Mindfulness

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

 

Mindfulness is Associated with Changing Neural Connectivity in Children and Adolescents

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Mindfulness is Associated with Changing Neural Connectivity in Children and Adolescents

By John M. de Castro, Ph.D.

 

“mindfulness meditation training increases resting state connectivity between top-down executive control regions, highlighting an important mechanism through which it reduces stress levels.” Daniel Reed

 

There has accumulated a large amount of research demonstrating that mindfulness has significant benefits for psychological, physical, and spiritual wellbeing. It even improves high level thinking known as executive function. Its positive effects are so widespread that it is difficult to find any other treatment of any kind with such broad beneficial effects on everything from thinking to mood and happiness to severe mental and physical illnesses. This raises the question of how mindfulness training could produce such widespread and varied benefits. One possibility is that mindfulness practice results in beneficial changes in the nervous system.

 

The nervous system is a dynamic entity, constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. These changes in the brain are called neuroplasticity. Over the last decade neuroscience has been studying the effects of contemplative practices on the brain and has identified neuroplastic changes in widespread areas. In other words, mindfulness practice appears to mold and change the brain, producing psychological, physical, and spiritual benefits.

 

The brains of children and adolescents are different from fully mature adult brains. They are dynamically growing and changing. It is unclear how mindfulness affects their maturing brains. In today’s Research News article “Mindfulness and dynamic functional neural connectivity in children and adolescents.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5610942/ ), Marusak and colleagues examined the relationship of mindfulness with brain activity in the maturing brain. They recruited children and adolescents aged 7 to 17 years and measured them for mindfulness, anxiety, and depression.

 

The children and adolescents then had their brains scanned with functional Magnetic Imaging (fMRI). The scans were evaluated for static connectivity, the relatively permanent connections between brain areas, and dynamic connectivity, the changing connections between areas. They looked specifically at 3 systems in the brain, the central executive network, associated with higher level thinking and attention, the salience and emotion network, associate with the importance of stimuli, and the default mode network, associated with mind wandering and self-referential thinking.

 

They found that mindfulness was associated with better mental health of the children and adolescents with high levels of mindfulness significantly associated with low levels of depression and anxiety. Mindfulness was also significantly associated with the amount of present-moment oriented thinking occurring during the brain scan session. Mindfulness was not associated with static connectivity within the children’s and adolescents’ brains.

 

With dynamic connectivity on the other hand, they found that mindfulness was associated with greater numbers of transitions between connectivity states. That is, the higher the levels of mindfulness the greater the number of times the connectivity pattern in the brain changed from one set of connections to another. Finally, they also found that the numbers of transitions between connectivity states mediated the association of mindfulness with lower anxiety, such that mindfulness was associated with lower anxiety both with a direct association of mindfulness with lower anxiety and indirectly by higher mindfulness being associated with greater dynamic connectivity which was in turn associated with lower anxiety.

 

The results suggest that mindfulness is associated with greater brain flexibility in transitioning from different states and this may allow for less anxiety. This suggests that mindfulness allows for greater ability to see things and evaluate what is occurring in different ways and this helps the youths to better appreciate what is happening and thereby lower anxiety. These are incredibly interesting findings that begin to reveal the neural dynamics occurring in children and adolescents that underlie the ability of mindfulness to improve mental health. Mindfulness isn’t associated with different brain connectivity structures in the brains but rather with different abilities to switch around in real time between systems and this improves mental health.

 

“Just 11 hours of learning a meditation technique induce positive structural changes in brain connectivity by boosting efficiency in a part of the brain that helps a person regulate behavior in accordance with their goals.” – University of Oregon

 

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

 

Marusak, H. A., Elrahal, F., Peters, C. A., Kundu, P., Lombardo, M. V., Calhoun, V. D., Goldberg, E. K., Cohen, C., Taub, J. W., … Rabinak, C. A. (2017). Mindfulness and dynamic functional neural connectivity in children and adolescents. Behavioural brain research, 336, 211-218.

 

Abstract

Background

Interventions that promote mindfulness consistently show salutary effects on cognition and emotional wellbeing in adults, and more recently, in children and adolescents. However, we lack understanding of the neurobiological mechanisms underlying mindfulness in youth that should allow for more judicious application of these interventions in clinical and educational settings.

Methods

Using multi-echo multi-band fMRI, we examined dynamic (i.e., time-varying) and conventional static resting-state connectivity between core neurocognitive networks (i.e., salience/emotion, default mode, central executive) in 42 children and adolescents (ages 6–17).

