Mindfulness

Improved Work Engagement is Associated with Mindfulness

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Improved Work Engagement is Associated with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness exerts its positive effect on work engagement by increasing positive affect, hope, and optimism, which on their own and in combination enhance work engagement.” – Peter Malinowski

 

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

 

To help overcome unhappiness, stress, and burnout, mindfulness practices have been implemented in the workplace. Indeed, mindfulness practices have been shown to markedly reduce the physiological and psychological responses to stress. As a result, it has become very trendy for business to incorporate meditation into the workday to help improve employee well-being, health, and productivity. It seems reasonable that mindfulness would be associated with greater engagement in work.

 

In today’s Research News article “The Influence of Individual and Team Mindfulness on Work Engagement.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2019.02928/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1232595_69_Psycho_20200204_arts_A), Liu and colleagues recruited employees of service companies and had them complete questionnaires at 3 different occasions. First, they completed measures of mindfulness, recovery, and work engagement. Three months later they completed measures of team mindfulness and recovery level. Three months later they completed a measure of work engagement. Recovery is the degree to which the individual recovers from stress or boredom.

 

They found significant relationships such that the higher the level of individual mindfulness the higher the levels of team mindfulness, recovery, and work engagement, and the higher the levels of recovery the higher the levels of work engagement. A confirmatory factor analysis revealed that mindfulness was directly related to higher levels of work engagement. Mindfulness was also indirectly related with work engagement via recovery such that mindfulness was related to higher levels of recovery which was in turn related to higher levels of work engagement.

 

The study did not manipulate mindfulness or recovery, so causation cannot be absolutely determined. But the results suggest an important role for mindfulness in the workplace. Work engagement is important for employee performance. Hence, the present results suggest that mindfulness is important for this performance. It is so by being directly related and also by being related to recovery which then is related to work engagement.

 

Mindfulness practices have been shown to markedly reduce the physiological and psychological responses to stress. This would allow for rapid recovery from the stress. Mindfulness appears to promote the ability to bounce back from stress and boredom and that this skill facilitates engagement in work. This suggests that that a mindful employee is a less stressed, better employee.

 

So, improved work engagement is associated with mindfulness.

 

“Better employee engagement is only one of the benefits of practicing mindfulness in the workplace. The additional advantages you can expect from it are the following: Better employee retention: Workers are less inclined to look for another job as mindfulness helps lower their emotional exhaustion at work. Better health of employees results in lower incidences of absences and healthcare costs. Better productivity¾because employees are happier and healthier!” –  Cheryl Chandola

 

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

 

Liu S, Xin H, Shen L, He J and Liu J (2020) The Influence of Individual and Team Mindfulness on Work Engagement. Front. Psychol. 10:2928. doi: 10.3389/fpsyg.2019.02928

 

Mindfulness metacognitive practice that can be performed in the workplace. Drawing on the theory of conservation of resources, we test a moderated mediating model of how and when employee mindfulness has a positive effect on work engagement. Via analysis of data from 311 employees from 83 teams at different times, this study investigates the relationship between employee mindfulness and work engagement as well as the moderating effect of team mindfulness and the mediating effect of recovery level. The results from this multi-wave field study show that the mindfulness of the individual employee has a positive influence on work engagement and that recovery level plays a mediating role. Team mindfulness positively moderates the relationship between individual mindfulness and work engagement. This conclusion may bridge the relationship between mindfulness and work engagement theory.

https://www.frontiersin.org/articles/10.3389/fpsyg.2019.02928/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1232595_69_Psycho_20200204_arts_A

 

Less Negative Emotions Occur in Mindful Children and Adolescents

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Less Negative Emotions Occur in Mindful Children and Adolescents

 

By John M. de Castro, Ph.D.

 

“We ultimately want to give children (and teens, and adults!) the ability to notice however they feel in the moment, and the tools to manage and respond appropriately to their inner and outer experience.” – Oren Jay Sofer

 

Childhood and adolescence are times of mental, physical, social, and emotional growth. But they can be difficult times, fraught with challenges. During these times the individual transitions from childhood to young adulthood; including the development of intellectual, psychological, physical, and social abilities and characteristics. There are so many changes occurring during these times that the child can feel overwhelmed and unable to cope with all that is required. This can heighten negative emotions and anxiety. Indeed, up to a quarter of adolescents suffer from depression or anxiety disorders, and an even larger proportion struggle with subclinical symptoms.

 

Mindfulness training in adults has been shown to reduce anxiety, depression, and perceived stress levels and improve emotional regulation. In addition, in adolescents it has been shown to improve emotion regulation and to benefit the psychological and emotional health. On the other hand, getting lost in thought (mind wandering) has been shown to be associated with negative emotions. Hence, there is a need to explore the relationship between mindfulness, getting lost in thought, and emotions in children and adolescents.

 

In today’s Research News article “Cognitive Fusion Mediates the Relationship between Dispositional Mindfulness and Negative Affects: A Study in a Sample of Spanish Children and Adolescent School Students.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6926870/), García-Gómez and colleagues recruited children and adolescents between the ages of 8 to 16 years. They were measured for cognitive fusion, experiential avoidance, mindfulness, positive and negative emotions, and anxiety.

 

They found that the higher the levels of mindfulness the lower the levels of cognitive fusion, experiential avoidance, negative emotions, and anxiety. A mediation analysis revealed that mindfulness had both direct and indirect associations such that mindfulness was negatively associated directly with both negative emotions and anxiety and also indirectly by way of its negative association with cognitive fusion which was in turn negatively associated with negative emotions and anxiety. Higher levels of mindfulness were associated with lower levels of cognitive fusion which, in turn, were associated with lower levels of negative emotions and anxiety.

 

These results are correlational and thus causation cannot be determined. Also, this study employed only children and adolescents, So, it is not established if similar findings would occur in adults. But there are a large number of studies that demonstrate a causal effect of mindfulness on negative emotions and anxiety with adults. Indeed, in the present study, age did not moderate the results. Hence the present results probably are due to the effects of mindfulness on cognitive fusion and on these negative emotions and occur regardless of age.

