: we did not review individual studies focused on specific cancers or stage, and we did not reassess the quality of the primary studies included in each review.

 

Abstract

Objectives

Over two million people in the UK are living with and beyond cancer. A third report diminished quality of life.

Design

A review of published systematic reviews to identify effective non-pharmacological interventions to improve the quality of life of cancer survivors.

Data sources

Databases searched until May 2017 included PubMed, Cochrane Central, EMBASE, MEDLINE, Web of Science, the Cumulative Index to Nursing and Allied Health Literature, and PsycINFO.

Study selection

Published systematic reviews of randomised trials of non-pharmacological interventions for people living with and beyond cancer were included; included reviews targeted patients aged over 18. All participants had already received a cancer diagnosis. Interventions located in any healthcare setting, home or online were included. Reviews of alternative therapies or those non-English reports were excluded. Two researchers independently assessed titles, abstracts and the full text of papers, and independently extracted the data.

Outcomes

The primary outcome of interest was any measure of global (overall) quality of life.

Analytical methods

Quality assessment assessing methdological quality of systematic reviews (AMSTAR) and narrative synthesis, evaluating effectiveness of non-pharmacological interventions and their components.

Results

Of 14 430 unique titles, 21 were included in the review of reviews. There was little overlap in the primary papers across these reviews. Thirteen reviews covered mixed tumour groups, seven focused on breast cancer and one focused on prostate cancer. Face-to-face interventions were often combined with online, telephone and paper-based reading materials. Interventions included physical, psychological or behavioural, multidimensional rehabilitation and online approaches. Yoga specifically, physical exercise more generally, cognitive behavioural therapy (CBT) and mindfulness-based stress reduction (MBSR) programmes showed benefit in terms of quality of life.

Conclusions

Exercise-based interventions were effective in the short (less than 3–8 months) and long term. CBT and MBSR also showed benefits, especially in the short term. The evidence for multidisciplinary, online and educational interventions was equivocal.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5719270/

Improve the Emotion Regulation of High School Students with Mindfulness

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Improve the Emotion Regulation of High School Students with Mindfulness

 

By John M. de Castro, Ph.D.

 

“A large part of being a human being is having social, emotional and attention skills and in the majority of schools I visit, we don’t actually teach kids how to pay attention or how to deal with their inner states in a healthy way. We just assume that they’ll learn them somewhere else.” – Patrick Cook-Deegan

 

It’s a normal human response to become anxious while being evaluated by others. In fact, the vast majority of students report that the stress and anxiety associated with being evaluated is greater than that produced by anything else in their lives. The majority of students are able to cope with the anxiety and perform on tests in spite of it. But, for a minority of students, somewhere around 16%-20%, the anxiety level is so high that it causes them to “freeze” on tests and markedly impair their performance. It is estimated that they perform 12 points lower, more than one letter grade, on average than students lower in anxiety. Counselling centers in colleges and universities report that evaluation anxiety is the most common complaint that they treat among students.

 

It has been demonstrated repeatedly that mindfulness counteracts anxiety and mindfulness training is an effective treatment for a variety of forms of anxiety. Mindfulness training has been shown to be effective for anxiety disorders in general and  in relieving test anxiety. Mindfulness-Based Stress Reduction (MBSR) is a classic program that includes three mindfulness techniques; meditation, body scan, and yoga. MBSR has been employed for years to successfully treat a myriad of psychological and medical conditions. But, it has not yet been tested for use to treat test anxiety.

 

In today’s Research News article “Effectiveness of mindfulness-based stress reduction on emotion regulation and test anxiety in female high school students.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5651652/ ),

Shahidi and colleagues recruited female High School students and randomly assigned them to a no-treatment control condition or to receive an 8-week, once a week for 90 minutes, program of Mindfulness-Based Stress Reduction (MBSR) with encouragement to practice at home. They were measured before and after training and 3-months later for test anxiety and emotion regulation.

 

They found that after the program and also 3-months later that the students who received MBSR had clinically significant 46% reductions in test anxiety. In addition, they showed significant improvement in emotion regulation including; blaming others, rumination/focus on thought, catastrophizing, putting into perspective, positive refocusing, positive reappraisal, acceptance, and refocus on planning. Only the self-blame strategy was not significantly affected by MBSR training. Hence, MBSR training for High School students produces a lasting relief of test anxiety and improves the ability to cope with emotions.