Results

We found that trait mindfulness in youth relates to dynamic but not static resting-state connectivity. Specifically, more mindful youth transitioned more between brain states over the course of the scan, spent overall less time in a certain connectivity state, and showed a state-specific reduction in connectivity between salience/emotion and central executive networks. The number of state transitions mediated the link between higher mindfulness and lower anxiety, providing new insights into potential neural mechanisms underlying benefits of mindfulness on psychological health in youth.

Conclusions

Our results provide new evidence that mindfulness in youth relates to functional neural dynamics and interactions between neurocognitive networks, over time.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5610942/

 

Interpretation Bias Mediates the Effect of Mindfulness and Acceptance on Anxiety and Depression

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Interpretation Bias Mediates the Effect of Mindfulness and Acceptance on Anxiety and Depression

 

By John M. de Castro, Ph.D.

 

“Anxiety softens when we can create a space between ourselves and what we’re experiencing. When you react in ways that aren’t mindful, they can gradually grow into habits that are detrimental to your health and well-being.” – Mindful

 

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 sufferer 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. This may indicate that treating the cognitive processes that underlie the anxiety may be an effective treatment. Indeed, Mindfulness practices have been shown to be quite effective in altering cognitive processes and  relieving anxiety.

 

Depression is the most common mental illness, affecting over 6% of the population. Depression can be difficult to treat and is usually treated with anti-depressive medication. But drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression. Fortunately, Mindfulness training is also effective for treating depression.

 

A cognitive tendency that can exacerbate anxiety and depression is interpretation bias. This is a tendency to interpret situations in a negative way even when the situation is ambiguous. This can lead to interpreting even neutral situations as threatening. An alternative explanation for the effectiveness of mindfulness training for anxiety and depression is that it may reduce interpretation bias, making it less likely that situations would be interpreted as threatening and thereby lowering anxiety and depression.

 

In today’s Research News article “Mindfulness, Interpretation Bias, and Levels of Anxiety and Depression: Two Mediation Studies.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320741/ ), Mayer and colleagues performed 2 studies to examine the relationships of mindfulness, anxiety, depression, and interpretation bias.

 

In the first study they recruited college students and had them complete online questionnaires and psychometric tests measuring mindfulness, anxiety, depression, and interpretation bias. The variables were then subjected to regression analysis. They found that the higher the level of mindfulness the lower the levels of depression, anxiety, and interpretation bias. They further found that the mindfulness association with reduced anxiety and depression was in part the result of mindfulness’ association with reduced interpretation bias. Mindfulness was both directly associated with lower anxiety and depression and indirectly by being associated with lower levels of interpretation bias which, in turn, was associated with lower anxiety and depression.

 

In the second study they recruited a community sample of adults with mixed ages and had them complete online questionnaires measuring mindfulness, anxiety, depression, interpretation bias, and acceptance of internal sensations. They found similar results for acceptance as they found in study 1 for mindfulness, with the higher the level of acceptance the lower the levels of depression, anxiety, and interpretation bias. Also similar to study 1 they found that the association of acceptance with reduced anxiety and depression was in part the result of acceptance’ association with reduced interpretation bias. Acceptance was both directly associated with lower anxiety and depression and indirectly by being associated with lower levels of interpretation bias which, in turn, was associated with lower anxiety and depression.

 

These are interesting findings but they are correlational. So, no clear conclusions regarding causation can be reached. Previous research, however, has clearly shown a causal connection between mindfulness and acceptance and anxiety and depression. This suggests that the relationships observed in the current study as due to mindfulness and acceptance causing the relief of anxiety and depression.

 

The results suggest that the associations of both mindfulness and acceptance of internal states are associated with lower levels of both anxiety and depression and that these associations are in part due to direct associations with anxiety and depression and also indirect associations involving both mindfulness and acceptance being associated with lower levels of interpretation bias that, in turn, is associated with lower levels of anxiety and depression. This suggests that mindfulness and acceptance, in part, affect anxiety and depression by altering the cognitive interpretation of situations, lowering the tendency to interpret situations as threatening and thereby lowering the anxiety and depression that results from threatening interpretations.

 

So, interpretation bias mediates the effect of mindfulness and acceptance on anxiety and depression.

 

“Mindfulness keeps us focused on the present, and helps us meet challenges head on while we appreciate all our senses absorb. On the contrary, focus on the future contributes to anxiety, while perseveration on the past feeds depression.” – Vincent Fitzgerald

 

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

 

Mayer, B., Polak, M. G., & Remmerswaal, D. (2018). Mindfulness, Interpretation Bias, and Levels of Anxiety and Depression: Two Mediation Studies. Mindfulness, 10(1), 55-65.

