Mindfulness

Trait Mindfulness is Only Loosely Associated with State Mindfulness

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Trait Mindfulness is Only Loosely Associated with State Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is a “state” of mind that I can practice when I sit, but it is also a “trait” of mind, an “enduring characteristic,” that can become a part of my basic temperament.” – James Walsh

 

Mindfulness 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, mindfulness training has been called the third wave of therapies. One problem with understanding mindfulness effects is that there are, a wide variety of methods to measure mindfulness.

 

There two basic forms of mindfulness, trait and state mindfulness. Trait mindfulness is an enduring characteristic that is a long-term proclivity to be mindful. It remains relatively stable over time. On the other hand, state mindfulness is a short-term characteristic that is dependent upon circumstances and can change from moment to moment. The relationship between trait and state mindfulness has not been systematically explored.

 

In today’s Research News article “When Traits Match States: Examining the Associations between Self-Report Trait and State Mindfulness following a State Mindfulness Induction.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5800747/ ), Bravo and colleagues recruited college students 31% of which had previous meditation experience. They were randomly assigned to receive a brief (8 minute) recorded guided mindfulness meditation induction focused on body sensations and the breath or a control condition consisting of an 8-minute recorded educational presentation on fruit flies. They were measured before and after the induction for state mindfulness including mindfulness of mind and mindfulness of body, and trait mindfulness including observing, describing, acting with awareness, non-judging, non-reactivity.

 

They found that at baseline there were few, weak, and small relationships between trait mindfulness facets and state mindfulness of either mind or body. This makes sense as trait mindfulness is fairly stable while state mindfulness can be highly variable, high one moment and low another. After the brief body focused meditation there was a significant increase in the participants state of mindfulness of their body but not mind which also is to be expected. They also found that “the association between observing trait mindfulness and state mindfulness of mind and body strengthened with more frequent mindfulness meditation practice.”

 

These are interesting but not surprising findings that the enduring tendency to be mindful is not necessarily related to the moment by moment state of mindfulness. This also tells us that these are independent characteristics that can be accurately measured with existing scales of mindfulness. This suggests that measures of both should be included in research studies of mindfulness as they reflect different components of mindfulness.

 

So, trait mindfulness is only loosely associated with state mindfulness.

 

“the trait-like propensity to be mindful in everyday life may be modifiable (for at least some individuals) through intentional practice of evoking the corresponding state during meditation.” – Laura Kiken

 

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

 

Bravo, A. J., Pearson, M. R., Wilson, A. D., & Witkiewitz, K. (2017). When Traits Match States: Examining the Associations between Self-Report Trait and State Mindfulness following a State Mindfulness Induction. Mindfulness, 9(1), 199-211.

 

Abstract

Previous research has found inconsistent relationships between trait mindfulness and state mindfulness. To extend previous research, we sought to examine the unique associations between self-report trait mindfulness and state mindfulness by levels of meditation experience (meditation-naïve vs. meditation-experienced) and by mindfulness induction (experimentally induced mindful state vs. control group). We recruited 299 college students (93 with previous mindfulness meditation experience) to participate in an experiment that involved the assessment of five facets of trait mindfulness (among other constructs), followed by a mindfulness induction (vs. control), followed by the assessment of state mindfulness of body and mind. Correlational analyses revealed limited associations between trait mindfulness facets and facets of state mindfulness, and demonstrated that a brief mindfulness exercise focused on bodily sensations and the breath elicited higher state mindfulness of body but not state mindfulness of mind. We found significant interactions such that individuals with previous meditation experience and higher scores on the observing facet of trait mindfulness had the highest levels of state mindfulness of body and mind. Among individuals with meditation experience, the strengths of the associations between observing trait mindfulness and the state mindfulness facets increased with frequency of meditation practice. Some other interactions ran counter to expectations. Overall, the relatively weak associations between trait and state mindfulness demonstrates the need to improve our operationalizations of mindfulness, advance our understanding of how to best cultivate mindfulness, and reappraise the ways in which mindfulness can manifest as a state and as a trait.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5800747/

 

Reduce Athletic Burnout with Mindfulness

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Reduce Athletic Burnout with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness training has the potential to prevent athlete burnout because of stress reduction and increased recovery.  It also has the potential to enhance performances.  Mindfulness exercises could be beneficial for athletes who struggle with demands from several sources.” – P. Furrer

 

Athletic performance requires the harmony of mind and body. Excellence is in part physical and in part psychological. Without inheriting an athletic body and without many hours of training the individual will never reach an elite level. But, once there, the difference between winning and losing is psychological. That is why an entire profession of Sports Psychology has developed. “In sport psychology, competitive athletes are taught psychological strategies to better cope with a number of demanding challenges related to psychological functioning.” They use a number of techniques to enhance performance including anxiety or energy management, attention and concentration control (focusing), communication, goal setting, imagery, visualization, mental practice, self-talk, controlling negative emotions, team building, time management/organization.

 

Mindfulness training has been shown to enhance a number of the characteristics that are taught by Sports Psychologists. Mindfulness training improves attention and concentration and emotion regulation and reduces anxiety and worry and rumination, and the physiological and psychological responses to stress. As a result, mindfulness training, including meditation and yoga practices, have been employed by elite athletes and even by entire teams to enhance their performance. It makes sense at this point to step back and take a look at the state of the research.

 

In today’s Research News article “Mindfulness and Athlete Burnout: 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/PMC6388258/ ), Li and colleagues review and summarize, and perform a meta-analysis of the published research literature on the effectiveness of mindfulness as an antidote to athletic burnout. They identified 10 studies including 2 controlled trials, 5 cross-sectional surveys, 1 prospective survey, and 2 qualitative studies.

