MBSR

Improve Psychological Health in Pregnancy with Mindfulness

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Improve Psychological Health in Pregnancy with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Not only does cultivating moment-to-moment awareness of thoughts and surroundings seem to help pregnant women keep their stress down and their spirits up—benefits that are well-documented among other groups of people—it may also lead to healthier newborns with fewer developmental problems down the line.” – Kira Newman

 

The perinatal period, from the onset of pregnancy to the end of the infants first year, is a time of intense physiological and psychological change in both the mother and the infant. Anxiety, depression, and fear are quite common during pregnancy. More than 20 percent of pregnant women have an anxiety disorder, depressive symptoms, or both during pregnancy. A debilitating childbirth fear has been estimated to affect about 6% or pregnant women and 13% are sufficiently afraid to postpone pregnancy. It is difficult to deal with these emotions under the best of conditions but in combinations with the stresses of pregnancy can turn what could be a joyous experience of creating a human life into a horrible worrisome, torment.

 

The psychological health of pregnant women has consequences for fetal development, birthing, and consequently, child outcomes. Depression during pregnancy is associated with premature delivery and low birth weight. Childbirth fear is associated with “low childbirth self-efficacy, greater use of pain medication during labor, more unwanted obstetric interventions in labor, as well as increased risk of postpartum depression.” Hence, it is clear that there is a need for methods to treat childbirth fear, depression, and anxiety during pregnancy. Since the fetus can be negatively impacted by drugs, it would be preferable to find a treatment that did not require drugs. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy. So, it would make sense to further study the effects of mindfulness training during the perinatal period.

 

In today’s Research News article “A Comparative Study of Mindfulness Efficiency Based on Islamic-Spiritual Schemes and Group Cognitive Behavioral Therapy on Reduction of Anxiety and Depression in Pregnant Women.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5385237/, Aslami and colleagues recruited Islamic women in their 16th to 32nd week of pregnancy and based upon pretesting of anxiety and depression selected two groups; a high anxiety and a high depression group. The groups were then randomly divided into a no-treatment control condition, a 12-week Cognitive Behavioral Therapy (CBT) condition or an 8-week Mindfulness-Based Stress Reduction (MBSR) condition. Traditional MBSR consists of training and practice in meditation, yoga, and body scan. The researchers modified the training protocol to include Islamic spiritual teachings. The CBT and MBSR conditions were assigned home practice for 45 minutes per day for 6 days per week. The participants were measured for anxiety and depression before and after treatment.

 

They found that both the Cognitive Behavioral Therapy (CBT) and Mindfulness-Based Stress Reduction (MBSR) conditions produced significant decreases in both anxiety and depression while the no-treatment control group did not. In addition, the MBSR condition produced significantly greater reductions than the CBT condition. In fact, MBSR produced a very large reduction, on average, of 79% in anxiety and 81% in depression while CBT produced, on average, only a 45% reduction in anxiety and a 43% reduction in depression. Hence, although CBT was effective, MBSR produced far greater improvements in the pregnant women’s psychological states.

 

These are excellent results. It has been well established that mindfulness training produces significant reductions in anxiety and depression in a wide variety of people with a variety of conditions. But, this trial compared its effectiveness to another known effective treatment, Cognitive Behavioral Therapy (CBT) and found MBSR to be far superior. I am not aware of any other direct comparisons of the two forms of therapy. It is not known, however, if the inclusion of Islamic spiritual teachings added to MBSR’s effectiveness in this group of Islamic women. Regardless, it is clear the MBSR training is highly effective in reducing anxiety and depression in pregnant women. This should be of great assistance in making for a smooth remainder of the pregnancy and delivery and may well produce better outcomes with the infant.

 

So, improve psychological health in pregnancy with mindfulness.

 

“There could not be a better time to learn mindfulness than during pregnancy and early motherhood. For one thing, this is a time when most people have a strong motivation to become the best person they can be in a relatively short period of time. When you realize the full enormity of the responsibility you have taken on by becoming a mom, the primary source of care for another whole human being, not to mention one that you love more than you thought you could ever love, there is a really high level of motivation to try your best to get yourself into the best mental and emotional shape possible.” – Cassandra Vieten

 

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

 

Aslami, E., Alipour, A., Najib, F. S., & Aghayosefi, A. (2017). A Comparative Study of Mindfulness Efficiency Based on Islamic-Spiritual Schemes and Group Cognitive Behavioral Therapy on Reduction of Anxiety and Depression in Pregnant Women . International Journal of Community Based Nursing and Midwifery, 5(2), 144–152.

 

Abstract

Background:

Anxiety and depression during the pregnancy period are among the factors affecting the pregnancy undesirable outcomes and delivery. One way of controlling anxiety and depression is mindfulness and cognitive behavioral therapy. The purpose of this study was to compare the efficiency of mindfulness based on the Islamic-spiritual schemas and group cognitive behavioral therapy on reduction of anxiety and depression in pregnant women.

Methods:

The research design was semi-experimental in the form of pretest-posttest using a control group. Among the pregnant women in the 16th to 32nd weeks of pregnancy who referred to the health center, 30 pregnant women with high anxiety level and 30 pregnant women with high depression participated in the research. Randomly 15 participants with high depression and 15 participants with high anxiety were considered in the intervention group under the treatment of mindfulness based on Islamic-spiritual schemes. In addition, 15 participants with high scores regarding depression and 15 with high scores in anxiety were considered in the other group. The control group consisted of 15 pregnant women with high anxiety and depression. Beck anxiety-depression questionnaire was used in two steps of pre-test and post-test. Data were analyzed using SPSS, version 20, and P≤0.05 was considered as significant.

Results:

The results of multivariate analysis of variance test and tracking Tukey test showed that there was a significant difference between the mean scores of anxiety and depression in the two groups of mindfulness based on spiritual- Islamic scheme (P<0.001) and the group of cognitive behavioral therapy with each other (P<0.001) and with the control group(P<0.001). The mean of anxiety and depression scores decreased in the intervention group, but it increased in the control group.