 

Abstract

In two studies, a possible mediation effect was tested of cognitive interpretation bias in the relation between respectively dispositional mindfulness and acceptance, on the one hand, and symptoms of depression and anxiety, on the other hand. An undergraduate student sample (N = 133; 86% female, Mage = 19.8) and a convenience community sample (N = 186; 66% female, Mage = 36.5) were examined by means of an online questionnaire measuring dispositional mindfulness (FFMQ-SF; Study 1) and acceptance (AAQ-II; Study 2), anxiety (STAI-trait) and depressive (BDI-II) symptoms, and interpretation bias (with the interpretation bias task, IBT). Considering both studies, results showed consistently the expected relations of larger mindfulness skills going together with a smaller cognitive interpretation bias and lower levels of depression and anxiety symptoms. More interestingly, it was found that interpretation bias served as a mediator in the relations between respectively dispositional mindfulness and acceptance, and symptoms of depression and anxiety. With these findings, some more insight in the working mechanisms of mindfulness-based treatments on internalizing psychopathology has been obtained.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320741/

 

Improve Well-Being and Psychological Flexibility with Mindfulness Practice

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Improve Well-Being and Psychological Flexibility with Mindfulness Practice

 

By John M. de Castro, Ph.D.

 

“There are an endless variety of ways to meditate and practice mindfulness. . . specific types of mindfulness-meditation seem to have specific benefits. Fine-tuning which type of mindfulness or meditation someone uses as a prescriptive to treat a specific need will most likely be the next big advance in the public health revolution of mindfulness and meditation.” – Christopher Bergland

 

Mindfulness training has been shown to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress. Techniques such as Mindfulness Training, Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) as well as Yoga practice and Tai Chi or Qigong practice have been demonstrated to be effective. This has led to an increasing adoption of these mindfulness techniques for the health and well-being of both healthy and ill individuals.

 

Mindfulness practice, however, is a complex involving formal and informal practices, and great differences in the frequency and duration of practice. It is not known which of these facets or which combinations of facets are responsible for the beneficial effects of mindfulness. In addition, learning and implementing mindfulness practices can be difficult with a number of impediments and problems present. Hence there is a need to investigate the characteristics of mindfulness practices and the impediments to and supports for practicing mindfulness and their relationship to the well-being and psychological flexibility of the participants.

 

In today’s Research News article “An Exploration of Formal and Informal Mindfulness Practice and Associations with Wellbeing.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320743/  ), Birtwell and colleagues recruited mindfulness practitioners and had them complete a questionnaire on their mindfulness practice, difficulties encountered with practice, and factors that supported their practice. They also completed scales measuring mental well-being and psychological flexibility.

 

They found 37% of the participants learned mindfulness practice through a formal course while the rest learned on their own through books, the internet, or through therapists. Most practiced several times per week or daily for 10 to 45 minutes. 57% of the participants indicated that falling asleep during practice was an impediment to practice and many indicated that finding time to practice was a problem. In support of their practice they reported that it was helpful to set up particular times for practice, to practice with others in groups, and having an accepting and kind attitude toward themselves, particularly during lapses in practice.

 

Correlating practice factors with mental well being and psychological flexibility they found that the greater the frequency and duration of formal and informal practice the greater the levels of mental well-being and psychological flexibility. But, when all of the practice factors were considered they found that the frequency of informal practice was the only one that significantly predicted improved mental well-being and psychological flexibility.

 

Informal practices involved everyday mindful moments such as being mindful while engaged in everyday activities such as “washing the dishes, eating, driving, brushing teeth, walking the dog, drinking coffee, and watching a wild bird or flower.” Hence, it would appear that integrating mindfulness into everyday life is essential for mindfulness to be associated with good mental well-being and psychological flexibility. In other words, feeling psychologically better and being able to approach psychological issues with acceptance and flexibly is best supported by engaging in daily activities mindfully.

 

It needs to be kept in mind that these findings are correlational and conclusions regarding causation cannot be reached. It is possible that people who are flexible and have mental well-being are those who engage in informal practices or some other factor may be responsible for both. There is a need for future manipulative research to determine causation.

 

So, improve well-being and psychological flexibility with mindfulness practice.

 

“Daily meditation is a powerful tool for managing your stress and enhancing your health. But bringing present-moment awareness to all your daily activities is important.” Melissa Young

 

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

 

Birtwell, K., Williams, K., van Marwijk, H., Armitage, C. J., & Sheffield, D. (2018). An Exploration of Formal and Informal Mindfulness Practice and Associations with Wellbeing. Mindfulness, 10(1), 89-99.

