MBSR

Improve the Psychological Health in Breast Cancer Patients with Mindfulness

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Improve the Psychological Health in Breast Cancer Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is a state of mind which we can all acquire and use to support our wellbeing physically, emotionally and mentally.  . . Having cancer, or specifically breast cancer, is no exception. Our cancer experiences take up a lot of energies, mental focus and can drain us emotionally. It is important to have a few tools to help us create ‘down’ and ‘out’ times, and to replenish and reconnect with who we are. “ – Breast Cancer Now

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress,  sleep disturbance, fear, and anxiety and depression. There has been considerable research conducted on the effectiveness of mindfulness practices in treating the psychological issues associated with cancer. So, it makes sense to step back and summarize what has been learned.

 

In today’s Research News article “Mindfulness-based stress reduction for women diagnosed with breast cancer.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436161/), Schell and colleagues review, summarize, and perform a meta-analysis of the published research studies investigating the effectiveness of the Mindfulness-Based Stress Reduction (MBSR) program for the treatment of the psychological problems that occur in women who survive breast cancer. MBSR includes meditation, body scan, yoga practices, and discussion along with daily home practice. They identified 14 randomized controlled trials.

 

They report that the published research studies provide evidence that the Mindfulness-Based Stress Reduction (MBSR) program improves the quality of life and sleep and reduces anxiety, depression, and fatigue in breast cancer patients. The effect sizes are small and the effects were no longer present at long-term follow-up a year after the end of treatment. MBSR is a complex of practices and the research to date cannot differentiate which components or which combination of components are responsible for the benefits.

 

There is substantial evidence that mindfulness training improves quality of life and sleep and reduces anxiety, depression, and fatigue in a wide variety of healthy and ill individuals. The present results suggest that it also has these benefits for women suffering with breast cancer. Hence, MBSR may be recommended to improve the psychological health of breast cancer patients.

 

So, improve the psychological health in breast cancer patients with mindfulness.

 

“Studies have shown mindfulness-based stress reduction can be effective in alleviating anxiety and depression, decreasing long-term emotional and physical side effects of treatments and improving the quality of sleep in breast cancer patients.” – Breast Cancer Research Foundation

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Schell, L. K., Monsef, I., Wöckel, A., & Skoetz, N. (2019). Mindfulness-based stress reduction for women diagnosed with breast cancer. The Cochrane database of systematic reviews, 3(3), CD011518. https://doi.org/10.1002/14651858.CD011518.pub2

 

Abstract

Background

Breast cancer is the most common cancer in women. Diagnosis and treatment may drastically affect quality of life, causing symptoms such as sleep disorders, depression and anxiety. Mindfulness‐based stress reduction (MBSR) is a programme that aims to reduce stress by developing mindfulness, meaning a non‐judgmental, accepting moment‐by‐moment awareness. MBSR seems to benefit patients with mood disorders and chronic pain, and it may also benefit women with breast cancer.

Objectives

To assess the effects of mindfulness‐based stress reduction (MBSR) in women diagnosed with breast cancer.

Search methods

In April 2018, we conducted a comprehensive electronic search for studies of MBSR in women with breast cancer, in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and two trial registries (World Health Organization’s International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov). We also handsearched relevant conference proceedings.

Selection criteria

Randomised clinical trials (RCTs) comparing MBSR versus no intervention in women with breast cancer.

Data collection and analysis

We used standard methodological procedures expected by Cochrane. Using a standardised data form, the review authors extracted data in duplicate on methodological quality, participants, interventions and outcomes of interest (quality of life, fatigue, depression, anxiety, quality of sleep, overall survival and adverse events). For outcomes assessed with the same instrument, we used the mean difference (MD) as a summary statistic for meta‐analysis; for those assessed with different instruments, we used the standardised mean difference (SMD). The effect of MBSR was assessed in the short term (end of intervention), medium term (up to 6 months after intervention) and long term (up to 24 months after intervention).

Main results

Fourteen RCTs fulfilled our inclusion criteria, with most studies reporting that they included women with early breast cancer. Ten RCTs involving 1571 participants were eligible for meta‐analysis, while four studies involving 185 participants did not report usable results. Queries to the authors of these four studies were unsuccessful. All studies were at high risk of performance and detection bias since participants could not be blinded, and only 3 of 14 studies were at low risk of selection bias. Eight of 10 studies included in the meta‐analysis recruited participants with early breast cancer (the remaining 2 trials did not restrict inclusion to a certain cancer type). Most trials considered only women who had completed cancer treatment.

MBSR may improve quality of life slightly at the end of the intervention (based on low‐certainty evidence from three studies with a total of 339 participants) but may result in little to no difference up to 6 months (based on low‐certainty evidence from three studies involving 428 participants). Long‐term data on quality of life (up to two years after completing MBSR) were available for one study in 97 participants (MD 0.00 on questionnaire FACT‐B, 95% CI −5.82 to 5.82; low‐certainty evidence).

In the short term, MBSR probably reduces fatigue (SMD −0.50, 95% CI −0.86 to −0.14; moderate‐certainty evidence; 5 studies; 693 participants). It also probably slightly reduces anxiety (SMD −0.29, 95% CI −0.50 to −0.08; moderate‐certainty evidence; 6 studies; 749 participants), and it reduces depression (SMD −0.54, 95% CI −0.86 to −0.22; high‐certainty evidence; 6 studies; 745 participants). It probably slightly improves quality of sleep (SMD −0.38, 95% CI −0.79 to 0.04; moderate‐certainty evidence; 4 studies; 475 participants). However, these confidence intervals (except for short‐term depression) are compatible with both an improvement and little to no difference.

In the medium term, MBSR probably results in little to no difference in medium‐term fatigue (SMD −0.31, 95% CI −0.84 to 0.23; moderate‐certainty evidence; 4 studies; 607 participants). The intervention probably slightly reduces anxiety (SMD −0.28, 95% CI −0.49 to −0.07; moderate‐certainty evidence; 7 studies; 1094 participants), depression (SMD −0.32, 95% CI −0.58 to −0.06; moderate‐certainty evidence; 7 studies; 1097 participants) and slightly improves quality of sleep (SMD −0.27, 95% CI −0.63 to 0.08; moderate‐certainty evidence; 4 studies; 654 participants). However, these confidence intervals are compatible with both an improvement and little to no difference.