 

It should be mentioned that this study did not contain an active control condition. So, bias and contamination of the results may be present. Also, the study only tested female students, thus limiting generalization of the results. Future research should include a both males and females and a group receiving active alternative treatment, say exercise training. Regardless, the results suggest that MBSR training can help students cope with their emotions, including test anxiety. This would predict that there would be improved academic performance and less psychological problems in the trained students. This further suggests that MBSR training should be considered to be routinely employed for High School students.

 

So, improve the emotion regulation of high school students with mindfulness.

 

“Mindfulness practices help children improve their ability to pay attention, by learning to focus on one thing (e.g., breath, sound) while filtering out other stimuli. Mindfulness also provides kids with skills for understanding their emotions and how to work with them.” – Sarah Beach

 

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

 

Shokooh Shahidi, Hossein Akbari, Fatemeh Zargar, Effectiveness of mindfulness-based stress reduction on emotion regulation and test anxiety in female high school students. J Educ Health Promot. 2017; 6: 87. Published online 2017 Oct 4. doi: 10.4103/jehp.jehp_98_16

 

 

Abstract

BACKGROUND:

Test anxiety is one of the most disabling disorders and annual school academic performance will affect millions of students. Hence, it needs attention and treatment. Therefore, this research aimed to examine the effectiveness of a mindfulness-based stress reduction (MBSR) therapy on emotion regulation and test anxiety of students and test the remaining effect of this treatment after 3 month.

METHODS:

Sample size of fifty participants randomly divided into experimental (MBSR) and control groups. The MBSR training interventions were implemented to the experimental group, in eight weekly sessions using MBSR manual by John Kabat-Zinn (2013). Participants in both groups were evaluated using the Test Anxiety Scale and the Cognitive Emotion Regulation Questionnaire. The study findings were analyzed using analysis of variance with repeated measures.

RESULTS:

The result shows that the MBSR program has had continuous significant effects on test anxiety (P< 000) and emotion regulation (P < 000) but was not significant only for the self-blame subscale (P = 0.126).

CONCLUSIONS:

The study results indicated that the effects of MBSR lasted through the follow-up, for both of these variables. Using the results of this study may be proposed school counselors use mindfulness to reduce the anxiety of their pupils.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5651652/

Personality Modulates the Effectiveness and Continued Use of Mindfulness Training

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Personality Modulates the Effectiveness and Continued Use of Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“Mindfulness-Based Stress Reduction is a formal eight-week program with a daylong intensive. This program is in over 250 hospitals around the country and many more around the world supporting people with stress, anxiety, depression, chronic pain, alleviating stress related to medical conditions and much more.” – Will Baum

 

Personality characteristics are thought to be relatively permanent traits that form an individual’s distinctive character. Current psychological research and theorization on personality has suggested that there are five basic personality characteristics. The so called “Big 5” are Extraversion, Agreeableness, Openness to Experience, Conscientiousness, and Neuroticism. Extraversion involves engagement with the external world, particularly other people. Agreeableness involves trust and helpfulness and a positive temperament. Openness to Experience is intellectual curiosity and is associated with creativity and a preference for novelty and variety. Conscientiousness involves planning, organization, dependability and self-discipline. Finally, Neuroticism involves moodiness, negative emotions, and a tendency to perceive even minor things as threatening or impossible. It is thought that most individual personalities can be captured by these five characteristics.

 

Measuring personality traits is only useful if it can predict the future behavior of the individual. 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 would be useful to be able to predict who would be most likely to participate fully and thereby benefit most from mindfulness training. It is possible that personality traits are good predictors of successful participation. So, it would be important to look to see if people high in some of these “Big 5” traits are more likely to engage in the program and continue practice even after the end of the formal program.

 

In today’s Research News article “Personality Predicts Utilization of Mindfulness-Based Stress Reduction During and Post-Intervention in a Community Sample of Older Adults “.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4860670/ ), Barkan and colleagues recruited elderly adults over the age of 60 years. They received a standard 8-week Mindfulness-Based Stress Reduction (MBSR) program that met once a week for 2 hours and near the end of the program for a 7-hour intensive retreat. They were also encouraged to practice at home during training and to continue practice after the end of the formal training. MBSR contains meditation, body scan, and yoga training. The participants were measured prior to training for “Big 5” personality traits, perceived stress, and cognitive functioning. They maintained logs of their engagement in the MBSR sessions and activities throughout the program and 6 months after the end of the program.