 

“Cognitive fusion is a process by which the individual becomes entangled with memories, thoughts, judgments, and evaluations and adjust behavior to the internal experiences.” Hence cognitive fusion is the antithesis of mindfulness. One cannot be mindful and at the same time be lost in thoughts. This suggests that being lost in thought (cognitive fusion) tends to produce negative emotions, while being mindful tends to reduce these negative emotions. This suggests that mindfulness by focusing the individual on the present moment improves the individual’s emotional state and also tends to prevent getting lost in thought which also improves the individual’s emotional state.

 

So, reduce getting lost in thought and negative emotions with mindfulness.

 

“When I look at childhood anxiety I see an enormous problem and a precursor to other problems in adolescents and adults,” – Randye Semple

 

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

 

García-Gómez, M., Guerra, J., López-Ramos, V. M., & Mestre, J. M. (2019). Cognitive Fusion Mediates the Relationship between Dispositional Mindfulness and Negative Affects: A Study in a Sample of Spanish Children and Adolescent School Students. International journal of environmental research and public health, 16(23), 4687. doi:10.3390/ijerph16234687

 

Abstract

Nowadays, mindfulness-based interventions (MBI) have experienced a remarkable development of studies among childhood and adolescent interventions. For this reason, dispositional mindfulness (DM) measures for children and adolescents have been developed to determine the effectiveness of MBI at this age stage. However, little is known about how key elements of DM (for example, cognitive de/fusion or experiential avoidance that both confirm psychological inflexibility) are involved in the mechanisms of the children and adolescents’ mental health outcomes. This research examined the mediating effect of cognitive fusion between DM and anxiety and other negative emotional states in a sample of 318 Spanish primary-school students (aged between 8 and 16 years, M = 11.24, SD = 2.19, 50.8% males). Participants completed the AFQ-Y (Avoidance and Fusion Questionnaire for youth), which is a measure of psychological inflexibility that encompasses cognitive defusion and experiential avoidance; CAMM (DM for children and adolescents), PANAS-N (positive and negative affect measure for children, Spanish version of PANASC), and STAIC (an anxiety measure for children). The study accomplished ethical standards. As MBI relevant literature has suggested, cognitive defusion was a significant mediator between DM and symptoms of both negative emotions and anxiety in children and adolescents. However, experiential avoidance did not show any significant mediating relationship. Probably, an improvement of the assessment of experiential avoidance is needed. MBI programs for children and adolescents may include more activities for reducing effects of the cognitive defusion on their emotional distress.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6926870/

 

Reduce Aggression with Mindfulness

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Reduce Aggression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“young adults who participated in an app-based meditation training were less aggressive after receiving critical feedback, but not less angry. It suggests that being mindful doesn’t interfere with experiencing emotions, but changes how one responds to them.” – AMRA

 

The human tendency to lash out with aggression when threatened was adaptive for the evolution of the species. It helped promote the survival of the individual, the family, and the tribe. In the modern world, however, this trait has become more of a problem than an asset. It results in individual violence and aggression such as physical abuse, fights, road rage, and even murders, and in societal violence such as warfare. It may even be the basis for the horrors of terrorism and mass murder. Obviously, there is a need in modern society to control these violent and aggressive urges.

 

Aggression may, at least in part, be amplified by anger rumination; an uncontrollable, repetitive thinking about anger and its sources. This can produce a downward spiral where people repeatedly think about their anger which, in turn, reinforces the anger making it worse and worse. It is like a record that’s stuck and keeps repeating the same lyrics. It’s replaying a dispute in the individual’s mind. It’s going over their anger, again and again. Fortunately, rumination may be interrupted by mindfulness and mindfulness may improve the individual’s ability to regulate their emotions. This may, in part, be a mechanism by which mindfulness training reduces aggression and hostility. Hence, mindfulness may be an antidote to violent and aggressive urges by interrupting anger rumination and improving emotion regulation.

 

In today’s Research News article “Emotion regulation mediates relationships between mindfulness facets and aggression dimensions.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6916265/), Garofalo and colleagues recruited adult prisoners and a community sample of adult nonoffenders. They then had them complete measures of mindfulness, emotion regulation, and aggressiveness.

 

Correlational analysis revealed that in both the offender and nonoffender samples, the higher the levels of mindfulness, the higher the levels of emotion regulation and the lower the levels of aggressiveness. In addition, the higher the levels of emotion regulation the lower the levels of aggressiveness. Further, structural equation modelling revealed that in both the offender and nonoffender samples that emotion regulation mediated the relationship between mindfulness and aggressiveness. That is, the mindfulness was not associated with aggressiveness directly but rather mindfulness was associated with higher levels of emotion regulation which, in turn, was associated with lower levels of aggressiveness.

 

These findings are correlational and as such causation cannot be determined. But, prior research has shown a causal connection between mindfulness and higher levels of emotion regulation and that emotion regulation has a causal connection to lower aggressiveness and that mindfulness has a causal connection to lower aggressiveness. So, it is likely that the present findings are the results of causal links between mindfulness, emotion regulation, and aggressiveness.

 

Hence, the present results suggest that being mindful goes along with having better ability to regulate emotions and that goes along with less aggressiveness. Emotion regulation is not suppression of emotions rather it is the ability to feel the emotions but not let them dictate behavior; feeling emotions but remaining in control. Thus, the results suggest that aggressiveness may result from uncontrolled reactions to emotions and that mindfulness by improving emotion regulation reduces these responses.

 

It is interesting that the results were exactly the same for both prisoners and nonoffender adults. This suggests that there is nothing special about the mechanisms controlling aggressiveness in prisoners. Rather it would appear that prisoners have a lower level of emotion regulation. This implies that improving mindfulness and emotion regulation in prisoners would lead to greater control and less violence and aggression.