In the long term, moderate‐certainty evidence shows that MBSR probably results in little to no difference in anxiety (SMD −0.09, 95% CI −0.35 to 0.16; 2 studies; 360 participants) or depression (SMD −0.17, 95% CI −0.40 to 0.05; 2 studies; 352 participants). No long‐term data were available for fatigue or quality of sleep.

No study reported data on survival or adverse events.

Authors’ conclusions

MBSR may improve quality of life slightly at the end of the intervention but may result in little to no difference later on. MBSR probably slightly reduces anxiety, depression and slightly improves quality of sleep at both the end of the intervention and up to six months later. A beneficial effect on fatigue was apparent at the end of the intervention but not up to six months later. Up to two years after the intervention, MBSR probably results in little to no difference in anxiety and depression; there were no data available for fatigue or quality of sleep.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436161/

 

Improve the Symptoms of Psychosis with Mindfulness

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Improve the Symptoms of Psychosis with Mindfulness

 

By John M. de Castro, Ph.D.

 

“There is increasing evidence that specially adapted mindfulness techniques can be used safely and effectively in the management and treatment of severe mental health problems, such as psychosis.” – Carly Samson

 

Psychoses are mental health problems that cause people to perceive or interpret things differently from those around them. This might involve hallucinations; seeing and, in some cases, feeling, smelling or tasting things that aren’t objectively there, or delusions; unshakable beliefs that, when examined rationally, are obviously untrue. The combination of hallucinations and delusional thinking can often severely disrupt perception, thinking, emotion, and behavior, making it difficult if not impossible to function in society without treatment. Psychoses appear to be highly heritable and involves changes in the brain. The symptoms of psychoses usually do not appear until late adolescence or early adulthood. There are, however, usually early signs of the onset of psychoses which present as cognitive impairments.

 

Mindfulness training has been shown to be beneficial for patients with psychosis. Implementing interventions early in the disease progression may maximize the benefits. This training improves a number of different facets of mindfulness. These include describing, observing, acting with awareness, non-judging, and nor-reacting facets. It has not been established which of these facets is critical for symptom improvement

 

In today’s Research News article “The Role of Five Facets of Mindfulness in a Mindfulness-Based Psychoeducation Intervention for People With Recent-Onset Psychosis on Mental and Psychosocial Health Outcomes.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078358/), Chien and colleagues recruited patients in the early stages of psychosis (< 5 years since onset) including schizophrenia, schizophreniform/schizoaffective disorders or other psychotic disorders. They were randomly assigned to receive either mindfulness-based psychoeducation, conventional psychoeducation, or treatment-as-usual. The mindfulness-based psychoeducation program was a Mindfulness-Based Stress Reduction (MBSR) modified for psychotic patients and consisted of one session every other week for 24 weeks along with daily practice of 20 minutes. They were measured before and after the program and 6 and 18 months later for positive and negative psychotic symptoms, process of recovery, insight, treatment attitude, level of functioning, and mindfulness.

 

They found that in comparison to baseline and the control groups the patients who received mindfulness-based psychoeducation had significantly greater increases in mindfulness that persisted at the 18-month follow-up. They also found that greater the increases in mindfulness the greater the improvements in positive and negative psychotic symptoms, process of recovery, insight, treatment attitude, and level of functioning. Psychosocial functioning was the most highly related symptom while psychotic symptoms were less associated. Of the facets of mindfulness, only the observing and acting with awareness facets were significantly associated with the symptom improvements.

 

These results are interesting and suggest that mindfulness can be improved in psychotic patients with training and that these improvements are related to improvements in symptoms. It appears that training that improves the patient’s ability to observe what is occurring in the present moment and to act with awareness in response to what is occurring are the most important aspects of mindfulness for symptom improvement. It would make sense that these abilities would be particularly useful for psychosocial functioning. Psychotic symptoms are extremely difficult to treat. So, these results suggest that mindfulness training may be a helpful program for psychotic patients in the early stages of the disease.

 

So, improve the symptoms of psychosis with mindfulness.

 

“There is emerging evidence that mindfulness for psychosis – when used in an adapted form – is safe and therapeutic.” – Paul Chadwick

 

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

 

Chien, W. T., Chow, K. M., Chong, Y. Y., Bressington, D., Choi, K. C., & Chan, C. (2020). The Role of Five Facets of Mindfulness in a Mindfulness-Based Psychoeducation Intervention for People With Recent-Onset Psychosis on Mental and Psychosocial Health Outcomes. Frontiers in psychiatry, 11, 177. https://doi.org/10.3389/fpsyt.2020.00177

 

Abstract

Objective: This study aimed to examine how five facets of mindfulness may be associated with the changes in psychotic patients’ health outcomes after participating in a mindfulness-based psychoeducation group (MBPEG) program.

Methods: Longitudinal follow-up data from two pragmatic randomized controlled trials of MBPEG for psychotic patients were used for this study. A total of 124 patients who completed the MBPEG program were included in this analysis. Patient outcomes (psychotic symptoms, functioning, insight into illness/treatment, subjective recovery) and five facets of mindfulness were assessed at baseline and six, 12 and 24 months post-intervention. Areas under the curve of individual outcomes in repeated-measures were computed using trapezoidal method, rescaled to the original possible range of the underlying variable and used for correlation and regression analyses.

Results: All mean scores of the five facets increased across time and were significantly correlated with the improvements in all patient outcomes (p-values ranged from <0.001 to <0.05), except “non-judging” facet and symptom severity. Regression analyses revealed that only “observing” and “acting with awareness” were significantly associated with positive changes across all outcomes (increase in adjusted R2 ranged from 5.9% to 24.2%, p < 0.001).

Conclusions: Two facets of mindfulness, “observing” and “acting with awareness,” were related to positive outcomes of psychotic patients after participating in the MBPEG. More efforts in addressing these two facets of mindfulness can be considered to increase the efficacy of mindfulness-based interventions in psychosis.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078358/

 

Long-Term Meditators have More Frequent Lucid Dreams

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How Tame Impala, Pink Floyd And The Doors Will Give You Lucid ...Long-Term Meditators have More Frequent Lucid Dreams

 

By John M. de Castro, Ph.D.

