MBSR

Improve Social Anxiety Disorder with Mindfulness

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Improve Social Anxiety Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“regular and consistent mindfulness meditation will help to strengthen your ability to overcome the initial problems that you experience. If you are suffering with the symptoms of social anxiety disorder (SAD), regular practice will eventually improve your self-concept and ability to handle negative emotions. You will also learn how to better respond to troubling thoughts and treat yourself with more compassion.” – Arlin Cuncic

 

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. It has a typical onset in late childhood or young adulthood, prior to the age of 25. Hence, it is particularly widespread among young adults. Anxiety disorders have generally been treated with drugs. It has been estimated that 11% of women in the U.S. are taking anti-anxiety medications. 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 only available to a small numbers of sufferers. In addition, 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 “An open trial of mindfulness-based stress reduction for young adults with social anxiety disorder.” (See summary below), Hjeltnes and colleagues perform a pilot study of the effectiveness of a Mindfulness-Based Stress Reduction (MBSR) program for the treatment of Social Anxiety Disorder (SAD) in young adults. They recruited university students, aged 19 to 25 years, who suffered from SAD. The students participated in a standard 8-week MBSR program. They were assessed at the beginning, midway, and at the end of the program for social anxiety, global psychological distress, mindfulness, self-compassion, and self-esteem.

 

They found that the MBSR program produced a large clinically significant reduction in social anxiety and global psychological distress. They also found significant increases in mindfulness, particularly in the non-judging and non-reacting facets of mindfulness, self-esteem, self-compassion, self-kindness, and common humanity. These results are impressive, but, it needs to be recognized that this was an uncontrolled pilot trial and as such the results could have been due to a number of contaminating factors including placebo effects, experimenter bias, attention effects etc. It remains for a randomized controlled clinical trial to verify these findings. But the magnitudes of the effects are impressive and the fact that MBSR has been demonstrated in controlled trials to reduce anxiety, makes it more likely that the MBSR program was responsible.

 

Anxiety is a fear of potential future negative events. It is dependent upon future oriented thought processes. Mindfulness training may counteract this by focusing the individual on the present moment. Since, there are no negative events there in the present moment, anxiety dissipates. In addition, mindfulness training improves the individual’s ability to see the negative future projections as they arise in the mind and recognize that they are not based in present reality. This can lead to reduced anxiety and better performance at school, work and other activities and improve the person’s ability to form relationships.

 

So, improve social anxiety disorder with mindfulness.

 

“When you develop a mindfulness-based relationship with your inner emotions, your anxiety and fear, you set up a completely different inner environment that greatly facilitates transformation, resolution and healing of the emotional constructs of anxiety and fear. The simple fact is that reactivity inhibits change, while mindfulness promotes change and healing.” – Peter Strong

 

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

Aslak Hjeltnes, Helge Molde, Elisabeth Schanche, Jon Vøllestad, Julie Lillebostad Svendsen, Christian Moltu and Per-Einar Binder. An open trial of mindfulness-based stress reduction for young adults with social anxiety disorder. Scandinavian Journal of Psychology, Volume 58, Issue 1, February 2017, Pages: 80–90, DOI: 10.1111/sjop.12342.

 

Abstract

The present study investigated mindfulness-based stress reduction (MBSR) for young adults with a social anxiety disorder (SAD) in an open trial. Fifty-three young adults in a higher education setting underwent a standard eight-week MBSR program. Eight participants (15%) did not complete the program. Participants reported significant reductions in SAD symptoms and global psychological distress, as well as increases in mindfulness, self-compassion, and self-esteem. Using intention-to-treat (ITT) analyses, effect sizes ranged from large to moderate for SAD symptoms (Cohen’s d = 0.80) and global psychological distress (d = 0.61). Completer analyses yielded large effect sizes for SAD symptoms (d = 0.96) and global psychological distress (d = 0.81). The largest effect sizes were found for self-compassion (d = 1.49) and mindfulness (d = 1.35). Two thirds of the participants who were in the clinical range at pretreatment reported either clinically significant change (37%) or reliable improvement (31%) on SAD symptoms after completing the MBSR program, and almost two thirds reported either clinically significant change (37%) or reliable improvement (26%) on global psychological distress. MBSR may be a beneficial intervention for young adults in higher education with SAD, and there is a need for more research on mindfulness and acceptance-based interventions for SAD.

Improve Mental and Physical Health in Women with Breast Cancer with Mindfulness

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Improve Mental and Physical Health in Women with Breast Cancer with Mindfulness

 

By John M. de Castro, Ph.D.

 

“What I’ve come to understand as a newly inaugurated breast cancer survivor is this: allowing a greater good to open up through me is more beneficial than expecting life to meet my personal demands. It is healthier for me to let go of my need for control in order to walk mindfully in the way of gratitude. And while my destiny will unfold with every step I take, the truth will manifest itself in time.” – Kimberly Holman

 

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 a death sentence. It is encouraging that the 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). In addition, breast cancer survivors can have to deal with a heightened fear of reoccurrence, and an alteration of their body image.

 

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.. Indeed, yoga practice has been found to improve sleep quality and memory, reduce the side effects from chemotherapy, relieve neuromuscular symptoms, and improve the quality of life in cancer survivors. Also, Tai Chi or Qigong practice has been shown to improve quality of life, reduce fatigue, and lower blood pressure and cortisol levels. Mindfulness-Based Stress Reduction (MBSR) combines meditation, yoga, and body scan meditation practices. As such, it should be an excellent treatment for the physical and psychological problems of women with breast cancer.

 

In today’s Research News article “Mindfulness and its efficacy for psychological and biological responses in women with breast cancer.” (See summary below), Sarenmalm and colleagues performed a randomized controlled clinical trial of the effectiveness of Mindfulness-Based Stress Reduction (MBSR) for the treatment of the physical and psychological problems of women with breast cancer. They recruited breast cancer patients who had completed “adjuvant chemotherapy and/or radiation therapy, with or without endocrine therapy.” Participants were randomly assigned to receive MBSR treatment for 8-weeks either instructor led or self-taught or no treatment. Measurements were taken before and after treatment and 1 month and 3 months later of depression, physical and psychological symptoms, health status, coping capacity, mindfulness, personal growth, and plasma measures of immune system and inflammatory system function.

