Meditation

Mindfulness-Based Therapies Benefits are Greatly Affected by Social Factors in Therapy

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Mindfulness-Based Therapies Benefits are Greatly Affected by Social Factors in Therapy

 

By John M. de Castro, Ph.D.

 

“Designed to deliberately focus a person’s attention on the present experience in a way that is non-judgmental, mindfulness-based interventions, whether offered individually or in a group setting, may offer benefit to people seeking therapy for any number of concerns.” – Manuel A. Manotas

 

Psychotherapy is an interpersonal transaction. Its effectiveness in treating the ills of the client is to some extent dependent upon the chemistry between the therapist and the client, termed the therapeutic alliance. Research has demonstrated that there is a positive relationship with moderate effect sizes between treatment outcomes and the depth of the therapeutic alliance.

 

There are also other factors that may be important for successful therapy. The client’s engagement in the process as well as the therapists interpersonal skills may also be important ingredients in producing successful therapeutic outcomes. There are also important social factors present particularly when the therapy is provided in groups. In addition, formal and informal practice effects are involved. There is little known, however, of the role of these components of therapy on the effectiveness of treatment for mental health issues such as depression.

 

In today’s Research News article “The Contribution of Common and Specific Therapeutic Factors to Mindfulness-Based Intervention Outcomes.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874060/ )  Canby and colleagues recruited patients diagnosed with mild to severe depression and randomly assigned them to receive once a week for 8 weeks, 3 hour sessions of either focused meditation, open monitoring meditation or Mindfulness-Based Cognitive Therapy (MBCT) which contains both focused and open monitoring meditation practices. Before and after the 8-weeks of practice and 3 months later they were measured for empathy, therapeutic alliance, formal and informal mindfulness practices, depression, anxiety, stress, mindfulness, and group therapeutic factors in group therapy: instillation of hope, secure emotional expression, awareness of relational impact, and social learning. Finally, they received structured interviews exploring mindfulness practices and impact of treatment.

 

They found that the over treatment and follow-up the groups had significantly increased mindfulness and significantly decreased anxiety, depression and stress. They found that the higher the ratings of the instructors. the ratings of the groups and the amounts of formal meditation practice the greater the changes. In general, the instructor and group factors had stronger relationships to the psychological improvements than the amount of formal meditation and the amount of informal meditation practice had no relationship with the improvements. The analysis of the structured interviews indicated that the participants found the instructor and group factors including bonding, instilling hope, and expressing feelings were important to their improvements.

 

These results are interesting replicate previous findings of mindfulness-based therapies produce improvements in anxiety, depression, and stress. The results suggest that mindfulness-based therapies have complex effects and changes in mindfulness may be less important than the social environment produced by the instructor and the group. These social factors may account for a large proportion of the benefits to the participants. These results are important as they suggest that empathizing the social interactions involved in therapy may improve the impact of the therapy on the patients’ psychological well-being.

 

So, mindfulness-based therapies benefits are greatly affected by social factors in therapy.

 

“Mindfulness’ strength is in helping us to see more clearly, by giving us the room to not be so quickly reactive. And over time the event does not have to jump to emotional distress, like a grasshopper leaping over a stream.” – Barry Boyce

 

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

 

Canby, N. K., Eichel, K., Lindahl, J., Chau, S., Cordova, J., & Britton, W. B. (2021). The Contribution of Common and Specific Therapeutic Factors to Mindfulness-Based Intervention Outcomes. Frontiers in psychology, 11, 603394. https://doi.org/10.3389/fpsyg.2020.603394

 

Abstract

While Mindfulness-Based Interventions (MBIs) have been shown to be effective for a range of patient populations and outcomes, a question remains as to the role of common therapeutic factors, as opposed to the specific effects of mindfulness practice, in contributing to patient improvements. This project used a mixed-method design to investigate the contribution of specific (mindfulness practice-related) and common (instructor and group related) therapeutic factors to client improvements within an MBI. Participants with mild-severe depression (N = 104; 73% female, M age = 40.28) participated in an 8-week MBI. Specific therapeutic factors (formal out-of-class meditation minutes and informal mindfulness practice frequency) and social common factors (instructor and group ratings) were entered into multilevel growth curve models to predict changes in depression, anxiety, stress, and mindfulness at six timepoints from baseline to 3-month follow-up. Qualitative interviews with participants provided rich descriptions of how instructor and group related factors played a role in therapeutic trajectories. Findings indicated that instructor ratings predicted changes in depression and stress, group ratings predicted changes in stress and self-reported mindfulness, and formal meditation predicted changes in anxiety and stress, while informal mindfulness practice did not predict client improvements. Social common factors were stronger predictors of improvements in depression, stress, and self-reported mindfulness than specific mindfulness practice-related factors. Qualitative data supported the importance of relationships with instructor and group members, involving bonding, expressing feelings, and instilling hope. Our findings dispel the myth that MBI outcomes are exclusively the result of mindfulness meditation practice, and suggest that social common factors may account for much of the effects of these interventions. Further research on meditation should take into consideration the effects of social context and other common therapeutic factors.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874060/

 

Maintain Vacation Benefits with Meditation

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Maintain Vacation Benefits with Meditation

 

By John M. de Castro, Ph.D.

” If you’re going to go on a vacation see if you can integrate meditation to really double up on that impact.” – Elisha Goldstein

 

A leisure vacation can rejuvenate the individual in body and mind. It decreases mental and physical fatigue and increases happiness. But unfortunately, its effects rapidly dissipate. It doesn’t take long for the positive benefits to wear off. Meditation retreats also rejuvenate the individual in body and mind, decreasing fatigue and increasing happiness. The effects of meditation appear have been generally found to be relatively longer lasting. Attending a meditation retreat or including meditation on vacation may help to sustain the effectiveness of the vacation for a longer period of time.

 

In today’s Research News article “Is a meditation retreat the better vacation? effect of retreats and vacations on fatigue, emotional well-being, and acting with awareness.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7869997/ ) Blasche and colleagues recruited adult participants in meditation retreats and also individuals who planned a vacation over the same period of time. They separated the vacation participants who did and did not include meditation in their vacation. They were measured before and after the retreat/vacation and

weeks later for acting with awareness, fatigue, emotional well-being, relaxation, control, and mastery.