 

Abstract

Mindfulness has transdiagnostic applicability, but little is known about how people first begin to practice mindfulness and what sustains practice in the long term. The aim of the present research was to explore the experiences of a large sample of people practicing mindfulness, including difficulties with practice and associations between formal and informal mindfulness practice and wellbeing. In this cross-sectional study, 218 participants who were practicing mindfulness or had practiced in the past completed an online survey about how they first began to practice mindfulness, difficulties and supportive factors for continuing to practice, current wellbeing, and psychological flexibility. Participants had practiced mindfulness from under a year up to 43 years. There was no significant difference in the frequency of formal mindfulness practice between those who had attended a face-to-face taught course and those who had not. Common difficulties included finding time to practice formally and falling asleep during formal practice. Content analysis revealed “practical resources,” “time/routine,” “support from others,” and “attitudes and beliefs,” which were supportive factors for maintaining mindfulness practice. Informal mindfulness practice was related to positive wellbeing and psychological flexibility. Frequency (but not duration) of formal mindfulness practice was associated with positive wellbeing; however, neither frequency nor duration of formal mindfulness practice was significantly associated with psychological flexibility. Mindfulness teachers will be able to use the present findings to further support their students by reminding them of the benefits as well as normalising some of the challenges of mindfulness practice including falling asleep.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320743/

 

Improve Attention in Children and Adults with ADHD with Mindfulness

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Improve Attention in Children and Adults with ADHD with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Unlike many tools for ADHD, mindfulness develops the individual’s inner skills. It improves your ability to control your attention by helping to strengthen your ability to self-observe, to train attention, and to develop different relationships to experiences that are stressful. In other words, it teaches you to pay attention to paying attention, and can also make people more aware of their emotional state, so they won’t react impulsively. That’s often a real problem for people with ADHD.” – Carl Sherman

 

Attention Deficit Hyperactivity Disorder (ADHD) is most commonly found in children, but for about half it persists into adulthood. It’s estimated that about 5% of the adult population has ADHD. Hence, this is a very large problem that can produce inattention, impulsivity, hyperactivity, and emotional issues, and reduce quality of life. The most common treatment is drugs, like methylphenidate, Ritalin, which helps reducing symptoms in about 30% of the people with ADHD. Unfortunately, the effectiveness of the drugs appears to be markedly reduced after the first year. In addition, the drugs often have troublesome side effects, can be addictive, and can readily be abused. So, drugs, at present, do not appear to be a good solution, only affecting some, only for a short time, and with unwanted side effects.

 

There are indications that mindfulness training may be an effective treatment for ADHD. It makes sense that it should be, as the skills and abilities strengthened by mindfulness training are identical to those that are defective in ADHD,  attention, impulse control, executive function, emotion control, and mood improvement. In addition, unlike drugs, it is a relatively safe intervention that has minimal troublesome side effects. Since mindfulness is so promising as a treatment, it is important to step back and summarize what has been learned in the scientific research of the effectiveness of mindfulness training for ADHD.

 

In today’s Research News article “The Effectiveness of Mindfulness-Based Intervention in Attention on Individuals with ADHD: A Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6092011/ ), Lee and colleagues review and summarize the published research studies on the effectiveness of mindfulness training for Attention Deficit Hyperactivity Disorder (ADHD) in children and adults. They found 9 articles, 5 with adults, 1 with adults and adolescents, 2 with adolescents, and 1 with children.

 

They report that the published studies on adults with ADHD found that mindfulness training produced significant improvements in attention. With both adolescents and children both teachers and parents reported that after mindfulness training there were significant improvements in attention. Unfortunately, many of these studies used weak experimental designs. Hence, there is a need to perform large scale randomized controlled studies with active controls before firm conclusions can be reached.

 

Mindfulness training, however, focuses on attention, with training to maintain attention in the present moment on a target, such as the breath or feelings from the body. It has been repeatedly shown to improve attention in a wide range of healthy and ill individuals of varying ages. So, it would seem reasonable to predict that mindfulness training would also improve attention in people with ADHD.

 

So, improve attention in children and adults with ADHD with mindfulness training.

 

“ADHD is characterized by difficulties with executive function, not just attention, and mindfulness is an avenue to developing interrelated cognitive skills, many related to executive function, not just attention.” – Mark Bertin

 

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

 

Lee, C., Ma, M. T., Ho, H. Y., Tsang, K. K., Zheng, Y. Y., & Wu, Z. Y. (2017). The Effectiveness of Mindfulness-Based Intervention in Attention on Individuals with ADHD: A Systematic Review. Hong Kong journal of occupational therapy : HKJOT, 30(1), 33-41.