Conclusion:

Both therapy methods were effective in reduction of anxiety and depression of pregnant women, but the effect of mindfulness based on spiritual- Islamic schemes was more.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5385237/

Improve Caregiver and Cirrhosis Patient Psychological Health with Mindfulness

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Improve Caregiver and Cirrhosis Patient Psychological Health with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness practices also help people observe their thoughts and behaviors with less reactivity and judgment, which could enable caregivers to better respond to the emotional and physical difficulties they encounter.” – Emily Nauman

 

There is a tremendous demand for caregiving in the US. It is estimated that over 65 million (29% of the adult population) provides care to someone who is mentally or physically ill, disabled or aged, averaging 20 hours per week spent caring for their loved ones. This caregiving comes at a cost to the caregiver. It exacts a tremendous toll on caregivers’ health and well-being. Caregiving has been associated with increased levels of depression and anxiety as well as higher use of psychoactive medications, poorer self-reported physical health, compromised immune function, and increased mortality.

 

Liver disease affects about 3.9 million people and Cirrhosis kills nearly 40,000 people each year. Providing care for an individual with end stage liver disease has not been seriously studied. The challenges of caring for an individual with cirrhosis require that the individual be able to deal with stress, to regulate their own emotions, and to be sensitive and attentive. These skills are exactly those that are developed in mindfulness training. It improves the psychological and physiological responses to stress. It improves emotion regulation. And it improves the ability to maintain attention and focus in the face of high levels of distraction. So, it is not surprising that mindfulness improves caregiving and assists the caregiver in coping with the stress.

 

In today’s Research News article “Mindfulness-Based Stress Reduction Therapy Improves Patient and Caregiver-Reported Outcomes in Cirrhosis.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5539344/, Bajaj and colleagues recruited patients with cirrhosis and their caregivers. The majority of the caregivers were women and spouses. They measured the patients before and after treatment for depression, anxiety, sleep quality, sleepiness, health related quality of life, and sickness impact. Caregivers were also measured for depression, anxiety, sleep quality, caregiving burden and perceived caregiver burden. Both patients and their caregivers received a 4-week program of modified structured Mindfulness-Based Stress Reduction (MBSR) along with discussions of barriers and strategies to deal with stress. The program included training in Qigong (gentle movements), body scan, progressive relaxation, and loving kindness meditation. Patients and caregivers were encouraged to practice these skills at home.

 

They found that following treatment the patients showed significant improvements in depression, sleep quality, and health related quality of life. In addition, they found that after treatment the caregivers had significant improvements in depression, sleep quality, caregiving burden and perceived caregiver burden. Mindfulness training has been shown to reduce depression, improve sleep and health related quality of life, and caregiving in a wide variety of healthy and ill individuals. So, it is not surprising that the modified MBSR program produced similar significant benefits for both the cirrhosis patients and their caregivers. It is encouraging that a relatively brief (4 week) program can have such positive benefits.

 

The study did not have a control condition. So, unequivocal conclusions cannot be reached. But, the results are sufficiently encouraging to justify the implementation of a large scale randomized controlled clinical trial including an active control condition of the effectiveness of MBSR training for cirrhosis patients and their caregivers.

 

So, improve caregiver and cirrhosis patient psychological health with mindfulness.

 

“When it comes to embracing mindfulness as a caregiver, start with asking yourself questions. How can you look at ways to reduce stress so you don’t take on the entire thing as your job and you have to do everything? When you’re more intentional, you can look at what is truly needed in this picture to help the care recipient and ask who might be supportive besides yourself and how can you involve other resources?” – Nancy Kriseman

 

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

 

Bajaj, J. S., Ellwood, M., Ainger, T., Burroughs, T., Fagan, A., Gavis, E. A., … Wade, J. B. (2017). Mindfulness-Based Stress Reduction Therapy Improves Patient and Caregiver-Reported Outcomes in Cirrhosis. Clinical and Translational Gastroenterology, 8(7), e108–. http://doi.org/10.1038/ctg.2017.38

 

Abstract

Objectives:

Patient-reported outcomes such as health-related quality of life (HRQOL) are impaired in cirrhosis due to under-treated mood and sleep disorders, which can adversely impact their caregivers. Mindfulness-based stress reduction (MBSR) can improve patient-reported outcomes (PRO) in non-cirrhotic patients but their impact in cirrhosis is unclear. To evaluate the effect of MBSR and supportive group therapy on mood, sleep and HRQOL in cirrhotic patients and their caregivers.

Methods:

Cirrhotic outpatients with mild depression (Beck Depression Inventory (BDI)>14) on screening with an adult caregiver were enrolled. At baseline, BDI, sleep (Pittsburgh sleep quality index PSQI, Epworth Sleepiness Scale, ESS), anxiety (Beck Anxiety inventory) and HRQOL (Sickness Impact Profile, SIP) for both patients/caregivers and caregiver burden (Zarit Burden Interview Short-form, ZBI-SF and perceived caregiver burden, PCB) and patient covert HE(CHE) status were measured. Patients who had BDI>14 at baseline, along with their caregivers then underwent a structured MBSR program with four weekly hour-long group sessions interspersed with home practice using CDs. After the last group, all questionnaires were repeated.

Results:

20 patient/caregiver dyads were included. All patients were men (60±8 years MELD 12.9±5.7, 14 prior hepatic encephalopathy (HE)) while most caregivers (n=15) were women (55±12 years, 23±14 years of relationship, 65% spouses). There was no change in patient BDI between screening and baseline (20.1±11.2 vs. 19.0±10.6, P=0.81). All dyads were able to complete the four MBSR+supportive group therapy sessions. There was a significant improvement in BDI (19.0±10.6 vs.15.6±8.2 P=0.01), PSQI (7.2±3.7 vs. 5.5±3.7, P<0.001) and overall HRQOL (25.0±13.2 vs. 17.7±14.0,P=0.01) but not in anxiety or CHE rates in patients. Similarly caregiver burden (ZBI-SF13.0±9.0 vs. 9.8±6.9,P=0.04, Perceived burden 72.1±29.9 vs. 63.0±14.5,P=0.05) and depression reduced (BDI 9.1±7.8 vs. 5.9±6.0,P=0.03) while caregiver sleep quality (7.2±3.7 vs. 5.5±3.7,P<0.001) improved. Prior HE did not affect PRO change after MBSR+supportive groups but the ZBI-SF of caregivers taking care of HE patients improved to a greater extent (delta −1.1±6.5 vs. 7.4±5.3 HE, P=0.04).