 

They found that after the retreat/vacation all groups had significant reductions in fatigue and emotional well-being while on the retreat and vacation with meditation groups had significant increases in acting with awareness. Ten weeks later, however, only the retreat and vacation with meditation groups had maintained significant increases in acting with awareness and emotional well-being and decreases in fatigue.

 

These are interesting findings. But, it needs to be recognized that this was not a randomized study and the participants who chose to go on retreat or those who meditate during a vacation may be significantly different than those who do not meditate during the vacation. People who meditate may be the kinds of people who get the most out of their vacations.

 

Regardless, the results suggest that all types of vacations improve the physical and mental health of the participants, when meditation is not included the benefits fade over the next few weeks. But including meditation either in retreat of during a vacation significantly improves the longevity of the benefits. This further suggests that including some quiet reflective time in a vacation is important in maximizing the impact of the vacation on the well-being of the participants.

 

So, maintain vacation benefits with meditation.

 

“So the “vacation effect” brings short term good news for everyone, and the “meditation effect” brings longer-lasting good news, especially when you keep at it!” – Crystal Goh

 

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

 

Blasche, G., deBloom, J., Chang, A., & Pichlhoefer, O. (2021). Is a meditation retreat the better vacation? effect of retreats and vacations on fatigue, emotional well-being, and acting with awareness. PloS one, 16(2), e0246038. https://doi.org/10.1371/journal.pone.0246038

 

Abstract

It is well established that leisure vacations markedly improve well-being, but that these effects are only of short duration. The present study aimed to investigate whether vacation effects would be more lasting if individuals practiced meditation during the leisure episode. Meditation is known to improve well-being durably, among others, by enhancing the mental faculty of mindfulness. In this aim, leisure vacations during which individuals practiced meditation to some extent were compared with holidays not including any formal meditation practice as well as with meditation retreats (characterized by intense meditation practice) utilizing a naturalistic observational design. Fatigue, well-being, and mindfulness were assessed ten days before, ten days after, and ten weeks after the stays in a sample of 120 individuals accustomed to meditation practices. To account for differences in the experience of these stays, recovery experiences were additionally assessed. Ten days after the stay, there were no differences except for an increase in mindfulness for those practicing meditation. Ten weeks after the stay, meditation retreats and vacations including meditation were associated with greater increases in mindfulness, lower levels of fatigue, and higher levels of well-being than an “ordinary” vacation during which meditation was not practiced. The finding suggests that the inclusion of meditation practice during vacation could help alleviate vacations’ greatest pitfall, namely the rapid decline of its positive effects.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7869997/

 

Focused Meditation has Superior Effectiveness for Emotional Disorders

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Focused Meditation has Superior Effectiveness for Emotional Disorders

 

By John M. de Castro, Ph.D.

               

“meditation can help you relax and reduce stress. It can also help you disengage from stressful or anxious thoughts, and better control your mood.” – Healthline

 

Meditation training has been shown to improve health and well-being. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. As a result, meditation training has been called the third wave of therapies. One problem with understanding meditation effects is that there are, a wide variety of meditation techniques and it is not known which work best for affecting different psychological areas.

 

There are a number of different types of meditation. Classically they’ve been characterized on a continuum with the degree and type of attentional focus. In focused attention meditation, the individual practices paying attention to a single meditation object, often the breath. In open monitoring meditation, the individual opens up awareness to everything that’s being experienced including thoughts regardless of its origin.  Mindfulness-Based Cognitive Therapy (MBCT) employs both focused and open monitoring meditation and also Cognitive Behavioral Therapy (CBT). During therapy the patient is trained to investigate and alter aberrant thought patterns. It is important to understand which form of meditation training works best for which conditions.

 

In today’s Research News article “The contributions of focused attention and open monitoring in mindfulness-based cognitive therapy for affective disturbances: A 3-armed randomized dismantling trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802967/ ) Cullen and colleagues recruited adults with mild-moderate depression and anxiety and randomly assigned them to an 8-week program of one of three meditation types; focused meditation, open monitoring meditation, or their combination as occurs in Mindfulness-Based Cognitive Therapy (MBCT). They were measured before training and weekly over the 8-week program and 12 weeks later for depression, stress, and anxiety.

 

They found that all three meditation programs produced significant improvements in depression, stress, and anxiety at the end of training and 12 weeks later. But Mindfulness-Based Cognitive Therapy (MBCT) and focused meditation produced significantly greater reductions in anxiety at the 12-week follow-up than open monitoring meditation. During training statistically significant improvements in depression, stress, and anxiety occurred first for focused meditation, followed by MBCT, and last by open monitoring meditation.

 

These are interesting results that again demonstrate the efficacy of meditation training in improving depression, stress, and anxiety. They also found that the training in both focused and open monitoring meditation as occurs in Mindfulness-Based Cognitive Therapy (MBCT) did not produce superior results to the individual meditation types. Finally, they show the focused meditation may be superior to open monitoring meditation in relieving depression, stress, and anxiety. The participants who practiced focused meditation improved faster and at follow up had lower levels of anxiety than those who practiced open monitoring meditation.

 

The reason for the differences in the effectiveness of the different meditation types is unknown. But focused meditation may be simpler and easier to learn and practice than open monitoring meditation. Also, open monitoring meditation by having the practitioner open up awareness to everything that’s being experienced may allow for anxiety, stress, and depression to more easily arise during the session. Future research should investigate these possibilities.

 

So, focused meditation has superior effectiveness for emotional disorders.

 

“Within just a week or two of regular meditation, you should see a noticeable change in your mood and stress level. “People will start to feel some inner peace and inner poise, even in the midst of their busy lives,” – Burke Lennihan.

 

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

 

Cullen, B., Eichel, K., Lindahl, J. R., Rahrig, H., Kini, N., Flahive, J., & Britton, W. B. (2021). The contributions of focused attention and open monitoring in mindfulness-based cognitive therapy for affective disturbances: A 3-armed randomized dismantling trial. PloS one, 16(1), e0244838. https://doi.org/10.1371/journal.pone.0244838

 

Abstract

Objective

Mindfulness-based cognitive therapy (MBCT) includes a combination of focused attention (FA) and open monitoring (OM) meditation practices. The aim of this study was to assess both short- and long-term between- and within-group differences in affective disturbance among FA, OM and their combination (MBCT) in the context of a randomized controlled trial.

