MBSR

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/

Reduce Stress with Preventative On-line Mindfulness Training

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Reduce Stress with Preventative On-line Mindfulness Training

 

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 physical and psychological health and particularly with the physical and psychological reactions to stress. Techniques such as Mindfulness Training, 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 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, 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.

 

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/, Jayawardene and colleagues reviewed and conducted a meta-analysis of the published research literature on the effectiveness of preventative mindfulness training on-line with normal, non-clinical, individuals for the relief of stress effects. They found 8 published randomized controlled trials. Most used modifications of the Mindfulness-Based Stress Reduction (MBSR) program and lasted from 2 to 12 weeks. MBSR includes body scan, meditation, and yoga practices.

 

They found that the published studies report significant reductions in perceived stress of moderate effect sizes and increases of mindfulness of small effect sizes following mindfulness training in comparison to baseline and control conditions. These effects persisted up to several months after the end of training. They also found that the older the participant the larger the reduction in perceived stress produced by mindfulness training.

 

These results are significant but not unexpected as Mindfulness-Based Stress Reduction (MBSR) was developed specifically to target perceived stress. What is significant is that this effectiveness occurs even when the training occurs strictly over the internet and with normal, non-clinical, populations. 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.

 

Mindfulness training has been shown to have a myriad of physical and psychological benefits. The present findings are exciting in that they suggest that mindfulness training can occur inexpensively to disparate populations. The on-line mindfulness training may then, by reducing stress effects in normal people, act to prevent the many physical and psychological problems that result from chronic stress, improving their health and well-being.

 

So, reduce stress with preventative on-line mindfulness training.

 

“These are difficult times right now for a lot of people. Learning to become more “present,” frees us to be more flexible and creative – and ultimately, more resilient, enjoying better health and well-being.’”– 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

 

Jayawardene, 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

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/

Mindfulness Improves Stress and Psychological Well-Being in Patients with Multiple Sclerosis

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Mindfulness Improves Stress and Psychological Well-Being in Patients with Multiple Sclerosis

 

By John M. de Castro, Ph.D.

 

“Studies show that for some people with MS, chronic exposure to stress is associated with worsening neurological symptoms and increased brain lesions. . . and relapses. Researchers believe that mindfulness may help people better respond to stress by fostering healthier coping strategies.” – Amit Sood

 

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

 

Although there is a progressive deterioration, MS is not fatal with MS patients having about the same life expectancy as the general population. Hence, most MS sufferers have to live with the disease for many years. So, quality of life becomes a major issue. Quality of life with MS is affected by fatigue, cognitive decrements, physical impairment, depression, and poor sleep quality. There is thus a critical need for safe and effective methods to help relieve the symptoms of MS and improve quality of life over the lifespan. Mindfulness has been previously shown to improve depression, sleep quality, cognitive impairments, emotion regulation, and fatigue. A number of forms of mindfulness training including meditation, yoga, and tai chi have been shown to improve the symptoms of multiple sclerosis. Since, the Mindfulness Based Stress Reduction (MBSR) program incorporates meditation, yoga, and body scan, it may be particularly helpful for patients with MS.

 

In today’s Research News article “Mindfulness-based stress reduction for people with multiple sclerosis – a feasibility randomised controlled trial.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5434553/, Simpson and colleagues perform a pilot study of the effectiveness of a Mindfulness Based Stress Reduction (MBSR) program for the symptoms of multiple sclerosis. They recruited adults with Multiple Sclerosis and randomly assigned them to either receive 8 weeks, once a week for 90 minutes, of Mindfulness Based Stress Reduction (MBSR) or a wait-list control condition. Patients were encouraged to practice daily at home. They were measured before and after treatment and three months later for perceived stress, quality of life, fatigue mental health, social support, cognitive function, pain, visual function, bladder function, bowel function, sexual satisfaction, mindfulness, self-compassion, and emotional lability.