 

They found that the literature in general reports that mindfulness training produces a reduction in burnout symptoms in athletes and that mindful individuals tend to have significantly lower levels of burnout symptoms. Meta-analysis revealed a significant association between mindfulness and lower burnout, particularly with the burnout symptoms of emotional and physical exhaustion.

 

Hence, the research suggests the mindfulness is a potential antidote to athletic burnout. But the reviewed studies were methodologically weak and larger, well controlled, randomized controlled trials, with long-term follow-up are needed. Thus, although the research has produced promising results, conclusions must be tempered pending more research.

 

So, reduce athletic burnout with mindfulness.

 

“Despite how physically ready athletes are for competition, their performances may suffer if they do not have control over their minds. Improving mindfulness, or participating in mindfulness-based interventions may help athletes monitor and cope with their sport related anxiety, help them focus during their competitions, and help boost their confidence. Athletes are looking for whatever will give them the advantage, so why not try mindfulness?” – Crystal Chariton

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Li, C., Zhu, Y., Zhang, M., Gustafsson, H., & Chen, T. (2019). Mindfulness and Athlete Burnout: A Systematic Review and Meta-Analysis. International journal of environmental research and public health, 16(3), 449. doi:10.3390/ijerph16030449

 

Abstract

Objective: This review aims to identify, appraise, and synthesize studies reporting the relationship between mindfulness and athlete burnout and the effects of mindfulness-based interventions (MBIs) on athlete burnout. Methods: Studies were identified through searching six electronic databases using combinations of three groups of keywords and manual search. Two independent reviewers screened the searched studies, extracted data of the included studies, and assessed the study quality. The extracted data were synthesized qualitatively and quantitatively. Results: Ten studies consisting of two controlled trials, six surveys, and two interview studies met the inclusion criteria. The two controlled trials had weak methodological quality, and the remaining studies were of moderate to high research quality. Results of controlled trials and interview research generally showed that MBIs had positive effects in burnout prevention. Meta-analytic results indicated a negative association between mindfulness and burnout. Conclusions: There is some evidence showing that mindfulness was negatively associated with athlete burnout. However, given the small number of interventions and qualitative studies, there is limited evidence on whether MBIs are useful in preventing athlete burnout. More studies are needed to corroborate these findings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388258/

 

Improve Sleep in Breast Cancer Patients Undergoing Chemotherapy with Yoga

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Improve Sleep in Breast Cancer Patients Undergoing Chemotherapy with Yoga

 

By John M. de Castro, Ph.D.

 

“Sleep disturbance is a common problem for women with breast cancer, and can have a variety of causes, from stress and depression related to the treatment or diagnosis, to a side effect of some of the drugs and anti-nausea medications used in chemotherapy regimens. Yoga not only produced benefits in the short term, it also produced benefits in sleep quality three months and six months after treatment.” – Paul Raeburn

 

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

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatigue, stress,  sleep disturbance, and anxiety and depression. Yoga practice is a form of mindfulness training that has been shown to be beneficial for cancer patients.  In today’s Research News article “Randomized trial of Tibetan yoga in patients with breast cancer undergoing chemotherapy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5735004/ ), Chaoul and colleagues examine the ability of yoga practice to improve sleep in breast cancer patients.

 

They recruited patients with Stage 1 to 3 breast cancer scheduled to undergo chemotherapy. They were randomly assigned to usual care or to either receive a Tibetan Yoga Program or a stretching program. Participants met for 4, 75 to 90-minute, sessions during chemotherapy and 3 booster sessions over the next 6 months. The participants were also encouraged to practice at home. The Tibetan Yoga Program consisted of “1) mindfulness and focused attention through guided meditation with breathing and visualization; 2) an alternate nostril breathing practice and a breath retention exercise; 3) Tsa Lung movements; and 4) closing with a brief compassion-based meditation.” The participants were measured before and after the programs and 3, 6, and 12 months later for sleep quality, fatigue, and actigraph measured sleep patterns.

 

They found that all groups improved in sleep quality and fatigue over the 12-month measurement period. But the Tibetan Yoga group had significantly less daily sleep disturbances and fewer minutes awake before sleep onset. Hence, participation in the Tibetan Yoga Program had modest benefits for the quality of sleep for the patients. The Tibetan Yoga Program contains a number of different components including meditation, postures, and breathing exercises. It is impossible to determine in the current study which components or which combinations of components were necessary and sufficient for the benefits.

 

These results are encouraging but not clinically significant as the effects were very modest. But,

it should be kept in mind that yoga and meditation programs have been shown to improve a number of other impacts of breast cancer diagnosis and survival. So, the total impact of participation in yoga for breast cancer patients may be much greater than implied by the current results.

 

So, improve sleep in breast cancer patients undergoing chemotherapy with yoga.

 

“it is encouraging to see that the women who practiced yoga outside of class had improved sleep outcomes over time. Previous research has established that yoga effectively reduces sleep disturbances for cancer patients, but have not included active control groups or long-term follow-up.” – Lorenzo Cohen

 

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

 

Chaoul, A., Milbury, K., Spelman, A., Basen-Engquist, K., Hall, M. H., Wei, Q., Shih, Y. T., Arun, B., Valero, V., Perkins, G. H., Babiera, G. V., Wangyal, T., Engle, R., Harrison, C. A., Li, Y., … Cohen, L. (2017). Randomized trial of Tibetan yoga in patients with breast cancer undergoing chemotherapy. Cancer, 124(1), 36-45.

 

Abstract

BACKGROUND

This randomized trial examined the effects of a Tibetan yoga program (TYP) versus a stretching program (STP) and usual care (UC) on sleep and fatigue in women with breast cancer undergoing chemotherapy.