Conclusion:

A short program of mindfulness and supportive group therapy significantly improves PRO and caregiver burden in cirrhotic patients with depression. This non-pharmacological method could be a promising approach to alleviate psychosocial stress in patients with end-stage liver disease and their caregivers.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5539344/

Add Home Practice to Mindfulness Training for Maximum Benefit

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Add Home Practice to Mindfulness Training for Maximum Benefit

 

By John M. de Castro, Ph.D.

 

“This is the clearest evidence we have that mindfulness-home practice can make a difference. This is a big source of debate because there are many components at play in a MBSR or MBCT course.“ – Christine Parsons

 

Mindfulness practices have been demonstrated to produce significant benefits for the practitioners’ health and well-being. Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) are specified practices that have proven track records over many years of effectiveness. They are both complex containing discussions, meditation, body scans, and yoga practices. Each is an 8-week program with participants only meeting for instruction once a week. They both rely on the participants practicing the techniques at home daily. There is, however, very little information regarding compliance with the home practice, to what extent do the participants fully comply with the instructions to practice at home, and what effects that may have on the effectiveness of the programs.

 

In today’s Research News article “Home practice in Mindfulness-Based Cognitive Therapy and Mindfulness-Based Stress Reduction: A systematic review and meta-analysis of participants’ mindfulness practice and its association with outcomes.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501725/, Parsons and colleagues review, summarize, and perform a meta-analysis of adherence to home practice requirements during 8 weeks of mindfulness training. They found 49 research articles employing Mindfulness-Based Stress Reduction (MBSR) or Mindfulness-Based Cognitive Therapy (MBCT) which required home practice.

 

They found that the studies reported that participants performed about 64% of the required home practice. That translated into an average of 29 minutes per day of the required 45 minutes. This level of compliance was found to be true regardless of whether clinical or non-clinical samples were used, or whether the primary outcomes were psychological or physical, or between MBSR or MBCT programs. They also found that there was a small, albeit significant, relationship between the amount of home practice and the magnitude of the benefits from the treatment, such that the greater the amount of home practice, the greater the benefit.

 

Hence, the published research literature suggests that participants in both MBSR and MBCT programs perform on average about 2/3rds of the required home practice and that the better the compliance with the home practice requirement the better the outcomes. This is actually surprising good levels of compliance. Unfortunately, most of the studies used self-reports of home practice and the participants may have felt compelled to report better compliance than what they actually did. Nevertheless, the research suggests that home practice is a beneficial component of the practices. It is possible that this is true because it brings the practice into the everyday environment of the participants, away from the artificiality of the clinic. This may help to more readily transfer what is learned from the clinic to the real world and thereby heighten the impact of the practices.

 

So, add home practice to mindfulness training for maximum benefit.

 

“home practice helps generate meaningful change in dispositional mindfulness, which is purportedly a key mechanism of action in mindfulness-based interventions.” – Dawn Epstein

 

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

 

Parsons, C. E., Crane, C., Parsons, L. J., Fjorback, L. O., & Kuyken, W. (2017). Home practice in Mindfulness-Based Cognitive Therapy and Mindfulness-Based Stress Reduction: A systematic review and meta-analysis of participants’ mindfulness practice and its association with outcomes. Behaviour Research and Therapy, 95, 29–41. http://doi.org/10.1016/j.brat.2017.05.004

 

Abstract

Mindfulness-Based Cognitive Therapy (MBCT) and Mindfulness-Based Stress Reduction (MBSR) emphasize the importance of mindfulness practice at home as an integral part of the program. However, the extent to which participants complete their assigned practice is not yet clear, nor is it clear whether this practice is associated with positive outcomes.

For this systematic review and meta-analysis, searches were performed using Scopus and PubMed for studies published through to the end of 2015, reporting on formal home practice of mindfulness by MBSR or MBCT participants.

Across 43 studies (N = 1427), the pooled estimate for participants’ home practice was 64% of the assigned amount, equating to about 30 minutes per day, six days per week [95% CI 60–69%]. There was substantial heterogeneity associated with this estimate. Across 28 studies (N = 898), there was a small but significant association between participants’ self-reported home practice and intervention outcomes (r = 0·26, 95% CI 0·19,–0·34).

MBSR and MBCT participants report completing substantial formal mindfulness practice at home over the eight-week intervention, albeit less than assigned amounts. There is a small but significant association between the extent of formal practice and positive intervention outcomes for a wide range of participants.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501725/

Mindfulness Training Benefits Neurotic Individuals the Most

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Mindfulness Training Benefits Neurotic Individuals the Most

 

By John M. de Castro, Ph.D.

 

“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

 

We know that people differ in how they interact with the environment and other people. We call these differences personality. Personality characteristics are thought to be relatively permanent traits that form an individual’s distinctive character. Different personalities predict different behaviors and different responses to the environment. This suggests that different personality types might respond differently to mindfulness training.

 

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.

 

It has been shown that people high in mindfulness are also high in the “Big 5” traits of Conscientiousness, and Neuroticism.  It is possible that people high in these traits are more susceptible to the effects of mindfulness training. In today’s Research News article “For Whom Does Mindfulness-Based Stress Reduction Work? Moderating Effects of Personality.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506177/, Nyklíček, I., & Irrmischer examine whether the effectiveness of mindfulness training is affected by the individual’s personality. They recruited adults and provided them with Mindfulness-Based Stress Reduction (MBSR) program. MBSR consists of meditation, yoga and body scan and training occurs over 8 weeks in 2.5-hour weekly sessions with daily homework assignments. Before training their personality was measured and before and after training and 3-months later, they were measured for anxiety and depression.

 

They found that as has been previously demonstrated MBSR resulted in substantial significant reductions in anxiety and depression after training and these mood states continued to improve and were even lower 3 months later. They then tested for mediation effects to determine if personality characteristics affected the MBSR reductions in anxiety and depression. They found that the personality characteristic of neuroticism accentuated the effect such that the higher the levels of neuroticism the greater the reductions in anxiety and depression produced by MBSR. This mediation effect, however, was in part due to the fact that high neuroticism was related to higher depression and anxiety. When they controlled for the levels of depression and anxiety present when the study began, the mediation effect for depression was no longer significant while neuroticism continued to mediate the effect of MBSR on anxiety.