 

“All that we see or seem/Is but a dream within a dream.” – Edgar Allan Poe

 

We spend about a third of our lives in sleep, but we know very little about it. It is known that sleep is not a unitary phenomenon. Rather, it involves several different states that can be characterized by differences in physiological activation, neural activity, and subjective experiences. Dreaming occurs several times each night during a particularly deep stage of sleep called rapid eye movement or REM sleep. Dreams have been the subject of much speculation and theorization but little empirical research.

 

An intriguing form of dreaming is the lucid dream where the individual is aware that they are dreaming. They may even be able to affect the content of the dream. These are quite common with about three quarters of people having a lucid dream at least once. It has been reported that meditation and mindfulness may increase the likelihood of lucid dreams. But there is very little empirical research on the subject.

 

In today’s Research News article “Increased lucid dream frequency in long-term meditators but not following MBSR training.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6490164/), Baird and colleagues recruited adults who were meditation naïve and long-term meditators who meditated at least 200 minutes per week for over 5 years. The meditation naïve participants were randomly assigned to a wait-list condition or to receive 9-week programs of Mindfulness-Based Stress Reduction (MBSR) or Health education. Training occurred over 9 weeks for 2.5 hours each week and included daily home practice. Participants were measured before and after training and 6 months later for how often they recalled dreams, lucid dreams, and mindfulness.

 

They found that long-term meditators had almost 2 and a half times more lucid dreams than meditation naïve participants while the groups did not differ on dream recall frequencies. There were no differences in lucid dream frequency with different meditation practices or amount of meditation experience. Among the long-term meditators those that had frequent lucid dreams were significantly higher in mindfulness especially the observing, acting with awareness, and decentering facets. Further, they found that neither the Mindfulness-Based Stress Reduction (MBSR) or Health education programs produced any significant changes in lucid dreaming in the meditation naïve participants.

 

These findings have to be interpreted with caution as the types of people who engage in long-term meditation might be significantly different than those individuals who do not choose to meditate. It could be that people who have frequent lucid dreams are exactly the same kinds of people who are attracted to meditation practice. The fact that mindfulness training with the Mindfulness-Based Stress Reduction (MBSR) did not influence lucid dream frequency supports this interpretation. Additionally, the fact that there the amount of meditation experience was unrelated to lucid dreaming also supports this interpretation.

 

Nevertheless, the results suggest that long-term meditators have relatively frequent lucid dreams. It is not known why this might be true. But it can be speculated that this is due to the fact that meditation practice improves meta-cognition, the ability to be aware of one’s own thoughts. This ability may make the individual more aware of their conscious process during dreams, lucid dreaming. It is also possible that increased mindfulness produced by meditation practice promotes lucid dreaming. It remains for future research to investigate these potential mechanisms.

 

But it is clear that long-term meditators have more frequent lucid dreams.

 

“You know that magical moment when you wake up within a dream and know you’re dreaming? That’s lucid dreaming. It’s a skill you can develop and a beneficial meditation practice you can do.” – Andrew Holecek

 

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

 

Baird, B., Riedner, B. A., Boly, M., Davidson, R. J., & Tononi, G. (2019). Increased lucid dream frequency in long-term meditators but not following MBSR training. Psychology of consciousness (Washington, D.C.), 6(1), 40–54. https://doi.org/10.1037/cns0000176

 

Abstract

Strong conceptual and theoretical connections have been made between meditation practice, mindfulness and lucid dreaming. However, only a handful of empirical studies have evaluated the relationship between lucid dreaming and meditation, and conclusions remain tempered by methodological limitations. Here we evaluate the relationship between meditation, mindfulness and lucid dream frequency using several complementary methods. First, using a cross-sectional design, we evaluate differences in lucid dream frequency between long-term meditators and meditation naïve individuals. Second, we evaluate the relationship between lucid dream frequency and specific facets of trait mindfulness in both meditators and non-meditators. Third, using a blinded randomized-controlled design, we evaluate the impact of an 8-week mindfulness course on lucid dreaming frequency. Our results show that lucid dreaming is more frequent in long-term meditators compared to meditation naïve individuals. Additionally, lucid dream frequency in meditation-naïve individuals was associated with a capacity to verbalize experience, while lucid dream frequency in long-term meditators was associated with observational and decentering facets of trait mindfulness. However, an 8-week mindfulness course did not increase the frequency of lucid dreams. Together these results support a continuity between increased awareness of waking and sleeping states, provide a novel form of evidence linking meditation training to meta-awareness, and support an association between meditation practice and lucid dreaming, but leave open the specific nature of this connection.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6490164/

Reduce Inflammation in Mildly Cognitive Impaired Elderly with Mindfulness

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Reduce Inflammation in Mildly Cognitive Impaired Elderly with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness practice was not directly linked to lower inflammation levels, but may have bolstered stress resilience among at-risk adults by preventing an increase in inflammatory biomarker levels.” – Grace Bullock

 

The immune system is designed to protect the body from threats like stress, infection, injury, and toxic chemicals. One of its tools is the Inflammatory response. This response works quite well for short-term infections and injuries. But when inflammation is protracted and becomes chronic, it can itself become a threat to health. It can produce autoimmune diseases such as colitis, Chron’s disease, arthritis, heart disease, increased cancer risk, lung disease, sleep disruption, gum disease, decreased bone health, psoriasis, and depression. In the elderly it is associated with the onset of dementia.

 

Needless to say, chronic inflammation can create major health problems. Indeed, the presence of chronic inflammation is associated with reduced longevity. So, it is important for health to control the inflammatory response, allowing it to do its job in fighting off infection but reducing its activity when no external threat is apparent. Of course, it is far better to prevent chronic inflammation in the first place than to treat it later. Mind-body techniques such as yoga, Tai Chi and meditation have been shown to adaptively reduce the inflammatory response. Mindfulness training, then, may reduce the prospect of the development of dementia by reducing the inflammatory response.