 

They found that MBSR taught by an instructor produced significant benefits relative to the self-taught MBSR and no treatment groups. In particular, instructor led MBSR significantly reduced depression, psychological symptoms, physical symptoms, total symptom burden, and improved vitality, physical functioning, mental health, and general health. In addition, MBSR was found to significantly improve coping capacity, post-traumatic growth, and mindfulness, particularly non-reactivity, and the immune response.

 

These are remarkable, striking, and very significant findings. Women with breast cancer had clinically significant improvements in their mental and physical health as a result of participation in an instructor MBSR training. It is interesting that self-taught MBSR did not have the same significant benefits, underscoring the need for professional leadership of the MBSR group. The self-taught MBSR group was an excellent active control group. The strength of this control condition makes the results all the more important as it suggests that placebo effects were not responsible for the benefits.

 

The results make it clear that instructor led Mindfulness-Based Stress Reduction (MBSR) should be prescribed for the treatment of the physical and psychological problems of women with breast cancer.

 

“Women who had the most stress . . . benefited the most from the Mindfulness-Based Stress-Reduction for Breast Cancer program. The results of this study echo results from other small studies showing that 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

 

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

Kenne Sarenmalm, E., Mårtensson, L. B., Andersson, B. A., Karlsson, P. and Bergh, I. (2017), Mindfulness and its efficacy for psychological and biological responses in women with breast cancer. Cancer Med. doi:10.1002/cam4.1052

 

Abstract

Many breast cancer survivors have to deal with a variety of psychological and physiological sequelae including impaired immune responses. The primary purpose of this randomized controlled trial was to determine the efficacy of a mindfulness-based stress reduction (MBSR) intervention for mood disorders in women with breast cancer. Secondary outcomes were symptom experience, health status, coping capacity, mindfulness, posttraumatic growth, and immune status. This RTC assigned 166 women with breast cancer to one of three groups: MBSR (8 weekly group sessions of MBSR), active controls (self-instructing MBSR) and non-MBSR. The primary outcome measure was the Hospital Anxiety and Depression Scale. Secondary outcome measures were: Memorial Symptom Assessment Scale, SF-36, Sense of Coherence, Five Facets of Mindfulness Questionnaire, and Posttraumatic Growth Index. Blood samples were analyzed using flow cytometry for NK-cell activity (FANKIA) and lymphocyte phenotyping; concentrations of cytokines were determined in sera using commercial high sensitivity IL-6 and IL-8 ELISA (enzyme-linked immunosorbent assay) kits. Results provide evidence for beneficial effects of MBSR on psychological and biological responses. Women in the MBSR group experienced significant improvements in depression scores, with a mean pre-MBSR HAD-score of 4.3 and post-MBSR score of 3.3 (P = 0.001), and compared to non-MBSR (P = 0.015). Significant improvements on scores for distress, symptom burden, and mental health were also observed. Furthermore, MBSR facilitated coping capacity as well as mindfulness and posttraumatic growth. Significant benefits in immune response within the MBSR group and between groups were observed. MBSR have potential for alleviating depression, symptom experience, and for enhancing coping capacity, mindfulness and posttraumatic growth, which may improve breast cancer survivorship. MBSR also led to beneficial effect on immune function; the clinical implications of this finding merit further research.

http://onlinelibrary.wiley.com.ezproxy.shsu.edu/doi/10.1002/cam4.1052/full

Reduce Grief with Mindfulness

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Reduce Grief with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Releasing the grief we carry is a long, tear-filled process. Yet it follows the natural intelligence of the body and heart. Trust it, trust the unfolding. Along with meditation, some of your grief will want to be written, to be cried out, to be sung, to be danced. Let the timeless wisdom within you carry you through grief to an open heart.” – Jack Kornfield

 

Grief is a normal, albeit complex, process that follows a loss of a significant person or situation in one’s life. This can involve the death of a loved one, a traumatic experience, termination of a relationship, loss of employment etc. Exactly what transpires depends upon the individual and the nature of the loss. It involves physical, emotional, psychological and cognitive processes. Not everyone grieves in the same way but there have been identified four general stages of grief, shock and denial, intense concern, despair and depression, and recovery. These are normal and healthy. But, in about 15% of people grief can be overly intense or long and therapeutic intervention may become necessary.

 

A stillbirth can be a devastating loss as the joyous anticipation of a new baby is replaced by a death. This can produce intense mental challenges. Mindfulness training is known to help with coping with emotions and stress, and is very effective for depression. Hence, mindfulness training may be helpful in coping with the grief following a stillbirth. In today’s Research News article “Mindfulness-based Intervention for Perinatal Grief Education and Reduction among Poor Women in Chhattisgarh, India: a Pilot Study.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367631/

Roberts and Montgomery recruited women, aged 18 to 35 years, in rural India who had a history of stillbirth. They provided them with a one session per week for 5-weeks of mindfulness training based upon Mindfulness-Based Stress Reduction (MBSR). This included meditation, body scanning, and yoga practices and had additional education materials on risk factors for stillbirth and prevention strategies. The women were measured before and after the intervention and 6-weeks later for grief, anxiety and depression symptoms, satisfaction with life, religious coping, social support, and mindfulness. During the 6-week follow up period the women practiced daily at home.

 

They found, not surprisingly, that at baseline the women had clinically significant levels of anxiety, depression, and grief. After the mindfulness training, there were significant improvements in grief, anxiety and depression, religious coping, and the mindfulness facets of describe and acting with awareness. Hence the mindfulness training appeared to increase mindfulness and help relieve some of the psychological consequences of having a stillbirth. This could be important as the grief and depression after stillbirth can be severe. Relieving these consequences may be very helpful to the women learning to cope with and move past their tragic loss.

 

These are encouraging results, but must be viewed as preliminary pilot data. There was no control condition so, there are a large number of possible other explanations for the results including placebo effects, attentional effects, experimenter bias, etc. The data do support, however, conducting a larger randomize controlled clinical trial. Such research could lead to mindfulness training being used to assist in coping with loss and grief.

 

So, reduce grief with mindfulness.

 

“Mindful grieving informs us to allow ourselves to feel what is there, without judgment. For me, there was sadness there and I needed to nonjudgmentally acknowledge it, feel it, and let it be. It was important in that moment that I didn’t resist it or strive to make it any different, but just feel it as it was. Ronald Pies, M.D. wrote to us, “Having problems means being alive”, and I’d add “Being alive, means grieving loved ones who pass.” Grief is a natural part of the human experience.” – Elisha Goldstein

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Roberts, L., & Montgomery, S. (2016). Mindfulness-based Intervention for Perinatal Grief Education and Reduction among Poor Women in Chhattisgarh, India: a Pilot Study. Interdisciplinary Journal of Best Practices in Global Development, 2(1), 1.