 

So, they found that MBSR training produces a long-lasting reduction in anxiety and depression. The effect of MBSR on depression occurs equally regardless of personality characteristics. On the other hand, MBSR training reduces anxiety to a greater extent in people high in neuroticism. By focusing attention more on the present moment, MBSR training reduces the past orientation that energizes depression and the future orientation that fuels anxiety. It appears to have its effect on anxiety magnified in highly neurotic people. Neuroticism involves a tendency to perceive even minor things as threatening. Focusing on the present moment interrupts seeing future threat and thereby may make the neuroticism less impactful.

 

So, mindfulness training benefits neurotic individuals the most.

 

“By the posture, by the action,
By eating, seeing, and so on,
By the kind of states occurring,
May temperament be recognized.” – Path of Purification

 

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

 

Nyklíček, I., & Irrmischer, M. (2017). For Whom Does Mindfulness-Based Stress Reduction Work? Moderating Effects of Personality. Mindfulness, 8(4), 1106–1116. http://doi.org/10.1007/s12671-017-0687-0

 

Abstract

The aim of the present study was to examine potentially moderating effects of personality characteristics regarding changes in anxious and depressed mood associated with Mindfulness-Based Stress Reduction (MBSR), controlling for socio-demographic factors. Meditation-naïve participants from the general population self-presenting with psychological stress complaints (n = 167 participants, 70% women, mean age 45.8 ± 9.3 years) were assessed in a longitudinal investigation of change in mood before and after the intervention and at a 3-month follow-up. Participants initially scoring high on neuroticism showed stronger decreases in both anxious and depressed mood (both p < 0.001). However, when controlled for baseline mood, only the time by neuroticism interaction effect on anxiety remained significant (p = 0.001), reflecting a smaller decrease in anxiety between pre- and post-intervention but a larger decrease in anxiety between post-intervention and follow-up in those with higher baseline neuroticism scores. Most personality factors did not show moderating effects, when controlled for baseline mood. Only neuroticism showed to be associated with delayed benefit. Results are discussed in the context of findings from similar research using more traditional cognitive-behavioral interventions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506177/

Improve Cognition after Cancer Recovery with Mindfulness

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Improve Cognition after Cancer Recovery with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness meditation practices enable cancer survivors to better manage cancer-related cognitive impairment. MBSR provides a creative solution for survivors whose social and occupational functioning may have been negatively impacted by cognitive difficulties.” – Shelly Johns

 

Cognitive impairments are a frequent side effect of cancer treatment. This has been dubbed “chemo brain.” Patients often refer to it as a mental cloudiness. The patients report problems including forgetting things, trouble concentrating, trouble remembering details like names and dates, trouble multi-tasking, like answering the phone while cooking, taking longer to finish things, disorganized and slower thinking, and trouble remembering common words. These cognitive impairments generally produce problems with work and even social relationships such that patients tend to isolate themselves. They can also produce treatment problems as the patients often forget to take their medications.

 

These problems result from the fact that chemotherapy, radiation therapy and many cancer drugs directly affect the nervous system. At present, there are no known treatments for these cognitive impairment side effects of chemotherapy. Contemplative practices have been shown to affect memory and have positive effects on cancer treatment and recovery.  There is some evidence that contemplative practices may be useful for the alleviation of “chemo brain” symptoms. So, it makes sense to further study the ability of mindfulness training to improve the cancer patient’s cognitive abilities.

 

In today’s Research News article “Randomized controlled pilot trial of mindfulness-based stress reduction for breast and colorectal cancer survivors: effects on cancer-related cognitive impairment.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4864185/, Johns and colleagues recruited breast cancer and colorectal cancer survivors with moderate fatigue and randomly assigned them to receive either an 8-week, once a week for 2 hours, fatigue education and support or a program of Mindfulness-Based Stress Reduction (MBSR) with home practice. MBSR contains meditation, yoga, and body scan practices. The participants were measured before and after the 8-week treatment period and 6 months later for attentional function, mindfulness, and cognitive executive function with the Stroop Test.

 

They found that compared to baseline and the fatigue education group, the participants in the MBSR program demonstrated significant improvement in attentional function, including greater effective attentional actions and fewer attentional lapses. Further mediational analysis revealed that MBSR acted by increasing the ability to act with awareness which in turn increased attentional function. In addition, the MBSR group had significantly fewer errors on the Stroop Test indicating better cognitive function.  Importantly, the benefits of the MBSR program were not only significant at the end of training but also 6 months later.

 

These are interesting and potentially important results. The “Chemo Brain” resulting from cancer treatments produces significant degradation in the patient’s cognitive abilities. The results suggest that a Mindfulness-Based Stress Reduction (MBSR) program can significantly produce lasting improvements in these degraded attentional abilities and thinking. MBSR appears to work, at least in part, by increasing the patient’s ability to act with awareness, thereby decreasing distractions and intrusions of off-topic thoughts. Cancer patients have suffered terribly from their disease and the treatments for the disease. It is heartening that a mindfulness practice can be so beneficial in relieving at least residual symptoms of “Chemo Brain.”

 

So, improve cognition after cancer recovery with mindfulness.

 

“Participation in a mindfulness-based stress reduction program yields robust and sustained improvement in cancer-related cognitive impairment, a prevalent and potentially debilitating condition that affects attention, memory and executive function in survivors” – CancerCommons

 

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

 

Johns, S. A., Von Ah, D., Brown, L. F., Beck-Coon, K., Talib, T. L., Alyea, J. M., … Giesler, R. B. (2016). Randomized controlled pilot trial of mindfulness-based stress reduction for breast and colorectal cancer survivors: effects on cancer-related cognitive impairment. Journal of Cancer Survivorship : Research and Practice, 10(3), 437–448. http://doi.org/10.1007/s11764-015-0494-3

 

Abstract

Purpose

Cancer-related cognitive impairment (CRCI) is a common, fatigue-related symptom that disrupts cancer survivors’ quality of life. Few interventions for CRCI exist. As part of a randomized pilot study targeting cancer-related fatigue, the effects of mindfulness-based stress reduction (MBSR) on survivors’ cognitive outcomes were investigated.

Methods

Breast and colorectal cancer survivors (n=71) with moderate-to-severe fatigue were randomized to MBSR (n=35) or a fatigue education and support (ES; n=36) condition. The Attentional Function Index (AFI) and the Stroop test were used to assess survivors’ cognitive function at baseline (T1), after the 8-week intervention period (T2), and 6 months later (T3) using intent-to-treat analysis. Mediation analyses were performed to explore mechanisms of intervention effects on cognitive functioning.