 

In today’s Research News article “Mindfulness improves inflammatory biomarker levels in older adults with mild cognitive impairment: a randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7026149/), Ng and colleagues recruited elderly (> 60 years of age) who had mild cognitive impairment but not dementia and randomly assigned them to receive once a week for 1 hour for 12 weeks of either health education or mindfulness awareness practice. For the next 6 months they received monthly booster sessions. The mindfulness awareness practice was based upon the Mindfulness-Based Stress Reduction (MBSR) program adapted for the elderly. The participants were also instructed to practice daily at home. Before and after training and 6 months later the participants contributed blood samples that were assayed for inflammatory biomarkers of high-sensitivity (hs)-CRP, BDNF, and DHEA-S. They also contributed salivary samples that were assayed for the inflammatory biomarkers of cortisol, IL-1β, and IL-6.

 

They found that in comparison to baseline and the health education group, the elderly participants who received mindfulness training had significantly lower blood levels of high-sensitivity (hs)-CRP at the end of training and 6 months later. This effect was particularly strong in female participants. Male participants had significantly reduced IL-6 and IL-1β levels at the end of training.

 

These findings are potentially very important. high-sensitivity (hs)-CRP has been associated with the onset of dementia. Hence, mindfulness training may significantly reduce this risk factor for dementia. Mindfulness training has been shown to improve the symptoms of dementia. The present findings suggest that mindfulness training may work to improve dementia by lowering high-sensitivity (hs)-CRP. It remains for future research to investigate this tantalizing prospect.

 

The results suggest that mindfulness training reduce biomarkers of inflammation in the elderly with mild cognitive impairment. Inflammation is characteristic of dementia. The results suggest that mindfulness training may reduce the likelihood that mild cognitive impairment develops into full-fledged dementia by reducing inflammation in the elderly. Regardless, the reduction in inflammation would be predicted to improve the overall health and longevity of the elderly.

 

So, reduce inflammation in mildly cognitive impaired elderly with mindfulness.

 

“Meditation is associated with many psychological and physical benefits. “In general, it’s been shown to decrease blood pressure and inflammation.” – Heidi Goldman

 

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

 

Ng, T., Fam, J., Feng, L., Cheah, I. K., Tan, C. T., Nur, F., Wee, S. T., Goh, L. G., Chow, W. L., Ho, R. C., Kua, E. H., Larbi, A., & Mahendran, R. (2020). Mindfulness improves inflammatory biomarker levels in older adults with mild cognitive impairment: a randomized controlled trial. Translational psychiatry, 10(1), 21. https://doi.org/10.1038/s41398-020-0696-y

 

Abstract

Few randomized controlled trials investigated the effects of mindfulness intervention on older adults diagnosed with mild cognitive impairment (MCI). Furthermore, there have been hypotheses and theoretical mechanisms on the benefits of mindfulness intervention on biomarkers of stress, inflammation, and neuroplasticity implicated in MCI that warrant empirical evidence. We conducted a pilot randomized controlled trial to examine whether Mindful Awareness Practice (MAP) improved biomarker levels in older adults with MCI. Fifty-five community-dwelling older adults aged 60 and above were randomized into either the treatment arm, MAP, or the active control arm, the health education program (HEP). Researchers who were blinded to treatment allocation assessed the outcomes at baseline, 3-month, and 9-month follow-ups. Linear-mixed models were used to examine the effect of MAP on biomarker levels. MAP participants had significantly decreased high-sensitivity c-reactive protein (hs-CRP) levels at 9-month (β = −0.307, 95% CI = −0.559 to −0.054 P = 0.018). Exploratory sub-group analyses by sex showed significantly decreased hs-CRP in females only (β = −0.445, 95% CI = −0.700 to −0.189, P = 0.001), while stratification by MCI subtype showed hs-CRP decreased only in amnestic-MCI (aMCI) (β = −0.569, 95% CI = −1.000 to −0.133, P = 0.012). Although total sample analyses were not significant, males had significantly decreased interleukin (IL)−6 (β = −1.001, 95% CI = −1.761 to −0253, P = 0.011) and IL-1β (β = −0.607, 95% CI = −1.116 to −0.100, P = 0.021) levels at 3-month and non-significant improvements at 9-month time-point. MAP improved inflammatory biomarkers in sex- and MCI subtype-specific manners. These preliminary findings suggest the potential of mindfulness intervention as a self-directed and low-cost preventive intervention in improving pathophysiology implicated in MCI.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7026149/

 

Improve Doctor’s Performance and Well-Being with Mindfulness

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Improve Doctor’s Performance and Well-Being with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Anyone whose work involves immense human suffering needs to be aware of their inner life. The nature of the work that physicians do makes [them] more vulnerable to negative emotions or making errors,” – Ronald Epstein

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It is estimated that over 45% of healthcare workers experience burnout. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion.

 

Improving the psychological health of doctors has to be a priority. Contemplative practices have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, improving emotional regulation, and improving sleep. Hence, mindfulness may be a means to improve the performance and psychological health of doctors. Indeed, there have been a number of research studies on the topic. So, it makes sense to step back and summarize what has been found.

 

In today’s Research News article “The impact of mindfulness-based interventions on doctors’ well-being and performance: A systematic review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7003865/), Scheepers and colleagues review and summarize the published research studies on the effects of mindfulness training on the performance and well-being of doctors. They report on 24 published studies.

 

They report that the published studies found that mindfulness-based trainings significantly improved the performance and well-being of doctors. This was true particularly for group based mindfulness trainings and for trainings such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) that contained multiple elements of mindfulness trainings. There are “five different elements: (i) integration of mindfulness theory; (ii) provision of didactic information on mindfulness; (iii) development of self‐awareness about thoughts, feelings and bodily sensations; (iv) promotion of attentive and behavioural self‐regulation and positive qualities (curiosity, joy, compassion), and (v) training of meditation practice.” These positive effects were reported across different educational and hospital settings and equally for residents and specialists.

 

The accumulating evidence makes a convincing case for the efficacy of mindfulness-based trainings to improve the performance and well-being of physicians. This should improve their impacts on their patients’ health and should reduce the likelihood of eventual burnout. Although, the review did not focus on mechanisms it is likely that mindfulness has these effects by improving the doctors’ ability to withstand stress and improve their ability to effectively deal with their emotions.