 

So, reduce aggression in with mindfulness.

 

“When any emotion rises up, we tend to first get caught up in it and then act it out, through speech or action. This couldn’t be truer for the heightened emotion of anger. Meditation, though, can teach us how to change a rash, reactive mindset into a more considered, responsive, and productive one.” – Headspace

 

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

 

Garofalo, C., Gillespie, S. M., & Velotti, P. (2020). Emotion regulation mediates relationships between mindfulness facets and aggression dimensions. Aggressive behavior, 46(1), 60–71. doi:10.1002/ab.21868

 

Abstract

Recent years have witnessed an increase of research on socio‐affective factors that can explain individual differences in aggressive tendencies across community and offender populations. Specifically, mindfulness and emotion regulation have emerged as important factors, which could also constitute important prevention and treatment targets. Yet, recent studies have advanced the possibility that mindfulness may also have a “dark” side, being associated with increased levels of aggression‐related variables, especially when accounting for the variance associated with emotion regulation. The present study sought to elucidate relationships among mindfulness, emotion regulation, and aggression dimensions (i.e., verbal and physical aggression, anger, and hostility) across violent offender (N = 397) and community (N = 324) samples. Results revealed expected associations between both mindfulness and emotion regulation and aggression dimensions, such that greater impairments in mindfulness and emotion regulation were related to increased levels of aggression across samples. Further, analyses of indirect effects revealed that a latent emotion dysregulation factor accounted for (i.e., mediated) relationships between mindfulness facets and aggression dimensions in both samples. Previously reported positive associations between the residual variance in mindfulness scales (i.e., controlling for emotion regulation) and aggression‐related variables were not replicated in the current samples. Taken together, findings suggest that mindfulness and emotion regulation have unequivocal relations with lower levels of aggression, and should therefore be considered as relevant targets for prevention and treatment programs aimed at reducing aggressive tendencies.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6916265/

 

Improve the Psychological and Physical Health of Pregnant Low-Income Women with Mindfulness

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Improve the Psychological and Physical Health of Pregnant Low-Income Women with Mindfulness

 

By John M. de Castro, Ph.D.

 

“in pregnant women at high risk for excessive weight gain, it is both feasible and effective to use mindfulness strategies taught in a group format. Further, increases in certain mindfulness skills may help with better management of stress and overeating during pregnancy.” – Thomas Vieten

 

The period of pregnancy is a time of intense physiological and psychological change. Anxiety, depression, and fear are quite common during pregnancy. Pregnancy produces vast changes in the woman’s life, her body, her emotions, and her family. These changes may well be desired and welcomed, but they produce stress. Indeed, stress is a common experience in pregnancy. But it must be controlled. Too much stress can produce sleeping problems, headaches, loss of appetite or its opposite, overeating. If the levels of stress are high and prolonged it can produce health problems such as hypertension (high blood pressure) and heart disease in the mother. It can also make it more likely that the baby will be born prematurely or with a low birthweight, both of which are indicators of health problems for the infant and in the later child’s life. These stresses are magnified in low-income women.

 

So, it is important to either control stress during pregnancy or find ways to better cope with it. Mindfulness training has been shown to reduce the individual’s psychological and physiological responses to stress. Hence, mindfulness training may be a safe and effective method to assist the pregnant woman in coping with the stresses of pregnancy. Low-income women are particularly vulnerable to these stresses and have a high rate of rapid weight gain and metabolic syndrome during pregnancy. Indeed, mindfulness training appears to be effective in improving the mental and physical health of low-income individuals. Hence, it is important to study if mindfulness training can improve the health of low-income women.

 

In today’s Research News article “Effects of a Mindfulness-Based Intervention on Distress, Weight Gain, and Glucose Control for Pregnant Low-Income Women: A Quasi-Experimental Trial Using the ORBIT Model.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6785577/), Epel and colleagues recruited low-income overweight and obese, pregnant women who were in their12th to 19th week of gestation. They were provided with a 2 hour once a week for 8 weeks program of a Mindful Moms training program. This included mindful movements and mindfulness practices and discussions of stress reduction, mindful eating, and nutrition. They were compared to a comparable group who simply continued with their usual treatments. They were measured for gestational weight gain, postpartum weight retention, and before and after the intervention for physical activity perceived stress, depression, pregnancy related anxiety, acceptance of negative experiences, eating behaviors, eating addiction, and mindfulness. They also received a glucose tolerance test.

 

They found that in comparison to baseline the group that received mindfulness training had significant reductions in perceived stress, depression, food addiction, emotional eating, external eating and significant increases in acceptance of negative experiences, glucose tolerance, and physical activity. Both groups gained excessive weight during pregnancy and retained it postpartum with no significant differences.

 

Conclusions must be tempered with the knowledge that the women were not randomly assigned to intervention and control conditions, rather they were assigned based upon whether their schedules allowed participation in the mindfulness training classes. Hence, there may have been systematic differences between the groups at the outset.

 

Nevertheless, the results are both disappointing and encouraging. They were disappointing in that the intervention did not alter the high weight gains during pregnancy or their retention postpartum even though there were improvements in their eating behaviors, physical activity, and glucose tolerance. These women were overweight and obese at the beginning, so the excess weight gains are unwanted and may further damage their health and that of their offspring.

 

The results, however, are encouraging in that they suggest that mindfulness training may improve the psychological and physical health of these women. Having low-income provides additional difficulty and stress on these pregnant women. So, the ability of mindfulness training to reduce the stress and improve their psychological health is welcome. The improvements in physical activity and glucose tolerance may signal improvements in the overall metabolic health of these women. Follow ups of these women need to be pursued to determine if there were significant impacts of the training on the infants and their development.

 

So, improve the psychological and physical health of pregnant low-income women with mindfulness.