 

Barkan and colleagues found that attendance at the MBSR training sessions was high at 94%. Further, they found that during the MBSR intervention, average weekly at home participation varied from 2.19 days/week for yoga to 3.56 days/week for body scanning. Importantly, they found that participants high in the “Big 5” personality trait of openness participated more frequently at home during the 8-week instruction period in meditation and body scanning and during the 6 months after in yoga, meditation and body scanning practices. Those participants who were high in agreeableness participated more frequently at home during the instruction period in meditation. None of the other three “Big 5” personality traits predicted participation rates.

 

Employing a sophisticated regression analysis to the data, they found that the combination of openness and agreeableness predicted both participation during and following the end of formal training and participation during training predicted participation in the following 6 months. Hence, openness and agreeableness were associated with higher participation after training both directly and because they promoted participation during training that, in turn, was associated with increased later participation.

 

It is interested that the personality characteristics of the participant were associated with their rates of participation in MBSR both during and after training. This suggests that participants high in openness to experience would be most likely to participate in and benefit from the practice. The “Big 5” personality trait of openness to experience is associated with creativity and a preference for novelty and variety. Certainly, participation in MBSR would be novel for this elderly group. So, it is not surprising that openness to experience predicted participation.

 

“Do you have neurotic tendencies? You might give mindfulness a try. The practice has been shown to help quell the voice of the “obnoxious roommate” in your head. One of the “Big Five” personality traits, neuroticism is characterized by negative affect, rumination on the past and worry about the future, moodiness and loneliness. Practicing mindfulness may be a powerful way for people to detach from common characteristics of neuroticism, including obsessive negative thoughts and worries, and challenges regulating one’s emotions and behavior.” – Carolyn Gregoire

 

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

 

Barkan, T., Hoerger, M., Gallegos, A. M., Turiano, N. A., Duberstein, P. R., & Moynihan, J. A. (2016). Personality Predicts Utilization of Mindfulness-Based Stress Reduction During and Post-Intervention in a Community Sample of Older Adults. Journal of Alternative and Complementary Medicine, 22(5), 390–395. http://doi.org/10.1089/acm.2015.0177

 

Abstract

Objectives: Mindfulness-based stress reduction (MBSR) is a promising intervention for older adults seeking to improve quality of life. More research is needed, however, to determine who is most willing to use the four techniques taught in the program (yoga, sitting meditation, informal meditation, and body scanning). This study evaluated the relationship between the Big Five personality dimensions (neuroticism, extraversion, openness to experience, conscientiousness, and agreeableness) and use of MBSR techniques both during the intervention and at a 6-month follow-up. The hypothesis was that those with higher levels of openness and agreeableness would be more likely to use the techniques.

Methods: Participants were a community sample of 100 older adults who received an 8-week manualized MBSR intervention. Personality was assessed at baseline by using the 60-item NEO Five-Factor Inventory. Use of MBSR techniques was assessed through weekly practice logs during the intervention and a 6-month follow-up survey. Regression analyses were used to examine the association between each personality dimension and each indicator of MBSR use both during and after the intervention.

Results: As hypothesized, openness and agreeableness predicted greater use of MBSR both during and after the intervention, while controlling for demographic differences in age, educational level, and sex. Openness was related to use of a variety of MBSR techniques during and after the intervention, while agreeableness was related to use of meditation techniques during the intervention. Mediation analysis suggested that personality explained postintervention MBSR use, both directly and by fostering initial uptake of MBSR during treatment.

Conclusions: Personality dimensions accounted for individual differences in the use of MBSR techniques during and 6 months after the intervention. Future studies should consider how mental health practitioners would use these findings to target and tailor MBSR interventions to appeal to broader segments of the population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4860670/

Improve the Regulation of Emotions in Social Anxiety Disorder with Mindfulness

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Improve the Regulation of Emotions in Social Anxiety Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“One way to do this . . . is mindfulness meditation, in which you observe your thoughts and feelings with the objectivity of a disinterested, nonjudgmental witness. This form of mental training gives you the wherewithal to pause, observe how easily the mind can exaggerate the severity of a setback, note that it as an interesting mental process, and resist getting drawn into the abyss,” – Ritchie Davidson

 

Mindfulness practices have 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. They have also been shown to effect a large number of physiological and psychological processes, including emotion regulation, attention, sensory awareness, decentering, and reappraisal. It is not known how mindfulness practices produce the myriad effects on the individual’s health and well-being, whether mindfulness has a direct effect or works through intermediary effects to produce the improved well-being.