 

So, improve doctor’s performance and well-being with mindfulness.

 

“Mindfulness is especially suited to physicians, because it can help counteract the worrying, perfectionism and self-judgment that are so common among doctors.” – WellMD

 

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

 

Scheepers, R. A., Emke, H., Epstein, R. M., & Lombarts, K. (2020). The impact of mindfulness-based interventions on doctors’ well-being and performance: A systematic review. Medical education, 54(2), 138–149. https://doi.org/10.1111/medu.14020

 

Abstract

Objectives

The well‐being of doctors is at risk, as evidenced by high burnout rates amongst doctors around the world. Alarmingly, burned‐out doctors are more likely to exhibit low levels of professionalism and provide suboptimal patient care. Research suggests that burnout and the well‐being of doctors can be improved by mindfulness‐based interventions (MBIs). Furthermore, MBIs may improve doctors’ performance (eg in empathy). However, there are no published systematic reviews that clarify the effects of MBIs on doctor well‐being or performance to inform future research and professional development programmes. We therefore systematically reviewed and narratively synthesised findings on the impacts of MBIs on doctors’ well‐being and performance.

Methods

We searched PubMed and PsycINFO from inception to 9 May 2018 and independently reviewed studies investigating the effects of MBIs on doctor well‐being or performance. We systematically extracted data and assessed study quality according to the Medical Education Research Study Quality Instrument (MERSQI), and narratively reported study findings.

Results

We retrieved a total of 934 articles, of which 24 studies met our criteria; these included randomised, (un)controlled or qualitative studies of average quality. Effects varied across MBIs with different training contents or formats: MBIs including essential mindfulness training elements, or employing group‐based training, mostly showed positive effects on the well‐being or performance of doctors across different educational and hospital settings. Doctors perceived both benefits (enhanced self‐ and other‐understanding) and challenges (time limitations and feasibility) associated with MBIs. Findings were subject to the methodological limitations of studies (eg the use of self‐selected participants, lack of placebo interventions, use of self‐reported outcomes).

Conclusions

This review indicates that doctors can perceive positive impacts of MBIs on their well‐being and performance. However, the evidence was subject to methodological limitations and does not yet support the standardisation of MBIs in professional development programmes. Rather, health care organisations could consider including group‐based MBIs as voluntary modules for doctors with specific well‐being needs or ambitions regarding professional development.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7003865/

Improve Body Size, Endocrine Function, and Anxiety in Anxious Obese Children with Mindfulness

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Improve Body Size, Endocrine Function, and Anxiety in Anxious Obese Children with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is a promising tool to be used as an adjunctive therapy for childhood obesity, either because of its potential to decrease stress or because it could counter act the stressful condition imposed by a restrictive dietary regimen,” – Mardia López-Alarcón

 

Obesity has become an epidemic in the industrialized world. In the U.S. the incidence of obesity, defined as a Body Mass Index (BMI) of 30 or above has more than doubled over the last 35 years to currently around 35% of the population, while two thirds of the population are considered overweight or obese (BMI > 25). Sadly, children and adolescents have not been spared with 1 in 5 school age children and young people (6 to 19 years) classified as obese.

 

Although the incidence rates have appeared to stabilize, the fact that over a third of the population is considered obese is very troubling. This is because of the health consequences of obesity. Obesity has been found to shorten life expectancy by eight years and extreme obesity by 14 years. This occurs because obesity is associated with cardiovascular problems such as coronary heart disease and hypertension, stroke, metabolic syndrome, diabetes, cancer, arthritis, and others.

 

Obviously, there is a need for effective treatments to prevent or treat obesity. But, despite copious research and a myriad of dietary and exercise programs, there still is no safe and effective treatment. Mindfulness is known to be associated with lower risk for obesity, alter eating behavior and improve health in obesity. This suggests that mindfulness training may be an effective treatment for overeating and obesity in children alone or in combination with other therapies. It would seem reasonable to attack the problem early in life with the children and adolescents. Hence, the benefits of mindfulness practice for obese children should be investigated.

 

In today’s Research News article “Mindfulness affects stress, ghrelin, and BMI of obese children: a clinical trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7040861/), López-Alarcón and colleagues recruited obese children and adolescents aged 10-17 years who scored high in anxiety levels and provided them with an 8-week, once a week for a half hour conventional nutritional intervention including recommendations for a 700 Kcal reduction in intake. They were then randomly assigned to receive either no further treatment or to receive an 8-week, once a week for 2 hours Mindfulness-Based Stress Reduction-Eat Mindful program based upon the Mindfulness-Based Stress Reduction (MBSR) program consisting on training in meditation, body scan, breathing exercises, mindful eating, and discussions of using mindfulness in everyday life. They were measured before and after the program and 8 weeks later for body size, perceived stress, and anxiety. Blood was drawn and assayed for insulin, cortisol, ghrelin, and leptin and a salivary sample was assayed for cortisol levels.

 

They found that in comparison to the baseline and the nutritional intervention only, the children and adolescents who received mindfulness training had significant reduction in anxiety levels of all forms, including phobias, generalized anxiety, obsessive-compulsive disorder, and separation anxiety. Also, there were significant reductions in body fat, cortisol, and ghrelin levels. In addition, at the 8- and 16-week follow-ups there were significant reductions in body size.

 

These are exciting results. Childhood obesity is major problem and the results of this study suggests that a mindfulness training program combined with a conventional nutritional intervention is safe and effective in improving the physical and psychological effects of obesity and in reducing body size. Mindfulness interventions have been shown to be effective in reducing anxiety in adults. But these programs have been found to have only small or mixed effectiveness in the treatment of adult obesity. But the present results suggest that mindfulness interventions may be particularly effective when applied to obese children and adolescents. A long-term follow up of these children is needed to determine the long-term effectiveness of mindfulness training.

 

So, improve body size, endocrine function, and anxiety in anxious obese children with mindfulness.