 

Abstract

Introduction

Stillbirth is a significant public health problem in low-to-middle-income countries and results in perinatal grief, often with negative psychosocial impact. In low-resource settings, such as Chhattisgarh, India, where needs are high, it is imperative to utilize low-cost, effective interventions. Mindfulness-based stress reduction (MBSR) is an empirically sound intervention that has been utilized for a broad range of physical and mental health problems, and is adaptable to specific populations. The main objective of this pilot study was to explore the feasibility and effectiveness of a shortened, culturally adapted mindfulness-based intervention to address complex grief after stillbirth.

Methods

We used an observational, pre-post-6-week post study design. The study instrument was made up of descriptive demographic questions and validated scales and was administered as a structured interview due to low literacy rates. We used a community participatory approach to culturally adapt the five-week mindfulness-based intervention and delivered it through two trained local nurses. Quantitative and qualitative data analyses explored study outcomes as well as acceptability and feasibility of the intervention.

Results

29 women with a history of stillbirth enrolled, completed the pretest and began the intervention; 26 completed the five-week intervention and post-test (89.7%), and 23 completed the six-week follow-up assessment (88.5%). Pretest results included elevated psychological symptoms and high levels of perinatal grief, including the active grief, difficulty coping, and despair subscales. General linear modeling repeated measures was used to explore posttest and six-week follow up changes from baseline, controlling for significantly correlated demographic variables. These longitudinal results included significant reduction in psychological symptoms; four of the five facets of mindfulness changed in the desired direction, two significantly; as well as significant reduction in overall perinatal grief and on each of the three subscales.

Discussion

The shortened, culturally adapted, mindfulness-based intervention pilot study was well received and had very low attrition. We also found significant reductions of perinatal grief and mental health symptoms over time, as well as a high degree of practice of mindfulness skills by participants. This study not only sheds light on the tremendous mental health needs among rural women of various castes who have experienced stillbirth in Chhattisgarh, it also points to a promising effective intervention with potential to be taken to scale for wider delivery.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367631/

Improve Anxiety and Work Better with Mindfulness

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Improve Anxiety and Work Better with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Being mindful means paying attention to the present moment, exactly as it is. It is really hard to be anxious if you are completely focused on the present moment” – AnxietyBC

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. Generalized Anxiety Disorder (GAD) affects about 3.1% of the U.S. population. GAD involves excessive worry about everyday problems. People with GAD become anxious in anticipation of problems with their finances, health, employment, and relationships. They typically have difficulty calming their concerns, even though they realize that their anxiety is more intense than the situation warrants. Physically, GAD sufferers will often show excessive fatigue, irritability, muscle tension or muscle aches, trembling, feeling twitchy, being easily startled, trouble sleeping, sweating, nausea, diarrhea or irritable bowel syndrome, and headaches. Clearly, GAD will interfere with the performance of normal daily activities including impairing work performance.

 

Anxiety disorders have generally been treated with drugs. It has been estimated that 11% of women in the U.S. are taking anti-anxiety medications. But, there are considerable side effects and these drugs are often abused. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders. Mindfulness-Based Stress Reduction (MBSR) contains three mindfulness trainings, meditation, body scan, and yoga, and has been shown to be effective in treating anxiety. So, it would be reasonable to expect that MBSR training would improve work performance in people with Generalized Anxiety Disorder (GAD).

 

In today’s Research News article “.” See summary below or view the full text of the study at:

http://www.sciencedirect.com.ezproxy.shsu.edu/science/article/pii/S0022399917300661

Hoge and colleagues recruited male and female adult patients who were diagnosed with Generalized Anxiety Disorder (GAD) and randomly assigned them to receive either an 8-week program of Mindfulness-Based Stress Reduction (MBSR) or a comparable stress management program. Participants were measured before and after the 8-week training period and also followed up 24 weeks later for workplace performance, absenteeism, including entire workdays missed and partial workdays missed, healthcare utilization practices, and home meditation practice.

 

They found that at the conclusion of treatment the MBSR group had significantly fewer partial days lost than the control group. In addition, they found that at follow-up the greater the amount of meditation practice the fewer the partial days missed and the fewer the visits to a mental health professional. Hence, MBSR training helps to improve attendance at work and reduce the utilization of mental health care in people with Generalized Anxiety Disorder (GAD). Hence, MBSR appears to improve GAD sufferers’ ability to function in their occupations.

 

Anxiety is a fear of potential future negative events. It is dependent upon future oriented thought processes. Mindfulness training may counteract this by focusing the individual on the present moment. Since, there are no negative events there in the present moment, anxiety dissipates. In addition, mindfulness training improves the individual’s ability to see the negative future projections as they arise in the mind and recognize that they are not based in present reality. This can lead to reduced anxiety and better performance at work.

 

So, improve anxiety and work better with mindfulness.

 

“The goal of mindful practices is to force us to be present, so we don’t waste precious days worrying. Needless anxiety and stress cannot burden us if the thoughts don’t enter our mind. And fortunately, we are only capable of focusing on one thing at a time. When you’re aware of only what you’re working on and the sensations of your body, conscious worry is not possible.” – Jordan Bates

 

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

Hoge EA, Guidos BM, Mete M, Bui E, Pollack MH, Simon NM, Dutton MA. Effects of mindfulness meditation on occupational functioning and health care utilization in individuals with anxiety. J Psychosom Res. 2017 Apr;95:7-11. doi: 10.1016/j.jpsychores.2017.01.011.

 

Highlights

  • Individuals that received mindfulness training had a reduction in partial workdays missed.
  • Work loss, specifically partial days missed decreased as patients practiced mindfulness more often at home.
  • Mental health visits decreased more in patients who practiced mindfulness more often at home.

Abstract

Objectives

To examine the effect of mindfulness meditation on occupational functioning in individuals with Generalized anxiety disorder (GAD).

Methods

Fifty-seven individuals with GAD (mean (SD) age = 39 (13); 56% women) participated in an 8-week clinical trial in which they were randomized to mindfulness-based stress reduction (MBSR) or an attention control class. In this secondary analysis, absenteeism, entire workdays missed, partial workdays missed, and healthcare utilization patterns were assessed before and after treatment.