 

“women in the mindfulness group had lower stress levels, higher mindfulness measures, and lower weight gains during pregnancy.” Elissa Epel

 

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

 

Epel, E., Laraia, B., Coleman-Phox, K., Leung, C., Vieten, C., Mellin, L., … Adler, N. (2019). Effects of a Mindfulness-Based Intervention on Distress, Weight Gain, and Glucose Control for Pregnant Low-Income Women: A Quasi-Experimental Trial Using the ORBIT Model. International journal of behavioral medicine, 26(5), 461–473. doi:10.1007/s12529-019-09779-2

 

Abstract

Background

Stress can lead to excessive weight gain. Mindfulness-based stress reduction that incorporates mindful eating shows promise for reducing stress, overeating, and improving glucose control. No interventions have tested mindfulness training with a focus on healthy eating and weight gain during pregnancy, a period of common excessive weight gain. Here, we test the effectiveness of such an intervention, the Mindful Moms Training (MMT), on perceived stress, eating behaviors, and gestational weight gain in a high-risk sample of low income women with overweight/obesity.

Method

We conducted a quasi-experimental study assigning 115 pregnant women to MMT for 8 weeks and comparing them to 105 sociodemographically and weight equivalent pregnant women receiving treatment as usual. Our main outcomes included weight gain (primary outcome), perceived stress, and depression.

Results

Women in MMT showed significant reductions in perceived stress (β = − 0.16) and depressive symptoms (β = − 0.21) compared to the treatment as usual (TAU) control group. Consistent with national norms, the majority of women (68%) gained excessive weight according to Institute of Medicine weight-gain categories, regardless of group. Slightly more women in the MMT group gained below the recommendation. Among secondary outcomes, women in MMT reported increased physical activity (β = 0.26) and had lower glucose post-oral glucose tolerance test (β = − 0.23), being 66% less likely to have impaired glucose tolerance, compared to the TAU group.

Conclusion

A short-term intervention led to significant improvements in stress, and showed promise for preventing glucose intolerance. However, the majority of women gained excessive weight. A longer more intensive intervention may be needed for this high-risk population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6785577/

 

Improve Emotional Response Inhibition in Patients with Chronic Pain and Opioid Use with Mindfulness

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Improve Emotional Response Inhibition in Patients with Chronic Pain and Opioid Use with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness meditation could represent a viable alternative to opioid-based therapy for chronic pain, and may be useful in helping patients taper their use of high doses of opioid-acting agents.” – Hymie Anisman

 

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 to demonstrate that mindfulness practices, in general, are effective in treating pain. In today’s Research News article “Effects of Mindfulness-Oriented Recovery Enhancement Versus Social Support on Negative Affective Interference During Inhibitory Control Among Opioid-Treated Chronic Pain Patients: A Pilot Mechanistic Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6735955/), Garland and colleagues examine the mechanisms by which mindfulness reduces perceived pain.

 

They recruited adult patients with non-cancer related chronic pain who were taking daily opioids. They were randomly assigned to receive 8-weeks of a Mindfulness-Oriented Recovery Enhancement (MORE) program or to an 8-week support groups meeting. Mindfulness-Oriented Recovery Enhancement (MORE) involves mindful breathing and body scan meditations, cognitive reappraisal to decrease negative emotions and craving, and savoring to augment natural reward processing and positive emotion. The patients were measured before and after treatment and 3 months later for pain severity and the mindfulness facet of nonreactivity. The patients also performed a go – no-go task. They viewed either neutral or pain related images in which was embedded either the letter “M” or “W”. They were asked to press a key a quickly as possible when the letter “M” was present.

 

They found that in comparison to baseline and the support group, after the mindfulness treatment there was a significant reduction in pain severity and increase in nonreactivity and improvement in go – no-go task accuracy. These changes were maintained 3 months after the completion of th treatment. In addition, they found that the higher the levels of nonreactivity and the greater the amount of meditation practice, the fewer errors occurred in the go – no-go task with pain-related images. In other words, the greater the improvement in response inhibition to emotional stimuli. Finally, they found that the greater the reductions in go – no-go task errors with pain related images, the greater the reduction in pain severity.

 

The results are complicated and so are the conclusions. Nevertheless, the results suggest that mindfulness training reduces pain severity and increases the mindfulness facet of nonreactivity. This suggests that the mindfulness training improves the patient’s ability to not react to pain stimuli and thereby reduce the perceived severity of the pain. This increase in nonreactivity would also explain why the patients didn’t react to pain related distractors in the go – no-go task and thereby improve their accuracy.

 

These results suggest that Mindfulness-Oriented Recovery Enhancement (MORE) enhances the chronic pain patient’s ability to inhibit emotional responses in the presence of pain related stimuli. This ability in turn reduces perceived pain. It remains to be seen if these improvements make it easier for the patients to wean off of opiates.

 

So, improve emotional response inhibition in patients with chronic pain and opioid use with mindfulness.

 

“Meditation teaches patients how to react to the pain. People are less inclined to have the ‘Ouch’ reaction, then they are able to control the emotional reaction to pain.” – Fadel Zeidan

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are available at the Contemplative Studies Blog http://contemplative-studies.org/wp/

They are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Garland, E. L., Bryan, M. A., Priddy, S. E., Riquino, M. R., Froeliger, B., & Howard, M. O. (2019). Effects of Mindfulness-Oriented Recovery Enhancement Versus Social Support on Negative Affective Interference During Inhibitory Control Among Opioid-Treated Chronic Pain Patients: A Pilot Mechanistic Study. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 53(10), 865–876. doi:10.1093/abm/kay096

 

Abstract

Background

Among opioid-treated chronic pain patients, deficient response inhibition in the context of emotional distress may contribute to maladaptive pain coping and prescription opioid misuse. Interventions that aim to bolster cognitive control and reduce emotional reactivity (e.g., mindfulness) may remediate response inhibition deficits, with consequent clinical benefits.

Purpose

To test the hypothesis that a mindfulness-based intervention, Mindfulness-Oriented Recovery Enhancement (MORE), can reduce the impact of clinically relevant, negative affective interference on response inhibition function in an opioid-treated chronic pain sample.