Method

One hundred and four participants with mild to severe depression and anxiety were randomized into one of three 8-week interventions: MBCT (n = 32), FA (n = 36) and OM (n = 36). Outcome measures included the Inventory of Depressive Symptomatology (IDS), and the Depression Anxiety Stress Scales (DASS). Mixed effects regression models were used to assess differential treatment effects during treatment, post-treatment (8 weeks) and long-term (20 weeks). The Reliable Change Index (RCI) was used to translate statistical findings into clinically meaningful improvements or deteriorations.

Results

All treatments demonstrated medium to large improvements (ds = 0.42–1.65) for almost all outcomes. While all treatments were largely comparable in their effects at post-treatment (week 8), the treatments showed meaningful differences in rapidity of response and pattern of deteriorations. FA showed the fastest rate of improvement and the fewest deteriorations on stress, anxiety and depression during treatment, but a loss of treatment-related gains and lasting deteriorations in depression at week 20. OM showed the slowest rate of improvement and lost treatment-related gains for anxiety, resulting in higher anxiety in OM at week 20 than MBCT (d = 0.40) and FA (d = 0.36), though these differences did not reach statistical significance after correcting for multiple comparisons (p’s = .06). MBCT and OM showed deteriorations in stress, anxiety and depression at multiple timepoints during treatment, with lasting deteriorations in stress and depression. MBCT showed the most favorable pattern for long-term treatment of depression.

Conclusions

FA, OM and MBCT show different patterns of response for different dimensions of affective disturbance.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802967/

 

Meditation Improves the Ability to Interface the Brain to Computers

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Meditation Improves the Ability to Interface the Brain to Computers

 

By John M. de Castro, Ph.D.

 

“Brain–computer interfaces (BCIs) are promising tools for assisting patients with paralysis, but suffer from long training times and variable user proficiency. Mind–body awareness training (MBAT) can improve BCI learning.” – ScienceDaily

 

It has long been a dream to develop methods to allow the brain to directly alter external devices. The efforts have been focused on developing a brain-computer interface such that recorded electrical activity of the brain is interfaced with a computer allowing control of the computer by the activity. It is hypothesized that a brain computer interface might be able to provide an alternative method to control muscles in patients with severe neuromuscular diseases.

 

Brain-computer interface methods have been developed but suffer from long training times before the participant is capable of affecting the computer activity. Meditation has been shown to alter the activity of the brain. Meditation training may make the individual better at controlling their brain activity. Hence, an interesting research question is to investigate whether meditation practitioners are better able to learn to control a computer with the brain’s electrical activity.

 

In today’s Research News article “Effects of Long-Term Meditation Practices on Sensorimotor Rhythm-Based Brain-Computer Interface Learning.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7858648/ ) Jiang and colleagues recruited 2 groups of healthy adults without brain-computer interface experience; one with at least two years of meditation practice and one without meditation experience. They were all measured for mindfulness. They all participated in 6 weekly, 1-hour, brain-computer interface training. Their brain electrical activity was recorded with an electroencephalogram (EEG) the electrical activity in the motor cortex was connected to a computer which moved a cursor over the screen. The participants were asked to try to move the cursor left or right by imagining opening and closing the left or right hand, to move the cursor up by imagining opening and closing both hands and down by resting.

 

They found that the meditators had significantly better performance throughout training. Improvement occurred at approximately the same rate but the meditators started off at a higher baseline. The recording of alpha rhythm power over the motor cortex increased in both groups over training. In addition, they found that the higher the level of mindfulness before training, the better the performance with the meditators having significantly higher levels of mindfulness.

 

This is an interesting study but it should be kept in mind that the meditators may be different from non-meditators in ways other than the meditation practice. Being better able to control their brain activity may be characteristic of people who choose to meditate, Nevertheless, the results demonstrate that adults can alter the electrical activity in their motor cortex by imagining opening and closing their hands and that they can learn to increase this with feedback from a moving cursor. Meditators appear to have a leg up in learning this task with being better able to control their brain activity right from the beginning. This suggests that meditation practice improves the individual’s ability to alter their brain activity making them capable of learning a brain-computer interface task faster.

 

So, meditation improves the ability to interface the brain to computers.

 

“Brain–computer interfaces (BCIs) are promising tools for assisting patients with paralysis, but suffer from long training times and variable user proficiency. Mind–body awareness training (MBAT) can improve BCI learning.” – James Stieger

 

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

 

Jiang, X., Lopez, E., Stieger, J. R., Greco, C. M., & He, B. (2021). Effects of Long-Term Meditation Practices on Sensorimotor Rhythm-Based Brain-Computer Interface Learning. Frontiers in neuroscience, 14, 584971. https://doi.org/10.3389/fnins.2020.584971

 

Abstract

Sensorimotor rhythm (SMR)-based brain–computer interfaces (BCIs) provide an alternative pathway for users to perform motor control using motor imagery. Despite the non-invasiveness, ease of use, and low cost, this kind of BCI has limitations due to long training times and BCI inefficiency—that is, the SMR BCI control paradigm may not work well on a subpopulation of users. Meditation is a mental training method to improve mindfulness and awareness and is reported to have positive effects on one’s mental state. Here, we investigated the behavioral and electrophysiological differences between experienced meditators and meditation naïve subjects in one-dimensional (1D) and two-dimensional (2D) cursor control tasks. We found numerical evidence that meditators outperformed control subjects in both tasks (1D and 2D), and there were fewer BCI inefficient subjects in the meditator group. Finally, we also explored the neurophysiological difference between the two groups and showed that the meditators had a higher resting SMR predictor, more stable resting mu rhythm, and a larger control signal contrast than controls during the task.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7858648/

 

Improve Psychological, Physiological, and Epigenetic Markers of Type 2 Diabetes with Mind-Body Practices

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Improve Psychological, Physiological, and Epigenetic Markers of Type 2 Diabetes with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

“Diabetes, like many other chronic diseases, can also affect the mind. Similarly the mind has great power to influence the body.” – Diabetes UK

 

Diabetes is a major health issue. It is estimated that 30 million people in the United States and nearly 600 million people worldwide have diabetes and the numbers are growing. Type II Diabetes results from a resistance of tissues, especially fat tissues, to the ability of insulin to promote the uptake of glucose from the blood. As a result, blood sugar levels rise producing hyperglycemia. Diabetes is heavily associated with other diseases such as cardiovascular disease, heart attacks, stroke, blindness, kidney disease, and circulatory problems leading to amputations. As a result, diabetes doubles the risk of death of any cause compared to individuals of the same age without diabetes.