METHODS

Women with stage I–III breast cancer undergoing chemotherapy were randomized to TYP (n=74), STP (n=68), or UC (n=85) groups. Participants in the TYP and STP groups participated in 4 sessions during chemotherapy, followed by three booster sessions over the subsequent 6 months, and encouraged to practice at home. Self-report measures of sleep disturbances (Pittsburgh Sleep Quality Index) fatigue (Brief Fatigue Inventory), and actigraphy were collected at baseline, 1-week post-treatment, and 3, 6 and 12 months.

RESULTS

There were no group differences in total sleep disturbances or fatigue levels over time. However, patients in TYP reported fewer daily disturbances 1-week post-treatment than STP (difference=−0.43, 95% CI: −0.82, −0.04, P=0.03) and UC (difference=−0.41, 95.5% CI: −0.77, −0.05, P=0.02). Group differences at the other time points were maintained for TYP versus STP. Actigraphy data revealed greater minutes awake after sleep onset for STP 1-week post treatment versus TYP (difference=15.36, 95% CI: 7.25,23.48, P=0.0003) and UC (difference=14.48, 95% CI: 7.09,21.87, P=0.0002). Patients in TYP who practiced at least two times a week during follow-up reported better PSQI and actigraphy outcomes at 3 and 6 months post-treatment than those who did not and better than those in UC.

CONCLUSIONS

Participating in TYP during chemotherapy resulted in modest short-term benefits in sleep quality, with long-term benefits emerging over time for those who practiced TYP at least two times a week.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5735004/

 

Improve Psychological Well-Being with a Smartphone Mindfulness App

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Improve Psychological Well-Being with a Smartphone Mindfulness App

 

By John M. de Castro, Ph.D.

 

“Mobile phones are often scorned as devices of distraction, but paradoxically, they may serve as a good platform to practice being in the moment and being mindful given their wide use,” – Jayde Flett

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress and 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, 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 today’s Research News article “). Effects of a Mindfulness Meditation App on Subjective Well-Being: Active Randomized Controlled Trial and Experience Sampling Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6329416/ ), Walsh and colleagues recruited undergraduate students and randomly assigned them to practice with one of two smartphone apps, “Wildflowers” Mindfulness Training or “2048” Cognitive Training, for 10 minutes per day for three weeks. “2048” is described as “fun and relaxing puzzle game”. “Wildflowers” involves a variety of meditation trainings. “Ratings of current mood, stress level, and heart rate were recorded within each app before and after each training session.” Also, before and after the 3 weeks of training with the Apps the participants completed online measures of perceived stress, personality, well-being, psychological inflexibility, experiential avoidance, mindfulness, interoceptive awareness, spirituality, meaning in life, attentional control, interoceptive attention, and positive and negative mood.

 

They found that in comparison to the before session mood and the cognitive training group, after the session the participants who engaged in mindfulness training had significantly improved mood and reduced perceived stress. Hence, on the short term, engagement with the mindfulness app improved the emotional state of the participants.

 

They also found that both groups significantly improved over the 3 weeks of training on awareness and self-acceptance. The mindfulness training group, however, had significantly greater improvement in self-acceptance. In addition, the mindfulness training group had a significant improvement in attentional control, specifically increased ability to deal with conflicts for attention. This may be particularly helpful for the academic ability of college students. Hence on the longer term, engaging with the mindfulness app results in improved attentional ability and self-acceptance.

 

This research is well structured as the control, comparison, condition involved an equivalent amount of practice, time commitment, and expectation of benefit. So, the findings can be viewed as solid. The study, however, lacks a follow-up to determine if the effects are lasting or fleeting. The results though demonstrate that engaging in mindfulness practices with a smartphone produces short-term benefits for the individual’s emotional and psychological state and attentional ability. These are substantial benefits for a 10 minute per day investment of time. The low cost, scalability, flexibility, and convenience of training using a smartphone make it an important advance in mindfulness training.

 

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

 

“Mindfulness does not mean avoiding digital media, nor does it mean making one’s own mindfulness dependent on it – so let’s be more mindful when it comes to mindfulness!” – Annika Heinemeyer

 

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

 

Walsh, K. M., Saab, B. J., & Farb, N. A. (2019). Effects of a Mindfulness Meditation App on Subjective Well-Being: Active Randomized Controlled Trial and Experience Sampling Study. JMIR mental health, 6(1), e10844. doi:10.2196/10844

 

Abstract

Background

Mindfulness training (MT) includes a variety of contemplative practices aimed at promoting intentional awareness of experience, coupled with attitudes of nonjudgment and curiosity. Following the success of 8-week, manualized group interventions, MT has been implemented in a variety of modalities, including smartphone apps that seek to replicate the success of group interventions. However, although smartphone apps are scalable and accessible to a wider swath of population, their benefits remain largely untested.

Objective

This study aimed to investigate a newly developed MT app called Wildflowers, which was codeveloped with the laboratory for use in mindfulness research. It was hypothesized that 3 weeks of MT through this app would improve subjective well-being, attentional control, and interoceptive integration, albeit with weaker effects than those published in the 8 week, manualized group intervention literature.

Methods

Undergraduate students completed 3 weeks of MT with Wildflowers (n=45) or 3 weeks of cognitive training with a game called 2048 (n=41). State training effects were assessed through pre- and postsession ratings of current mood, stress level, and heart rate. Trait training effects were assessed through pre- and postintervention questionnaires canvassing subjective well-being and behavioral task measures of attentional control and interoceptive integration. State and trait training data were analyzed in a multilevel model using emergent latent factors (acceptance, awareness, and openness) to summarize the trait questionnaire battery.