 

Abstract

Background/Objective

Mindfulness-based intervention has received more clinical interest and empirical support for individuals with ADHD especially to improve attention. However, no systematic review has been done to analyze and compare the effectiveness of mindfulness-based intervention on individuals with ADHD in different age groups. This review examined its effectiveness for individuals (children, adolescents and adults) with ADHD to improve attention.

Methods

In 7 databases, totally of 152 studies were identified; 9 met the inclusion and exclusion criteria and were reviewed. Five of the studies recruited adults as the participants, two recruited adolescents as the participants, one recruited both adults and adolescents as the participants and one recruited children as the participants.

Results

It was found that mindfulness-based intervention was comparatively more popularly used in adults with ADHD to improve attention, and the improvement was significant.

Conclusion

It is still unclear whether mindfulness-based intervention is effective for children and adolescence with ADHD due to limited studies available and the limitations of the study design in the reviewed studies. Therefore, more research in the future is required to answer the question.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6092011/

 

Reduce Anxiety and Depression with Mindfulness

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Reduce Anxiety and Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Being unwilling to experience negative thoughts, feelings, or sensations is often the first link in a mental chain that can lead to automatic, habitual, and critical patterns of mind becoming re-established. By accepting unpleasant experiences, we can shift our attention to opening up to them. Thus, “I should be strong enough” shifts to “Ah, fear is here,” or “Judgment is present.”—Zindel Segal,

 

Meditation training has been shown to improve health and well-being. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. Meditation practice has been found to improve the regulation of emotions and reduce difficult emotional states such as anxiety and depression.

 

A characterizing feature of anxiety disorders is recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Indeed, Mindfulness practices have been shown to be quite effective in relieving anxiety. Anxiety often co-occurs with depression and mindfulness training is also effective for treating depression. Anxiety disorders and depression have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. So, there is a need to develop alternative treatments. Since mindfulness- based treatments are relatively new, it makes sense to step back and summarize what is known regarding the effectiveness of mindfulness training for anxiety disorders and for depression.

 

In today’s Research News article “Mindfulness-Based Interventions for Anxiety and Depression. The Psychiatric clinics of North America.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5679245/ ), Hofmann and Gomez review and summarize the published research literature on the effectiveness of mindfulness training for the relief of anxiety and depression.

 

They report that randomized controlled trials found that Mindfulness-Based interventions including the Mindfulness-Based Stress Reduction (MBSR), the Mindfulness-Based Cognitive Therapy (MBCT), Dialectical Behavior Therapy, and Acceptance and Commitment Therapy treatment programs were “moderately-to-largely effective at reducing anxiety and depression symptom severity among individuals with a broad range of medical and psychiatric conditions.” They also report that these programs are effective whether provided in person or over the internet. They are consistently more effective than health education, relaxation training, and supportive psychotherapy, but equivalently effective as Cognitive Behavioral Therapy (CBT).

 

Hence, accumulating controlled research has built a strong case for the use of Mindfulness-Based Interventions for the treatment of anxiety and depression. Since, these treatments are generally safe and effective with little if any side effects, they would appear to be preferable to pharmacological treatments.

 

So, reduce anxiety and depression with mindfulness.

 

“Mindfulness keeps us focused on the present, and helps us meet challenges head on while we appreciate all our senses absorb. On the contrary, focus on the future contributes to anxiety, while perseveration on the past feeds depression. Far too often when we look to the future, we ask ourselves, “What if,” and the answer we give ourselves is often a prediction of a negative result.” – Vincent Fitzgerald

 

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

 

Hofmann, S. G., & Gómez, A. F. (2017). Mindfulness-Based Interventions for Anxiety and Depression. The Psychiatric clinics of North America, 40(4), 739-749.

 

Key Points

  • Research on mindfulness-based interventions (MBIs) for anxiety and depression has increased exponentially in the past decade. The most common include Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT).
  • MBIs have demonstrated efficacy in reducing anxiety and depression symptom severity in a broad range of treatment-seeking individuals.
  • MBIs consistently outperform non-evidence-based treatments and active control conditions, such as health education, relaxation training, and supportive psychotherapy.
  • MBIs also perform comparably to cognitive-behavioral therapy (CBT). The treatment principles of MBIs for anxiety and depression are compatible with those of standard CBT.

Synopsis

This article reviews the ways in which cognitive and behavioral treatments for depression and anxiety have been advanced by the application of mindfulness practices. Research on mindfulness-based interventions (MBIs) has increased exponentially in the past decade. The most common include Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT). MBIs have demonstrated efficacy in reducing anxiety and depression symptom severity in a broad range of treatment-seeking individuals. MBIs consistently outperform non-evidence-based treatments and active control conditions, such as health education, relaxation training, and supportive psychotherapy. MBIs also perform comparably to cognitive-behavioral therapy (CBT). The treatment principles of MBIs for anxiety and depression are compatible with those of standard CBT.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5679245/

 

Reduce Aging Cognitive Decline with Mindfulness

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Reduce Aging Cognitive Decline with Mindfulness

 

By John M. de Castro, Ph.D.

