Improve Attachment Style with Mindfulness

January 6, 2018 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“using mindfulness in specific ways, we can become aware of our hidden attachment conditioning and, if it’s not working, begin to change it. This results in a meditation practice that is truly comprehensive: not just an escape, but an empowering force to enrich life and propel us happily through it.” – Insight Meditation Support

Mindfulness training has been shown to have a myriad of positive benefits for the physical and psychological health of the individual. It has also been shown to be beneficial for those suffering from a wide range of physical and mental diseases. Research is revealing the mechanisms by which increasing this simple state can alter the individual so profoundly. For example, stress, particularly chronic stress, is known to have deleterious effects on physical and mental health and mindfulness has been shown to reduce the physical and psychological effects of stress on the individual. By reducing stress effects, mindfulness can have wide ranging positive effects on the individual’s well-being.

Attachment has been shown to affect the individual’s well-being. There are a variety of ways that individuals attach to others. The particular strategies are thought to develop during childhood through attachments to caregivers. They are secure, insecure, avoidant, ambivalent, fearful, preoccupied, and disorganized attachment styles. Secure attachment style is healthy and leads to positive development while all of the others are maladaptive and unhealthy. These can lead to psychological difficulties and interfere with the individual’s ability to relate to others. Depression has also been long hypothesized to have roots in early childhood. Patterns of mother-child interactions are thought to produce different forms of attachment styles in the infant. All of attachment styles, save secure attachment style, have been found to be associated with depression.

It is possible that one of the ways that mindfulness promotes well-being is by affecting attachment. In today’s Research News article “The Relationship Between Adult Attachment Orientation and Mindfulness: 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/PMC5693974/), this relationship is examined. Stevenson and colleagues review, summarize, and perform a meta-analysis of the 31 published research studies on mindfulness and attachment style.

They found that the published research studies report that mindfulness is significantly associated with lower levels of attachment anxiety and attachment avoidance. In other words, the higher the level of mindfulness in the individual the lower the levels of adult attachment anxiety and avoidance. This was true for each of the individual components of mindfulness; describing, acting with awareness, non-reactivity, and non-judging. Each of these four facets of mindfulness were found to be inversely related to both attachment anxiety and avoidance. Hence, mindfulness appeared to be counter to adult maladaptive attachment.

It should be noted that these studies are correlational. So, causation cannot be concluded. That mindfulness and attachment style covary does not mean that one is the cause of the other. But, that the two are related suggests that there may be a causal connection. This may indicate another mechanism by which mindfulness improves mental health, by countering maladaptive attachment styles. Anxious and avoidant attachment styles are both known to be associated with mental illness. So, mindfulness may promote mental health, at least in part, by decreasing these maladaptive styles. It remains for future research to investigate if mindfulness training can be a useful technique to promote healthy secure attachment and decrease maladaptive attachment and in turn promote mental health.

So, improve attachment style with mindfulness.

“Whether it’s understanding each other better, increasing intimacy, or just tackling day-to-day relationship problems, it takes awareness to make things work. Noticing patterns of behavior can give us a really useful insight. It’s sometimes helpful to understand how your partner is likely to react in a given situation. Not so that you can anticipate that with a prepared strategy, but just in order to be mindful of your own responses and reactions. It’s no exaggeration – short-circuiting these habitual patterns of conflict can be life changing.” – Headspace

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Stevenson, J. C., Emerson, L.-M., & Millings, A. (2017). The Relationship Between Adult Attachment Orientation and Mindfulness: a Systematic Review and Meta-analysis. Mindfulness, 8(6), 1438–1455. http://doi.org/10.1007/s12671-017-0733-y

Abstract

Mindfulness can be measured as an individual trait, which varies between individuals. In recent years, research has investigated the overlap between trait mindfulness and attachment. The aim of the present review and meta-analysis was to investigate the current evidence linking adult attachment dimensions to trait mindfulness dimensions, and to quantitatively synthesize these findings using meta-analyses. A systematic literature search was conducted using five scientific databases of which, upon review, 33 articles met inclusion criteria. Inclusion criteria were peer-reviewed journals and dissertations published in English that relied on quantitative methods using reliable and validated self-report measures where study participants were aged 16 years and older. Random-effects model meta-analytic procedures were used to investigate the relationship between both constructs. Cross-sectional studies found significant negative correlations between adult attachment insecurity, on either dimension (anxiety or avoidance) and both total mindfulness score and all five sub-dimensions of mindfulness (act with awareness, observe, describe, non-reacting, and non-judging), with the exception of a non-significant positive correlation between attachment anxiety and observe. The effect size of the relationships ranged from small to medium. The overall mean effect sizes were moderate (anxiety, r + = .34; avoidance, r + = −.28), with both attachment dimensions associated with lower levels of total mindfulness. Results are discussed in relation to theory and research. Implications for future research include the need to utilize longitudinal design to address causality and mechanisms of the relationship between these constructs.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5693974/