 

There has been some research on this question, for instance mindfulness has been found to improve some symptoms of mental illness by increasing reappraisal which then affects the symptoms. In today’s Research News article “Testing the mindfulness-to-meaning theory: Evidence for mindful positive emotion regulation from a reanalysis of longitudinal data.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718463/ ), Garland and colleagues examine the hypothesis that mindfulness practices influence social anxiety disorder (SAD) through a series of intermediaries. They postulate that mindfulness training increases attention which, in turn increases decentering, which, in turn, broadens sensory awareness, which, in turn increases reappraisal, which increases emotion regulation and reductions in social anxiety disorder (SAD).

 

To examine this idea they reanalyzed the data from a longitudinal study of the effects of Mindfulness-Based Stress Reduction (MBSR) and Cognitive Behavioral Therapy (CBT) on social anxiety disorder (SAD) to determine the temporal sequence of mindfulness effects. Participants with SAD were randomly assigned to receive either 12 weeks of MBSR or CBT group therapy or on a wait-list control condition. MBSR consists of a combination of meditation, body scanning, and yoga practices. The participants were measured pretreatment, post-treatment, and 3, 6, 9, and 12 months later for attentional control, decentering, reappraisal, sensory awareness, dispositional mindfulness, emotion regulation and positive emotions. The data were analyzed with a sophisticated multivariate path analysis.

 

The best fit path revealed by the analysis had excellent model fit. It revealed that both MBSR and CBT produced significant improvements in attentional control at the end of the 12-week treatment. These attentional improvements were significantly associated with increases in decentering 3 months later. Similarly, change in decentering was significantly associated with broadened sensory awareness at the 6-month follow-up measurement. In turn, the broadened sensory awareness was significantly associated with increases in reappraisal at the 9-month follow-up measurement. Finally, increases in reappraisal were significantly associated with increases in positive emotions at the 12-month follow-up measurement. In comparing Mindfulness-Based Stress Reduction (MBSR) with Cognitive Behavioral Therapy (CBT) in this model, it was found that MBSR produced significantly greater decentering and broadened sensory awareness. So, both MBSR and CBT would appear effective for social anxiety disorder (SAD) but MBSR would appear to be the superior treatment.

 

These are interesting and important findings suggest the mechanism by which mindfulness training improves emotion regulation in patients with social anxiety disorder (SAD). They suggest that mindfulness training sets off a chain of events consisting of improved attention followed by increased decentering followed by broadened sensory awareness, followed by increased reappraisal, followed by increased emotion regulation and reduced social anxiety disorder (SAD). It remains for future research to determine if this sequence events accounts for any other of the mental or physical health benefits of mindfulness training.

 

So, improve the regulation of emotions in social anxiety disorder with mindfulness.

 

“Through your mindful acceptance, you can embrace or hold the feeling in your awareness– this alone can calm and soothe you. This is an act of self-compassion and responsiveness to your own distress, and it is so much more effective than punishing yourself for having this feeling.” – Melli O’Brien

 

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

 

Garland, E. L., Hanley, A. W., Goldin, P. R., & Gross, J. J. (2017). Testing the mindfulness-to-meaning theory: Evidence for mindful positive emotion regulation from a reanalysis of longitudinal data. PLoS ONE, 12(12), e0187727. http://doi.org/10.1371/journal.pone.0187727

 

Abstract

Background and objective

The Mindfulness to Meaning Theory (MMT) provides a detailed process model of mindful positive emotion regulation.

Design

We conducted a post-hoc reanalysis of longitudinal data (N = 107) derived from a RCT of mindfulness-based stress reduction (MBSR) versus cognitive-behavioral therapy (CBT) for social anxiety disorder to model the core constructs of the MMT (attentional control, decentering, broadened awareness, reappraisal, and positive affect) in a multivariate path analysis.

Results

Findings indicated that increases in attentional control from baseline to post-training predicted increases in decentering by 3 months post-treatment (p<.01) that in turn predicted increases in broadened awareness of interoceptive and exteroceptive data by 6 months post-treatment (p<.001). In turn, broadened awareness predicted increases in the use of reappraisal by 9 months post-treatment (p<.01), which culminated in greater positive affect at 12 months post-treatment (p<.001). MBSR led to significantly greater increases in decentering (p<.05) and broadened awareness than CBT (p<.05). Significant indirect effects indicated that increases in decentering mediated the effect of mindfulness training on broadening awareness, which in turn mediated enhanced reappraisal efficacy.