Results

MBSR participants reported significantly greater improvement on the AFI total score compared to ES participants at T2 (d=0.83, p=0.001) and T3 (d=0.55, p=0.021). MBSR also significantly outperformed ES on most AFI subscales, although both groups improved over time. MBSR produced greater Stroop accuracy rates relative to ES at T2 (r=0.340, p=0.005) and T3 (r=0.280, p=0.030), with improved accuracy over time only for the MBSR group. There were no significant differences in Stroop reaction time between groups. Improvements in mindfulness mediated the effect of group (e.g., MBSR vs. ES) on AFI total score at T2 and T3.

Conclusions

Additional randomized trials with more comprehensive cognitive measures are warranted to definitively assess the efficacy of MBSR for CRCI.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4864185/

Reduce Negative Emotions and Stress Sensitivity with Mindfulness

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Reduce Negative Emotions and Stress Sensitivity with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness training teaches people to be fully attentive to their present experience in a nonjudgmental way, which is believed to help reduce the rumination common to mood disorders. A mindful perspective teaches people how to apply a brake between a single lonely thought and what could be a resulting chain of distressing thoughts and feelings,” – J. David Creswell

 

Mindfulness training has been shown to improve the psychological well-being of healthy people. It also has been shown to be beneficial for a variety of mental health problems, including anxiety, depression, Antisocial Personality Disorder, Borderline personality disorder, impulsivity, obsessive compulsive disorder, phobias, post-traumatic stress disorder, sexual dysfunction, suicidality and even with psychosis.  Mindfulness is thought to work in part by improving the physiological and psychological responses to stress. This increases the individual’s ability to withstand the negative effects of stress on emotions and to cope with it adaptively. It also appears to work by improving emotion regulation. This improves the individual’s ability to fully sense and experience emotions, but respond to them in more appropriate and adaptive ways. In other words, mindful people are better able to cope with stress and experience yet control emotions.

 

These is a very important consequence of mindfulness. Humans are very emotional creatures and emotions can be very pleasant, providing the spice of life. But, when they get extreme they can produce misery and even mental illness. Humans, particularly in the developed world, are also embedded in a high stress environment that can damage their health and well-being. So, it is important to understand, in depth, how mindfulness training may reduce responses to stress and improve the responses to emotions. It would also be useful to learn how these factors change over the course of treatment.

 

In today’s Research News article “The Shape of Change in Perceived Stress, Negative Affect, and Stress Sensitivity During Mindfulness-Based Stress Reduction.” (See summary below). Snoppe and colleagues recruited people who had enrolled in a Mindfulness-Based Stress Reduction (MBSR) program that met once a week for 2.5 hours for eight weeks and consisted of body scan, meditation, and yoga practice. Participants were also request to practice at home for 40 minutes each day. The participants completed pretraining measures and daily on-line diaries during the 8-weeks of the program which included measures of perceived stress, mindfulness practice, and negative emotions including depression, tension, anger, and fatigue.

 

They found that over the 8 weeks of the program negative emotions and perceived stress decreased in a linear fashion, improving day by day. They also found that the lower the daily levels of perceived stress, the lower the levels of negative emotions. In addition, they found that the degree of association between stress and negative emotions did not change over the 8 weeks. So, mindfulness training appeared to reduce their levels but did not decouple their mutual influences. Hence, day by day of mindfulness practice produces a progressive reduction in perceived stress and negative emotions.

 

It has been well established that mindfulness programs like MBSR are effective in reducing the physiological and psychological responses to stress and negative emotions such as depression, anxiety, anger, and fatigue. What is new in the present study is the documentation of the linear growth in these benefits. Each day of practice appeared to produce increased benefit. It would be interesting to follow this growth over a longer period of time to determine at what point do the benefits stabilize. But for now, it appears that the more practice the better.

 

So, reduce negative emotions and stress sensitivity with mindfulness.

 

“Instead of ‘turning away’ from pain in avoidance we can learn to gently ‘turn towards’ what we’re experiencing. We can bring a caring open attention towards the wounded parts of ourselves and make wise choices about how to respond to ourselves and to life. It’s a paradox that we all must understand: It is by turning towards negative emotions that we find relief from them – not by turning away.” – 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

 

Snippe, E., Dziak, J.J., Lanza, S.T., Nyklíček, I., Wichers, M.  The Shape of Change in Perceived Stress, Negative Affect, and Stress Sensitivity During Mindfulness-Based Stress Reduction. Mindfulness (2017) 8: 728. doi:10.1007/s12671-016-0650-5

 

Abstract

Both daily stress and the tendency to react to stress with heightened levels of negative affect (i.e., stress sensitivity) are important vulnerability factors for adverse mental health outcomes. Mindfulness-based stress reduction (MBSR) may help to reduce perceived daily stress and stress sensitivity. The purpose of this study was to examine how change in perceived stress, negative affect (NA), and the decoupling between perceived stress and NA evolved over the course of a MBSR program, without making any a priori assumptions on the shape of change. Seventy-one adults from the general population participating in MBSR provided daily diary assessments of perceived stress and NA during MBSR. The time-varying effect model (TVEM) indicated that perceived stress and NA decreased in a linear fashion rather than in a nonlinear fashion, both as a function of time and as a function of the cumulative number of days of mindfulness practice. Both TVEM and multilevel growth modeling showed that the association between perceived stress and NA did not decrease over the course of MBSR. The findings support the hypothesis that MBSR reduces NA and also reduces the extent to which individuals perceive their days as stressful. Also, the results suggest that there is a dose-response relationship between the amount of mindfulness practice and reductions in daily stress and NA.

Improve Well-Being in the Workplace with Mindfulness

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Improve Well-Being in the Workplace with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Toxic emotions disrupt the workplace, and mindfulness increases your awareness of these destructive patterns, helping you recognize them before they run rampant. It’s a way of reprogramming your mind to think in healthier, less stressful, ways.” – Drew Hansen

 

Work is very important for our health and well-being. We spend approximately 25% of our adult lives at work. How we spend that time is immensely important for our psychological and physical health. Indeed, the work environment has even become an important part of our social lives, with friendships and leisure time activities often attached to the work environment. But, more than half of employees in the U.S. and nearly 2/3 worldwide are unhappy at work. This is partially due to work-related stress which is epidemic in the western workplace. Almost two thirds of workers reporting high levels of stress at work. This stress can result in impaired health and can result in burnout; producing fatigue, cynicism, and professional inefficacy.