Happy New Year with Mindfulness

January 1, 2018 psyjdc Leave a comment

Happy New Year with Mindfulness

By John M. de Castro, Ph.D.

“The object of a new year is not that we should have a new year. It is that we should have a new soul.” ~G.K. Chesterton

At the stroke of midnight on December 31st all over the world revelers ring in the new calendar year with a hearty celebration. It’s a celebration of a relatively arbitrary day that has been designated as the first day of a new calendar year. The celebration of the solstice, 10 days before, at least has astrological meaning as the shortest day of the year. But, January 1 has no such physical meaning. January 1 was designated as the start of the year by Julius Caesar in 45 BC. That date was chosen to honor the Roman God Janus, the god of beginnings, whose two faces allowed him to look back into the past and forward into the future. That symbolism has stuck as the new year’s celebration involves a reflection about the year past and hope for the year to come.

Don’t Look Back

To some extent this looking back into the past and forward into the future is the antithesis of mindfulness which emphasizes the present moment. Our recollection of the past is, in fact, an illusion. When we look at the past we view it with the distorted lens of memory and the delusions that we have about the self. The memories of what happened during the last year bare only a fleeting resemblance to what actually happened. Recollections tend to be dominated by hazy and distorted memories of emotionally charged events and neglects everyday times of calm and contentment. When we look back we primarily remember the highs and the lows and believe that if we could simply keep repeating the highs and eliminate the lows then we’d be truly happy. This is the trap sometimes known as the hedonic treadmill. We keep seeking the highs and are unhappy when we can’t reproduce them or if we are successful are unhappy to find that we can’t maintain them. Unfortunately, our New Year’s celebration and our resolutions reinforce and amplify these ideas propelling us to even greater unhappiness in the new year.

Our view of the past is additionally distorted by the beliefs that we have about ourselves. These self-concepts are mainly incorrect and terribly distorted. Western culture, by its adoration of extraordinary and unrealistic models of perfection, produces and reinforces rampant self-dislike. We can never really attain the societal norm of perfection and this makes us feel horribly deficient. As a result, most westerners don’t like what they are and want to be different. As a consequence, people look back on the events of the year and interpret them through the lens of self-dislike.

We remember primarily those events that conform to our beliefs about what we should be, but cannot achieve. This creates a vicious cycle where the low self-esteem and self-worth causes us to remember events that exemplify this self-concept, creating even greater self-dislike. Those rare events that reveal us to be adequate are quickly forgotten. The events of the past year, then, are perceived as evidence to support our harsh view of ourselves. Rather than accurately remembering what actually happened during the year, our recollections are dominated by this distorted reality. So, don’t look back at the past year, rather look carefully and mindfully at yourself. You need to develop self-acceptance, before you can ever hope to have an honest idea of what the past contained.

Don’t Look to the Future

These distortions also color our thoughts about the upcoming year. We resolve to change ourselves to better conform to our unrealistic beliefs about what we should be. The New year’s resolutions that are such a common part of our new year’s celebration are a direct outgrowth of our self-dislike. The problem with these new year’s resolutions is that they are a declaration that we’re not happy with ourselves or the way things are. We want to be different. That’s not bad unto itself. Striving to better oneself is a good thing. The problem is that what we desire for ourselves is usually totally unrealistic as it’s based on a distorted reality. But, we strongly believe that this is what we need to be happy. It’s all a delusion that’s doomed to failure. In fact, research has suggested that only 8% of these resolutions are ever achieved.