 

“We know that approximately 50 percent of people diagnosed with mild cognitive impairment—the intermediate stage between the expected declines of normal aging and the more serious cognitive deterioration associated with dementia—may develop dementia within five years.” – Rebecca Erwin Wells

 

The aging process involves a systematic progressive decline in every system in the body, the brain included. This includes our mental abilities (cognition) which decline with age including impairments in memory, attention, and problem solving abilities. It is inevitable and cannot be avoided. An encouraging new development is that mindfulness practices such as meditation training can significantly reduce these declines in cognitive ability. In addition, it has been found that mindfulness practices reduce the deterioration of the brain that occurs with aging restraining the loss of neural tissue. Indeed, the brains of practitioners of meditation and yoga have been found to degenerate less with aging than non-practitioners.

 

Before active dementia occurs, patients show problems with attention, thinking, and memory known as mild cognitive impairment. Intervening at this point may be able to delay or even prevent full blown dementia, So, it is important to study the effectiveness of mindfulness training on older adults with mild cognitive impairment to improve their cognitive performance.

 

In today’s Research News article “The Effects of Mindfulness on Older Adults with Mild Cognitive Impairment.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6159696/ ), Wong and colleagues recruited healthy older adults (> 60 years of age) who were diagnosed with mild cognitive impairment and were meditation naïve. They participated in an 8-week, 1.5 hours per week, program of mindfulness training that included body scan meditation, breath meditation, loving kindness meditation, and everyday mindfulness practice. The participants were also encouraged to practice at home. They were measured before and after training and one year later for cognitive function, psychological health, mindfulness, mindfulness adherence, and daily living functionality.

 

They found that after training the participants had significant improvements in mindfulness and cognitive function. These improvements were no longer significant at the one year follow up. This appears, however, to be due to the level of continuing practice as the greater the amount of meditation practice during the 1-year follow-up period the greater the level of cognitive function. Indeed, those who practiced above the group average had significantly better cognitive performance at the 1-year follow-up than those who were below average in practicing.

 

These results suggest that mindfulness training produces significant cognitive benefits for elderly individuals with mild cognitive impairments. But continued practice is necessary to maintain the benefits. Hence, long-term mindfulness practice may be able to restrain further cognitive decline in these patients and may delay or prevent the onset of dementia. It is clear however, that continuing mindfulness practice is required.

 

So, reduce aging cognitive decline with mindfulness.

 

“What we do know is that long-term engagement in mindfulness meditation may enhance cognitive performance in older adults, and that with persistent practice, these benefits may be sustained. That’s great news for the millions of aging adults working to combat the negative effects of aging on the brain.” – Grace Bullock

 

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

 

Wong, W. P., Coles, J., Chambers, R., Wu, D. B., & Hassed, C. (2017). The Effects of Mindfulness on Older Adults with Mild Cognitive Impairment. Journal of Alzheimer’s disease reports, 1(1), 181-193. doi:10.3233/ADR-170031

 

Abstract

Background:

The current lack of an effective cure for dementia would exacerbate its prevalence and incidence globally. Growing evidence has linked mindfulness to cognitive and psychological improvements that could be relevant for mild cognitive impairment (MCI).

Objective:

To investigate whether mindfulness practice can improve health outcomes of MCI.

Methods:

The study is the first longitudinal mixed-methods observational study with a one-year follow-up period, that customized an eight-week group-based mindfulness training program for older adults with MCI (n = 14). Measures included cognitive function, psychological health, trait mindfulness, adherence to mindfulness practice, and everyday activities functioning as assessed at pre-intervention, post-intervention, and one-year follow-up. Repeated measures ANOVAs, Pearson’s correlation analyses, and Mann-Whitney U tests were performed.

Results:

The MCI participants showed significant improvements in cognitive function (p < 0.05) and trait mindfulness (p < 0.05) after completing the intervention. Between program intervention and one-year follow-up (59 weeks), positive correlations were found between their cognitive function (p < 0.05) and everyday activities functioning (p < 0.05) with the duration of mindfulness meditation; and between trait mindfulness and the level of informal mindfulness practice (p < 0.05). Those who meditated more during these 59 weeks, showed greater improvements in cognitive function (p < 0.05) and everyday activities functioning (p < 0.05), with large effect sizes at the one-year follow-up. Qualitative findings will be reported separately.