 

Type 2 diabetes is largely preventable. One of the reasons for the increasing incidence of Type 2 Diabetes is its association with overweight and obesity which is becoming epidemic in the industrialized world. A leading cause of this is a sedentary life style. Current treatments for Type 2 Diabetes focus on diet, exercise, and weight control. Recently, mindfulness practices have been shown to be helpful in managing diabetes. Mindful movement practices such as Tai Chi and Qigong  and yoga are mindfulness practices that are also gentle exercises. There is accumulating research on the effectiveness of these mind-body practices for the treatment of Type 2 Diabetes. So, it makes sense to examine what has been learned.

 

In today’s Research News article “Changes Induced by Mind-Body Intervention Including Epigenetic Marks and Its Effects on Diabetes.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7865217/ ) Yang and colleagues review and summarize the published research studies of the effects of mind-body practices on the symptoms of Type 2 Diabetes including epigenetic markers.

 

They report that moving meditation practices such as Tai Chi and Qigong  and yoga have been shown to significantly improve blood glucose, HbA1c, postprandial blood glucose, total cholesterol, and both low-density and high-density lipoprotein cholesterol. Mindfulness meditation has been shown to significantly improve HbA1c, diabetes-related distress, depression, and stress. In addition, mind-body interventions produce epigenetic changes reflected in DNA methylation modification. More study is needed but these epigenetic changes may underlie the improvements in Type 2 Diabetes produced by mind-body interventions.

 

Mind-body interventions have been repeatedly demonstrated to significantly reduce depression, anxiety and stress. These psychological states tend to aggravate Type 2 Diabetes. Since mind-mind-body practices reduce depression, anxiety and stress, they produce improvements in the symptoms of diabetes. In addition, mind-body practices produce physiological changes that can improve the symptoms of Type 2 Diabetes. These include activation of the parasympathetic (relaxation) nervous system, lower stress hormone (cortisol) secretion, reduced inflammation, and even reduced age based physiological changes.

 

These are remarkable findings that suggest that mind-body practices are effective in producing psychological and physiological changes that are very beneficial for the relief of the symptoms of Type 2 Diabetes. These benefits are reflected in changes on the epigenetic level that might ultimately be responsible for the benefits. Clearly, mind-body practices should be incorporated into Type 2 Diabetes treatment programs.

 

So, improve psychological, physiological, and epigenetic markers of type 2 diabetes with mind-body practices.

 

“meditation strategies can be useful adjunctive techniques to lifestyle modification and pharmacological management of diabetes and help improve patient wellbeing.” Gagan Priya

 

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

Yang, H. J., Koh, E., Sung, M. K., & Kang, H. (2021). Changes Induced by Mind-Body Intervention Including Epigenetic Marks and Its Effects on Diabetes. International journal of molecular sciences, 22(3), 1317. https://doi.org/10.3390/ijms22031317

 

Abstract

Studies have evidenced that epigenetic marks associated with type 2 diabetes (T2D) can be inherited from parents or acquired through fetal and early-life events, as well as through lifelong environments or lifestyles, which can increase the risk of diabetes in adulthood. However, epigenetic modifications are reversible, and can be altered through proper intervention, thus mitigating the risk factors of T2D. Mind–body intervention (MBI) refers to interventions like meditation, yoga, and qigong, which deal with both physical and mental well-being. MBI not only induces psychological changes, such as alleviation of depression, anxiety, and stress, but also physiological changes like parasympathetic activation, lower cortisol secretion, reduced inflammation, and aging rate delay, which are all risk factors for T2D. Notably, MBI has been reported to reduce blood glucose in patients with T2D. Herein, based on recent findings, we review the effects of MBI on diabetes and the mechanisms involved, including epigenetic modifications.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7865217/

Improve Caregivers Psychological and Physiological Health with Meditation

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Improve Caregivers Psychological and Physiological Health with Meditation

 

By John M. de Castro, Ph.D.

 

“Feel overwhelmed with the responsibilities of caring for a loved one? One of the most effective ways to avoid burnout is engaging in a mindfulness practice like meditation.” – Audrey Meinertzhagen

 

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

 

In today’s Research News article “Effects of Meditation on Mental Health and Cardiovascular Balance in Caregivers.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828286/ ) Díaz-Rodríguez and colleagues recruited caregivers for dependent family members for at least 2 years. They were assigned to either no treatment or to receive twice weekly, 2-hour, sessions of focused meditation training on the basis of availability for the training sessions. They were measured before and after training for happiness, anxiety, depression, heart rate, heart rate variability, and blood pressure.

 

They found that in comparison to baseline and the control group, the group that received meditation training were significant higher in happiness and heart rate variability and significantly lower in anxiety, heart rate, and blood pressure. Hence meditation training improved the mental health and cardiovascular balance of caregivers.

 

These are excellent results. A higher level of heart rate variability is an indicator of increased parasympathetic and reduced sympathetic nervous system activity. Hence, the relaxation promoting portion of the autonomic nervous system increases while the portion promoting activation and arousal decreases. This is further evidenced by the significant decrease in heart rate and blood pressure. This suggest that a 4-week training in meditation improves caregivers’ psychological and physiological state. The effectiveness of the caregiving was not measured but based upon the improvements observed it would be expected that the quality of caregiving would also be improved. This suggests that meditation training should be recommended for caregivers.

 

So, improve caregivers psychological and physiological health with meditation.