 

“We think mindfulness could recalibrate the imbalance in the brain connections associated with childhood obesity,” – Ronald Cowan

 

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

 

López-Alarcón, M., Zurita-Cruz, J. N., Torres-Rodríguez, A., Bedia-Mejía, K., Pérez-Güemez, M., Jaramillo-Villanueva, L., Rendón-Macías, M. E., Fernández, J. R., & Martínez-Maroñas, P. (2020). Mindfulness affects stress, ghrelin, and BMI of obese children: a clinical trial. Endocrine connections, 9(2), 163–172. https://doi.org/10.1530/EC-19-0461

 

Abstract

Childhood obesity is associated with stress. However, most treatment strategies include only dietary and physical activity approaches. Mindfulness may assist in weight reduction, but its effectiveness is unclear. We assessed the effect of mindfulness on stress, appetite regulators, and weight of children with obesity and anxiety. A clinical study was conducted in a pediatric hospital. Eligible children were 10–14 years old, BMI ≥95th percentile, Spence anxiety score ≥55, and who were not taking any medication or supplementation. Participants were assigned to receive an 8-week conventional nutritional intervention (CNI) or an 8-week mindfulness-based intervention plus CNI (MND-CNI). Anthropometry, body composition, leptin, insulin, ghrelin, cortisol, and Spence scores were measured at baseline and at the end of the intervention. Anthropometry was analyzed again 8 weeks after concluding interventions. Log-transformed and delta values were calculated for analysis. Thirty-three MND-CNI and 12 CNI children finished interventions; 17 MND-CNI children accomplished 16 weeks. At the end of the intervention, significant reductions in anxiety score (−6.21 ± 1.10), BMI (−0.45 ± 1.2 kg/m2), body fat (−1.28 ± 0.25%), ghrelin (−0.71 ± 0.37 pg/mL), and serum cortisol (−1.42 ± 0.94 µg/dL) were observed in MND-CNI children. Changes in anxiety score, ghrelin, and cortisol were different between groups (P < 0.05). Children who completed 16 weeks decreased BMI after intervention (−0.944 ± 0.20 kg/m2, P < 0.001) and remained lower 8 weeks later (−0.706 ± 0.19 kg/m2, P = 0.001). We concluded that mindfulness is a promising tool as an adjunctive therapy for childhood obesity. However, our findings need confirmation in a larger sample population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7040861/

 

Improve the Quality of Life of Multiple Sclerosis Patients with Mindfulness

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Improve the Quality of Life of Multiple Sclerosis Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness can improve quality of life and help people cope better with their MS. Various studies found that mindfulness decreased pain, stress, anxiety and depression.” – MS Trust

 

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. Mindfulness practices have been shown to improve the symptoms of multiple sclerosis.  Mindfulness-Based Stress Reduction (MBSR) is a mindfulness training program that involves meditation, yoga, body scan, discussion. and daily practice at home.

 

In today’s Research News article “The Effect of Mindfulness-Based Stress Reduction (MBSR) Therapy on Quality of Life in Women with Multiple Sclerosis, Ahvaz, Iran.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6942645/), Kolahkaj and colleagues examine the ability of MBSR training to improve the quality of life of women with Multiple Sclerosis (MS). They recruited women with Multiple Sclerosis and randomly assigned them to receive either a 2-hour, once a week, for 8 weeks program of Mindfulness-Based Stress Reduction (MBSR) or treatment as usual. They were measured before and after treatment and 2 months later for quality of life, pain, physical function, and mental and physical health.

 

They found that in comparison to baseline and the treatment as usual group, the patients who received Mindfulness-Based Stress Reduction (MBSR) practice had significantly better general health, physical function, vitality, mental health, physical, social, and emotional quality of life, and bodily pain.

 

These results are quite striking and corroborate previous findings that mindfulness training can significantly improve the mental health and quality of life of patients with Multiple Sclerosis. Future research should include an active comparison condition such as exercise to eliminate potential bias effects. Nevertheless, the results clearly demonstrate that mindfulness training markedly improvove the physical and mental condition of women with Multiple Sclerosis.

 

So, improve the quality of life of Multiple Sclerosis patients with mindfulness.

 

“Mindfulness helped them begin to let go of the frustration that they can’t control [the disease],” They were able to accept their MS, reduce their stress, and hopefully, improve the quality of their lives.” – Ed Tobias

 

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

 

Kolahkaj, B., Zargar, F., & Majdinasab, N. (2018). The Effect of Mindfulness-Based Stress Reduction (MBSR) Therapy on Quality of Life in Women with Multiple Sclerosis, Ahvaz, Iran. Journal of caring sciences, 8(4), 213–217. https://doi.org/10.15171/jcs.2019.030

 

Abstract

Introduction: Low quality of life is one of the most common symptoms of Multiple Sclerosis (MS) which can reduce satisfaction with life, as well as increase death ratio and neuro-mental problems. The present study aimed to determine the effect of Mindfulness-Based Stress Reduction (MBSR) therapy on the quality of life in women with Multiple sclerosis in the city of Ahvaz.

Methods: Forty eight patients who had referred to neurologists were selected by convenient sampling and were assigned into two groups (MBSR and control) randomly. The participants of the two groups answered the 36-item quality of life questionnaire. The experimental group was under treatment for 8 sessions while the control group did not receive any psychological treatment. Data were analyzed, using SPSSver.13 software by repeated measures analysis of variance.

Results: In the MBSR group, the mean subscales of QOL had more significant reduction compare to control group. Also the improvement of all subscales of mental and physical QOL continued after two months later in follow up stage.

Conclusion: The findings suggest that MBSR is useful for improving the quality of life in patients with MS.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6942645/

 

Relieve Generalized Anxiety Disorder with Mindfulness

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Relieve Generalized Anxiety Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“a way to reduce the symptoms of anxiety is to be fully, mindfully, anxious. As anxiety reveals itself to be a misperception, symptoms will dissipate.” – George Hofmann

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. 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. But there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for anxiety. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments.

 

Recently, it has been found that mindfulness training can be effective for anxiety disorders. One way that this training might affect anxiety disorders is by reducing negative interpretation bias. This involves a tendency to interpret relatively ambiguous situations as threatening. Indeed, such bias is characteristic of patients with anxiety disorders.