Methods

We examined data from a controlled trial comparing adults with chronic pain and long-term prescription opioid use randomized to either MORE (n = 27) treatment or to an active support group comparison condition (n = 30). Participants completed an Emotional Go/NoGo Task at pre- and post-treatment, which measured response inhibition in neutral and clinically relevant, negative affective contexts (i.e., exposure to pain-related visual stimuli).

Results

Repeated-measures analysis of variance indicated that compared with the support group, participants in MORE evidenced significantly greater reductions from pre- to post-treatment in errors of commission on trials with pain-related distractors relative to trials with neutral distractors, group × time × condition F(1,55) = 4.14, p = .047, η2partial = .07. Mindfulness practice minutes and increased nonreactivity significantly predicted greater emotional response inhibition. A significant inverse association was observed between improvements in emotional response inhibition and treatment-related reductions in pain severity by 3-month follow-up.

Conclusions

Study results provide preliminary evidence that MORE enhances inhibitory control function in the context of negative emotional interference.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6735955/

 

Improve Vascular Function and blood Pressure with Meditation

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Improve Vascular Function and blood Pressure with Meditation

 

By John M. de Castro, Ph.D.

 

“Studies have also linked meditation to healthier arteries and improved blood flow to the heart.” – CardioSmart

 

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. Indeed, meditation, tai chi, and yoga, have also been shown to be helpful for heart health. These practices have also been shown to reduce the physiological and psychological responses to stress and to be helpful for producing the kinds of lifestyle changes needed to prevent heart disease such as smoking cessation, and weight reduction. They have also been shown to be effective in maintaining cardiovascular health and the treatment of cardiovascular disease. Hence it is reasonable to review and summarize what has been learned concerning the effects of mindfulness training on cardiovascular health.

 

In today’s Research News article “Buddhist meditation for vascular function: A narrative review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6881634/?report=classic), Amarasekera and colleagues review and summarize the published research studies on the effects of meditation on vascular endothelial function and blood pressure. They found 5 published research reports.

 

They report that the research found that meditation practice increased mindfulness and decreased stress and blood pressure, both systolic and diastolic. They also found that meditation improved vascular endothelial function, including a reduction in vascular stiffness and an increase in flow mediated dilatation. These benefits occurred in both old and young individuals.

 

The findings of the research to date suggests that meditation practice produces significant improvements in vascular function. This is particularly important as today’s sedentary life styles are associated with increased blood pressure and impaired vascular function which in turn is associated with poorer health. It is likely that the ability of meditation practice to increase mindfulness and to reduce the psychological and physiological responses to stress are responsible for the cardiovascular improvements.

 

So, improve vascular function and blood pressure with meditation.

 

“it is not the stress in our life, but the reaction to stress that is so potentially harmful to our health, including cardiovascular health. Hence . . . meditation and relaxation techniques are extremely important and useful to minimize these unhealthy reactions to stress.” – Joon Sup Lee

 

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

 

Amarasekera, A. T., & Chang, D. (2019). Buddhist meditation for vascular function: A narrative review. Integrative medicine research, 8(4), 252–256. doi:10.1016/j.imr.2019.11.002

 

Abstract

Background

High blood pressure represents an important risk factor for diseases related to cardiovascular system and is directly associated with high oxidative stress, inflammation and vascular endothelial dysfunction. Recently, there is promising data available to suggest that meditation-based low-cost and low-risk lifestyle modification strategies may provide beneficial effects on chronic inflammation, oxidative stress and maintenance of blood pressure, both in young and older adults. This review aims to summarize the evidence regarding the effectiveness of Buddhist meditation for vascular endothelial function and blood pressure.

Method

A search was conducted using Ovid MEDLINE, Scopus, CINAHL and PsycINFO for articles published from 1990 to 2018.

Results

Relevant articles (n = 407) were reviewed and 5 met selection criteria. Several lines of studies have provided compelling data showing that Buddhist meditation approach was effective in improving inflammation and vascular function (endothelial vasodilation and arterial stiffness) in both young and elderly cohorts. Particularly, Buddhist meditation approach has shown to be effective in reducing plasma inflammatory markers, increasing nitric oxide concentration and improving vascular endothelial function and glycemic control, which in turn can be favorable factors for demonstrated positive effects of Buddhist meditation on blood pressure and vascular function.

Conclusion

This paper presents brief overview of clinical outcomes of complementary therapeutic approach of Buddhist meditation in vascular function. In future, well-structured systematic reviews are essential to report specificity of Buddhist mindfulness-based approach on vascular function, blood pressure and other cardiovascular risk factors.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6881634/?report=classic

 

Effective Online Mindfulness Training Characteristics

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Effective Online Mindfulness Training Characteristics

 

By John M. de Castro, Ph.D.

 

“Practicing mindfulness can help all sorts of people no matter what is going on in their lives. Learning mindfulness is very accessible, whether you have a center in your hometown or just an internet connection, whether you have enough money for a retreat or do not have any money at all, or if you want to learn how to teach mindfulness to others. No matter what your situation is, there is a mindfulness training option tailored to your needs.” – Joaquín Selva

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with reducing the physical and psychological reactions to stress and increasing resilience in the face of stress. 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 over the internet 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.

 

The research has indicated that mindfulness training online can be effective for improving the health and well-being of the participants. But the question arises as to what is the best way to train mindfulness online for improving psychological health. In today’s Research News article “Relating Instructional Design Components to the Effectiveness of Internet-Based Mindfulness Interventions: A Critical Interpretive Synthesis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6906627/?report=classic), Lippmann and colleagues review the research studies employing online mindfulness training.

 

They focused on the instructional designs used in the online trainings. In particular they focused on formal learning tasks, supportive educational materials, timely support and reminders, and informal practices of targeted skills. There were 18 published research studies of online mindfulness training that fulfilled the criteria. There were a variety of outcome measures that varied with different studies but primarily they measured anxiety, depression, stress, distress, pain, physical fitness, and quality of life.