 

“Caregiving is a tough job and the stress can seriously affect your physical and mental health. An effective and simple way to combat that is to meditate.” – Daily Caring

 

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

 

Díaz-Rodríguez, L., Vargas-Román, K., Sanchez-Garcia, J. C., Rodríguez-Blanque, R., Cañadas-De la Fuente, G. A., & De La Fuente-Solana, E. I. (2021). Effects of Meditation on Mental Health and Cardiovascular Balance in Caregivers. International journal of environmental research and public health, 18(2), 617. https://doi.org/10.3390/ijerph18020617

 

Abstract

Background: Caring for a loved one can be rewarding but is also associated with substantial caregiver burden, developing mental outcomes and affecting happiness. The aim of this study was to determine the effects of a four-week, 16-h presential meditation program on physiological and psychological parameters and vagal nerve activity in high-burden caregivers, as compared to a control group. Methods: A non-randomized repeated-measures controlled clinical trial was conducted. Results: According to the ANCOVA results, the global happiness score (F = 297.42, p < 0.001) and the scores for all subscales were significantly higher in the experimental group than in the control group at 5 weeks. Anxiety levels were also significantly reduced in the experimental group (F = 24.92, p < 0.001), systolic (F = 16.23, p < 0.001) and diastolic blood (F = 34.39, p < 0.001) pressures, and the resting heart rate (F = 17.90, p < 0.05). HRV results revealed significant between-group differences in the HRV Index (F = 8.40, p < 0.05), SDNN (F = 13.59, p < 0.05), and RMSSD (F = 10.72, p < 0.05) in the time domain, and HF (F = 4.82 p < 0.05)) in the frequency domain, which were all improved in the experimental group after the meditation program. Conclusions: Meditation can be a useful therapy to enhance the mental health and autonomic nervous system balance of informal caregivers, improving symptoms of physical and mental overload.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828286/

 

Reduce Opioid-Treated Pain and Opioid Dosage with Mindfulness

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Reduce Opioid-Treated Pain and Opioid Dosage with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mind-body therapies — including meditation, cognitive behavioral therapy and hypnosis — were associated with improvements in pain and reduced opioid doses.” – Erin Michael

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain.

 

There is an accumulating volume of research findings that demonstrate that mindfulness practices, in general, are effective in treating pain. What is not known is the most effective mind-body treatments for chronic pain. There are a large variety of mind-body therapies including meditation, hypnosis, relaxation, guided imagery, therapeutic suggestion, and Cognitive Behavioral Therapy (CBT). It is not known which are the most effective for reducing pain and opioid use in patients with chronic pain who are being treated with opioids.

 

In today’s Research News article “Mind-Body Therapies for Opioid-Treated Pain: 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/PMC6830441/ ) Garland and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials of the effectiveness of mind-body techniques for opioid-treated pain. They identified 60 published trials.

 

They report that the published research found that the studies that used Mind-Body Therapies produced significant reductions in pain outcomes and opioid use. This was true for studies that employed meditation, hypnosis, or Cognitive Behavioral Therapy (CBT), with the largest effect sizes found for meditation. Suggestion, imagery, and relaxation were all found to be less effective.

 

Hence, the published randomized controlled trials support the use of Mind-Body Therapies for the treatment of patients with chronic pain who are being treated with opioids. Meditation, hypnosis, or Cognitive Behavioral Therapy (CBT) are particularly effective in both treating pain and reducing opioid use. This is compatible with other results that mindfulness meditation has been repeatedly shown to reduce pain and improve recovery from opioid addiction.

 

Meditation, hypnosis, or Cognitive Behavioral Therapy (CBT) have a common property of changing the patient’s thought patterns associated with their pain and thereby alter their relationship with the pain. These thought patterns such as worry, rumination, and catastrophizing tend to amplify the physical pain. Reducing these tendencies can eliminate the amplification and thereby reduce the experienced pain. With less pain, less opioids are needed to control it.

 

So, reduce opioid-treated pain and opioid dosage with mindfulness.

 

“Using mindfulness, meditation, hypnosis, therapeutic suggestion, and cognitive behavior therapy, in addition to opioid treatment of acute or chronic pain, provides an additional benefit to patients by reducing pain scores. Some of these interventions will decrease the duration or amount of opioid needed.” – Sumi Sexton

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Garland, E. L., Brintz, C. E., Hanley, A. W., Roseen, E. J., Atchley, R. M., Gaylord, S. A., Faurot, K. R., Yaffe, J., Fiander, M., & Keefe, F. J. (2019). Mind-Body Therapies for Opioid-Treated Pain: A Systematic Review and Meta-analysis. JAMA internal medicine, 180(1), 91–105. Advance online publication. https://doi.org/10.1001/jamainternmed.2019.4917

 

Key Points

Question

Are mind-body therapies (ie, meditation, hypnosis, relaxation, guided imagery, therapeutic suggestion, and cognitive behavioral therapy) associated with pain reduction and opioid-related outcome improvement among adults using opioids for pain?

Findings

In this systematic review and meta-analysis of 60 randomized clinical trials with 6404 participants, mind-body therapies were associated with improved pain (Cohen d = −0.51; 95% CI, −0.76 to −0.27) and reduced opioid dose (Cohen d = −0.26; 95% CI, −0.44 to −0.08).

Meaning

Practitioners should be aware that mind-body therapies may be associated with moderate improvements in pain and small reductions in opioid dose.

Abstract

Importance

Mind-body therapies (MBTs) are emerging as potential tools for addressing the opioid crisis. Knowing whether mind-body therapies may benefit patients treated with opioids for acute, procedural, and chronic pain conditions may be useful for prescribers, payers, policy makers, and patients.

Objective

To evaluate the association of MBTs with pain and opioid dose reduction in a diverse adult population with clinical pain.

Data Sources

For this systematic review and meta-analysis, the MEDLINE, Embase, Emcare, CINAHL, PsycINFO, and Cochrane Library databases were searched for English-language randomized clinical trials and systematic reviews from date of inception to March 2018. Search logic included (pain OR analgesia OR opioids) AND mind-body therapies. The gray literature, ClinicalTrials.gov, and relevant bibliographies were also searched.

Study Selection

Randomized clinical trials that evaluated the use of MBTs for symptom management in adults also prescribed opioids for clinical pain.

Data Extraction and Synthesis

Independent reviewers screened citations, extracted data, and assessed risk of bias. Meta-analyses were conducted using standardized mean differences in pain and opioid dose to obtain aggregate estimates of effect size with 95% CIs.

Main Outcomes and Measures

The primary outcome was pain intensity. The secondary outcomes were opioid dose, opioid misuse, opioid craving, disability, or function.