Results

Compared to the attention control class, participation in MBSR was associated with a significantly greater decrease in partial work days missed for adults with GAD (t = 2.734, df = 51, p = 0.009). Interestingly, a dose effect was observed during the 24-week post-treatment follow-up period: among MBSR participants, greater home mindfulness meditation practice was associated with less work loss and with fewer mental health professional visits.

Conclusion

Mindfulness meditation training may improve occupational functioning and decrease healthcare utilization in adults with GAD.

http://www.sciencedirect.com.ezproxy.shsu.edu/science/article/pii/S0022399917300661

Improve Generalized Anxiety Disorder by Decentering and Mindfulness

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Improve Generalized Anxiety Disorder by Decentering and Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness allows us to interrupt automatic, reflexive fight, flight, or freeze reactions—reactions that can lead to anxiety, fear, foreboding, and worry.” – Bob Stahl

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. Generalized Anxiety Disorder (GAD) affects about 3.1% of the U.S. population. GAD involves excessive worry about everyday problems. People with GAD become anxious in anticipation of problems with their finances, health, employment, and relationships. They typically have difficulty calming their concerns, even though they realize that their anxiety is more intense than the situation warrants. A characterizing feature of anxiety disorders is that the suffer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake.

 

Anxiety disorders have generally been treated with drugs. It has been estimated that 11% of women in the U.S. are taking anti-anxiety medications. But, there are considerable side effects and these drugs are often abused. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders. Mindfulness-Based Cognitive Therapy (MBCT) is targeted at changing unproductive and unreasonable thought patterns and has been shown to be effective for anxiety disorders. Mindfulness-Based Stress Reduction (MBSR) has also been shown to be effective. Acceptance and Commitment Therapy (ACT) combines elements from MBCT and mindfulness training and has also been shown to be effective.

 

These therapies have in common the attempt to decenter thought processes. Decentering changes the nature of experience by having the individual step outside of experiences and observe them from a distanced perspective. The individual learns to observe thoughts and feelings as objective events in the mind rather than personally identifying with the thoughts or feelings which is so characteristic of Generalized Anxiety Disorder (GAD). The individual, then, sees their thoughts as a constructed reality produced by their self and not as absolute truth. This, in turn, results in an ability to see anxiety provoking thoughts as not true, but simply a construct of the mind’s operation, allowing the individual to begin to change how they interpret experience.

 

In today’s Research News article “Change in Decentering Mediates Improvement in Anxiety in Mindfulness-Based Stress Reduction for Generalized Anxiety Disorder.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5354303/

Hoge and colleagues examine the degree to which decentering and mindfulness mediate the effect of Mindfulness-Based Stress Reduction (MBSR) on Generalized Anxiety Disorder (GAD). They recruited adult patients who were diagnosed with GAD and randomly assigned them to receive either an 8-week MBSR program or stress management education program which aimed to improve “overall health and wellness through education about diet, exercise, sleep, time management, and resilience.” Before and after the 8-weeks of training the participants were measured for anxiety, worry, mindfulness, and decentering.

 

They found that both groups showed improvements but the MBSR group had significantly greater increases in mindfulness and decentering. In addition, they found that the greater the increase in mindfulness the greater the decrease in anxiety levels and similarly, the greater the increase in decentering the greater the decrease in anxiety. A sophisticated statistical mediation analysis technique revealed that MBSR had its primary effect on anxiety levels through decentering rather than mindfulness. On the other hand, MBSR training reduced worry by increasing the mindfulness facets of acting with awareness and non-reactivity to inner experience.

 

The results are interesting and suggest that Mindfulness-Based Stress Reduction (MBSR) reduces anxiety and worry through different mechanisms; anxiety by increasing decentering and worry by increasing mindfulness. This is reasonable as anxiety is highly affected by illogical thought processes and decentering provides a means by which these thoughts can be seen as false. Mindfulness, on the other hand produces a focus on the present moment and thereby reduces worry about the future.

 

So, improve generalized anxiety disorder by decentering and mindfulness.

 

“People with anxiety have a problem dealing with distracting thoughts that have too much power. They can’t distinguish between a problem-solving thought and a nagging worry that has no benefit. If you have unproductive worries, you might think ‘I’m late, I might lose my job if I don’t get there on time, and it will be a disaster!’ Mindfulness teaches you to recognize, ‘Oh, there’s that thought again. I’ve been here before. But it’s just that—a thought, and not a part of my core self,’” – Elizabeth Hoge.

 

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

Hoge, E. A., Bui, E., Goetter, E., Robinaugh, D. J., Ojserkis, R. A., Fresco, D. M., & Simon, N. M. (2015). Change in Decentering Mediates Improvement in Anxiety in Mindfulness-Based Stress Reduction for Generalized Anxiety Disorder. Cognitive Therapy and Research, 39(2), 228–235. http://doi.org/10.1007/s10608-014-9646-4

 

Abstract

Objective

We sought to examine psychological mechanisms of treatment outcomes of a mindfulness meditation intervention for Generalized Anxiety Disorder (GAD).

Methods

We examined mindfulness and decentering as two potential therapeutic mechanisms of action of generalized anxiety disorder (GAD) symptom reduction in patients randomized to receive either mindfulness-based stress reduction (MBSR) or an attention control class (N=38). Multiple mediation analyses were conducted using a non-parametric cross product of the coefficients approach that employs bootstrapping.

Results

Analyses revealed that change in decentering and change in mindfulness significantly mediated the effect of MBSR on anxiety. When both mediators were included in the model, the multiple mediation analysis revealed a significant indirect effect through increases in decentering, but not mindfulness. Furthermore, the direct effect of MBSR on decrease in anxiety was not significant, suggesting that decentering fully mediated the relationship. Results also suggested that MBSR reduces worry through an increase in mindfulness, specifically by increases in awareness and nonreactivity.

Conclusions

Improvements in GAD symptoms resulting from MBSR are in part explained by increased levels of decentering.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5354303/

 

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Improve Migraine Headaches with Mindfulness

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Improve Migraine Headaches with Mindfulness

 

By John M. de Castro, Ph.D.