Conclusion:

Long-term mindfulness practice may be associated with cognitive and functional improvements for older adults with MCI. Mindfulness training could be a potential efficacious non-pharmacological therapeutic intervention for MCI.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6159696/

Reduce Pain Catastrophizing and Pain with Mindfulness

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Reduce Pain Catastrophizing and Pain with Mindfulness

 

By John M. de Castro, Ph.D.

 

“People often increase the pain experience by adding to the physical sensations with a host of thoughts and feelings, like catastrophizing the pain or trying to suppress and ignore the pain. Mindfulness is a practice of attending to pain — or body sensations — and thoughts and feelings with that present-moment attention in an accepting and curious manner.” – Susan Smalley

 

Fibromyalgia is a mysterious disorder whose causes are unknown. It is very common affecting over 5 million people in the U.S., about 2% of the population with about 7 times more women affected than men. It is characterized by widespread pain, abnormal pain processing, sleep disturbance, and fatigue that lead to psychological distress. Fibromyalgia may also have morning stiffness, tingling or numbness in hands and feet, headaches, including migraines, irritable bowel syndrome, sleep disturbances, thinking and memory problems, and painful menstrual periods. The symptoms are so severe and debilitating that about half the patients are unable to perform routine daily functions and about a third have to stop work. Although it is not itself fatal, suicide rates are higher in fibromyalgia sufferers.

 

There are no completely effective treatments for fibromyalgia. Symptoms are generally treated with pain relievers, antidepressant drugs and exercise. But these only reduce the severity of the symptoms and do not treat the disease directly. Mindfulness practices have also been shown to be effective in reducing pain from fibromyalgia. Some of the effects of mindfulness practices are to alter thought processes, changing what is thought about. In terms of pain, mindfulness training, by focusing attention on the present moment has been shown to reduce worry and catastrophizing. Pain is increased by worry about the pain and the expectation of greater pain in the future. So, mindfulness may reduce worry and catastrophizing and thereby reduce fibromyalgia pain.

 

In today’s Research News article “Interactive effects of pain catastrophizing and mindfulness on pain intensity in women with fibromyalgia.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6198401/ ), Dorado and colleagues recruited adult women suffering with fibromyalgia and had them complete questionnaires measuring mindfulness, pain, pain catastrophizing and fibromyalgia interference in daily activities and keeping a 7-day diary of their daily levels of pain and pain catastrophizing. They then examined predictors of the daily pain intensity and pain catastrophizing.

 

They found a strong positive relationship between pain catastrophizing and pain intensity indicating that the higher the daily levels of catastrophizing the greater the levels of pain. They also found that the higher the levels of mindfulness the lower the levels of daily pain catastrophizing and daily levels of pain. They found that this relationship was modified by facets of mindfulness. In particular, the greater the observing facet of mindfulness the smaller the relationship between daily pain catastrophizing and daily pain intensity. On the other hand, when the mindfulness facets of non-judging and acting with awareness were high then the greater the daily levels of catastrophizing the greater the levels of pain.

 

These relationships suggest that observing mindfully tends to mitigate the relationship of catastrophizing to pain while mindfully non-judging and acting with awareness tends to amplify the relationship. But, overall, mindfulness tends to be associated with lower catastrophizing. It has been shown in other work that mindfulness tends to lower fibromyalgia pain, The present study suggests that it may do so by reducing pain catastrophizing. Even though mindfulness, in general lowers pain and catastrophizing not judging the situation and acting toward it with awareness can actually heighten the effects of catastrophizing on pain.

 

It should be kept in mind that these results are correlational and conclusions about causation cannot be made. In addition, the results are complicated suggesting complex relationships between mindfulness and daily pain and catastrophizing levels. This indicates that further research is needed especially work in which mindfulness is altered by training and then observing the effects of this change on pain levels and catastrophizing and their relationships with each other.

 

So, reduce pain catastrophizing and pain with mindfulness.

 

“When pain is consistently part of your day, you can start to dwell on it. You may feel stress and anxiety about the pain you’re feeling now, as well as pain that may occur in the future. Mindfulness may lead to changes in the brain that provide benefits for those with fibromyalgia.” – Peggy Pletcher

 

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

 

Dorado, K., Schreiber, K. L., Koulouris, A., Edwards, R. R., Napadow, V., & Lazaridou, A. (2018). Interactive effects of pain catastrophizing and mindfulness on pain intensity in women with fibromyalgia. Health psychology open, 5(2), 2055102918807406. doi:10.1177/2055102918807406

 

Abstract

The objective of this study was to examine the association between facets of trait mindfulness, pain catastrophizing, and pain severity in a sample of patients with fibromyalgia. Patients with fibromyalgia completed validated baseline and diary assessments of clinical pain, mindfulness, and pain catastrophizing. Multilevel modeling analyses indicated that the daily association between catastrophizing and pain intensity was moderated by certain mindfulness facets. Our findings suggest that various aspects of mindfulness may interact differently with pain and catastrophizing, which may have implications for the design and testing of interventions targeting mindfulness and catastrophizing in fibromyalgia patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6198401/

 

Increase Wellness and Decrease Burnout in Medical Students with Mindfulness

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Increase Wellness and Decrease Burnout in Medical Students with Mindfulness

 

By John M. de Castro, Ph.D.