 

To help overcome unhappiness, stress, and burnout, mindfulness practices have been implemented in the workplace. Indeed, mindfulness practices have been shown to markedly reduce the physiological and psychological responses to stress. As a result, it has become very trendy for business to incorporate meditation into the workday to help improve employee well-being, health, and productivity. For example, Google offers “Search Inside Yourself” classes to teach mindfulness at work. But, although there is a lot of anecdotal evidence of meditation improving well-being and work performance, there is actually very little systematic research on its effectiveness.

 

In today’s Research News article “Acceptability, Feasibility, and Efficacy of a Workplace Mindfulness Program for Public Sector Employees: a Pilot Randomized Controlled Trial with Informant Reports.” (See summary below). Bartlett and colleagues performed a pilot study of mindfulness training effects on well-being in the workplace. They recruited adults employed in the public sector and assigned them to either receive a 5-week, 1.5 hours per week, mindfulness training, based upon Mindfulness-Based Stress Reduction (MBSR) program, tailored for the workplace, or self-help education program regarding workplace issues including coping with stress. The participants completed before and after training measures of mindfulness, observable mindfulness behaviors, perceived stress, psychological distress, health-related quality of life, sleep quality, job stressors, absenteeism and presenteeism, social functioning, and job demands and security.

 

They found that the mindfulness trained group had significant improvements, with moderate effect sizes, in mindfulness, perceived stress, psychological distress, health-related quality of life, and social functioning. They also reported significantly less absenteeism, presenteeism, and lost productive days. An analysis of the participants’ reports regarding their participation revealed that the mindfulness training produced improvements in relationships, attention, productivity, stress, emotional regulation, and vigor. Mediation analysis indicated that mindfulness mediated, wholly or in part, the effects of the training on well-being.

 

The results are impressive for a pilot study that did not have a large group of participants. Of course, a larger randomized controlled trial with an active control group is needed to conclusively demonstrate the benefits of mindfulness training. But, the results suggest that mindfulness training produces marked improvement in public sector employee physical and psychological well-being. Although, not measured, the results suggest that the mindfulness training would reduce workplace burnout and improve health and productivity.

 

So, improve well-being in the workplace with mindfulness.

 

“Mindful awareness is an extremely important business skill. It creates a solid foundation for all other Human Resources and Learning and Development initiatives, from sales training to leadership development. By first teaching teams to manage their attention, all other training is maximised. It’s a win-win for both employee and employer.” – Smiling Mind

 

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

 

Bartlett, L., Lovell, P., Otahal, P., Sanderson, K. Acceptability, Feasibility, and Efficacy of a Workplace Mindfulness Program for Public Sector Employees: a Pilot Randomized Controlled Trial with Informant Reports. Mindfulness (2017) 8: 639. doi:10.1007/s12671-016-0643-4

 

Abstract

Mindfulness training appears to reduce stress and distress, but little is known about whether it results in changes that can be observed by colleagues, family, or friends or its appropriateness as a workplace stress management intervention for a large and distributed public sector workforce. This study evaluated a pilot 5-week Mindfulness at Work Program (MaWP) for acceptability, feasibility, and efficacy in relation to stress and related mental health and productivity problems for public sector employees. A parallel group randomized controlled trial compared the MaWP intervention (n = 20) with an information-only control (n = 100). Exploratory qualitative and quantitative methods were used to assess changes observed by informants (n = 63). Results suggest a high degree of acceptability, although location and inflexible work schedules presented feasibility obstacles. Compared with the control, the primary outcome of mindfulness improved for MaWP participants (d = 0.57, p < 0.001), as did perceived stress (d = 0.97, p < 0.001), psychological distress (d = 0.61, p < 0.001), health-related quality of life (d = 0.51, p = 0.002), and social functioning (d = 0.08, p = 0.019). All secondary outcomes were at least partly mediated by changes in mindfulness. The intervention thus appears to have potential merit as a workplace intervention for public sector employees across a range of outcomes. Obtaining informant observations was feasible and while qualitative analyses indicated positive changes that supported self-reported outcomes, quantitative analyses returned ambiguous results. A seven-item scale adapted from a popular self-report mindfulness scale for use by informants showed promise, but further work is needed to establish validity, reliability, and scalability of this method of assessing observable changes following mindfulness training.

Teacher Training Improves the Effectiveness of Mindfulness Training

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Teacher Training Improves the Effectiveness of Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“Ultimately, it is the depth of your own personal commitment to learning, growing and healing – as well as a dedication to the well-being of others – that will contribute most to your integrity and effectiveness as a teacher.” ~Center for Mindfulness, UMass Medical Center

 

“Mindfulness is awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally. It’s about knowing what is on your mind.” (Jon Kabat-Zinn). It has been shown to be highly related to the health and well-being of the individual. Mindfulness training has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. As a result, mindfulness training has been called the third wave of therapies. In fact, though, little is known about the components that maximize the effectiveness of mindfulness training.

 

Mindfulness-Based Stress Reduction (MBSR) is a classic mindfulness training that combines meditation, yoga, and body scan meditation practices. In most cases MBSR is conducted by a certified trained therapist. But, recently, it has been shown to be effective when presented on-line without the presence of an instructor. When MBSR is taught live by a certified instructor is costly and many clients can’t afford it. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules or at locations that may not be convenient. But many believe that that the interpersonal interactions, compassion, understanding, and modelling provided by a teacher is crucial for MBSR effectiveness. So, it is unclear whether the presence of an instructor produces benefits that balance or exceed the added costs.

 

In today’s Research News article “Impact of Mindfulness-Based Teacher Training on MBSR Participant Well-Being Outcomes and Course Satisfaction.” (See summary below). Ruijgrok-Lupton and colleagues examined whether the amount of training that MBSR instructors have received is associated with improved outcomes. They recruited Mindfulness-Based Stress Reduction (MBSR) certified instructors who varied in the amount of training either Basic Teacher Training (Level 1), Advanced Teacher Training (Level 2) or Advanced Teacher Training with Continuing Professional Development (Level 3). They then recruited participants who were attending one of the instructors’ 8-week MBSR classes. They measured the participants before and after the class for mindfulness, self-compassion, well-being, perceived stress, and teacher satisfaction including impact on daily life and teacher support.