 

“When we allow our minds, hearts, and bodies to be heard and felt through mindful attention, they will say back to us, “Thank you for listening,” not because we tried to fix anything but just because we paid attention with gentle, nonjudgmental awareness. This nurturing umbrella of awareness is the key. It is both a form of refuge and a means of really being able to take control of and managing our lives. It is a way we can cultivate and honor the wholeness of our being. It is how we heal.” – American Migraine Foundation

 

Migraine headaches are a torment far beyond the suffering of a common headache. It is an intense throbbing pain usually unilateral, focused on only one side of the head. They last from 4 hours to 3 days. They are actually a collection of neurological symptoms. Migraines often include: visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch and smell, and tingling or numbness in the extremities or face. Migraines are the 8th most disabling illness in the world. They disproportionately affect women with about 18% of American women and 6% of men suffering from migraine. In the U.S. they affect roughly 40 million men, women and children. While most sufferers experience attacks once or twice a month, 14 million people or about 4% have chronic daily headaches. Migraines are very disruptive to the sufferer’s personal and work lives as most people are unable to work or function normally when experiencing a migraine.

 

There is no known cure for migraine headaches. Treatments are targeted at managing the symptoms. Prescription and over-the-counter pain relievers are frequently used. There are a number of drug and drug combinations that appear to reduce the frequency of migraine attacks. These vary in effectiveness but unfortunately can have troubling side effects and some are addictive. Behaviorally, relaxation and sleep appear to help lower the frequency of migraines. Mindfulness practices have been shown to reduce stress and improve relaxation. So, they may be useful in preventing migraines. Indeed, it has been shown that mindfulness practice can reduce headache pain.

 

In today’s Research News article “Mindfulness and pharmacological prophylaxis after withdrawal from medication overuse in patients with Chronic Migraine: an effectiveness trial with a one-year follow-up.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292107/

Grazzi and colleagues recruited patients who were diagnosed with chronic migraine headaches with accompanying overuse of medications. They were withdrawn from medications over a 45-day period. The patients then volunteered to participate in a research study and were assigned to receive and 8-week Mindfulness Based Stress Reduction (MBSR) program or prophylactic (preventive) migraine medication. They were measured before and after treatment and at 6-months and 12-months later for headache frequency, frequency of pain reliever use, headache impact, migraine disability, depression, and anxiety.

 

They found that both MBSR and prophylactic medication treatment produced clinically significant reductions in headache frequency, pain reliever use, headache impact, migraine disability, and depression. These benefits were maintained at 6-monmth and 1-year follow-ups. These are preliminary findings as there wasn’t a control group present. But, the findings are exciting and the effects large, suggesting that mindfulness training is as effective in treating migraine headaches as prophylactic medications. Since the MBSR training, unlike the drugs, has no known adverse effects, it would appear to be a preferred treatment for migraine headaches.

 

Some of the effects of mindfulness practices are to alter thought processes, changing what is thought about. In terms of pain, mindfulness training, by focusing attention on the present moment has been shown to reduce worry and catastrophizing. Pain is increased by worry about the pain and the expectation of greater pain in the future. So, reducing worry and catastrophizing can reduce headache pain. In addition, mindfulness improves self-efficacy, the belief that the individual can adapt to and handle headache pain. Mindfulness training also has been shown to alter not only what is thought, but also how thoughts are processed. Central to this cognitive change is mindfulness and acceptance. By mindfully viewing pain as a present moment experience it can be experienced just as it is and by accepting it, the individual stops fighting against the pain which can amplify the pain.

 

So, improve migraine headaches with mindfulness.

 

“Can you namaste your migraines away? A new, small study published in the journal Headache suggests that meditation may help relieve the intensity and duration of migraines.” – Mandy Oaklander

 

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

Grazzi, L., Sansone, E., Raggi, A., D’Amico, D., De Giorgio, A., Leonardi, M., … Andrasik, F. (2017). Mindfulness and pharmacological prophylaxis after withdrawal from medication overuse in patients with Chronic Migraine: an effectiveness trial with a one-year follow-up. The Journal of Headache and Pain, 18(1), 15. http://doi.org/10.1186/s10194-017-0728-z

 

Abstract

Background

Chronic Migraine (CM) is a disabling condition, worsened when associated with Medication Overuse (MO). Mindfulness is an emerging technique, effective in different pain conditions, but it has yet to be explored for CM-MO. We report the results of a study assessing a one-year course of patients’ status, with the hypothesis that the effectiveness of a mindfulness-based approach would be similar to that of conventional prophylactic treatments.

Methods

Patients with CM-MO (code 1.3 and 8.2 of the International Classification of Headache Disorders-3Beta) completed a withdrawal program in a day hospital setting. After withdrawal, patients were either treated with Prophylactic Medications (Med-Group), or participated in a Mindfulness-based Training (MT-Group). MT consisted of 6 weekly sessions of guided mindfulness, with patients invited to practice 7–10 min per day. Headache diaries, the headache impact test (HIT-6), the migraine disability assessment (MIDAS), state and trait anxiety (STAI Y1-Y2), and the Beck Depression Inventory (BDI) were administered before withdrawal and at each follow-up (3, 6, 12 after withdrawal) to patients from both groups. Outcome variables were analyzed in separate two-way mixed ANOVAs (Group: Mindfulness vs. Pharmacology x Time: Baseline, 3-, 6-, vs. 12-month follow-up).

Results

A total of 44 patients participated in the study, with the average age being 44.5, average headache frequency/month was 20.5, and average monthly medication intake was 18.4 pills. Data revealed a similar improvement over time in both groups for Headache Frequency (approximately 6–8 days reduction), use of Medication (approximately 7 intakes reduction), MIDAS, HIT-6 (but only for the MED-Group), and BDI; no changes on state and trait anxiety were found. Both groups revealed significant and equivalent improvement with respect to what has become a classical endpoint in this area of research, i.e. 50% or more reduction of headaches compared to baseline, and the majority of patients in each condition no longer satisfied current criteria for CM.

Conclusions

Taken as a whole, our results suggest that the longitudinal course of patients in the MT-Group, that were not prescribed medical prophylaxis, was substantially similar to that of patients who were administered medical prophylaxis.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292107/

 

 

Improve Mental Health in Disadvantaged Populations with Mindfulness

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Improve Mental Health in Disadvantaged Populations with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness training could be integrated into educational settings on a city, state, or national level, thus promoting health and mental health. Integrating mindfulness-based practices into educational settings could offer the potential to promote a more positive path for our children, something that would be particularly beneficial for disadvantaged urban youth like the kids in our studies.” –  Tamar Mendelson

 

Disadvantaged populations have a disproportionate share of mental health issues. Indeed, the lower the socioeconomic status of an individual the greater the likelihood of a mental disorder. It is estimated that major mental illnesses are almost 3 times more likely in the disadvantaged, including almost double the incidence of depression, triple the incidence of anxiety disorders, alcohol abuse, and eating disorders. These higher incidences of mental health issues occur, in part, due to mental health problems leading to unemployment and poverty, but also to the stresses of life in poverty.