 

In today’s Research News article “Investigating the Role of Interpretation Bias in Mindfulness-Based Treatment of Adults With Generalized Anxiety Disorder.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2020.00082/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1254058_69_Psycho_20200225_arts_A), Hoge and colleagues recruited adult patients with Generalized Anxiety Disorder (GAD) and provided them with an 8-week program in Mindfulness-Based Stress Reduction (MBSR). The program involves weekly 2-hour sessions consisting of meditation, body scan, yoga, and discussion with daily home practice. The patients were measured before and after training for mindfulness, anxiety, and interpretation bias.

 

They found that in comparison to baseline, after Mindfulness-Based Stress Reduction (MBSR) training there were significant increases in mindfulness and significant decreases in anxiety and interpretation bias. They then performed mediation analysis and found that the higher the levels of mindfulness after training the lower the levels of anxiety but negative interpretation bias did not significantly mediate the association. They also found that the greater the change in mindfulness from baseline, the greater the change in anxiety. But the change in negative interpretation bias did not significantly mediate the association.

 

These findings corroborate previous findings that mindfulness training produces decreases in anxiety. But, contrary to the experimental hypothesis, there was no evidence that mindfulness’ effectiveness for Generalized Anxiety Disorder (GAD) results from a change in negative interpretation bias. This is contrary to previous findings that interpretation bias mediates the effects of mindfulness on anxiety. The current study used patients with GAD while prior research used healthy undergraduate students. This suggests that interpretation bias may mediate the effect of mindfulness on normal, typical, levels of anxiety but not pathological levels.

 

Other research has suggested that changes in emotion regulation, rumination and worry, or  self-compassion might partially mediate  the effects of mindfulness training on anxiety. The present results, taken together with prior findings suggests that mindfulness induced reductions in negative interpretation bias may help to lower anxiety levels when the levels are relatively low but not when the levels are extreme as in Generalized Anxiety Disorder (GAD). At extreme levels it is known that anxiety begets anxiety. That is, that the high levels of anxiety tend to produce more anxiety. It may be this amplifying effect is not addressed by changes in interpretation bias while the initial levels are.

 

So, relieve generalized anxiety disorder with mindfulness.

 

“Breathing in, I calm my body. Breathing out, I smile. Dwelling in the present moment, I know this is a wonderful moment.” – Thich Nhat Hahn

 

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, Reese HE, Oliva IA, Gabriel CD, Guidos BM, Bui E, Simon NM and Dutton MA (2020) Investigating the Role of Interpretation Bias in Mindfulness-Based Treatment of Adults With Generalized Anxiety Disorder. Front. Psychol. 11:82. doi: 10.3389/fpsyg.2020.00082

 

Although mindfulness-based interventions (MBIs) have garnered empirical support for a wide range of psychological conditions, the psychological processes that mediate the relationship between MBIs and subsequent symptomatic improvement are less well-understood. In the present study we sought to examine, for the first time, the relationship between mindfulness, negative interpretation bias as measured by the homophone task, and anxiety among adults with Generalized Anxiety Disorder (GAD). Forty-two individuals with GAD completed measures of mindfulness, interpretation bias, and anxiety before and after treatment with Mindfulness-based Stress Reduction (MBSR). Contrary to prior research, we did not find evidence of an indirect relationship between baseline levels of mindfulness and anxiety via negative interpretation bias. MBSR did result in significant reductions in negative interpretation bias from baseline to post-treatment; however, we did not find evidence of an indirect relationship between changes in mindfulness and changes in anxiety via changes in interpretation bias. Taken together, these results provide minimal support for the hypothesized relationship between mindfulness, negative interpretation bias, and anxiety among adults with GAD. Limitations and specific suggestions for further inquiry are discussed.

Highlights

– We examined the role of interpretation bias in the mindfulness-based treatment of adults with GAD.

– Participants experienced significant reductions in mindfulness, negative interpretation bias, and anxiety.

– We did not find evidence for an indirect relationship between mindfulness and anxiety via interpretation bias.

https://www.frontiersin.org/articles/10.3389/fpsyg.2020.00082/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1254058_69_Psycho_20200225_arts_A

 

Improve the Long-Term Mental Health of Breast Cancer Survivors with Mindfulness

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Improve the Long-Term Mental Health of Breast Cancer Survivors with Mindfulness

 

By John M. de Castro, Ph.D.

 

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

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatigue, stress,  sleep disturbance, and anxiety and depression. Although there is considerable research on the topic, there is very little on the long-term effectiveness of mindfulness training on Hispanic breast cancer survivors.

 

In today’s Research News article “Long-Term Effect of a Nonrandomized Psychosocial Mindfulness-Based Intervention in Hispanic/Latina Breast Cancer Survivors.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971966/), Elimimian and colleagues recruited patients who had received a breast cancer diagnosis within the last 5 years. They provided them with a once a week for 2 hours, 8 week program of Mindfulness-Based Stress Reduction (MBSR). The program included meditation, body scan, yoga practices, and discussion along with daily home practice. They were measured before the program and every 3 months thereafter for 2 years for anxiety, depression, mental, emotional, and physical health, and physical and mental quality of life.

 

They found that after MBSR treatment and over the 2-year follow-up period that there were significant reductions in anxiety and depression, and significant improvements in mental quality of life. It should be noted that there wasn’t a control comparison condition present so the results must be interpreted with caution. But prior better controlled research studies have demonstrated that MBSR treatment is effective in improving symptoms in cancer survivors. So, it is likely that the present results were due to the effectiveness of the MBSR program and not to a confounding factor. The contribution of the present study is that it demonstrates that these mental health improvements also occur in Hispanic women.

 

So, improve the long-term mental health of breast cancer survivors with mindfulness.