 

There were too few teachers in the Level 1 group (n=2), so comparisons were restricted to the Level 2 and Level 3 groups. They found that overall the participants in the MBSR classes not surprisingly showed significant gains in mindfulness and reductions in perceived stress. Importantly, they also found that the participants in the MBSR classes taught by Level 3 teachers had significantly greater gains in well-being and significantly greater reductions in perceived stress than those taught by Level 2 teachers. In addition, the participants in the MBSR classes taught by Level 3 teachers indicated significantly greater satisfaction with their teachers than those taught by Level 2 teachers.

 

The findings suggest that MBSR teachers with advanced teacher training plus continuing professional development produce better results than teachers with advanced teacher training only. The lack of a sufficient number of teachers with only basic teacher training was disappointing since this greatly restricted the range of teacher training levels. But, the fact that only adding continuing professional development to advanced teacher training had significant effects is striking. After all, both groups are highly professionally trained. These results, then, clearly suggest that the greater the training, even of highly trained teachers, of the MBSR teachers the greater their effectiveness. Future research should include more basic level instructors and an on-line comparison condition.

 

But, it’s clear that teacher training improves the effectiveness of mindfulness training.

 

“The teaching of mindfulness is never a matter of merely teaching or operationalizing techniques. Mindfulness is a way of being in a wiser relationship to one’s experience, not one particular mental state to be pursued and attained. Thus, the non-instrumental dimensionality of the work and of the practice of mindfulness is the foundation of effective practice and teaching.” – Jon Kabat-Zinn

 

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

 

Ruijgrok-Lupton, P.E., Crane, R.S. & Dorjee, D. Impact of Mindfulness-Based Teacher Training on MBSR Participant Well-Being Outcomes and Course Satisfaction. Mindfulness (2017). doi:10.1007/s12671-017-0750-x

 

Abstract

Growing interest in mindfulness-based programs (MBPs) has resulted in increased demand for MBP teachers, raising questions around safeguarding teaching standards. Training literature emphasises the need for appropriate training and meditation experience, yet studies into impact of such variables on participant outcomes are scarce, requiring further investigation. This feasibility pilot study hypothesised that participant outcomes would relate to teachers’ mindfulness-based teacher training levels and mindfulness-based teaching and meditation experience. Teachers (n = 9) with different MBP training levels delivering mindfulness-based stress reduction (MBSR) courses to the general public were recruited together with their course participants (n = 31). A teacher survey collected data on their mindfulness-based teacher training, other professional training and relevant experience. Longitudinal evaluations using online questionnaires measured participant mindfulness and well-being before and after MBSR and participant course satisfaction. Course attendees’ gains after the MBSR courses were correlated with teacher training and experience. Gains in well-being and reductions in perceived stress were significantly larger for the participant cohort taught by teachers who had completed an additional year of mindfulness-based teacher training and assessment. No correlation was found between course participants’ outcomes and their teacher’s mindfulness-based teaching and meditation experience. Our results support the hypothesis that higher mindfulness-based teacher training levels are possibly linked to more positive participant outcomes, with implications for training in MBPs. These initial findings highlight the need for further research on mindfulness-based teacher training and course participant outcomes with larger participant samples.

Improve Social Anxiety Disorder with Mindfulness

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Improve Social Anxiety Disorder with Mindfulness

 

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. The client experiences this as feeling like they have a choice about how they will respond to a trigger.” – Jeena Cho 

 

It is a common human phenomenon that being in a social situation can be stressful and anxiety producing. This is particularly true when asked to perform in a social context such as giving a speech. 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.

 

SAD is the most common form of anxiety disorder and it is widespread, occurring in about 7% of the U.S. population and is particularly widespread among young adults. 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 SAD. Although, these therapies can be effective they are costly and because of availability, cost, and inconvenience, are only available to small numbers of sufferers. As a result, there is a growing trend to using group based therapy. 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) contains three mindfulness trainings, meditation, body scan, and yoga, and has been shown to be effective in treating anxiety disorders. So, it would be reasonable to expect that MBSR training would improve the symptoms of Social Anxiety Disorder (SAD) in young adults.

 

In today’s Research News article “Group CBT versus MBSR for Social Anxiety Disorder: A Randomized Controlled Trial.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837056/, Goldin and colleagues compared the efficacy of Group Cognitive Behavioral Therapy (Group-CBT) to Mindfulness-Based Stress Reduction (MBSR) program for the relief of Social Anxiety Disorder (SAD). They recruited through clinician referrals and community listings, patients who were diagnosed with SAD but had not been treated with drugs, CBT or MBSR in the recent past. In Group-CBT 6 patients met once a week for 2.5 hours over 12 weeks while the standard MBSR program was modified to include meetings of 6 patients once a week for 2.5 hours over 12 weeks. They were assigned in consecutive blocks of 6 patients to either Group-CBT, MBSR, or a wait-list control group. They were measured before and after treatment and every 3 months for the next year for social anxiety, emotion regulation, cognitive reappraisal self-efficacy, subtle avoidance, cognitive distortions, mindfulness, attention control, and rumination.

 

They found that compared to the wait-list control patients both Group-CBT and MBSR produced clinically significant improvements in social anxiety, increases in mindfulness, cognitive reappraisal, cognitive reappraisal self-efficacy, and attention control, and decreases in subtle avoidance, cognitive distortions, and rumination. There were no significant differences in the effectiveness of Group-CBT and MBSR and the effects appeared to last for a year afterward. Hence, both forms of therapy were highly effective and long-lasting for patients with Social Anxiety Disorder (SAD), improving emotions and thought processes.

 

It is interesting that the two therapies had such similar effects given that they target different processes. But, the results showed that both therapies equally improved the processes that are targeted by Group-CBT, thought processes, and the processes that are targeted by MBSR,  mindfulness and attention. So, although designed to effect different processes the two therapies produced the same outcomes. Regardless, they were both highly effective in oriducing long-lasting improvements in the conditions of these patients suffering from SAD.

 

So, improve social anxiety disorder with mindfulness.