Results

Analyses revealed both state and trait effects specific to MT; participants engaging in MT demonstrated improved mood (r=.14) and a reduction of stress (r=−.13) immediately after each training session compared with before the training session and decreased postsession stress over 3 weeks (r=−.08). In addition, MT relative to cognitive training resulted in greater improvements in attentional control (r=−.24). Interestingly, both groups demonstrated increased subjective ratings of awareness (r=.28) and acceptance (r=.23) from pre- to postintervention, with greater changes in acceptance for the MT group trending (r=.21).

Conclusions

MT, using a smartphone app, may provide immediate effects on mood and stress while also providing long-term benefits for attentional control. Although further investigation is warranted, there is evidence that with continued usage, MT via a smartphone app may provide long-term benefits in changing how one relates to their inner and outer experiences.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6329416/

 

Increase Positive Feelings About Caregiving for Cancer Patients with Mindfulness

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Increase Positive Feelings About Caregiving for Cancer Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“caregivers of cancer patients face under-recognized health challenges. “Studies have suggested that caregivers are more depressed than patients themselves. There is also a reciprocal relationship between caregivers and patients, so improving quality of life for caregivers could improve patient outcomes.” – Sarah Stanley

 

There is a tremendous demand for caregiving in the U.S. It is estimated that over 65 million (29% of the adult population) provides care to someone who is mentally or physically ill, disabled or aged, averaging 20 hours per week spent caring for their loved ones. This caregiving comes at a cost to the caregiver. It exacts 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.

 

Family members are an increasingly important source of caregiving. But it comes with a cost to the caregiver. Mindfulness training has been shown to be beneficial for both the caregiver and the patients. So, mindfulness training may be helpful in decreasing the psychological difficulty of caring for a patient with cancer.

 

In today’s Research News article “Mindful Learning Improves Positive Feelings of Cancer Patients’ Family Caregivers.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352041/ ), Geng and colleagues recruited caregivers for cancer patients and randomly assigned them to receive either 4, 30-minute, mindfulness training sessions or mindlessness training. The mindfulness training involved “innovation classification” in which they were asked to “think and write four answers from different perspectives to a picture-related question.” The mindlessness condition involved writing answers to the same pictures but from only one perspective. They were measured before and after training for mindfulness, caregiver reactions, and positive aspects of caregiving.

 

They found in comparison to baseline and the mindlessness group, that after training the mindfulness group had significantly higher mindfulness and positive feelings toward caregiving. In addition, the higher the levels of mindfulness, the greater the positive feelings toward caregiving.

 

These results suggest that a simple form of mindfulness training can improve caregiver’s mindfulness and feeling about caregiving for cancer patients. It remains for future research to demonstrate if these benefits are lasting and can result in improved care for the patients and less stress and burnout for the caregivers.

 

So, increase positive feelings about caregiving for cancer patients with mindfulness.

 

“We are set up for short-term stress, but caregiving is long-term stress. Mindfulness is basically coming back into the present moment, so it works to inhibit the stress response. Most of us run around listening to our thoughts, and this is particularly true of caregivers, who are driven by the to-do list. They are never at rest.” – Joan Griffiths Vega

 

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

 

Geng, L., Wang, J., Cheng, L., Zhang, B., & Shen, H. (2019). Mindful Learning Improves Positive Feelings of Cancer Patients’ Family Caregivers. International journal of environmental research and public health, 16(2), 248. doi:10.3390/ijerph16020248

 

Abstract

Positive feelings are an important health dimension for family caregivers of cancer patients. The aim of this study was to investigate whether Langerian mindfulness is a valid proactive method to increase the positive feelings of family caregivers for cancer patients. Participants were randomly assigned to either a mindfulness group or a mindlessness group and completed the Caregiver Reaction Assessment (CRA) as a measure of caregivers’ feelings before the intervention. Subsequently, both groups were given four sessions of mindfulness training using “innovation classification”. Finally, participants completed the Langer Mindfulness Scale (LMS) and the Positive Aspects of Caregiving (PAC) scale as post-intervention measures. The results revealed that participants in the mindfulness and mindlessness groups differed significantly in LMS and PAC scores, with the mindfulness group having higher levels of positive feelings than those in the mindlessness group. The results also indicated that mindfulness level significantly predicted positive feelings of caregivers. Thus mindful interventions may play a meaningful role in promoting family caregivers’ spirituality and faith, improving the willingness of sharing their thoughts, beliefs, and grief, which could be useful for increasing the positive feelings of caregivers.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352041/

 

Improve Prisoner Mental Health with Mindfulness

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Improve Prisoner Mental Health with Mindfulness

 

By John M. de Castro, Ph.D.

 

“It is truly within the reach of anyone to create an environment in which kindness and resilience can flourish. Even the most powerless among us—prisoners—have the ability to live mindfully and treat others with kindness and respect. In doing so, they are able to improve life and build resilience not just for themselves, but for other inmates, guards, and in fact everyone in their community.” – Doug Carnine

 

Around 2 ¼ million people are incarcerated in the United States. Even though prisons are euphemistically labelled correctional facilities very little correction actually occurs. This is supported by the rates of recidivism. About three quarters of prisoners who are released commit crimes and are sent back to prison within 5-years. The lack of actual treatment for the prisoners leaves them ill equipped to engage positively in society either inside or outside of prison. Hence, there is a need for effective treatment programs that help the prisoners while in prison and prepares them for life outside the prison.