Better New Year’s Resolutions

We need to craft a new set of resolutions, based upon self-acceptance, and a realistic view about what needs to be and can be achieved. The resolutions should be to better see things, including ourselves as they really are. To look at the world and ourselves mindfully without judgment, just as we are. These are the kinds of resolutions that can really work towards, not making us happy, but letting us be happy in the coming year; to simply experience the happiness that has been within us all along.

There are some rules of thumb about these resolutions. Don’t be too grandiose. Don’t set goals of perfection. Small steps with a recognition that you won’t always be successful are recommended. Make a resolution to practice mindfulness. Pick a practice that you not only can do, but that you can comfortably sustain. The only one perfect right practice is the one that you’ll do and keep doing. It may be meditation, yoga, body scan, tai chi or qigong, contemplative prayer, or another of the many available practices or some combination of practices. The only thing that matters is that you’re drawn to it, comfortable doing it, and you’ll stick with it. Once you start, don’t try too hard. Remember the Buddha recommended the middle way, with right effort, not too much and not too little. Practice nonjudgmentally. Don’t judge whether you’re doing it right or wrong, whether the particular practice was good or bad, or whether you’re making progress or not. Just practice. Just relax and let the practice do you. You don’t need to do it.

Focus on Now

All of these various practices promote nonjudgmental attention to what is occurring in the present moment, the now. Slowly you come to realize that the now is the only time available where you can be satisfied and happy. The past are only nows that are gone and the future are only nows that have yet to happen. So, focus on the present moment. It’s where life happens. If you can learn to be happy right now, then you’ll be able to happy in the future when it becomes now. As you look calmly, nonjudgmentally, and deeply at what is happening right now you begin to see the beauty and wonder that is there all of the time. You just need to stop ruminating about the past and worrying about the future. Learn to enjoy the moment.

Focusing on the present moment the impermanence of all things becomes evident. In the present we can observe things rising up and then falling away. Change is constant. If things are bad at the moment, you can be sure that it’ll change. So, be patient. On the other hand, if things are good, know also that this will change too. Don’t try to hang onto what is present. Learn to enjoy the moment as it is. These observations reveal that every moment is new. It has never happened before and it will never happen again. Every moment is a new opportunity. Don’t worry about it passing. The next moment will again provide a new opportunity. Make the most of it. If you can learn to do this, you’ll enjoy life to its fullest, as the dynamically changing perpetual now.

Renewal

In the new year, we need to not think about a “happy new year.” Rather think about a “happy new day.” In fact, it’s best to think about each “happy new moment.” Focus on the present moment and wish yourself and everyone else a “happy new moment.” Every moment is a unique opportunity to experience life as it is, appreciate its wonder, and enjoy it while it’s here, in the present moment. Each moment is an opportunity for renewal. If we’re not happy in the moment, we can be in the next. We have a new opportunity every new moment. If we pay attention to them, we can use the opportunity to create happiness.

So, have a “happy new moment” with mindfulness.

“Empty your glass and feel your way through this New Year. If it feeds your soul, do it. If it makes you want to get out of bed in the morning with a smile, carry on. Be present and let your energy synchronise with the earth and give you the clarity to move forward and be comfortable and contented with who you are. Let your intuition guide you through a wonderful year and attract an abundance of positive opportunity.” – Alfred James

“Many of us are thinking about new year’s resolutions and taking stock at this time, but how many of those typical resolutions are just ‘self’ improvement projects (which means we’re trying to get more, be more or have more) rather than ways to actually embrace the life we already have right here and now?” – Mrs. Mindfulness

CMCS – Center for Mindfulness and Contemplative Studies

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Positive Mindfulness

December 31, 2017 psyjdc Leave a comment

Positive Mindfulness

By John M. de Castro, Ph.D.

“It is possible to live happily in the here and the now. So many conditions of happiness are available – more than enough for you to be happy right now. You don’t have to run into the future in order to get more.” – Thich Nhat Hanh
Much of the tone of Buddhist teachings was established with the Four Noble Truths; there is suffering, there are causes of suffering, suffering can be relieved, and there is a path to the end of suffering. This focuses us on suffering, the negative side of existence. Without a doubt, these Four Noble Truths are correct and following them is a means to end suffering, become happy, and become enlightened. But, the negative tone has permeated much of the practice. The focus on the unpleasant has made the practice seem to be a chore, a necessary chore, but, nevertheless a chore. The unpleasantness prompts escape into mind wandering.