 

They classified 11 studies as having highly effective outcomes, 6 as less effective, and 1 as ineffective. They found that the studies that produced more and less effective outcomes all implemented formal practice at least twice a week. But the studies with more effective outcomes also had good supportive educational materials, timely support and reminders, and informal practices of targeted skills, while the studies with less effective outcomes had much less robust implementations of supportive educational materials, timely support and reminders, and informal practices of targeted skills. The study that had ineffective outcomes had formal practice only once a week and none of the other instructional design components were present.

 

The results suggest that online mindfulness trainings can be very effective in improving the physical and psychological health of the participants. But there needs to be several instructional components present and well implemented to maximize effectiveness. These components include clear formal mindfulness training occurring at least twice a week, instruction in the ideas underlying the practices, frequent reminders to practice, and an emphasis on practice outside of the formal online instruction. The better these components are implemented in the online instruction the better the improvements in the well-being of the participants.

 

So, online mindfulness training programs are very effective if they are well designed to implement four important instructional components.

 

“participants who completed the online mindfulness course reported significantly lower levels of perceived stress, depression and anxiety. The large effect sizes associated with completing the intervention were maintained for all of the outcome variables at 3- and 6-month follow-up.” – Dawn Querstret

 

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

 

Lippmann, M., Laudel, H., Heinzle, M., & Narciss, S. (2019). Relating Instructional Design Components to the Effectiveness of Internet-Based Mindfulness Interventions: A Critical Interpretive Synthesis. Journal of medical Internet research, 21(11), e12497. doi:10.2196/12497

 

Abstract

Background

Internet-based mindfulness interventions are a promising approach to address challenges in the dissemination and implementation of mindfulness interventions, but it is unclear how the instructional design components of such interventions are associated with intervention effectiveness.

Objective

The objective of this study was to identify the instructional design components of the internet-based mindfulness interventions and provide a framework for the classification of those components relative to the intervention effectiveness.

Methods

The critical interpretive synthesis method was applied. In phase 1, a strategic literature review was conducted to generate hypotheses for the relationship between the effectiveness of internet-based mindfulness interventions and the instructional design components of those interventions. In phase 2, the literature review was extended to systematically explore and revise the hypotheses from phase 1.

Results

A total of 18 studies were identified in phase 1; 14 additional studies were identified in phase 2. Of the 32 internet-based mindfulness interventions, 18 were classified as more effective, 11 as less effective, and only 3 as ineffective. The effectiveness of the interventions increased with the level of support provided by the instructional design components. The main difference between effective and ineffective interventions was the presence of just-in-time information in the form of reminders. More effective interventions included more supportive information (scores: 1.91 in phases 1 and 2) than less effective interventions (scores: 1.00 in phase 1 and 1.80 in phase 2), more part-task practice (scores: 1.18 in phase 1 and 1.60 in phase 2) than less effective interventions (scores: 0.33 in phase 1 and 1.40 in phase 2), and provided more just-in-time information (scores: 1.35 in phase 1 and 1.67 in phase 2) than less effective interventions (scores: 0.83 in phase 1 and 1.60 in phase 2). The average duration of more effective, less effective, and ineffective interventions differed for the studies of phase 1, with more effective interventions taking up more time (7.45 weeks) than less effective (4.58 weeks) or ineffective interventions (3 weeks). However, this difference did not extend to the studies of phase 2, with comparable average durations of effective (5.86 weeks), less effective (5.6 weeks), and ineffective (7 weeks) interventions.

Conclusions

Our results suggest that to be effective, internet-based mindfulness interventions must contain 4 instructional design components: formal learning tasks, supportive information, part-task practice, and just-in-time information. The effectiveness of the interventions increases with the level of support provided by each of these instructional design components.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6906627/?report=classic

 

Moderate the Negative Psychological Effects of Racism with Mindfulness

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Moderate the Negative Psychological Effects of Racism with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness and related practices do assist in increasing focus and raising awareness, and have been shown to assist in minimizing bias.” – Rhonda Magee

 

Discrimination based upon race, religion, gender, national origin, sexual orientation, etc. has been going on since the beginning of recorded history. Even though quite common, it can have considerable negative impact for all who are involved but especially for the subject of the discrimination. General well-being, self-esteem, self-worth, and social relations can be severely impacted as a result of discrimination. This can, in turn, result in anxiety and depression.

 

It is important that we identify methods to deal with the consequences of discrimination. Mindfulness practices have been shown to reduce prejudice. It has also been shown to reduce depression and enhance positive emotions and reduce the negative effects of discrimination. So perhaps mindfulness can modulate the impact of discrimination on the individual.

 

In today’s Research News article “The Experience of Racism on Behavioral Health Outcomes: The Moderating Impact of Mindfulness.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402779/?report=classic), Zapolski and colleagues recruited African American college students aged 18 to 24 years. They completed an on-line questionnaire measuring demographics, frequency of experiencing racial discrimination, anxiety, depression, alcohol use, and mindfulness.

 

They found that 57% of the African American students had experienced racial discrimination over the last year. A correlational analysis revealed that the greater the frequency of racial discrimination reported, the greater the levels of anxiety, depression, and alcohol use. They also found that the higher the levels of mindfulness the lower the levels of anxiety, depression, and alcohol use. A mediation analysis of these data revealed that mindfulness moderated the effects of racial discrimination on anxiety, depression, and alcohol use such that the higher the levels of mindfulness the smaller the impact of racial discrimination on anxiety, depression, and alcohol use.

 

The study was correlational and as such causation cannot be concluded. Nevertheless, the results suggest that racial discrimination is associated with the individuals’ levels of psychological health and alcohol use but that these associations are weaker when mindfulness levels are high. This suggests that mindfulness may be helpful in mitigating the negative consequences of experience racism. It remains to be established if mindfulness training can immunize the individual from the impact of racism on their psychological health.

 

So, moderate the negative psychological effects of racism with mindfulness.