 

“The power of a mindfulness practice, however, may come in the realization that one can live a meaningful life even with social anxiety. (Participant) 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

 

Goldin, P. R., Morrison, A., Jazaieri, H., Brozovich, F., Heimberg, R., & Gross, J. J. (2016). Group CBT versus MBSR for Social Anxiety Disorder: A Randomized Controlled Trial. Journal of Consulting and Clinical Psychology, 84(5), 427–437. http://doi.org/10.1037/ccp0000092

 

Abstract

Objective

To investigate treatment outcome and mediators of Cognitive-Behavioral Group Therapy (CBGT) vs. Mindfulness-Based Stress Reduction (MBSR) vs. Waitlist (WL) in patients with generalized social anxiety disorder (SAD).

Method

108 unmedicated patients (55.6% female; mean age = 32.7, SD = 8.0; 43.5% Caucasian, 39% Asian, 9.3% Hispanic, 8.3% other) were randomized to CBGT vs. MBSR vs. WL and completed assessments at baseline, post-treatment/WL, and at 1-year follow-up, including the Liebowitz Social Anxiety Scale – Self-Report (primary outcome) as well as measures of treatment-related processes.

Results

Linear mixed model analysis showed that CBGT and MBSR both produced greater improvements on most measures compared to WL. Both treatments yielded similar improvements in social anxiety symptoms, cognitive reappraisal frequency and self-efficacy, cognitive distortions, mindfulness skills, attention focusing and rumination. There were greater decreases in subtle avoidance behaviors following CBGT than MBSR. Mediation analyses revealed that increases in reappraisal frequency, mindfulness skills, attention focusing and attention shifting, and decreases in subtle avoidance behaviors and cognitive distortions mediated the impact of both CBGT and MBSR on social anxiety symptoms. However, increases in reappraisal self-efficacy and decreases in avoidance behaviors mediated the impact of CBGT (vs. MBSR) on social anxiety symptoms.

Conclusions

CBGT and MBSR both appear to be efficacious for SAD. However, their effects may be a result of both shared and unique changes in underlying psychological processes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837056/

Improve Parkinson’s Disease with Mindfulness

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Improve Parkinson’s Disease with Mindfulness

 

By John M. de Castro, Ph.D.

 

“A practical and powerful way to reduce stress is to become more mindful which, simply put, means being present in the moment rather than agonizing over the past or anticipating the future. Once stress levels are well under control, symptoms of Parkinson’s will have enormous difficulty presenting themselves. When people experience stress, their symptoms get much worse. When stress levels are under control, symptoms subside.” – Robert Rogers

 

Parkinson’s Disease (PD) is an incurable progressive degenerative disease of the central nervous system. The condition is caused by the death of nerve cells in the brain that produce the neurotransmitter dopamine. There are around seven million people worldwide and one million people in the U.S. living with PD and about 60,000 people are diagnosed with PD every year. PD is associated with aging as the vast majority of patients are diagnosed after age 50. In fact, it has been speculated that everyone would eventually develop PD if they lived long enough.

 

Its physical symptoms include resting tremor, slow movements, muscle rigidity, problems with posture and balance, loss of automatic movements, and slurring of speech. PD itself is not fatal but is often associated with related complications which can reduce life expectancy, such as falls, choking, and cardiovascular problems. Parkinson’s Disease (PD) also has psychological effects, especially anxiety and depression. All of these symptoms result in a marked reduction in the quality of life.

 

Mindfulness training has been found to improve the psychological symptoms and the quality of life with PD patients. In addition, stress is known to exacerbate the symptoms of PD. So, it would make sense that Mindfulness-Based Stress Reduction (MBSR), a mindfulness training that was developed specifically for stress reduction, would be effective for relieving some of the symptoms of PD. In today’s Research News article “Mindfulness-based stress reduction in Parkinson’s disease: a systematic review.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5433018/, McLean and colleagues review the published research literature on the effectiveness of an 8-week program of  MBSR for patients with PD.

 

As it turns out, the research is sparse. They were only able to identify 3 published articles which described 2 controlled trials, both of small size and with non-active control groups. The studies reported that MBSR participants, in comparison to controls, had improved motor ability, mindfulness, and quality of life with PD, and decreases in depression. One study found potentially beneficial changes in the patients’ brains in the MBSR group.

 

The scarce published research to date is promising and suggests that MBSR may be a beneficial treatment for patients with Parkinson’s Disease (PD) producing improvements in motor ability, psychological well-being, and quality of life. There is obviously a need for larger and better controlled trials. But, the research suggests that such research is warranted. Mindfulness training may be helpful in easing some of the symptom burden that plagues PD sufferers.

 

So, improve Parkinson’s disease with mindfulness.

 

“Mindfulness training, as taught by qualified and experienced teachers, may offer a more participatory medicine, empowering the individual by engagement to learn how to strengthen internal resources to help cope with chronic disease. Mindfulness training may help to restore some degree of self-determination in the experience of living with PD.” – Margaret Tuchman

 

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

 

McLean, G., Lawrence, M., Simpson, R., & Mercer, S. W. (2017). Mindfulness-based stress reduction in Parkinson’s disease: a systematic review. BMC Neurology, 17, 92. http://doi.org/10.1186/s12883-017-0876-4

 

Abstract

Background

Mindfulness based stress reduction (MBSR) is increasingly being used to improve outcomes such as stress and depression in a range of long-term conditions (LTCs). While systematic reviews on MBSR have taken place for a number of conditions there remains limited information on its impact on individuals with Parkinson’s disease (PD).

Methods

Medline, Central, Embase, Amed, CINAHAL were searched in March 2016. These databases were searched using a combination of MeSH subject headings where available and keywords in the title and abstracts. We also searched the reference lists of related reviews. Study quality was assessed based on questions from the Cochrane Collaboration risk of bias tool.

Results

Two interventions and three papers with a total of 66 participants were included. The interventions were undertaken in Belgium (n = 27) and the USA (n = 39). One study reported significantly increased grey matter density (GMD) in the brains of the MBSR group compared to the usual care group. Significant improvements were reported in one study for a number of outcomes including PD outcomes, depression, mindfulness, and quality of life indicators. Only one intervention was of reasonable quality and both interventions failed to control for potential confounders in the analysis. Adverse events and reasons for drop-outs were not reported. There was also no reporting on the costs/benefits of the intervention or how they affected health service utilisation.

Conclusion

This systematic review found limited and inconclusive evidence of the effectiveness of MBSR for PD patients. Both of the included interventions claimed positive effects for PD patients but significant outcomes were often contradicted by other results. Further trials with larger sample sizes, control groups and longer follow-ups are needed before the evidence for MBSR in PD can be conclusively judged.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5433018/