But, this tone can be completely altered without altering the truth of the teachings. The Four Noble Truths can be simply restated in the positive; there is happiness, there are causes of happiness, happiness can be increased, and there is a path to endless happiness. This simple rejiggering of the teaching makes a tremendous difference. It focuses the practice on happiness, making it a pleasant endeavor that can be enjoyed, relished, pleasurable, and looked forward to. It changes the practice from a chore to a joyful endeavor.

The science of Psychology has long established that all creatures, and especially humans, respond best to the positive. Negatives produce distaste and avoidance behaviors. On the other hand, if someone receives a positive reward for doing something they are not only more likely to do it again, but they will also feel good about it. So, changing the Four Noble Truths into the positive, can make practice not only an enjoyable experience, but more likely to occur.

This does not suggest that we should pursue happiness as is done in the modern western world. In this paradigm, happiness is pursued by consumption and accomplishment. When we buy something new, say a designer watch, it makes us happy. But, this happiness, like everything is impermanent, it fades and the watch no longer makes us happy. So, now we pursue something else, perhaps a new car. After working hard and saving, we go out a buy a brand new luxury car. This brings us happiness. But, just like the happiness from buying the watch, it fades and eventually the car no longer makes us happy. In fact, the monthly payments may make it a source of suffering.

In the modern world happiness is also pursued by accomplishment. We go through a prolonged education to acquire a degree. Upon graduation, we feel very happy, but this too fades. So we think that when we get a good job, then we’ll be happy, and indeed when we obtain it we do feel very good and happy for a while, but unfortunately, that too fades. So, we look for a promotion or a new job to make us happy, and again it does but only temporarily. This whole cycle is termed by Psychologists as the “hedonic treadmill.” We keep pursuing things because they temporarily make us happy but each happiness is impermanent and we get back on the treadmill looking for the next thing that will make us happy, on and on and on. Instead of happiness it brings disappointment and suffering.

Perhaps there’s a better way, and that is pursuing happiness in our practice. We look carefully and mindfully at what actually produces more lasting happiness. This can begin very simply. When you feel happy, even for a brief moment, simply look at it carefully and reflect on exactly how you feel, what are the sensations you experience in your body. This practice can make you more sensitive to happiness and more aware when happiness actually arises. Also, reflect on what led up to this happiness. This can help to make it clearer what the roots of happiness are to you and perhaps how to produce it in the future.

This simple practice of meditating on the state and causes of your happiness will slowly begin to expand the frequency, duration, and depth of the happiness you experience. This can begin to interrupt and push suffering away. There’s a process in psychological practice called counter conditioning. In this process, you eliminate an unwanted state or behavior, not by stopping it, but by replacing it with a positive state or behavior. This is very effective. So, as you expand happiness you are in fact counter conditioning suffering and replacing it with happiness. This suggests that there’s no need to focus on the elimination of suffering. In fact, trying to eliminate it often amplifies it or becomes itself a suffering. In contrast, focusing on happiness, eliminates it in a joyful way, overwhelming the gloom with sunshine.

During mindfulness practice it’s good to keep in mind Thich Nhat Hahn’s instruction to start by putting a smile on your face. Even if it’s a bit forced, it still somehow makes you feel happier. It’s also a reminder to look for good feelings and happiness during the practice. I like to focus while meditating on what and where something feels good on my body, maybe a subtle tingling sensation in a foot or an obvious cool breeze striking the face. I meditate on how beautiful it is to just be alive and sitting quietly. I listen closely to the symphony of sounds, some even internally in my head, and wonder at the miracle of hearing and the beauty of the sounds themselves. In hearing you own internal voice you can laugh at its inane content, bring joy rather than frustration at not being able to quiet the voice. What actually is looked at doesn’t matter so much but that the habit be built of seeing the goodness, the aliveness, the joy, and the happiness that is right there, all the time while doing something as simple and mundane as meditating.

This may seem contrary to the instruction of focused meditation to pay attention to only one thing and become single pointed. But, you’ll find that when you focus on the good, it becomes easier to concentrate and you become better at single pointedness. It is transformed from a frustrating chore to a source of joy. This not only enhances meditation but also makes it more likely that you’ll meditate in the future and look forward to it. Positive practice might also seem contrary to the instruction of open monitoring meditation let go of trying to control experience but to allow everything to just arise and fall away on its own, while just noticing. Looking for the positive may seem to be controlling. But, as it turns out, positive practice leads to better open monitoring as you learn to experience the joy and happiness in what is spontaneously occurring around you. It becomes easier to continue observing and lessens the mind wandering.