Results

Of 4212 citations reviewed, 60 reports with 6404 participants were included in the meta-analysis. Overall, MBTs were associated with pain reduction (Cohen d = −0.51; 95% CI, −0.76 to −0.26) and reduced opioid dose (Cohen d = −0.26; 95% CI, −0.44 to −0.08). Studies tested meditation (n = 5), hypnosis (n = 25), relaxation (n = 14), guided imagery (n = 7), therapeutic suggestion (n = 6), and cognitive behavioral therapy (n = 7) interventions. Moderate to large effect size improvements in pain outcomes were found for meditation (Cohen d = −0.70), hypnosis (Cohen d = −0.54), suggestion (Cohen d = −0.68), and cognitive behavioral therapy (Cohen d = −0.43) but not for other MBTs. Although most meditation (n = 4 [80%]), cognitive-behavioral therapy (n = 4 [57%]), and hypnosis (n = 12 [63%]) studies found improved opioid-related outcomes, fewer studies of suggestion, guided imagery, and relaxation reported such improvements. Most MBT studies used active or placebo controls and were judged to be at low risk of bias.

Conclusions and Relevance

The findings suggest that MBTs are associated with moderate improvements in pain and small reductions in opioid dose and may be associated with therapeutic benefits for opioid-related problems, such as opioid craving and misuse. Future studies should carefully quantify opioid dosing variables to determine the association of mind-body therapies with opioid-related outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6830441/Importance

Mind-body therapies (MBTs) are emerging as potential tools for addressing the opioid crisis. Knowing whether mind-body therapies may benefit patients treated with opioids for acute, procedural, and chronic pain conditions may be useful for prescribers, payers, policy makers, and patients.

Lower Cardiovascular Disease Risk by Improving Emotion Regulation with Mindfulness

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Lower Cardiovascular Disease Risk by Improving Emotion Regulation with Mindfulness

 

By John M. de Castro, Ph.D.

 

“People who meditate regularly reported feeling more balanced and less stressed, and . . . improved the outcomes when they were added to cardiac rehabilitation programmes for patients with CHD.” – Heart Matters

 

Cardiovascular disease is the number one killer. A myriad of treatments has been developed including a variety of surgical procedures and medications. In addition, lifestyle changes have proved to be effective including quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Unfortunately, for a variety of reasons, 60% of cardiovascular disease patients decline engaging in these lifestyle changes, making these patients at high risk for another attack.

 

Contemplative practices have been shown to be safe and effective alternative treatments for cardiovascular disease. Practices such as meditation, tai chi, and yoga, have been shown to be helpful for heart health and to reduce the physiological and psychological responses to stress. They have also been shown to be effective in maintaining cardiovascular health and the treatment of cardiovascular disease. The means by which mindfulness reduces cardiovascular disease risk have not been explored using the qualitative experiences of the patients.

 

In today’s Research News article “Mindfulness and cardiovascular health: Qualitative findings on mechanisms from the mindfulness-based blood pressure reduction (MB-BP) study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7510988/ ) Nardi and colleagues recruited patients with hypertension who had participated in a study of the effectiveness of Mindfulness-Based Stress Reduction (MBSR) modified for hypertension, to reduce blood pressure. The participants participated in focus groups or were interviewed individually with semi-structured interviews. The groups and interviews focused on their experiences with the intervention and its effects. Transcripts of the responses were subjected to thematic analysis to identify common themes and ideas.

 

They found that the participants practiced breath awareness and body scans most in their everyday lives. Breath awareness allowed them to pause and relax to better address issues while the body scans made them more aware of their bodily states. These practices produced a greater awareness of the present moment and their responses to emotional situations allowing them to better regulate their emotions in these situations. They learned to apply self-kindness rather than self-criticism and to direct attention to mindfulness when stressful situations came up rather than worrying about them. All of this resulted in the improved ability to deal with their emotions. The participants indicated that they used the emotion regulation abilities to effectively deal with stress, learning to relax in the face of stress. This led to important changes in their health behaviors particularly diet.

 

These qualitative results suggest that the mindfulness program improved the patients’ cardiovascular health. It provided them with tools to employ when emotional situations arose to heighten their awareness of exactly what was transpiring and how they felt in the present moment. This resulted in better regulation of emotions which in turn led to better responses to stress and improved health behaviors.

 

These qualitative results correspond to the results of controlled empirical studies of the effects of mindfulness training on a wide variety of individuals and conditions. These studies found that mindfulness training produced improved emotion regulation, increased self-kindness, improved responses to stress, and improved cardiovascular health.  Hence, mindfulness training provides individuals with skills that improve their lives and well-beeing.

 

So, lower cardiovascular disease risk by improving emotion regulation with mindfulness.

 

“there are four things that have scientifically been shown to reduce the risk of a heart attack in patients with mild to moderate coronary artery disease and they include – reduced stress (use meditation to do so), diet, exercise and love.” – Jeena Cho

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Nardi, W. R., Harrison, A., Saadeh, F. B., Webb, J., Wentz, A. E., & Loucks, E. B. (2020). Mindfulness and cardiovascular health: Qualitative findings on mechanisms from the mindfulness-based blood pressure reduction (MB-BP) study. PloS one, 15(9), e0239533. https://doi.org/10.1371/journal.pone.0239533

 

Abstract

Background

Mindfulness-based programs hold promise for improving cardiovascular health (e.g. physical activity, diet, blood pressure). However, despite theoretical frameworks proposed, no studies have reported qualitative findings on how study participants themselves believe mindfulness-based programs improved their cardiovascular health. With an emphasis on in-depth, open-ended investigation, qualitative methods are well suited to explore the mechanisms underlying health outcomes. The objective of this qualitative study was to explore the mechanisms through which the mindfulness-based program, Mindfulness-Based Blood Pressure Reduction (MB-BP), may influence cardiovascular health.

Methods

This qualitative study was conducted as part of a Stage 1 single arm trial with one-year follow-up. The MB-BP curriculum was adapted from Mindfulness-Based Stress Reduction to direct participants’ mindfulness skills towards modifiable determinants of blood pressure. Four focus group discussions were conducted (N = 19 participants), and seven additional participants were selected for in-depth interviews. Data analysis was conducted using the standard approach of thematic analysis. Following double-coding of audio-recorded transcripts, four members of the study team engaged in an iterative process of data analysis and interpretation.

Results

Participants identified self-awareness, attention control, and emotion regulation as key mechanisms that led to improvements in cardiovascular health. Within these broader themes, many participants detailed a process beginning with increased self-awareness to sustain attention and regulate emotions. Many also explained that the specific relationship between self-awareness and emotion regulation enabled them to respond more skillfully to stressors. In a secondary sub-theme, participants suggested that higher self-awareness helped them engage in positive health behaviors (e.g. healthier dietary choices).