 

“Mindfulness can help us with a lot of the really subtle difficulties of doing the work that must be done to dismantle these patterns and habits that draw us to reinvest in segregation.” – Rhonda Magee

 

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

 

Zapolski, T., Faidley, M. T., & Beutlich, M. (2019). The Experience of Racism on Behavioral Health Outcomes: The Moderating Impact of Mindfulness. Mindfulness, 10(1), 168–178. doi:10.1007/s12671-018-0963-7

 

Abstract

Research shows that racial discrimination results in adverse behavioral health outcomes for African American young adults, including risk for depression, anxiety, and substance use. Although high levels of mindfulness have been shown to reduce risk for such health outcomes, it is unknown whether mindfulness can reduce risk as a consequence of racial discrimination, particularly among African Americans. Three-hundred and eighty-eight African American young adults between the ages of 18–24 (M=20.6, 62% female) completed measures assessing past year experiences of racial discrimination, depressive symptoms, anxiety symptoms, alcohol use, and trait mindfulness. A positive correlation was found between racial discrimination and the behavioral health outcomes, as well as a negative correlation between mindfulness and the behavioral health outcomes. Moreover, mindfulness was found to significantly moderate the effect of racial discrimination on mood symptoms. Although mindfulness was found to lessen the effect of racial discrimination on alcohol use, this difference was not statistically significant. In line with previous literature, racial discrimination was shown to have a negative impact on behavioral health outcomes among African Americans. Moreover, our findings provide support for the buffering effect of mindfulness on mood symptoms as a consequence discrimination. This suggests that increasing mindfulness may be an effective strategy to include in interventions targeting improvement in mood symptoms for African American young adults. However, alternative strategies may be more appropriate to address outcomes, such as alcohol use, as a consequence of racial discrimination.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402779/?report=classic

 

Improve Well-Being with a Smartphone Mindfulness App

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Improve Well-Being with a Smartphone Mindfulness App

 

By John M. de Castro, Ph.D.

 

“What do you do when you can’t afford therapy but are struggling to handle your mental illness alone? You could download an app. In recent years, there’s been a proliferation of mental health apps available to smartphone users. These reasonably-priced, or most often free, mental health apps offer a wealth of resources that make therapeutic techniques more accessible, portable, and cost-effective.” – Jessica Truchel

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health. The vast majority of the mindfulness training techniques, however, require a trained teacher. This results in costs that many college students 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 college 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. But the question arises as to the effectiveness of these Apps in inducing mindfulness and improving psychological health in college students.

 

In today’s Research News article “Intermittent mindfulness practice can be beneficial, and daily practice can be harmful. An in depth, mixed methods study of the “Calm” app’s (mostly positive) effects.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6928287/?report=classic), Clarke and Draper recruited healthy college students and had them complete a 7-day mindfulness training with the “Calm” smartphone app. The program consists of once a day 10-minute trainings. The students completed measures before and after training of mindfulness, well-being, and self-efficacy.

 

They found that after the 7-day training there were significant increases in mindfulness, well-being, and self-efficacy. They report that students who only completed 1 or 2 of the 7 “Calm” modules did not obtain the benefits. It appears that completing 3 or more of the modules is necessary to improve the students’ psychological health.

 

This is a brief study without a comparison condition and so the results must be interpreted cautiously. But, a number of prior studies have demonstrated that mindfulness trainings with smartphone apps are effective in improving well-being. In addition, the students who did not complete a significant number of the 7 training modules did not show improvements in psychological health. So, it would appear that the use of smartphone apps are a convenient method to teach mindfulness and this can have a significant impact on the psychological health of the users.

 

So, improve well-being with a smartphone mindfulness app.

 

“Mental health apps can be effective in making therapy more accessible, efficient, and portable.” – Mary Let

 

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

 

Clarke, J., & Draper, S. (2019). Intermittent mindfulness practice can be beneficial, and daily practice can be harmful. An in depth, mixed methods study of the “Calm” app’s (mostly positive) effects. Internet interventions, 19, 100293. doi:10.1016/j.invent.2019.100293

 

Abstract

Objectives

Despite a weak evidence base, daily use of mindfulness-based self-help smartphone applications (apps) is said to promote wellbeing. However, many do not use these apps in the way that app developers and mindfulness proponents recommend. We sought to determine whether the “Calm” app works, and whether it does so even when it is used intermittently.

Methods

Employing a mixed-methods design, we recruited a self-selected sample of 269 students from a Scottish university (81% female, 84% white, mean age 23.89) to engage with a seven-day introductory mindfulness course, delivered using Calm, currently one of the most popular, yet under-researched, apps.

Results

Daily course engagement was associated with significant gains in wellbeing (p ≤.001, d = 0.42), trait mindfulness (p ≤.001, d = 0.50) and self-efficacy (p ≤.014, d = 0.21). Intermittent course engagement was also associated with significant gains in wellbeing (p ≤.028, d = 0.34), trait mindfulness (p ≤.010, d = 0.47) and self-efficacy (p ≤.028, d = 0.32). This study is therefore the first to demonstrate that the Calm app is associated with positive mental health outcomes. It also shows that regular use is not essential. A thematic analysis of qualitative data supported these quantitative findings. However it also revealed that some participants had negative experiences with the app.

Conclusions for practice

Mindfulness-based self-help apps such as Calm have the potential to both enhance and diminish users’ wellbeing. Intermittent mindfulness practice can lead to tangible benefits. Therefore, mindfulness proponents should not recommend daily practice, should increase awareness of the potential for negative outcomes, and resist the idea that mindfulness practice works for everyone. Developers of mindfulness apps ought to make specific features customisable in order to enhance their effectiveness.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6928287/?report=classic

 

Improve Borderline Personality Disorder with Dual Diagnosis with Mindfulness

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Improve Borderline Personality Disorder with Dual Diagnosis with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The pain, emotional instability and impulsive behavior of borderline personality disorder place these individuals at risk of drug or alcohol abuse.” – Foundation Recovery

 

Borderline Personality Disorder (BPD) is a very serious mental illness that is estimated to affect 1.6% of the U.S. population. It involves unstable moods, behavior, and relationships, problems with regulating emotions and thoughts, impulsive and reckless behavior, and unstable relationships. BPD is associated with high rates of co-occurring depression, anxiety disorders, substance abuse, eating disorders, self-harm, suicidal behaviors, and completed suicides. Needless to say, it is widespread and debilitating.