Meditation is only a platform to practice skills to apply to everyday life. Happiness can be found while doing everyday things. I like to look for good feelings and happiness no matter where I am, what I’m doing, or the conditions around me. I sometimes swim laps in a pool. This can be excruciatingly boring. But, I focus on how good my body feels in the water, the exquisite feelings of the internal sensations of energy in each part of my body, and the miracle of body in motion and the automatic unconscious movements controlling it. This changes what could be experienced as a chore to a joyous, mindful, and pleasurable experience.

You can do something similar almost anywhere, perhaps driving a car. Looking at traffic and noticing how well people work together to produce a safe environment, or accommodate someone who is driving not so safely, can produces a loving smile. When stopped at a traffic light, looking around and at the sky, looking for and finding the beauty and wonder all around can transform impatience to happiness. While driving remembering and seeing the joy experienced when you first got behind the wheel and drove as a teenager. Again, what exactly you do is unimportant. Rather the practice is to see the happiness everywhere around you all of the time.

We need to accept that this will be an ongoing process. As Thich Nhat Hahn reflected “When I was a young monk, I wondered why the Buddha kept practicing mindfulness and meditation even after he had already become a buddha. Now I find the answer is plain enough to see. Happiness is impermanent, like everything else. In order for happiness to be extended and renewed, you have to learn how to feed your happiness. Nothing can survive without food, including happiness; your happiness can die if you don’t know how to nourish it.” This makes it clear that we should continually renew and reinforce the state of happiness.

Happiness is self-reinforcing. The more you find it the more it promotes more happiness. It slowly builds upon itself, generalizing to other similar activities and circumstances producing an upward spiral of good feelings. You’ll find that slowly happiness begins to fill more and more of your day displacing more and more of the suffering. This is an automatic byproduct of positive practice which can completely change your view and experience of existence. Life become transformed from constant suffering to constant happiness. Try it. You’ll like it.

“Mindfulness helps you go home to the present. And every time you go there and recognize a condition of happiness that you have, happiness comes.” – Thich Nhat Hanh
CMCS – Center for Mindfulness and Contemplative Studies

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Improve Chronic Back Pain with Mindfulness and Cognitive Therapy

December 28, 2017 psyjdc Leave a comment

Improve Chronic Back Pain with Mindfulness and Cognitive Therapy

By John M. de Castro, Ph.D.

“Mindful mediation is an appealing option for treating your pain because it has an unusual benefit; it places you in a position of control. Unlike pain medications or surgical procedures, meditation is not done to you—but rather it is something you do for yourself.” – Stephanie Burke

Low Back Pain is the leading cause of disability worldwide and affects between 6% to 15% of the population. It is estimated, however, that 80% of the population will experience back pain sometime during their lives. The pain interferes with daily living and with work, interfering with productivity and creating absences. There are varied treatments for low back pain including chiropractic care, acupuncture, biofeedback, physical therapy, cognitive behavioral therapy, massage, surgery, opiate pain killing drugs, steroid injections, and muscle relaxant drugs. These therapies are sometimes effective particularly for acute back pain. But, for chronic conditions the treatments are less effective and often require continuing treatment for years.

Pain involves both physical and psychological issues. Physically, exercise can be helpful in strengthening the back to prevent or relieve pain. Psychologically, the stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. So, reducing the emotional reactions to pain may be helpful in pain management. Mindfulness practices have been shown to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. Indeed, mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of low back pain.

In today’s Research News article “Mindfulness-based stress reduction and cognitive-behavioral therapy for chronic low back pain: similar effects on mindfulness, catastrophizing, self-efficacy, and acceptance in a randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5069124/ ), Turner and colleagues recruited adults suffering from chronic low back pain and randomly assigned them to either receive usual care, or 8 weeks, 2 hours per day, of Mindfulness-Based Stress Reduction (MBSR), or Cognitive Behavioral Therapy (CBT). The therapies were supplemented with home practice. They were measured before and after treatment and at 26 and 52 weeks later, for mindfulness, back pain bothersomeness, pain duration, pain frequency, pain catastrophizing, pain acceptance, and pain self-efficacy.