 

The disadvantaged are much more likely to be uninsured, not have mental health services available, and less likely to seek treatment. In addition, when they are treated it is almost exclusively with drugs. These often do not work, have adverse effects, or are not taken as prescribed and are thus ineffective. Most psychotherapies were developed to treat disorders in affluent populations and are not affordable or sensitive to the unique situations and education levels of the disadvantaged. So, very few disadvantaged people with mental health problems are treated with psychotherapies.

 

Hence, there is a great need for alternative treatments for the mentally ill disadvantaged. One increasingly popular alternative is mind-body practices. These include meditation, tai chi, qigong, yoga, guided imagery, etc. In today’s Research News article “Mind–Body Approaches to Treating Mental Health Symptoms Among Disadvantaged Populations: A Comprehensive Review.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4761814/

Burnett-Zeigler and colleagues review the published research literature on the effectiveness of mind-body practices for the treatment of mental health issues in disadvantaged populations.

 

They found that in general mind-body techniques are feasible, acceptable, and efficacious with disadvantaged populations. The published research reports than Mindfulness Based Stress Reduction (MBSR) programs produced significant improvements in disadvantaged populations in general health, social functioning, vitality, physical and emotional role functioning, stress, mindfulness, anxiety, self-compassion, life satisfaction, depression, relationships, awareness, self-acceptance, and self-empowerment, nonreactivity, improved self-care, and decreased distress. The research also reports that yoga practice results in significant improvements in distressed mood, depression, emotional well-being, body weight, depression, and disease-specific quality of life. Other mind-body techniques were also reported to have similar benefits.

 

Hence the published research studies are fairly uniform in finding that mind-body practices can be successfully implemented with disadvantaged populations and produce significant mental health benefits. Although much more research is needed, these are exciting findings. Mind-body techniques show tremendous promise for the mental health needs of the disadvantaged. They can be implemented cost-effectively and many of these practices can be employed at home on convenient schedules. Hence mind-body practices, if implemented broadly, may be major contributors to improved mental health in disadvantaged populations. This, in turn, may lead to better employment possibilities and a route out of poverty.

 

So, improve mental health in disadvantaged populations with mindfulness.

 

“Research and experience have shown that meditation-based or contemplative practices have proven to be beneficial with populations that are considered at risk, marginalized, or oppressed and with those who are incarcerated.” – Sadye Logan

 

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

Burnett-Zeigler, I., Schuette, S., Victorson, D., & Wisner, K. L. (2016). Mind–Body Approaches to Treating Mental Health Symptoms Among Disadvantaged Populations: A Comprehensive Review. Journal of Alternative and Complementary Medicine, 22(2), 115–124. http://doi.org/10.1089/acm.2015.0038

 

Abstract

Mind–body approaches are commonly used to treat a variety of chronic health conditions, including depression and anxiety. A substantial proportion of individuals with depression and anxiety disorders do not receive conventional treatment; disadvantaged individuals are especially unlikely to receive treatment. Mind–body approaches offer a potentially more accessible and acceptable alternative to conventional mental health treatment for disadvantaged individuals, who may not otherwise receive mental health treatment. This review examines evidence for the efficacy of mind–body interventions for mental health symptoms among disadvantaged populations. While rates of utilization were relatively lower for racial/ethnic minorities, evidence suggests that significant proportions of racial/ethnic minorities are using complementary health approaches as health treatments, especially prayer/healers and natural or herbal remedies. This review of studies on the efficacy of mind–body interventions among disadvantaged populations found evidence for the efficacy of mind–body approaches for several mental and physical health symptoms, functioning, self-care, and overall quality of life.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4761814/

 

Alleviate General Practitioner Burnout with Mindfulness

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Alleviate General Practitioner Burnout with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Enhancing the already inherent capacity of the physician to experience fully the clinical encounter—not only its pleasant but also its most unpleasant aspects—without judgment but with a sense of curiosity and adventure seems to have had a profound effect on the experience of stress and burnout. It also seems to enhance the physician’s ability to connect with the patient as a unique human being and to center care around that uniqueness.” – Michael Krasner

 

General Practitioners confront stress on a daily basis. Even moderate levels of stress when prolonged, all too frequently results in a professional burnout. This is the fatigue, cynicism, emotional exhaustion, and professional inefficacy that comes with work-related stress. Healthcare is a high stress occupation. It is estimated that over 45% of healthcare workers experience burnout. Currently, over a third of healthcare workers report that they are looking for a new job. Nearly half plan to look for a new job over the next two years and 80% expressed interest in a new position if they came across the right opportunity.

 

Regardless of the reasons for burnout or its immediate presenting consequences, it is a threat to the healthcare providers and their patients. In fact, it is a threat to the entire healthcare system as it contributes to the shortage of doctors and nurses. Hence, preventing existing healthcare workers from burning out has to be a priority. Mindfulness has been demonstrated to be helpful in treating and preventing burnout. One of the premiere techniques for developing mindfulness and dealing effectively with stress is Mindfulness Based Stress Reduction (MBSR) pioneered by Jon Kabat-Zinn. It is a diverse mindfulness training containing practice in meditation, body scan, and yoga. As a result, there have been a number of trials investigating the application of MBSR to the treatment and prevention of health care worker burnout.

 

In today’s Research News article “Mindfulness-based stress reduction for GPs: results of a controlled mixed methods pilot study in Dutch primary care.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4723221/

Verweij and colleagues investigated the effectiveness of Mindfulness Based Stress Reduction (MBSR) in preventing burnout in General Practitioners. They recruited General Practitioners who were required to participate in continuing professional education courses and offered as an option participation in an 8-week MBSR program. They compared GPs who selected the MBSR program during one 8-week period to those who selected a waitlist condition and received the usual continuing professional education course. They completed measures both before and after the treatment of burnout, work engagement, and mindfulness.