 

One of the few treatments that appears to be effective for Borderline Personality Disorder (BPD) is Dialectical Behavior Therapy (DBT). It is targeted at changing the problem behaviors characteristic of BPD through focusing on changing the thoughts and emotions that precede problem behaviors, as well as by solving the problems faced by individuals that contribute to problematic thoughts, feelings and behaviors. In DBT five core skills are practiced; mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness.

 

Borderline Personality Disorder (BPD) frequently occurs with other problems, particularly drug and alcohol abuse. This dual diagnosis increases the issues presenting with the patient. It is therefore important to establish if Dialectical Behavior Therapy (DBT) is effective in the dual diagnosis patients. In today’s Research News article “Does an adapted Dialectical Behaviour Therapy skills training programme result in positive outcomes for participants with a dual diagnosis? A mixed methods study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6694661/?report=classic), Flynn and colleagues examine the effectiveness of Dialectical Behavior Therapy (DBT) skills training for patients with dual diagnosis.

 

They recruited patients diagnosed with Borderline Personality Disorder (BPD) and substance abuse (primarily alcohol abuse). The patients were treated with a 48-week program of skills training adapted from Dialectical Behavior Therapy (DBT); mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness. They were measured before and after treatment and 6 months later for mindfulness, emotion regulation, coping behavior, and the frequency and severity of substance abuse. At the end of the program they were interviewed regarding their experiences with the program.

 

They found that compared with baseline, at the end of the program there were significant increases in mindfulness and Dialectical Behavior Therapy (DBT) skills use and significant reductions in dysfunctional coping behavior and emotional dysregulation that were maintained at the 6-month follow-up. Substance abuse was also significantly reduced after treatment. There was still a reduced use at the 6-month follow-up but it was no longer statistically significant. In the interviews the patients reported that the program improved their self-assurance and confidence, but there was a need for continued care after the end of the program.

 

These results are important as Borderline Personality Disorder (BPD) is extremely difficult to treat and when it is combined with substance abuse it is even more difficult to treat. It is very encouraging that training in Dialectical Behavior Therapy (DBT) skills of mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness is effective in improving emotion regulation and coping behavior and reducing substance abuse in BPD patients with dual diagnosis. This suggests that this skills training may be an acceptable and effective treatment for patients with both BPD and substance abuse.

 

So, improve borderline personality disorder with dual diagnosis with mindfulness.

 

“[Dialectical Behavior Therapy] DBT is reported to reduce suicidal behavior, non-suicidal self-injurious behavior, other impulsive behaviors strongly linked with borderline personality disorder, and significantly reduce psychiatric hospitalization (relapse), self-injury, and depression among adolescents and adults.” – Burning Tree

 

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

 

Flynn, D., Joyce, M., Spillane, A., Wrigley, C., Corcoran, P., Hayes, A., … Mooney, B. (2019). Does an adapted Dialectical Behaviour Therapy skills training programme result in positive outcomes for participants with a dual diagnosis? A mixed methods study. Addiction science & clinical practice, 14(1), 28. doi:10.1186/s13722-019-0156-2

 

Abstract

Background

Treating severe emotional dysregulation and co-occurring substance misuse is challenging. Dialectical behaviour therapy (DBT) is a comprehensive and evidence-based treatment for borderline personality disorder (BPD). It has been hypothesised that the skills training, which is a facet of the full DBT programme, might be effective for people with severe emotional dysregulation and other co-occurring conditions, but who do not meet the criteria for BPD. However, there is limited research on standalone DBT skills training for people with substance misuse and emotional dysregulation.

Methods

A mixed methods study employing an explanatory sequential design was conducted where participants with a dual diagnosis (n = 64) were recruited from a community-based public addiction treatment service in Ireland between March 2015 and January 2018. DBT therapists screened potential participants against the study eligibility criteria. Quantitative self-report measures examining emotion regulation, mindfulness, adaptive and maladaptive coping responses including substance misuse, and qualitative feedback from participants were collected. Quantitative data were summarised by their mean and standard deviation and multilevel linear mixed effects models were used to estimate the mean change from baseline to post-intervention and the 6-month follow-up period. Thematic analysis was used to analyse the qualitative data.

Results

Quantitative results indicated reductions in binge drinking and use of Class A, B and C drug use from pre-intervention (T1) to the 6-month follow-up (T3). Additionally, significant improvements were noted for mindfulness practice and DBT skills use from T1 to T3 (p < 0.001). There were also significant reductions in dysfunctional coping and emotional dysregulation from T1 to T3 (p < 0.001). Significant differences were identified from pre to post intervention in reported substance use, p = 0.002. However, there were no significant differences between pre-intervention and 6-month follow up reports of substance use or at post-intervention to 6 month follow up. Qualitative findings indicated three superordinate themes in relation to participants’ experiences of a DBT skills training programme, adapted from standard DBT: (1) new lease of life; (2) need for continued formal aftercare and (3) programme improvements. Participants described reductions in substance misuse, while having increased confidence to use the DBT skills they had learned in the programme to deal with difficult emotions and life stressors.

Conclusions

This DBT skills training programme, adapted from standard DBT, showed positive results for participants and appears effective in treating people with co-occurring disorders. Qualitative results of this mixed methods study corroborate the quantitative results indicating that the experiences of participants have been positive. The study indicates that a DBT skills programme may provide a useful therapeutic approach to managing co-occurring symptoms.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6694661/?report=classic