They found that before treatment the higher the levels of pain catastrophizing the lower the levels of mindfulness, pain acceptance, and pain self-efficacy. Following treatment both MBSR and CBT produced significant decreases in pain catastrophizing and increases in mindfulness, pain self-efficacy and pain acceptance that remained significant a year later. Hence, both Mindfulness-Based Stress Reduction (MBSR), or Cognitive Behavioral Therapy (CBT) produced significant improvements in the ability of the patients to adjust and cope with low back pain.

These results are interesting as MBSR and CBT are quite different treatments. MBSR consists of a combination of meditation, yoga, and body scan practices that are designed to improve mindfulness and reduce stress On the other hand, CBT is designed to assess and alter aberrant thought process that underlie catastrophizing and pain amplification. So, it would seem that the two therapies may work by different mechanisms but end up producing the same result. This would predict that their combination would be even more effective. On the other hand, it is also possible that they both improve mindfulness and this in turn produces the improvements. In which case their combination would only be as effective as each alone. It remains to be seen if Mindfulness-Based Cognitive Therapy (MBCT) would be even more effective for treating chronic low back pain.

Regardless, both MBSR and CBT appear to help relieve the suffering of patients with chronic low back pain. So, improve chronic back pain with mindfulness and cognitive therapy.

“Mindfulness-based stress reduction (MBSR) practices like yoga and meditation have also been found to improve chronic lower back pain and its physical limitations and can provide patients with ongoing pain management skills,” – Susan McQuillan

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

Turner, J. A., Anderson, M. L., Balderson, B. H., Cook, A. J., Sherman, K. J., & Cherkin, D. C. (2016). Mindfulness-based stress reduction and cognitive-behavioral therapy for chronic low back pain: similar effects on mindfulness, catastrophizing, self-efficacy, and acceptance in a randomized controlled trial. Pain, 157(11), 2434–2444. http://doi.org/10.1097/j.pain.0000000000000635

Abstract

Cognitive-behavioral therapy (CBT) is believed to improve chronic pain problems by decreasing patient catastrophizing and increasing patient self-efficacy for managing pain. Mindfulness-based stress reduction (MBSR) is believed to benefit chronic pain patients by increasing mindfulness and pain acceptance. However, little is known about how these therapeutic mechanism variables relate to each other or whether they are differentially impacted by MBSR versus CBT. In a randomized controlled trial comparing MBSR, CBT, and usual care (UC) for adults aged 20-70 years with chronic low back pain (CLBP) (N = 342), we examined (1) baseline relationships among measures of catastrophizing, self-efficacy, acceptance, and mindfulness; and (2) changes on these measures in the 3 treatment groups. At baseline, catastrophizing was associated negatively with self-efficacy, acceptance, and 3 aspects of mindfulness (non-reactivity, non-judging, and acting with awareness; all P-values <0.01). Acceptance was associated positively with self-efficacy (P < 0.01) and mindfulness (P-values < 0.05) measures. Catastrophizing decreased slightly more post-treatment with MBSR than with CBT or UC (omnibus P = 0.002). Both treatments were effective compared with UC in decreasing catastrophizing at 52 weeks (omnibus P = 0.001). In both the entire randomized sample and the sub-sample of participants who attended ≥6 of the 8 MBSR or CBT sessions, differences between MBSR and CBT at up to 52 weeks were few, small in size, and of questionable clinical meaningfulness. The results indicate overlap across measures of catastrophizing, self-efficacy, acceptance, and mindfulness, and similar effects of MBSR and CBT on these measures among individuals with CLBP.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5069124/

Improve Behavior in the Classroom with Mindfulness

December 23, 2017 psyjdc Leave a comment

Improve Behavior in the Classroom with Mindfulness

By John M. de Castro, Ph.D.

“Mindfulness practices help children improve their ability to pay attention, by learning to focus on one thing (e.g., breath, sound) while filtering out other stimuli. Mindfulness also provides kids with skills for understanding their emotions and how to work with them. I’m not sure if there any other skills besides these — paying attention and regulating one’s emotions — that are more important for successful human functioning, let alone education!” – Sarah Beach

Elementary school is an environment that has a huge effect on development. It is also an excellent time to teach children the skills to adaptively negotiate its environment. Mindfulness training in school, at all levels has been shown to have very positive effects. These include academic, cognitive, psychological, and social domains. Importantly, mindfulness training in school appears to improve the student’s self-concept. It also improves attentional ability and reduces stress, which are keys to successful learning in school. Another key is the ability of children to manage their behavior in school and remain on-task as much as possible.