Conclusion

Results suggest that the mechanisms of change identified by the MMT form an iterative chain that promotes long-term increases in positive affectivity. Though these mechanisms may reflect common therapeutic factors that cut across mindfulness-based and cognitive-behavioral interventions, MBSR specifically boosts the MMT cycle by producing significantly greater increases in decentering and broadened awareness than CBT, providing support for the foundational assumption in the MMT that mindfulness training may be a key means of stimulating downstream positive psychological processes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718463/

Improve Mental and Physical Health of Breast Cancer Survivors with Mindfulness

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Improve Mental and Physical Health of Breast Cancer Survivors with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness-based meditation can help ease the stress, anxiety, fear, and depression that often come along with a breast cancer diagnosis and treatment.” – Breastcancer.org

 

About 12.5% of women in the U.S. develop invasive breast cancer over their lifetimes and every year about 40,000 women die. Indeed, more women in the U.S. die from breast cancer than from any other cancer, besides lung cancer. Breast cancer diagnosis, however, is not always a death sentence. Death rates have been decreasing for decades from improved detection and treatment of breast cancer. Five-year survival rates are now at around 95%. The improved survival rates mean that more women are now living with cancer.

 

Surviving cancer, however, carries with it a number of problems. “Physical, emotional, and financial hardships often persist for years after diagnosis and treatment. Cancer survivors are also at greater risk for developing second cancers and other health conditions.” (National Cancer Survivors Day). Also, breast cancer survivors can have to deal with a heightened fear of reoccurrence. This is particularly true with metastatic cancer. Additionally, cancer survivors frequently suffer from anxiety, depression, mood disturbance, Post-Traumatic Stress Disorder (PTSD), sleep disturbance, fatigue, sexual dysfunction, loss of personal control, impaired quality of life, an alteration of their body image, and psychiatric symptoms which have been found to persist even ten years after remission. So, safe and effective treatments for the symptoms in breast cancer and the physical and psychological effects of the treatments are needed.

 

Mindfulness training has been shown to help with general cancer recovery and breast cancer recovery. Mindfulness helps to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. Yoga practice has also been shown to be helpful with the residual symptoms and the psychological and physical ability to deal with cancer treatment. The Mindfulness-Based Stress Reduction (MBSR) program includes meditation, body scan, and yoga. So, it would likely be of great benefit for women with breast cancer during and after treatment.

 

In today’s Research News article “Examination of Broad Symptom Improvement Resulting From Mindfulness-Based Stress Reduction in Breast Cancer Survivors: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5012660/ ), Lengacher and colleagues recruited women with Stage 0 to III breast cancer who had been diagnosed within the last 2 years. They were randomly assigned to receive usual care or usual care plus a 6-week, 2-hour, once a week program of Mindfulness-Based Stress Reduction (MBSR). The MBSR group was encouraged to practice at home for 15 to 45 minutes daily. They were measured before and after treatment and 6-weeks later for pain, fatigue, quality of life, anxiety, depression, perceived stress, concerns about recurrence, and clinical history of cancer diagnosis and treatment. Participation rates were high with 91% of the original participants completing the program.

 

They found that MBSR participation produced significant symptom improvements that were generally maintained for the following 6 weeks. The MBSR group had significantly greater reductions in anxiety, fear of recurrence overall, and fear of recurrence problems and physical symptoms of fatigue severity and fatigue interference. They also found that the women who had the greatest levels of stress at the beginning of the training benefited the most from it, with significantly greater reductions in fear of recurrence and fatigue.

 

MBSR has been shown in other healthy and ill groups to reduce anxiety, fatigue, and stress. So, it is good to see that MBSR is effective for this highly compromised and stressed group. The trial did not have an active control condition, leaving open the possibility of bias. Future research should include and active control, perhaps exercise. Regardless, the results are very encouraging and suggest that Mindfulness-Based Stress Reduction (MBSR) may be an excellent additional treatment for women with breast cancer improving their mental and physical health.

 

So, improve mental and physical health of breast cancer survivors with Mindfulness.