 

Contemplative practices are well suited to the prison environment. Mindfulness training teaches skills that may be very important for prisoners. In particular, it puts the practitioner in touch with their own bodies and feelings. It improves present moment awareness and helps to overcome rumination about the past and negative thinking about the future. It’s been shown to be useful in the treatment of the effects of trauma and attention deficit disorder. It also relieves stress and improves overall health and well-being. Finally, mindfulness training has been shown to be effective in treating depression, anxiety, and anger. It has also been shown to help overcome trauma in male prisoners.

 

In today’s Research News article “The Effects of Mindfulness Training on Emotional Health in Chinese Long-Term Male Prison Inmates.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345534/ ), Xu and colleagues recruited healthy prisoners and randomly assigned them to either a wait-list control condition or to receive a 6-week program of a modified version of Mindfulness-Based Cognitive Therapy (MBCT). It was modified by replacing depression discussions with yoga practice. MBCT training occurred once a week for 2.5 hours and included practice on the prisoners own time. The mindfulness training involved sitting, walking and body scan meditations, and cognitive therapy that is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. The prisoners were measured before and after training for anxiety, depression, mindfulness, and mood.

 

They found that at the time of pretest the higher the prisoner’s level of mindfulness the lower their levels of anxiety, depression, tension-anxiety, depression-dejection, anger-hostility, confusion-bewilderment, and total mood disturbance. They also found that in comparison to baseline and the wait-list control group the mindfulness training group had significant improvements in mindfulness, anxiety, depression, tension-anxiety, depression-dejection, anger-hostility, confusion-bewilderment, or total mood disturbance.

 

These are interesting results that suggest that Mindfulness-Based Cognitive Therapy (MBCT) significantly improve the mental health of prisoners. This is important as better mental health may lead to better adjustment to life in prison and to life after release. This may lead to lower recidivism.

 

So, improve prisoner mental health with mindfulness.

 

“By working with both prisoners and correctional facilities professionals, mindfulness programs systematically transform the impact of our criminal justice system. Through cultivating greater awareness and compassion, mindfulness “encourages a shift away from fear-based and often anti-social or criminal strategies for meeting needs” – Prison Mindfulness Institute

 

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

 

Xu, W., Jia, K., Liu, X., & Hofmann, S. G. (2016). The Effects of Mindfulness Training on Emotional Health in Chinese Long-Term Male Prison Inmates. Mindfulness, 7(5), 1044-1051.

 

Abstract

Long-term imprisonment can cause severe emotional problems, which in turn can trigger behavioral problems, self-harm, and suicide. Mindfulness-based intervention can enhance emotional health. This study investigated the effects of a 6-week mindfulness training program on the emotional health of long-term male Chinese prison inmates. Forty long-term male prisoners completed a pretest and posttest, with 19 in the mindfulness training group and 21 in the waitlist control group. The treatment group showed a significant improvement in mindfulness level, anxiety, depression, tension-anxiety, depression-dejection, anger-hostility, confusion-bewilderment, and total mood disturbance. Implications and limitations of this study were discussed. These results support the use of a mindfulness-based intervention to enhance the emotional health of long-term male prison inmates.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345534/

 

Improve Psychological Well-Being with a Smartphone Mindfulness App

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Improve Psychological Well-Being with a Smartphone Mindfulness App

 

By John M. de Castro, Ph.D.

 

“Mindfulness mediation apps can be useful for some people, but for others, when unwell, using these apps or even engaging in mediation its self can be quite difficult,” – Kym Jenkins

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress and resilience in the face of stress. The vast majority of the mindfulness training techniques, however, require a certified 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, 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 today’s Research News article “The efficacy of a brief app-based mindfulness intervention on psychosocial outcomes in healthy adults: A pilot randomised controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312207/ ), Champion and colleagues recruited over the internet healthy adults who were not mindfulness practitioners and randomly assigned them to either a wait-list control condition or to receive mindfulness training via a smartphone app (Headspace). They practiced once a day for 10 minutes for 30 days. “The program is intended to introduce the key principles behind mindfulness, and how one can apply mindfulness to their daily life, using technique such as breath awareness, body scanning, and noting. . . The audio content is supplemented with educational videos and animations.” The participants completed questionnaires over the internet measuring general health, satisfaction with life, perceived stress, resilience, and engagement and experience with the app.

 

They found in comparison to baseline and to the wait-list controls that the participants who used the app had significant improvements in satisfaction with life, perceived stress, and resilience. The increases in psychological health were greatest between baseline and day 10 of practice but continued to increase over the next 20 days. This suggests that the benefits are available relatively rapidly but continued practice produces greater benefits. It remains to be determined whether these effects are enduring or are only present in the immediate aftermath of training.

 

These effects of mindfulness training are well established. This study adds to the accumulating evidence of the effectiveness of mindfulness training over the internet or with smartphone apps. The present study demonstrates that a widely available commercial smartphone app is also effective. This is important as it suggests that training in mindfulness can be made widely and inexpensively available without the presence of a trained therapist and at the convenience of the participant. This may allow for the benefits of mindfulness practice to spread far and wide to tremendous numbers of people. In this regard the Headspace app has already been downloaded 30 million times.

 

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

 

“A good number of new meditators begin sitting with the hope that the holistic benefits of meditation will make themselves felt in a matter of days. They expect meditation to act as a quick fix – like swallowing a pain relief tablet. It isn’t a reasonable expectation. Most genuine meditation teachers say that while a fortunate few newbies experience benefits very quickly, for the rest of us, meditation has to be practiced regularly over time before its beneficial effects can be appreciated.” – Mindworks

 

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

 

Champion, L., Economides, M., & Chandler, C. (2018). The efficacy of a brief app-based mindfulness intervention on psychosocial outcomes in healthy adults: A pilot randomised controlled trial. PloS one, 13(12), e0209482. doi:10.1371/journal.pone.0209482

 

Abstract

Background

Previous evidence suggests that mindfulness training may improve aspects of psychosocial well-being. Whilst mindfulness is traditionally taught in person, consumers are increasingly turning to mindfulness-based smartphone apps as an alternative delivery medium for training. Despite this growing trend, few studies have explored whether mindfulness delivered via a smartphone app can enhance psychosocial well-being within the general public.