 

“training in mindfulness – focusing controlled attention on physical sensations, thoughts, and emotions in the present moment – helps students to acknowledge and process the stresses and strains of their work.” – Cathy Kerr

 

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. Currently, over a third of healthcare workers report that they are looking for a new job. 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 as it 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. It would be best to provide techniques to combat burnout early in a medical career. Medical School is extremely stressful and many students show distress and express burnout symptoms. Medical school may be an ideal time to intervene.

 

In today’s Research News article “A Targeted Mindfulness Curriculum for Medical Students During Their Emergency Medicine Clerkship Experience.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6040904/ ), Chung and colleagues in an uncontrolled pilot study delivered a mindfulness curriculum to students during their training in emergency medicine. The training was delivered in 4-weekly 60 minute sessions that included meditation practice, readings, journaling, discussion, and developing a personal wellness plan. They completed questionnaires before and after the 4 weeks of training and 6 months later regarding the impact of the training on their behavior and attitudes.

 

They found that in comparison to baseline, after training there were significant improvements in self-reported behaviors and attitudes. The students reported increased confidence in their ability to meditate and be mindful, explain these skills to others, and recommend these practices to others. They also reported that they practiced meditation and mindfulness more often and talked to others about these practices. In addition, they reported that wellness was important to medical students and that they were using their own wellness plan. Importantly, these improvements were still present 6 months after the completion of the training.

 

These are very preliminary results from an uncontrolled pilot study and need to be verified in a randomized controlled trial with objective measures of wellness and resistance to stress. Previous controlled studies, however, have shown that mindfulness training is effective in treating and preventing burnout and reducing the psychological and physiological responses to stress. So, these present results are suggestive that this simple brief curriculum may produce similar benefits.

 

It is important to use a brief training and this one only involved 4 hours of formal instruction. Medical students have a vast amount of important information to learn and master in a limited amount of time. They do not have the luxury of unused time for extensive instruction. So, a brief training that produces positive results that persist could be very valuable to their health and well-being during this stressful time and during a stressful career.

 

So, increase wellness and decrease burnout in medical students with mindfulness.

 

“I have taken my own advice. I am still at it: sitting on the deck, focusing on my breath, watching my thoughts, clearing my mind amid the shrill end-of-summer calls of the cicadas. I think I have noticed an effect — I feel a deeper sense of acceptance in my life, without losing a passion or resolve to change things for the better.” – Manoj Jain

 

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

 

Chung, A. S., Felber, R., Han, E., Mathew, T., Rebillot, K., & Likourezos, A. (2018). A Targeted Mindfulness Curriculum for Medical Students During Their Emergency Medicine Clerkship Experience. The western journal of emergency medicine, 19(4), 762-766.

 

Abstract

Introduction

Despite high rates of burnout in senior medical students, many schools provide the majority of their wellness training during the first and second preclinical years. Students planning a career in emergency medicine (EM) may be at particularly high risk of burnout, given that EM has one of the highest burnout rates of all the specialties in the United States We developed an innovative, mindfulness-based curriculum designed to be integrated into a standard EM clerkship for senior medical students to help students manage stress and reduce their risk of burnout.

Methods

The curriculum included these components: (1) four, once-weekly, 60-minute classroom sessions; (2) prerequisite reading assignments; (3) individual daily meditation practice and journaling; and (4) the development of a personalized wellness plan with the help of a mentor. The design was based on self-directed learning theory and focused on building relatedness, competence, and autonomy to help cultivate mindfulness.

Results

Thirty students participated in the curriculum; 20 were included in the final analysis. Each student completed surveys prior to, immediately after, and six months after participation in the curriculum. We found significant changes in the self-reported behaviors and attitudes of the students immediately following participation in the curriculum, which were sustained up to six months later.

Conclusion

Although this was a pilot study, our pilot curriculum had a significantly sustained self-reported behavioral impact on our students. In the future, this intervention could easily be adapted for any four-week rotation during medical school to reduce burnout and increase physician wellness.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6040904/