 

They found that immediately after treatment the MBSR group compared to the wait-list controls had significant improvements in their quality of life with small effect size and in perceived stress, depression, self-compassion, anxiety, and positive emotions with large effect sizes. For the most part these effects were maintained at the three-month follow-up. These results need to be replicated in a large randomized controlled clinical trial with an active control group.

 

The results demonstrate that MBSR has relatively large beneficial effects on the quality of life and psychological well-being of patients with multiple sclerosis that appear to endure, at least for three months after treatment. It will be important to see if continued practice at home can maintain the benefits for long periods of time.

 

But it is clear that mindfulness improves stress and psychological well-being in patients with multiple sclerosis

 

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

 

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

 

Simpson, R., Mair, F. S., & Mercer, S. W. (2017). Mindfulness-based stress reduction for people with multiple sclerosis – a feasibility randomised controlled trial. BMC Neurology, 17, 94. http://doi.org/10.1186/s12883-017-0880-8

 

Abstract

Background

Multiple sclerosis (MS) is a stressful condition. Mental health comorbidity is common. Stress can increase the risk of depression, reduce quality of life (QOL), and possibly exacerbate disease activity in MS. Mindfulness-Based Stress Reduction (MBSR) may help, but has been little studied in MS, particularly among more disabled individuals.

Methods

The objective of this study was to test the feasibility and likely effectiveness of a standard MBSR course for people with MS. Participant eligibility included: age > 18, any type of MS, an Expanded Disability Status Scale (EDSS).

Results

Fifty participants were recruited and randomised (25 per group). Trial retention and outcome measure completion rates were 90% at post-intervention, and 88% at 3 months. Sixty percent of participants completed the course. Immediately post-MBSR, perceived stress improved with a large effect size (ES 0.93; p < 0.01), compared to very small beneficial effects on QOL (ES 0.17; p = 0.48). Depression (ES 1.35; p < 0.05), positive affect (ES 0.87; p = 0.13), anxiety (ES 0.85; p = 0.05), and self-compassion (ES 0.80; p < 0.01) also improved with large effect sizes. At three-months post-MBSR (study endpoint) improvements in perceived stress were diminished to a small effect size (ES 0.26; p = 0.39), were negligible for QOL (ES 0.08; p = 0.71), but were large for mindfulness (ES 1.13; p < 0.001), positive affect (ES 0.90; p = 0.54), self-compassion (ES 0.83; p < 0.05), anxiety (ES 0.82; p = 0.15), and prospective memory (ES 0.81; p < 0.05).

Conclusions

Recruitment, retention, and data collection demonstrate that a RCT of MBSR is feasible for people with MS. Trends towards improved outcomes suggest that a larger definitive RCT may be warranted. However, optimisation changes may be required to render more stable the beneficial treatment effects on stress and depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5434553/

Improve Mood and Stress Symptoms in Breast Cancer Survivors with Mindfulness

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Improve Mood and Stress Symptoms in Breast Cancer Survivors with Mindfulness

 

By John M. de Castro, Ph.D.

 

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

 

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. Death rates have been decreasing for decades from improved detection and treatment of breast cancer. Five-year survival rates are now at around 95%. The improved survival rates mean that more women are now living with cancer.

 

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

 

Mindfulness training has been shown to help with general cancer recovery and breast cancer recovery. Mindfulness helps to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. Most forms of mindfulness training contain a number of non-mindfulness components such as the social support and social interactions that occur in the course of treatment. In today’s Research News article “Mindfulness-Based Cancer Recovery (MBCR) versus Supportive Expressive Group Therapy (SET) for distressed breast cancer survivors: evaluating mindfulness and social support as mediators.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5406481/, Schellekens and colleagues examine the contribution of social support to the effectiveness of mindfulness training in alleviating distress in breast cancer survivors.