 

“The most widely researched meditation program is called Mindfulness-Based Stress Reduction or MBSR. It combines a variety of techniques, including body scan, sitting meditation, and gentle and mindful yoga. Studies of MBSR in women with breast cancer show that the practice can have a strong positive impact on mental health and lower levels of hormones that cause stress.” – LBBC.org

 

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

 

Lengacher, C. A., Reich, R. R., Paterson, C. L., Ramesar, S., Park, J. Y., Alinat, C., … Kip, K. E. (2016). Examination of Broad Symptom Improvement Resulting From Mindfulness-Based Stress Reduction in Breast Cancer Survivors: A Randomized Controlled Trial. Journal of Clinical Oncology, 34(24), 2827–2834. http://doi.org/10.1200/JCO.2015.65.7874

 

Abstract

Purpose

The purpose of this randomized trial was to evaluate the efficacy of the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR[BC]) program in improving psychological and physical symptoms and quality of life among breast cancer survivors (BCSs) who completed treatment. Outcomes were assessed immediately after 6 weeks of MBSR(BC) training and 6 weeks later to test efficacy over an extended timeframe.

Patients and Methods

A total of 322 BCSs were randomly assigned to either a 6-week MBSR(BC) program (n = 155) or a usual care group (n = 167). Psychological (depression, anxiety, stress, and fear of recurrence) and physical symptoms (fatigue and pain) and quality of life (as related to health) were assessed at baseline and at 6 and 12 weeks. Linear mixed models were used to assess MBSR(BC) effects over time, and participant characteristics at baseline were also tested as moderators of MBSR(BC) effects.

Results

Results demonstrated extended improvement for the MBSR(BC) group compared with usual care in both psychological symptoms of anxiety, fear of recurrence overall, and fear of recurrence problems and physical symptoms of fatigue severity and fatigue interference (P < .01). Overall effect sizes were largest for fear of recurrence problems (d = 0.35) and fatigue severity (d = 0.27). Moderation effects showed BCSs with the highest levels of stress at baseline experienced the greatest benefit from MBSR(BC).

Conclusion

The MBSR(BC) program significantly improved a broad range of symptoms among BCSs up to 6 weeks after MBSR(BC) training, with generally small to moderate overall effect sizes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5012660/

Improve Multiple Sclerosis’ Psychological Symptoms with Mindfulness

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Improve Multiple Sclerosis’ Psychological Symptoms with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Learning a mind-body technique called “mindfulness meditation” seems to help people with multiple sclerosis cope with the depression, fatigue, and anxiety associated with the disease” – WebMD

 

Multiple Sclerosis (MS) is a progressive demyelinating disease which attacks the coating on the neural axons which send messages throughout the body and nervous system. It affects about 2 million people worldwide and about 400,000 in the U.S. It is most commonly diagnosed in people between the ages of 20 and 50 years.  Unfortunately, there is no cure for multiple sclerosis. There are a number of approved medications that are used to treat MS but are designed to lessen frequency of relapses and slow the progression of the disease, but they don’t address individual symptoms.

 

Although there is a progressive deterioration, MS is not fatal with MS patients having about the same life expectancy as the general population. Hence, most MS sufferers have to live with the disease for many years. So, quality of life becomes a major issue. Quality of life with MS is affected by fatigue, cognitive decrements, physical impairment, depression, and poor sleep quality. Indeed, clinically significant depression is present in 15% to 47% of MS patients. There is a thus a critical need for safe and effective methods to help relieve the symptoms of MS, reduce depression and improve quality of life. Mindfulness practices have been previously shown to improve depression, sleep quality, cognitive impairments, emotion regulation, and fatigue. It has also been shown to improve the symptoms of multiple sclerosis.  Yoga is a mindfulness practice that has the added feature of exercising and stretching the muscles.

 

In today’s Research News article “The Effectiveness of a Body-Affective Mindfulness Intervention for Multiple Sclerosis Patients with Depressive Symptoms: A Randomized Controlled Clinical Trial.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2017.02083/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_485496_69_Psycho_20171214_arts_A ), Tesio and colleagues examine the effectiveness of mindfulness training on the symptoms of Multiple Sclerosis (MS).

 

They recruited MS patients and randomly assigned them to receive either mindfulness training or psychoeducation. Mindfulness training consisted of 8 weekly 2.5-hour sessions of a modified Mindfulness-Based Stress Reduction (MBSR) program that included meditation, body scan, and yoga practices. It was modified with Sensorimotor psychotherapy that “emphasizes the use of somatic resources to attain and sustain a mindful disposition and integrates the concept of a stress response with the concept of a “window of tolerance.”  Psychoeducation occurred on a similar schedule and involved education on MS, stretching, and relaxation. Prior to and after the interventions and 6-months later the patients were measured for depression, anxiety, perceived stress, fatigue, illness perception, Functionality with MS, and neuropsychiatric symptoms.