Behavior management based upon behavior modification techniques has been shown to be very effective in promoting positive classroom behavior. It is not known, however, if mindfulness training can supplement and improve the effectiveness of the application of behavior management techniques. In today’s Research News article “Preliminary Evidence on the Efficacy of Mindfulness Combined with Traditional Classroom Management Strategies.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5622000/, Kasson and Wilson employ a multiple baseline research design to investigate the effectiveness of the combination of mindfulness and behavior management in promoting positive classroom behaviors in 3^rd grade students.

They observed the behaviors of 6 3^rd grade students in their classroom. They rated the students every 5 minutes for on-task behaviors, defined as “remaining within 1 ft. of one’s desk and interacting with materials as to participate in current classroom activity.” Students were observed initially (baseline) and under three conditions; behavior management, behavior management plus mindfulness, and self-monitoring. Behavior management consisted of “(a) use of a signal to obtain student attention (e.g., clapping sequence to be repeated by students), (b) use of a transition timer (e.g., visual countdown timer on Smart Board during activity transitions), (c) ignoring inappropriate student behavior, and (d) implementing a reinforcer incentive system.” Mindfulness exercises occurred for 15 minutes three times per week. The exercises included quiet time, deep breathing, structured breathing, present moment awareness, mindful eating, and mindful movement. Self-monitoring consisted of each student giving “himself a plus or minus during each activity throughout the day based on how well he thought he followed classroom rules.”

They found that during baseline the students were on task an average of 79% of the time. The behavior management phase the students increased their on-task behaviors with an average of 87% on task with an effect size of .58, while during the combined behavior management plus mindfulness phase the students further increased their on-task behaviors to 91% with an average effect size of .78. Self-monitoring produced mixed effects with most students regressing to baseline levels of on-task behaviors.

The study suggests that behavior management is effective in improving elementary students’ positive classroom behaviors and that mindfulness training can further improve on-task behavior. This was a short-term study and there is a need for further research to investigate if the effectiveness of behavior management and mindfulness training is sustained over longer periods up to school semesters. It is assumed but not measured that the improved attention to task translates to improved learning. This also remains for future research to investigate.

Nevertheless, these results suggest that mindfulness training is a positive asset in promoting attention to classroom learning tasks. It has been previously established that mindfulness training has positive benefits for children. The present study demonstrates that, mindfulness training, in school, even in young children, can be effectively implemented and can improve the students’ attention to the task at hand in the classroom.

So, improve behavior in the classroom with mindfulness.

“Students “are just craving for ways to handle and cope with their stress” in healthy and nondestructive ways. It becomes sort of like instinctive and intuitive for them to just search for alternative ways to cope with their stress that have nothing to do with drugs or alcohol or whatever destructive behavior.” – Violaine Gueritault

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

Kasson, E. M., & Wilson, A. N. (2017). Preliminary Evidence on the Efficacy of Mindfulness Combined with Traditional Classroom Management Strategies. Behavior Analysis in Practice, 10(3), 242–251. http://doi.org/10.1007/s40617-016-0160-x

Abstract

The current case study combined mindfulness-based strategies with a classroom behavior management treatment package, to assist teachers with managing 3rd grade student behaviors. Two teachers (Classroom teacher and Specials teacher) and six students within the same classroom were observed using a 5-min momentary time sampling procedure. A delayed multiple baseline across settings (e.g., Classroom teacher, Specials teacher) design was used to assess student behaviors across baseline (A), classroom behavior management treatment package (CBM) (B), CBM plus mindfulness (C), and CBM plus mindfulness and self-monitoring (D). Behavioral treatment alone increased on-task behaviors for four of six (66%) students compared to baseline; however, five of six (83%) students increased and sustained high rates of on-task behaviors when mindfulness exercises were added to the behavior analytic techniques. These preliminary results support the combination of mindfulness-based strategies with traditional behavior analytic interventions for increasing student on-task behaviors in classroom settings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5622000/

Brief Mindfulness Training may Increase Drinking Impulsivity to Negative Emotions

December 18, 2017 psyjdc Leave a comment

Brief Mindfulness Training may Increase Drinking Impulsivity to Negative Emotions

By John M. de Castro, Ph.D.