Methods

The present pilot randomised controlled trial compared the impact of engaging with the self-guided mindfulness meditation (MM) app ‘Headspace’ (n = 38) for a period of 10 or 30 days, to a wait-list (WL) control (n = 36), using a cohort of adults from the general population. The Satisfaction with Life Scale, Perceived Stress Scale, and Wagnild Resilience Scale were administered online at baseline and after 10 and 30 days of the intervention.

Results

Twelve participants (MM n = 9, WL n = 3) were lost to follow-up for unknown reasons. Relative to the WL control, the MM app positively impacted self-reported satisfaction with life, stress, and resilience at day 10, with further improvements emerging at day 30 (Cohen’s d = 0.57, 1.42, 0.63 respectively). The rate of improvement was largest at the 10-day assessment point, dropping moderately by day 30. Participants that rated the MM app as easy to engage with experienced the largest self-reported benefits. Moreover, the MM app was able to protect against an unexpected increase in perceived stress that emerged in the control group.

Conclusions

This pilot randomised controlled trial shows that self-reported improvements in psychosocial outcomes can be achieved at low cost through short-term engagement with a mindfulness-based smartphone app, and should be followed up with more substantive studies.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312207/

 

Improve Severe Mental Illness with Yoga and Mindfulness

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Improve Severe Mental Illness with Yoga and Mindfulness

 

By John M. de Castro, Ph.D.

 

“yoga does in fact have positive effects on mild depression and sleep problems, and it improves the symptoms of psychiatric disorders like schizophrenia and ADHD among patients using medication.” – Alexandra Sifferin

 

Psychoses are mental health problems that cause people to perceive or interpret things differently from those around them. This might involve hallucinations; seeing and, in some cases, feeling, smelling or tasting things that aren’t objectively there, or delusions; unshakable beliefs that, when examined rationally, are obviously untrue. The combination of hallucinations and delusional thinking can often severely disrupt perception, thinking, emotion, and behavior, making it difficult if not impossible to function in society without treatment. Psychoses appear to be highly heritable and involves changes in the brain. Psychoses are very difficult to treat with psychotherapy and are usually treated with antipsychotic drugs. These drugs, however, are not always effective, sometimes lose effectiveness, and can have some difficult side effects. Hence, there is a need for safe and effective alternative treatments for psychosis.

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. It is also generally episodic, coming and going. Some people only have a single episode but most have multiple reoccurrences of depression.  Depression can be difficult to treat. It is usually treated with antidepressant medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time.

 

Clearly, there is a need for treatment alternatives that can be effective alone or in combination with drugs. Both mindfulness and yoga training has been shown to be beneficial for patients with psychosis and with major depression. It is important at this point to step back and review the published studies of the application of mindfulness and yoga practices for the treatment of severe mental illnesses, In today’s Research News article “Role of Yoga and Mindfulness in Severe Mental Illnesses: A Narrative Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6329226/ ), Sathyanarayanan and colleagues review and summarize 49 published research studies on the effectiveness of mindfulness and yoga practices for the treatment of severe mental illnesses.

 

They report that the research finds that both mindfulness practices and yoga practice in combination with antipsychotic medications significantly reduces both the positive and negative symptoms of schizophrenia and other psychotic disorders, improves the patient’s ability to effectively engage in everyday activities and also improves higher level thought processes, cognition. With Bipolar Disorder they report that there are only a very small number of studies that suggest improvements but more research is needed. With Major Depressive Disorders both mindfulness and yoga practices have been shown to produce significant reductions in depression alone or in combination with anti-depressive medications.

 

Hence, they find that the current published research supports the use of either mindfulness or yoga practices for the treatment of severe mental illnesses. There is clearly a need for more research, but the studies to date are very encouraging. They suggest that these practices are safe and effective whether used alone or in combination with drugs and may then be a needed alternative treatment to drugs.

 

So, improve severe mental illness with yoga and mindfulness.

 

“Yoga can be an incredible tool for self-growth, empowerment, healing, and health for those with mental disorders.” – Zoie Kanakis

 

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

 

Sathyanarayanan, G., Vengadavaradan, A., & Bharadwaj, B. (2019). Role of Yoga and Mindfulness in Severe Mental Illnesses: A Narrative Review. International journal of yoga, 12(1), 3-28.

 

Abstract

Background:

Yoga has its origin from the ancient times. It is an integration of mind, body, and soul. Besides, mindfulness emphasizes focused awareness and accepting the internal experiences without being judgemental. These techniques offer a trending new dimension of treatment in various psychiatric disorders.

Aims:

We aimed to review the studies on the efficacy of yoga and mindfulness as a treatment modality in severe mental illnesses (SMIs). SMI includes schizophrenia, major depressive disorder (MDD), and bipolar disorder (BD).

Methods:

We conducted a literature search using PubMed, Google Scholar, and Cochrane Library with the search terms “yoga,” “meditation,” “breathing exercises,” “mindfulness,” “schizophrenia spectrum and other psychotic disorders,” “depressive disorder,” and “bipolar disorder” for the last 10-year period. We also included relevant articles from the cross-references.