 

They found, not surprisingly, that compared to the waitlist controls, the MBSR program resulted in higher levels of mindfulness. But, importantly, it also significantly decreased levels of burnout depersonalization and increased levels of work dedication. During interviews after completion of the program The GPs reported that the MBSR program helped them to become more aware of their bodily sensations, thoughts, and emotions, of their beliefs and values, and a recognition of the autopilot mode they usually engaged in. They also reported that the MBSR program increased their wellbeing and compassion towards themselves and others, including their patients.

 

The findings from this pilot study are very encouraging. They demonstrate that mindfulness training reduces self-reported burnout, and improves professional dedication, recognition of bodily reactions and how activities have become routinized, and general wellbeing. By improving their awareness of the sensations, thoughts, and actions in the present moment mindfulness training appears to be somewhat an antidote to burnout. This suggests that mindfulness practices should be included in the continuing education of healthcare professionals.

 

So, alleviate general practitioner burnout with mindfulness.

 

“Mindfulness gives doctors permission to attend to their own health and well-being. But is also allows doctors to help patients by listening more, talking less and seeing what the patient needs.” – Mary Breach

 

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

Verweij, H., Waumans, R. C., Smeijers, D., Lucassen, P. L., Donders, A. R. T., van der Horst, H. E., & Speckens, A. E. (2016). Mindfulness-based stress reduction for GPs: results of a controlled mixed methods pilot study in Dutch primary care. The British Journal of General Practice, 66(643), e99–e105. http://doi.org/10.3399/bjgp16X683497

 

Abstract

Background

Burnout is highly prevalent in GPs and can have a negative influence on their wellbeing, performance, and patient care. Mindfulness-based stress reduction (MBSR) may be an effective intervention to decrease burnout symptoms and increase wellbeing.

Aim

To gain insight into the feasibility and effectiveness of MBSR on burnout, empathy, and (work-related) wellbeing in GPs.

Design and setting

A mixed methods pilot study, including a waiting list-controlled pre-/post-study and a qualitative study of the experiences of participating GPs in the Netherlands.

Method

Participants were sent questionnaires assessing burnout, work engagement, empathy, and mindfulness skills, before and at the end of the MBSR training/waiting period. Qualitative data on how GPs experienced the training were collected during a plenary session and with evaluation forms at the end of the course.

Results

Fifty Dutch GPs participated in this study. The MBSR group reported a greater decrease in depersonalisation than the control group (adjusted difference −1.42, 95% confidence interval [CI] = −2.72 to −0.21, P = 0.03). Dedication increased more significantly in the MBSR group than in the control group (adjusted difference 2.17, 95% CI = 0.51 to 3.83, P = 0.01). Mindfulness skills increased significantly in the MBSR group compared with the control group (adjusted difference 6.90, 95% CI = 1.42 to 12.37, P = 0.01). There was no significant change in empathy. The qualitative data indicated that the MBSR course increased their wellbeing and compassion towards themselves and others, including their patients.

Conclusion

The study shows that MBSR for GPs is feasible and might result in fewer burnout symptoms and increased work engagement and wellbeing. However, an adequately powered randomised controlled trial is needed to confirm the study’s findings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4723221/

 

Reduce Youth Dissociative Disorders with Mindfulness

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Reduce Youth Dissociative Disorders with Mindfulness

 

By John M. de Castro, Ph.D.

 

“It sounds elementary, I know. But that’s the beauty of it. Rather than wasting energy fighting dissociation, we can decrease its severity simply by increasing awareness.” – Holly Gray

 

Sometime during the lives of about 2% of the population, a Dissociative Disorder occurs. It is more likely in women than in men and is most frequently triggered by a traumatic event. Dissociative Disorders involve an involuntary escape from reality characterized by a disconnection between thoughts, identity, consciousness and memory. These can include significant memory loss of specific times, people and events, out-of-body experiences, such as feeling as though you are watching a movie of yourself, mental health problems such as depression, anxiety and thoughts of suicide, a sense of detachment from emotions, or emotional numbness, and a lack of a sense of self-identity.

 

There are three kinds of diagnosed Dissociative Disorders, Dissociative Amnesia, Depersonalization disorder, and Dissociative identity disorder (aka multiple personalities). These disorders are thought to be coping mechanisms for intense stress. They are generally treated with drugs, particularly antidepressants, and with psychotherapies including Cognitive Behavioral Therapy and Dialectical Behavioral Therapy. Mindfulness training has been found to be effective in treating a myriad of mental and physical disorders and particularly with stress related disorders. It has also been shown to be effective with trauma reactions including Post-Traumatic Stress Disorder (PTSD). So, it makes sense to test the effectiveness of mindfulness training in treating Dissociative Disorders.

 

In today’s Research News article “Role of mindfulness in Dissociative Disorders among adolescents.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5100126/

Sharma and colleagues recruited a small sample of adolescents (average age = 13 and 86% female) who were diagnosed with a Dissociative Disorder. They were provided 6 weekly sessions of mindfulness training based upon the Mindfulness-Based Stress reduction (MBSR) program and encouragement to practice at home. The treatment included both sitting and walking meditation, body scan, yoga, and mindful eating practices. They were measured for dissociative experiences and mindfulness, before treatment, 3 weeks into treatment, and immediately after treatment.

 

They found that the treatment produced a significant, 54% decrease in dissociative symptoms and a 25% increase in mindfulness. The increase in mindfulness would be expected, given the extensive literature demonstrating increases in mindfulness produced by MBSR training. The decrease in dissociative symptoms is, to our knowledge, unprecedented. It is reasonable though given the demonstrated ability of mindfulness training to improve present moment awareness and decrease mind wandering. Attending to what is happening in the present moment would tend to counteract tendencies to drift away from reality.

 

These are potentially important results but should be looked upon as a pilot, proof of concept study. There was no control condition and the sample was small and confined to young adolescents, primarily girls. The results, though, provide a strong rationale to implement a large scale randomized controlled clinical trial. This could provide evidence that mindfulness training may be an effective treatment for dissociative disorders.

 

“Having a daily mindfulness practice allows you to reach trauma, implicit memories and a way of integrating your childhood abuse. You start with neutral judgements and work towards emotional charged memories. You can heal much quicker than you believe. It takes daily work strengthening your focus on the breath. It seems mundane to focus on the breath but the breath controls the nervous system and allows us to reach our trauma quickly and decisively.” – Marty

 

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 Twitter @MindfulResearch

 

Study Summary

Sharma, T., Sinha, V. K., & Sayeed, N. (2016). Role of mindfulness in dissociative disorders among adolescents. Indian Journal of Psychiatry, 58(3), 326–328. http://doi.org/10.4103/0019-5545.192013

 

Abstract

Context: Dissociation is understood as maladaptive coping and is common in children and adolescents. Treatment outcome studies show improvement in comorbid conditions suggesting the need to implement programs that target dissociative pathology.