Conclusion

Qualitative analyses suggest that MB-BP mindfulness practices allowed participants to engage more effectively in self-regulation skills and behaviors lowering cardiovascular disease risk, which supports recent theory. Results are consistent with quantitative mechanistic findings showing emotion regulation, perceived stress, interoceptive awareness, and attention control are influenced by MB-BP.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7510988/

 

Ethnicity Modulates Improvements in Sleep in Prehypertensive Patients with a Smartphone Meditation App

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Ethnicity Modulates Improvements in Sleep in Prehypertensive Patients with a Smartphone Meditation App

 

“Several practices that help calm the mind can also lower blood pressure. All are types of meditation.” – Harvard Health

 

By John M. de Castro, Ph.D.

 

High Blood Pressure (Hypertension) is an insidious disease because there are no overt symptoms. The individual feels fine. But it can be deadly as more than 360,000 American deaths, roughly 1,000 deaths each day, had high blood pressure as a primary or contributing cause. In addition, hypertension markedly increases the risk heart attack, stroke, heart failure, and kidney disease.  It is also a very common disorder with about 70 million American adults (29%) having high blood pressure and only about half (52%) of people with high blood pressure have their condition under control. Treatment frequently includes antihypertensive drugs. But these medications often have adverse side effects. So, patients feel lousy when taking the drugs, but fine when they’re not. So, compliance is a major issue with many patients not taking the drugs regularly or stopping entirely.

 

Obviously, there is a need for alternative to drug treatments for hypertension. Mindfulness practices have been shown to aid in controlling hypertension. The vast majority of the mindfulness training techniques, however, require a trained teacher. This results in costs that many patients 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 and at locations that may not be convenient. As an alternative, Apps for smartphones have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations.

 

In today’s Research News article “Ethnicity Differences in Sleep Changes Among Prehypertensive Adults Using a Smartphone Meditation App: Dose-Response Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576537/ ) Sieverdes and colleagues recruited patients diagnosed with prehypertension. They had the participants use a smartphone app, “Tension Tamer” for 6 months. The app provided focused breath following meditation practice and also measured heart rate and blood pressure. The participants were randomized into 3 dosage groups, 5, 10, or 15 minutes of daily practice. They were measured before and after training and at 1 and 3-months during training for sleep with a self-reports and 7-days of wrist actigraphy which also measured activity levels.

 

They found that the 47% of the participants who were African American had significantly shorter sleep durations, poorer sleep quality, and greater sleep disturbance at baseline both in the self-report and actigraphy measures than non-Hispanic white participants. They also found that the effects of the meditation app on sleep varied according to ethnic group. For the Non-Hispanic White participants, the 5-minute per day dose of “Tension timer” use produced significantly greater improvements in sleep efficiency and quality, lower fragmentation, and longer sleep duration than the 10 or 15-minute doses. For the African American participants, the 5-minute dose produced significantly less sleep fragmentation and duration than the 10 or 15-minute doses. In comparing the ethnic groups, they found that the Non-Hispanic White participants had significantly greater improvements in sleep efficiency, reduced fragmentation, and longer sleep duration than the African American participants.

 

These results are interesting and suggest that smartphone app guided meditation practice improves sleep in patients diagnosed as prehypertensive. But the effects are less positive for African American participants than Non-Hispanic White participants. This is a bit surprising as African American participants appear to have more problematic sleep to start with and hence had greater room for improvement. It is also surprising that the lower amount of meditation practice, 5-minutes per day, was more beneficial that the longer daily meditations. It appears that the 5-minute practice participants tended to use the app more often and to use it more often just prior to going to bed than the other dose participants and this may have led to the differences.

 

Improving sleep is important in promoting relaxation and reducing the likelihood that prehypertension will progress to patent hypertension. So, the use of the app may be helpful in maintaining the health of prehypertensive patients. The ethnic differences, however, suggest that app usage may be more beneficial for white as opposed to black participant. The results also suggest that brief daily practice, 5-minutes, may promote more frequent use that improves effectiveness.

 

So, ethnicity modulates improvements in sleep in prehypertensive patients with a smartphone meditation app.

 

“If you struggle with “turning your brain off”, you may find yourself feeling restless and unable to sleep. Fortunately, meditation is one way to quiet your thoughts and fight insomnia. Meditation has been shown to help people who struggle with insomnia and other sleep disturbances.“ – Florida Medical Clinic

 

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

 

Sieverdes, J. C., Treiber, F. A., Kline, C. E., Mueller, M., Brunner-Jackson, B., Sox, L., Cain, M., Swem, M., Diaz, V., & Chandler, J. (2020). Ethnicity Differences in Sleep Changes Among Prehypertensive Adults Using a Smartphone Meditation App: Dose-Response Trial. JMIR formative research, 4(10), e20501. https://doi.org/10.2196/20501

 

Abstract

Background

African Americans (AAs) experience greater sleep quality problems than non-Hispanic Whites (NHWs). Meditation may aid in addressing this disparity, although the dosage levels needed to achieve such benefits have not been adequately studied. Smartphone apps present a novel modality for delivering, monitoring, and measuring adherence to meditation protocols.

Objective

This 6-month dose-response feasibility trial investigated the effects of a breathing awareness meditation (BAM) app, Tension Tamer, on the secondary outcomes of self-reported and actigraphy measures of sleep quality and the modulating effects of ethnicity of AAs and NHWs.

Methods

A total of 64 prehypertensive adults (systolic blood pressure <139 mm Hg; 31 AAs and 33 NHWs) were randomized into 3 different Tension Tamer dosage conditions (5,10, or 15 min twice daily). Sleep quality was assessed at baseline and at 1, 3, and 6 months using the Pittsburgh Sleep Quality Index (PSQI) and 1-week bouts of continuous wrist actigraphy monitoring. The study was conducted between August 2014 and October 2016 (IRB #Pro00020894).