Results:

We found that asanas and pranayama are the most commonly studied forms of yoga for schizophrenia. These studies found a reduction in general psychopathology ratings and an improvement in cognition and functioning. Some studies also found modest benefits in negative and positive symptoms. Mindfulness has not been extensively tried, but the available evidence has shown benefits in improving psychotic symptoms, improving level of functioning, and affect regulation. In MDD, both yoga and mindfulness have demonstrated significant benefit in reducing the severity of depressive symptoms. There is very sparse data with respect to BD.

Conclusion:

Both yoga and mindfulness interventions appear to be useful as an adjunct in the treatment of SMI. Studies have shown improvement in the psychopathology, anxiety, cognition, and functioning of patients with schizophrenia. Similarly, both the techniques have been established as an effective adjuvant in MDD. However, more rigorously designed and larger trials may be necessary, specifically for BD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6329226/

 

Reduce Health Care Professional’s Burnout with Mindfulness

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Reduce Health Care Professional’s Burnout with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness programs in the workplace may help employees better deal with stress, and develop the ability to observe negative emotions and automatic thought patterns and behaviors, and remain calm, present, self-aware and alert, rather than succumbing to the slippery slope of negative emotions.” – Grace Bullock

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It is estimated that over 45% of healthcare workers experience burnout. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout, in fact, it is a threat to the entire healthcare system. Currently, over a third of healthcare workers report that they are looking for a new job. Hence, burnout contributes to the shortage of doctors and nurses.

 

Preventing burnout has to be a priority. Unfortunately, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout. So it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, and improving sleep. Hence, mindfulness may be a means to reduce burnout.

 

In today’s Research News article “Being Mindful: A Long-term Investigation of an Interdisciplinary Course in Mindfulness.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6328954/ ), Braun and colleagues recruited health care professionals and students and treated them with an 8-week, once a week for 2 hours, program of mindfulness training including meditation, yoga, and discussion, relevant to health care work. They were measured before and after treatment and follow-up occurring 6 months to 1.5 years later for burnout, including depersonalization, emotional exhaustion, and personal accomplishment subscales, perceived stress, anxiety, depression, mindfulness, and the nature of any continued practice.

 

They found that after training and at follow-up there were significant reductions in burnout including reduced depersonalization and emotional exhaustion. There were also significant improvements in mindfulness including the acting with awareness, non-judging, and non-reacting facets. In interviews with the participants afterwards they reported the “importance of integrating mindfulness into their lives using informal practices and noted the positive effects of mindfulness on their relationships with themselves, others, and patients.”

 

The fact that mindfulness training can effectively reduce burnout has been previously demonstrated by other researchers with a number of different types of professionals including health care workers. The importance of the present study is that it demonstrated that the effectiveness of the training endures for many months. The participants indicated that continued formal and informal practice was important. This suggests that training should include instruction on integrating mindfulness practice into daily life, and, if it is successful, the positive effects of mindfulness training can be maintained over the long term.

 

So, reduce health care professional’s burnout with mindfulness.

 

“We all have stresses and difficulties, both personally and professionally. While there are many ways of coping, mindfulness has been found to be a potential way for many to reduce anxiety, relieve depression and focus on the important tasks at hand.” – Jen Robertson

 

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

 

Ellen Braun, S., Kinser, P., Carrico, C. K., & Dow, A. (2019). Being Mindful: A Long-term Investigation of an Interdisciplinary Course in Mindfulness. Global advances in health and medicine, 8, 2164956118820064. doi:10.1177/2164956118820064

 

Short abstract

Background

Burnout and work-related stress in health-care professionals (HCPs) is a growing concern to the optimal functioning of the health-care system. Mindfulness-based interventions may be well-suited to address burnout in HCPs.

Objective

The purpose of this study was (1) to quantitatively evaluate the effect of a mindfulness-based intervention for interdisciplinary HCPs over time and at a long-term follow-up and (2) to explore perceived benefits, facilitators, and barriers to the practice of mindfulness at the long-term follow-up.

Design

A mixed-method, repeated measures, within-subjects design was used to investigate Mindfulness for Interdisciplinary HCPs (MIHP) at baseline, post-MIHP, and a follow-up (6 months to 1.5 years after MIHP). MIHP is an 8-week, group-based course for interdisciplinary HCPs and students, with weekly meditation training, gentle yoga, and discussions on the application of mindfulness to common stressors faced by HCPs. Main outcome measures were the Maslach Burnout Inventory—Health Services Survey and the Five Facet Mindfulness Questionnaire. A semistructured interview was used to explore participants’ perceptions of sustained effects and practice in the context of HCP work at the long-term follow-up. The study protocol was registered with ClinicalTrials.gov (NCT02736292).

Results

Eighteen HCPs (88% female) participated in the study. Significant reductions were found after the intervention for 2 subscales of burnout: depersonalization, F(2, 17) = 5.98, P = .01, and emotional exhaustion, F(2, 17) = 2.64, P = .10. Three facets of dispositional mindfulness showed significant increases at long-term follow-up, act aware: F(2, 15) = 4.47, P = .03, nonjudge: F(2, 15) = 4.7, P = .03, and nonreactivity: F(2, 15) = 3.58, P = .05. Continued practice of skills long term was facilitated by the use of informal practice and perceived improvement in work and personal life.

Conclusion

In sum, MIHP improved subscales of burnout and mindfulness. These findings should be further explored with a larger, controlled study. Interventions should focus on developing mindfulness practice that can be integrated into the work of HCPs.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6328954/

 

Enhance the Effectiveness of Mindfulness Training to Treat Anxiety Disorders with Virtual Reality

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Enhance the Effectiveness of Mindfulness Training to Treat Anxiety Disorders with Virtual Reality

 

By John M. de Castro, Ph.D.