Aim: To study the effect of practicing mindfulness among adolescents diagnosed with dissociative disorders.

Settings and Design: It was a hospital-based repeated measures design.

Materials and Methods: 7 adolescents participated in a mindfulness-based therapeutic program for 6 weeks.

Statistical Analysis: Scores were expressed as mean ± standard deviation. Friedman test was used to assess significance of the difference in scores at various assessment phases. Wilcoxon signed rank test was used for post hoc analysis.

Results: Participants were mostly female adolescents from rural, Eastern India. There was a significant reduction in dissociative experiences and significant improvement in mindfulness.

Conclusions: Incorporating mindfulness in clinical practice may prove effective in reducing dissociation and promoting adaptive functioning.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5100126/

 

Learn Mindfulness On-Line to Reduce Stress Effects

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Learn Mindfulness On-Line to Reduce Stress Effects

 

By John M. de Castro, Ph.D.

 

“Mindfulness not only reduces stress but also gently builds an inner strength so that future stressors have less impact on our happiness and physical well-being.” –  Shamash Alidina

 

Mindfulness training has been shown through extensive research to be effective in improving the physical and psychological condition of otherwise healthy people and also treating the physical and psychological issues of people with illnesses and particularly with the physical and psychological reactions to stress. Techniques such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) as well as Yoga practice and Tai Chi or Qigong practice have been demonstrated to be particularly effective. This has led to an increasing adoption of these mindfulness techniques for the health and well-being of both healthy and ill individuals.

 

The vast majority of the mindfulness training techniques, adopted so far, however, require a certified trained therapist. This produces costs that many clients can’t afford. 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. As a result, there has been attempts to develop on-line mindfulness training programs. These have tremendous advantages in decreasing costs and making training schedules much more flexible. But, the question arises as to whether these programs are as effective as their traditional counterparts. Many believe that the presence of a therapist is a crucial component to the success of the programs and the lack of an active therapist in on-line programs may greatly reduce their effectiveness.

 

In today’s Research News article “Effects of preventive online mindfulness interventions on stress and mindfulness: A meta-analysis of randomized controlled trials.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5199155/

Jayewardene and colleagues review and perform a meta-analysis of the published research literature investigating the effectiveness of preventive mindfulness interventions delivered exclusively online for reducing stress responses in normal adults. They identified 8 randomized controlled trials with 75% having waitlist control groups and interventions lasting from 2 to 12 weeks. All but one study employed interventions that were modifications of the Mindfulness Based Stress Reduction (MBSR) program for completely online implementation. MBSR is composed of meditation, body scan and yoga training.

 

They found that overall the published literature reported significant improvements in mindfulness of small effect size and significant reductions in perceived stress of moderate size. They reported that there was no evidence suggesting publication bias as being responsible for the reported effects. So, the literature supports the assertion that mindfulness training online is effective in reducing perceived stress and increasing mindfulness.

 

These are exciting findings. It is well established that mindfulness training is effective for reducing the physical and psychological reactions to stress and that Mindfulness Based Stress Reduction (MBSR) programs are effective. What is new in this review is establishing that these benefits can be produced with training occurring exclusively online. This is important as it suggests that inexpensive mindfulness training can be offered to widespread audiences. In addition, online training is convenient for the participants, as they do not have to go to a practitioners site on a particular schedule. This, in turn, allows for the application of mindfulness training for the prevention and treatment of psychological and physical disorders with busy people, low income people, and even people in remote locations, thus greatly expanding the numbers of people who can benefit.

 

So, learn mindfulness on-line to reduce stress effects.

 

“A live, in-person Mindfulness-Based Stress Reduction (MBSR) class is still the best way to learn mindfulness, because it is more likely that you will complete the course, due to the live interaction and group support. But doing an in-person course is not always possible, for financial and logistical reasons. The online course uses precisely the same course curriculum and resources that are used in the local in-person course, and if you follow the suggestions and practices for each of the eight weeks of the course, the learning can be just as deep and profound.” – Dave Potter

 

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 Twitter @MindfulResearch

 

Study Summary

Jayewardene, W. P., Lohrmann, D. K., Erbe, R. G., & Torabi, M. R. (2017). Effects of preventive online mindfulness interventions on stress and mindfulness: A meta-analysis of randomized controlled trials. Preventive Medicine Reports, 5, 150–159. http://doi.org/10.1016/j.pmedr.2016.11.013

 

Abstract

Empirical evidence suggested that mind-body interventions can be effectively delivered online. This study aimed to examine whether preventive online mindfulness interventions (POMI) for non-clinical populations improve short- and long-term outcomes for perceived-stress (primary) and mindfulness (secondary). Systematic search of four electronic databases, manuscript reference lists, and journal content lists was conducted in 2016, using 21 search-terms. Eight randomized controlled trials (RCTs) evaluating effects of POMI in non-clinical populations with adequately reported perceived-stress and mindfulness measures pre- and post-intervention were included. Random-effects models utilized for all effect-size estimations with meta-regression performed for mean age and %females. Participants were volunteers (adults; predominantly female) from academic, workplace, or community settings. Most interventions utilized simplified Mindfulness-Based Stress Reduction protocols over 2–12 week periods. Post-intervention, significant medium effect found for perceived-stress (g = 0.432), with moderate heterogeneity and significant, but small, effect size for mindfulness (g = 0.275) with low heterogeneity; highest effects were for middle-aged individuals. At follow-up, significant large effect found for perceived-stress (g = 0.699) with low heterogeneity and significant medium effect (g = 0.466) for mindfulness with high heterogeneity. No publication bias was found for perceived-stress; publication bias found for mindfulness outcomes led to underestimation of effects, not overestimation. Number of eligible RCTs was low with inadequate data reporting in some studies. POMI had substantial stress reduction effects and some mindfulness improvement effects. POMI can be a more convenient and cost-effective strategy, compared to traditional face-to-face interventions, especially in the context of busy, hard-to-reach, but digitally-accessible populations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5199155/