Results

At baseline, PSQI and actigraphy data indicated that AAs had shorter sleep duration, greater sleep disturbance, poorer efficiency, and worse quality of sleep (range P=.03 to P<.001). Longitudinal generalized linear mixed modeling revealed a dose effect modulated by ethnicity (P=.01). Multimethod assessment showed a consistent pattern of NHWs exhibiting the most favorable responses to the 5-min dose; they reported greater improvements in sleep efficiency and quality as well as the PSQI global value than with the 10-min and 15-min doses (range P=.04 to P<.001). Actigraphy findings revealed a consistent, but not statistically significant, pattern in the 5-min group, showing lower fragmentation, longer sleep duration, and higher efficiency than the other 2 dosage conditions. Among AAs, actigraphy indicated lower sleep fragmentation with the 5-min dose compared with the 10-min and 15-min doses (P=.03 and P<.001, respectively). The 10-min dose showed longer sleep duration than the 5-min and 15-min doses (P=.02 and P<.001, respectively). The 5-min dose also exhibited significantly longer average sleep than the 15-min dose (P=.03).

Conclusions

These findings indicate the need for further study of the potential modulating influence of ethnicity on the impact of BAM on sleep indices and user-centered exploration to ascertain the potential merits of refining the Tension Tamer app with attention to cultural tailoring among AAs and NHWs with pre-existing sleep complaints.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576537/

 

Improve Psychological Health with a Self-Guided, Smartphone-Based Mindfulness App

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Improve Psychological Health with a Self-Guided, Smartphone-Based Mindfulness App

 

By John M. de Castro, Ph.D.

 

“Another part of the appeal of smartphone-based apps is their anonymity. “The apps also allow for privacy and confidentiality and can be a safe space for individuals who may be too ashamed to admit their mental health issues in person or who may feel that they will be negatively labeled or stigmatized by others,” – Sal Raichback

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health. But the vast majority of the mindfulness training techniques, however, require a trained therapist. This results in 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 and at locations that may not be convenient. As an alternative, mindfulness training with smartphone apps has been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. In addition, research has indicated that mindfulness training via smartphone apps can be effective for improving the health and well-being of the participants.

 

In today’s Research News article “Testing the Efficacy of a Multicomponent, Self-Guided, Smartphone-Based Meditation App: Three-Armed Randomized Controlled Trial. JMIR mental health.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732708/ ) Goldberg and colleagues recruited adults who did not have extensive meditation experience and randomly assigned them to a wait-list control condition or to receive either of 2 8-week smartphone app mindfulness training with the Healthy Minds Program. They received 4 weeks of awareness training including awareness of breathing and awareness of sounds. They were then again randomly assigned to receive 4 weeks of either Connection training consisting or gratitude and kindness practices or Insight Training consisting of “the changing nature of the phenomenon (ie, impermanence) and examining how thoughts and emotions influence perception” practices. They were measured before after the first 4-week module and after the second 4-week module for mindfulness, psychological distress, perceived stress, interpersonal connections, interpersonal reactivity, compassion, self-reflection, rumination, and defusion.

 

They found that compared to baseline and the wait-list control group both intervention conditions produced significant increases in mindfulness, social connection, self-reflection and defusion and significant decreases in psychological distress, and rumination with no significant differences between the smartphone interventions. There were no differences between the wait-list controls and the intervention in compassion and empathy.

 

These are interesting findings that correspond to the finding in prior research that training the increases mindfulness produces significant increases in social connection, self-reflection and defusion and significant decreases in psychological distress, and rumination. They demonstrate that smartphone trainings that improve mindfulness produce improvement in the psychological health of the participants.

 

It was a bit surprising that the benefits of the awareness plus connection training did not significantly differ from the benefits of awareness plus insight training. But since both trainings equivalently higher mindfulness and increased mindfulness has been shown to produce these benefits, it is reasonable to conclude that any training the improves mindfulness will improve psychological health..

 

So, improve psychological health with a self-guided, smartphone-based mindfulness App.

 

“Using a smartphone app, may provide immediate effects on mood and stress while also providing long-term benefits for attentional control. . . there is evidence that with continued usage, [mindfulness training] via a smartphone app may provide long-term benefits in changing how one relates to their inner and outer experiences.” – Kathleen Marie Walsh

 

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

 

Goldberg, S. B., Imhoff-Smith, T., Bolt, D. M., Wilson-Mendenhall, C. D., Dahl, C. J., Davidson, R. J., & Rosenkranz, M. A. (2020). Testing the Efficacy of a Multicomponent, Self-Guided, Smartphone-Based Meditation App: Three-Armed Randomized Controlled Trial. JMIR mental health, 7(11), e23825. https://doi.org/10.2196/23825

 

Abstract

Background

A growing number of randomized controlled trials (RCTs) suggest psychological benefits associated with meditation training delivered via mobile health. However, research in this area has primarily focused on mindfulness, only one of many meditative techniques.

Objective

This study aims to evaluate the efficacy of 2 versions of a self-guided, smartphone-based meditation app—the Healthy Minds Program (HMP)—which includes training in mindfulness (Awareness), along with practices designed to cultivate positive relationships (Connection) or insight into the nature of the self (Insight).

Methods

A three-arm, fully remote RCT compared 8 weeks of one of 2 HMP conditions (Awareness+Connection and Awareness+Insight) with a waitlist control. Adults (≥18 years) without extensive previous meditation experience were eligible. The primary outcome was psychological distress (depression, anxiety, and stress). Secondary outcomes were social connection, empathy, compassion, self-reflection, insight, rumination, defusion, and mindfulness. Measures were completed at pretest, midtreatment, and posttest between October 2019 and April 2020. Longitudinal data were analyzed using intention-to-treat principles with maximum likelihood.

Results

A total of 343 participants were randomized and 186 (54.2%) completed at least one posttest assessment. The majority (166/228, 72.8%) of those assigned to HMP conditions downloaded the app. The 2 HMP conditions did not differ from one another in terms of changes in any outcome. Relative to the waitlist control, the HMP conditions showed larger improvements in distress, social connectedness, mindfulness, and measures theoretically linked to insight training (d=–0.28 to 0.41; Ps≤.02), despite modest exposure to connection- and insight-related practice. The results were robust to some assumptions about nonrandom patterns of missing data. Improvements in distress were associated with days of use. Candidate mediators (social connection, insight, rumination, defusion, and mindfulness) and moderators (baseline rumination, defusion, and empathy) of changes in distress were identified.

Conclusions

This study provides initial evidence of efficacy for the HMP app in reducing distress and improving outcomes related to well-being, including social connectedness. Future studies should attempt to increase study retention and user engagement.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732708/