 

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

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. A characterizing feature of anxiety disorders is that the suffer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Health anxiety is a fear of a serious illness can interfere with their daily life. It often leads to seeking unnecessary testing and to spend days consumed by worry. Health anxiety is a relatively common condition, affecting 4% to 5% of both men and women equally.

 

Anxiety disorders have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for anxiety. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders.

 

Technology has recently been applied to training in mindfulness. Indeed, mindfulness training carried out completely on-line has been shown to be effective for as number of conditions. But, now virtual reality (VR) devices are improving and becoming readily available. Previously it has been shown the virtual reality (VR) can be helpful in treating phobias. and Borderline Personality Disorder (BPD). But, it is not known if VR can enhance the effectiveness of mindfulness training in the treatment of Anxiety Disorders.

 

In today’s Research News article “Evaluation of a Mindfulness-Based Intervention With and Without Virtual Reality Dialectical Behavior Therapy® Mindfulness Skills Training for the Treatment of Generalized Anxiety Disorder in Primary Care: A Pilot Study.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00055/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_896935_69_Psycho_20190131_arts_A ), Navarro-Haro and colleagues recruited adults with Generalized Anxiety Disorder (GAD) and provided them with a group based once per week 90 minute mindfulness training session for 7 weeks. Half the participants were randomly assigned to receive an additional 10-minute virtual reality session (mindful river world) in combination with mindfulness instructions. They were measured before and after training for mindfulness, generalized anxiety disorder, depression, emotion regulation, and interoceptive awareness. In addition, before and after the virtual reality sessions they were measured for emotional state and sense of presence.

 

They found that the addition of virtual reality significantly increased the completion rates for the treatment, where 70% of the mindfulness treatment group completed the program, 100% of the participants who received additional virtual reality completed participation. They also found that both groups had large and significant improvements in generalized anxiety disorder, mindfulness, depression, emotion regulation, and interoceptive awareness. But the virtual reality group had significantly greater improvements in the non-judging facet of mindfulness and in interference in emotion regulation. The first virtual reality session produced significant improvements in the participants’ emotional states. But by the last session the improvements across the session markedly diminished.

 

The results are interesting and suggest that mindfulness training is effective for the treatment of generalized anxiety disorders. They further suggest that the addition of virtual reality training significantly improves non-judging mindfulness and the ability to not let strong negative emotions interfere with concentration and everyday tasks. Importantly, the addition of virtual reality significantly improved the completion rate. To have a maximum impact on generalized anxiety disorder completing the therapy program is important. The improved engagement in the mindfulness program provided by the addition of virtual reality sessions suggests that this addition is important for maximizing the treatment’s effectiveness.

 

So, enhance the effectiveness of mindfulness training to treat anxiety disorders with virtual reality.

 

“Anxiety is the “check engine light” on our psychophysiological dashboard. It lets us know the system needs some balancing. Agitation is therefore not our enemy; ideally, we see it as a wake up call for mindfulness practice.” – Mitch Abblett

 

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

 

Navarro-Haro MV, Modrego-Alarcón M, Hoffman HG, López-Montoyo A, Navarro-Gil M, Montero-Marin J, García-Palacios A, Borao L and García-Campayo J (2019) Evaluation of a Mindfulness-Based Intervention With and Without Virtual Reality Dialectical Behavior Therapy® Mindfulness Skills Training for the Treatment of Generalized Anxiety Disorder in Primary Care: A Pilot Study. Front. Psychol. 10:55. doi: 10.3389/fpsyg.2019.00055

 

ABSTRACT

Generalized Anxiety Disorder (GAD) is a very prevalent disorder in primary care (PC). Most patients with GAD never seek treatment, and those who do seek treatment often drop out before completing treatment. Although it is an understudied treatment, Mindfulness-Based Interventions (MBIs) indicate preliminary efficacy for the treatment of GAD symptoms, but many patients with GAD present other associated symptoms (e.g., attention deficits) that complicate the treatment. Virtual Reality DBT® Mindfulness Skills learning has recently been developed to make learning mindfulness easier for patients with emotion dysregulation who have trouble concentrating. Virtual Reality (VR) might serve as a visual guide for practicing mindfulness as it gives patients the illusion of “being there” in the 3D computer generated world. The main goal of this study was to evaluate the effect of two MBIs (a MBI in a group setting alone and the same MBI plus 10 min VR DBT® Mindfulness skills training) to reduce GAD symptoms. A secondary aim was to explore the effect in depression, emotion regulation, mindfulness, and interoceptive awareness. Other exploratory aims regarding the use of VR DBT® Mindfulness skills were also carried out. The sample was composed of 42 patients (roughly half in each group) with GAD attending PC visits. After treatment, both groups of patients showed significant improvements in General Anxiety Disorder measured by the GAD-7 using mixed regression models [MBI alone (B = -5.70; p < 0.001; d = -1.36), MBI+VR DBT® Mindfulness skills (B = -4.38; p < 0.001; d = -1.33)]. Both groups also showed significant improvements in anxiety, depression, difficulties of emotion regulation and several aspects of mindfulness and interoceptive awareness. Patients in the group that received additional 10 min VR DBT Mindfulness Skills training were significantly more adherent to the treatment than those receiving only standard MBI (100% completion rate in MBI + VR vs. 70% completion rate in MBI alone; Fisher = 0.020). Although randomized controlled studies with larger samples are needed, this pilot study shows preliminary effectiveness of MBI to treat GAD, and preliminary evidence that adjunctive VR DBT® Mindfulness Skills may reduce dropouts.

https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00055/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_896935_69_Psycho_20190131_arts_A