 

They found that both mindfulness and psychoeducation programs produced significant decreases in depression, anxiety, and perceived stress, but the mindfulness treatment was significantly better at reducing depression (52% vs. 23% reductions in depression respectively). In addition, only mindfulness training produced a significant improvement in quality of life in the patients including improvements in contentment and thinking and fatigue. All of these effects were maintained and still significant at the 6-month follow-up, demonstrating that the interventions produced lasting positive effects.

 

These are interesting and important results that suggest the mindfulness training is a safe and effective treatment for the psychological suffering accompanying Multiple Sclerosis (MS), reducing anxiety, perceived stress and especially depression and improving the patients’ quality of life. Importantly, these effects endured for at least a half a year. The fact that the study contained an active control condition (psychoeducation) further strengthens the conclusions. Mindfulness training has been previously shown to reduce anxiety, perceived stress, and depression in a wide variety of healthy and sick individuals. So, it’s effectiveness with MS patients is not a surprise. But, it is important to make sure that any treatment is effective with each specific target group, and this study demonstrates that it is with MS patients.

 

So, improve multiple sclerosis’ psychological symptoms with mindfulness.

 

“MS is an unpredictable disease, People can go for months feeling great and then have an attack that may reduce their ability to work or take care of their family. Mindfulness training can help those with MS better to cope with these changes. Increased mindfulness in daily life may also contribute to a more realistic sense of control, as well as a greater appreciation of positive experiences that continue be part of life.” – Paul Grossman

 

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

 

Carletto S, Tesio V, Borghi M, Francone D, Scavelli F, Bertino G, Malucchi S, Bertolotto A, Oliva F, Torta R and Ostacoli L (2017) The Effectiveness of a Body-Affective Mindfulness Intervention for Multiple Sclerosis Patients with Depressive Symptoms: A Randomized Controlled Clinical Trial. Front. Psychol. 8:2083. doi: 10.3389/fpsyg.2017.02083

 

Purpose: Mindfulness interventions have been shown to treat depressive symptoms and improve quality of life in patients with several chronic diseases, including multiple sclerosis, but to date most evaluation of the effectiveness of mindfulness interventions in multiple sclerosis have used patients receiving standard care as the control group. Hence we decided to evaluate the effectiveness of a group-based body-affective mindfulness intervention by comparing it with a psycho-educational intervention, by means of a randomized controlled clinical trial. The outcome variables (i.e., depression, anxiety, perceived stress, illness perception, fatigue and quality of life) were evaluated at the end of the interventions (T1) and after a further 6 months (T2).

Methods: Of 90 multiple sclerosis patients with depressive symptoms (Beck Depression Inventory-II score greater than 13) who were randomized, 71 completed the intervention (mindfulness group n = 36; psycho-educational group n = 35). The data were analyzed with GLM repeated-measures ANOVA followed by pairwise comparisons.

Results: Per-protocol analysis revealed a time by group interaction on Beck Depression Inventory-II score, with the mindfulness intervention producing a greater reduction in score than the psycho-educational intervention, both at T1 and at T2. Furthermore, the mindfulness intervention improved patients’ quality of life and illness perception at T1 relative to the baseline and these improvements were maintained at the follow-up assessment (T2). Lastly, both interventions were similarly effective in reducing anxiety and perceived stress; these reductions were maintained at T2. A whole-sample intention-to-treat (ITT) analysis broadly confirmed the effectiveness of the mindfulness intervention.

Conclusion: In conclusion, these results provide methodologically robust evidence that in multiple sclerosis patients with depressive symptoms mindfulness interventions improve symptoms of depression and anxiety and perceived stress, modulate illness representation and enhance quality of life and that the benefits are maintained for at least 6 months.

https://www.frontiersin.org/articles/10.3389/fpsyg.2017.02083/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_485496_69_Psycho_20171214_arts_A

A Pilot Study of Mindfulness Training for the Cognitive and Psychological Symptoms with Multiple Sclerosis

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A Pilot Study of Mindfulness Training for the Cognitive and Psychological Symptoms with Multiple Sclerosis

 

By John M. de Castro, Ph.D.

 

“Mindfulness practice appears to be a safe, drug-free approach to coping with stress and anxiety, which may in turn help reduce your MS symptoms.” Amit Sood

 

Multiple Sclerosis (MS) is a progressive demyelinating disease which attacks the coating on the neural axons which send messages throughout the body and nervous system. It affects about 2 million people worldwide and about 400,000 in the U.S. It is most commonly diagnosed in people between the ages of 20 and 50 years.  Unfortunately, there is no cure for multiple sclerosis. There are a number of approved medications that are used to treat MS but are designed to lessen frequency of relapses and slow the progression of the disease, but they don’t address individual symptoms.