 

They recruited women with breast cancer and randomly assigned them to receive either 8-weeks of Mindfulness Based Cancer Recovery (MBCR) or 12-weeks of Supportive Expressive Group Therapy (SET). MBCR was based upon Mindfulness Based Stress Reduction (MBSR) program which includes body scan meditation, yoga, and meditation practice but was modified for cancer patients. MBCR was administered in 8 weekly 90 minute sessions with home practice strongly encouraged. SET is a group based program designed to develop mutual and family support and openness and emotional expressiveness. SET was administered in 12 weekly 90 minute group sessions. Before and after treatment the participants were measured for mood disturbance, stress symptoms, quality of life, mindfulness, and social support. Mood disturbance was calculated as the sum of anxiety, depression, anger, vigor, fatigue, and confusion symptoms.

 

They found that the mindfulness program produced marked and significant reductions in mood disturbance and stress symptoms and increases in social support that were significantly greater than the Supportive Expressive Group Therapy (SET). Both groups increased in mindfulness but were not significantly different. Mediation analysis revealed that MBCR relative to SET reduced mood disturbance in part directly and in part indirectly by increasing social support which in turn reduced mood disturbance. Similarly, MBCR relative to SET reduced stress symptoms in part directly and in part indirectly by increasing social support which in turn reduced stress symptoms. This is an excellent study as it was randomized and the comparison condition was an active control which received appropriate treatment. This is a much stronger design than the typical wait-list no treatment control, excluding placebo effects and attentional effects as alternative explanations.

 

These results are interesting and suggest that the effectiveness of mindfulness treatments for mood disturbance and stress in cancer patients are due in part to mindfulness training increasing the amount of social support that the patient receives. Family and friends, if supportive, can do wonders to reduce the stress and emotional consequences of a cancer diagnosis. Mindfulness training by enhancing the social support improves mood and relieves stress. But, the results also show that mindfulness training itself produces reductions in emotional problems and the symptoms of stress independent of its effects on social support. This is not surprising as the ability of mindfulness training to improve emotional regulation and stress responding are well documented. So, it is clear that mindfulness training invokes a number of beneficial processes that assist the cancer sufferer in dealing with their illness.

 

So, improve mood and stress symptoms in breast cancer survivors with mindfulness.

 

“A brief mindfulness-based intervention has a positive short-term effect on psychological and behavioral measures as well as proinflammatory signal markers in younger breast cancer survivors” – Julienne Bower

 

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

 

Schellekens, M. P. J., Tamagawa, R., Labelle, L. E., Speca, M., Stephen, J., Drysdale, E., … Carlson, L. E. (2017). Mindfulness-Based Cancer Recovery (MBCR) versus Supportive Expressive Group Therapy (SET) for distressed breast cancer survivors: evaluating mindfulness and social support as mediators. Journal of Behavioral Medicine, 40(3), 414–422. http://doi.org/10.1007/s10865-016-9799-6

 

Abstract

Despite growing evidence in support of mindfulness as an underlying mechanism of mindfulness-based interventions (MBIs), it has been suggested that nonspecific therapeutic factors, such as the experience of social support, may contribute to the positive effects of MBIs. In the present study, we examined whether change in mindfulness and/or social support mediated the effect of Mindfulness-Based Cancer Recovery (MBCR) compared to another active intervention (i.e. Supportive Expressive Group Therapy (SET)), on change in mood disturbance, stress symptoms and quality of life. A secondary analysis was conducted of a multi-site randomized clinical trial investigating the impacts of MBCR and SET on distressed breast cancer survivors (MINDSET). We applied the causal steps approach with bootstrapping to test mediation, using pre- and post-intervention questionnaire data of the participants who were randomised to MBCR (n = 69) or SET (n = 70). MBCR participants improved significantly more on mood disturbance, stress symptoms and social support, but not on quality of life or mindfulness, compared to SET participants. Increased social support partially mediated the impact of MBCR versus SET on mood disturbance and stress symptoms. Because no group differences on mindfulness and quality of life were observed, no mediation analyses were performed on these variables. Findings showed that increased social support was related to more improvement in mood and stress after MBCR compared to support groups, whereas changes in mindfulness were not. This suggests a more important role for social support in enhancing outcomes in MBCR than previously thought.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5406481/

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/