 

“Results show promise for mindfulness-based interventions to treat common psychological problems such as anxiety, stress, and depression in cancer survivors and to improve overall quality of life.” – Linda E. Carlson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Elimimian, E., Elson, L., Bilani, N., Farrag, S. E., Dwivedi, A. K., Pasillas, R., & Nahleh, Z. A. (2020). Long-Term Effect of a Nonrandomized Psychosocial Mindfulness-Based Intervention in Hispanic/Latina Breast Cancer Survivors. Integrative cancer therapies, 19, 1534735419890682. https://doi.org/10.1177/1534735419890682

 

Abstract

Background: There is a paucity of research on the long-term impact of stress-reduction in Hispanic/Latina breast cancer (BC) survivors, a growing minority. In this article, we assess the long-term efficacy of an 8-week training program in mindfulness-based stress reduction (MBSR) on quality of life (QoL) in Hispanic BC survivors. Methods: Hispanic BC survivors, within the first 5 years of diagnosis, stages I to III BC, were recruited. Participants were enrolled in bilingual, 8-week intensive group training in MBSR and were asked to practice a- home, daily. They were also provided with audio recordings and a book on mindfulness practices. Patient-reported outcomes for QoL and distress were evaluated at baseline, and every 3 months, for 24 months. Results: Thirty-three self-identified Hispanic women with BC completed the MBSR program and were followed at 24 months. Statistically significant reduction was noted for the Generalized Anxiety Disorder measure (mean change −2.39, P=0.04); and Patient Health Questionnaire (mean change −2.27, P=0.04), at 24 months, compared with baseline. Improvement was noted in the Short-Form 36 Health-related QoL Mental Component Summary with an increase of 4.07 (95% confidence interval = 0.48-7.66, P=0.03). However, there was no significant change in the Physical Component Summary. Conclusions: Hispanic BC survivors who participated in an 8-week MBSR–based survivorship program reported persistent benefits with reduced anxiety, depression, and improved mental health QoL over 24 months of follow-up. Stress reduction programs are beneficial and can be implemented as part of a comprehensive survivorship care in BC patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971966/

 

Improve the Psychological Well-Being of Patients Living with HIV/AIDS with Mindfulness

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Improve the Psychological Well-Being of Patients Living with HIV/AIDS with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Given the stress-reduction benefits of mindfulness meditation training, these findings indicate there can be health protective effects not just in people with HIV but in folks who suffer from daily stress,” – – David Creswell

 

More than 35 million people worldwide and 1.2 million people in the United States are living with HIV infection. These include a significant number of children and adolescents. In 1996, the advent of the protease inhibitor and the so-called cocktail changed the prognosis for HIV. Since this development a 20-year-old infected with HIV can now expect to live on average to age 69. Hence, living with HIV is a long-term reality for a very large group of people.

 

People living with HIV infection experience a wide array of physical and psychological symptoms which decrease their perceived quality of life. The symptoms include chronic pain, muscle aches, anxiety, depression, weakness, fear/worries, difficulty with concentration, concerns regarding the need to interact with a complex healthcare system, stigma, and the challenge to come to terms with a new identity as someone living with HIV. Mindfulness training has been shown to improve psychological well-being, lower depression and strengthen the immune system of patients with HIV infection. Yoga practice has also been found to be effective in treating HIV.

 

The research is accumulating. So, it makes sense to step back and review what has been learned about the effectiveness of mindfulness training for the treatment of the symptoms of living with HIV/AIDS. In today’s Research News article “Mindfulness-Based Interventions for Adults Living with HIV/AIDS: A Systematic Review and Meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6344266/), Scott-Sheldon and colleagues review, summarize, and perform a meta-analysis of the effectiveness of Mindfulness-Based Interventions (MBIs) for the treatment of the symptoms experienced by people living with HIV/AIDS.

 

They identified 16 published research studies containing a total of 1059 participants. Of these studies 11 employed Mindfulness-Based Stress Reduction (MBSR) while 5 studies employed Mindfulness-Based Cognitive Therapy (MBCT). All studies compared pre- to post-treatment measures while 9 of these studies also had a control comparison group.

 

They report that the published research found that in comparison to baseline after treatment with Mindfulness-Based Interventions (MBIs) there were significant improvements in quality of life and positive emotions and significant reductions in anxiety and depression. The reductions in depression were significantly greater for those participants who received Mindfulness-Based Cognitive Therapy (MBCT). No significant effects were reported for improvements in immune system function (CD4 counts).

 

This analysis of the available research suggests that Mindfulness-Based Interventions (MBIs) are a safe and effective treatment to improve the psychological health of patients diagnosed with HIV/AIDS. The fact that Mindfulness-Based Cognitive Therapy (MBCT) was more effective for depression was not surprising as MBCT was specifically developed to treat depression. It has been well established the Mindfulness-Based Interventions (MBIs) are effective in reducing anxiety and depression and improving positive emotions and quality of life in a wide variety of patients. The present analysis simply extends types of patients for which Mindfulness-Based Interventions (MBIs)are beneficial to patients diagnosed with HIV/AIDS.

 

So, improve the psychological well-being of patients living with HIV/AIDS with mindfulness.

 

“mindfulness-based therapies . . . had a long-term effect on stress and both a short- and long-term effect on depression in people living with an HIV infection.” – Xu Tian

 

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

 

Scott-Sheldon, L., Balletto, B. L., Donahue, M. L., Feulner, M. M., Cruess, D. G., Salmoirago-Blotcher, E., … Carey, M. P. (2019). Mindfulness-Based Interventions for Adults Living with HIV/AIDS: A Systematic Review and Meta-analysis. AIDS and behavior, 23(1), 60–75. doi:10.1007/s10461-018-2236-9

 

Abstract

This meta-analysis examined the effects of mindfulness-based interventions (MBIs) on stress, psychological symptoms, and biomarkers of disease among people living with HIV/AIDS (PLWHA). Comprehensive searches identified 16 studies that met the inclusion criteria (N = 1,059; M age = 42 years; 20% women). Participants had been living with HIV for an average of 8 years (range = <1 to 20 years); 65% were currently on antiretroviral therapy. Between-group analyses indicated that depressive symptoms were reduced among participants receiving the MBIs compared to controls (d+ = 0.37, 95% CI = 0.03, 0.71). Within-group analyses showed reductions in psychological symptoms (i.e., less anxiety, fewer depressive symptoms) and improved quality of life over time among MBI participants (d+s = 0.40–0.85). No significant changes were observed for immunological outcomes (i.e., CD4 counts) between- or within- groups. MBIs may be a promising approach for reducing psychological symptoms and improving quality of life among PLWHA. Studies using stronger designs (i.e., randomized controlled trials) with larger sample sizes and longer follow-ups are needed to clarify the potential benefits of MBIs for PLWHA.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6344266/