 

Although there is a progressive deterioration, MS is not fatal with MS patients having about the same life expectancy as the general population. Hence, most MS sufferers have to live with the disease for many years. So, quality of life becomes a major issue. Quality of life with MS is affected by fatigue, physical impairment, depression, and poor sleep quality. In addition, there are marked deficits in cognition in around half of MS patients that include impairments in memory, information processing speed, executive functioning, attention, and verbal fluency. There is a thus a critical need for safe and effective methods to help relieve the symptoms of MS and improve quality of life. Mindfulness has been previously shown to improve depression, sleep quality, cognitive impairments, emotion regulation, and fatigue. It has also been shown to improve the symptoms of multiple sclerosis.

 

In today’s Research News article “The Effectiveness of Mindfulness-Based Stress Reduction on Psychological Distress and Cognitive Functioning in Patients with Multiple Sclerosis: a Pilot Study.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605592/, Blankespoor and colleagues investigated the ability of mindfulness training to relieve the psychological symptoms, including cognitive impairments, with Multiple Sclerosis (MS). In a pilot study, they recruited patients with MS and provided them with an 8-week Mindfulness-Based Stress Reduction (MBSR) program consisting of meditation, body scan, and yoga practice. The participants met in group sessions for 2.5 hours once a week and also performed home practice. The participants were measured before and one week after training for mindfulness, depression, multiple sclerosis quality of life, fatigue, self-compassion, and cognitive ability including tests of memory, visuospatial memory, processing speed, working memory, attention, and executive function.

 

They found that in comparison to baseline measures, after MBSR training the patients showed significant improvements in their psychological states including their physical and emotional quality of life, self-compassion, and mindfulness. Unfortunately, the patients did not show cognitive impairments at baseline. So, it was not surprising that the only cognitive ability that significantly improved was visuospatial processing.

 

Unfortunately, the study was flawed in a number of ways. In particular the lack of a control comparison condition opens the way for a large number of alternative, confounding, explanations for the results. Also, there was a 30% dropout rate which raises the possibility that only those who felt better continued and were measured after treatment. Finally, the lack of baseline impairment in cognitive abilities precluded the assessment of the effectiveness of MBSR to improve these common symptoms of MS. The study needs to be repeated in a Randomized Controlled Clinical Trial (RCT) with procedures implemented to maximize patient retention and with patients who demonstrate cognitive impairment prior to treatment.

 

Patients with Multiple Sclerosis suffer in many ways and it will be important to determine if mindfulness training can reduce the suffering.

 

“Studies in multiple sclerosis, these have shown that mindfulness can improve quality of life and help people cope better with their MS. The studies also found that it decreased stress, anxiety and depression.” – MSTrust

 

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

 

Blankespoor, R. J., Schellekens, M. P. J., Vos, S. H., Speckens, A. E. M., & de Jong, B. A. (2017). The Effectiveness of Mindfulness-Based Stress Reduction on Psychological Distress and Cognitive Functioning in Patients with Multiple Sclerosis: a Pilot Study. Mindfulness, 8(5), 1251–1258. http://doi.org/10.1007/s12671-017-0701-6

 

Abstract

Patients with multiple sclerosis (MS) often suffer from psychological distress and cognitive dysfunctioning. These factors negatively impact the health-related quality of life. Only recently behavioral therapeutic approaches are being used to treat psychological distress in MS. The aim of the present pilot study was not only to investigate the effectiveness of mindfulness-based stress reduction (MBSR) on psychological distress but also to explore whether it can improve cognitive functioning among patients with MS. Outpatients of the MS Center of the Radboud University Medical Center (Radboudumc) were invited to participate in an MBSR training. Psychological and cognitive measures were administered pre- and post-intervention. Twenty-five MS patients completed the MBSR training and psychological measures, of which 16 patients completed the cognitive tests. Significant improvements were found in depressive symptoms, quality of life, fatigue, mindfulness skills, and self-compassion. Of the cognitive tests, performance on a visual spatial processing test significantly improved after the intervention. Overall, this pilot study showed promising results of the effects of MBSR on reducing psychological distress, and it suggests MBSR might improve cognitive functioning in MS patients. Future randomized controlled trials should be conducted to confirm the possible effectiveness of MBSR—and its long-term effects—on psychological and cognitive functioning in MS patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605592/