“it’s helping people become really aware of what’s happening in their minds. Once they see that, they have a choice and they have some freedom.” – Sarah Bowen

Inappropriate use of alcohol is a major societal problem. In fact, about 25% of US adults have engaged in binge drinking in the last month and 7% have what is termed an alcohol use disorder. Alcohol abuse is very dangerous and frequently fatal. Nearly 88,000 people in the US and 3.3 million globally die from alcohol-related causes annually, making it the third leading preventable cause of death in the United States. Drunk driving accounted for over 10,000 deaths; 31% of all driving fatalities. Excessive alcohol intake has been shown to contribute to over 200 diseases including alcohol dependence, liver cirrhosis, cancers, and injuries. It is estimated that over 5% of the burden of disease and injury worldwide is attributable to alcohol consumption.

Alcohol abuse often develops during adolescence and it on display with college students where about four out of five college students drink alcohol and about half of those consume alcohol through binge drinking. About 25 percent of college students report academic consequences of their drinking including missing class, falling behind, doing poorly on exams or papers, and receiving lower grades overall. More than 150,000 students develop an alcohol-related health problem. These are striking and alarming statistics and indicate that controlling alcohol intake is an important priority for the individual and society.

There are a wide range of treatment programs for alcohol abuse, with varying success. Recently, mindfulness training has been successfully applied to treatment. One attractive feature of this training is that it appears to increase the ability of the drinker to control their intake, resulting in less binge drinking and dangerous inebriation. Since, mindfulness appears to hold promise as a treatment for excessive alcohol intake, there is a need to better understand its mechanisms of action in order to maximize its effectiveness. In today’s Research News article “Examination of trait impulsivity on the response to a brief mindfulness intervention among college student drinkers.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4975969/, Vinci and colleagues examined how mindfulness training might alter impulsivity related drinking urges.

They administered the Alcohol Use Disorders Identification Test to college students and identified a group of at-risk drinkers. They were then randomly assigned to receive either a 10-minute guided mindfulness meditation, muscle relaxation instruction, or engaged for 10-minutes in a word search puzzle. Before and after the interventions the at-risk students were administered measures of the mindfulness, positive and negative emotions, urge to drink, drinking motives of Enhancement, Coping, Social Affiliative, and Social Conformity and of impulsivity including Negative Urgency, (lack of) Premeditation, (lack of) Perseverance, Sensation Seeking, and Positive Urgency.

They found that mindfulness was increased by the brief mindfulness training. They also found that mindfulness and relaxation modulated the effects of drinking motives on the urge to drink. For participants in the mindfulness group, having low Negative Urgency was associated with a low urge to drink, while participants with high Negative Urgency reported a high urge to drink. The opposite pattern was observed for participants in the relaxation group, such that for those with low Negative Urgency, urge to drink was high; for those with high Negative Urgency, the urge to drink was low.

Negative Urgency is the likelihood of acting impulsively when experiencing negative emotions. A brief Mindfulness experience appears to have an immediate effect of heightening the ability of acting impulsively to negative emotions to affect the urge to drink. It may, by focusing the individual on the present moment, make the individual more aware of their own emptions and therefore they become more responsive to them. A brief relaxation, on the other hand tends to lower the ability of acting impulsively to negative emotions to affect the urge to drink. Perhaps relaxation make the students less aware of their own emotions.

These results suggest that a brief mindfulness training of students who are at-risk for alcohol abuse may be counterproductive, sensitizing them to feeling emotionally bad and thereby making drinking more likely. Since, it has been well established that mindfulness training decreases drinking and drinking motives, the results suggest that care must be taken to insure that sufficient training occurs to produce benefits as opposed to sensitizing impulsive responses to negative emotions.

So, care must be taken t administer and adequate dose of mindfulness training when treating at-risk college students.

“mindfulness . . . just 11 minutes of the therapy can reduce alcohol consumption in heavy drinkers.” – Liat Clark

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

Vinci, C., Peltier, M., Waldo, K., Kinsaul, J., Shah, S., Coffey, S. F., & Copeland, A. L. (2016). Examination of trait impulsivity on the response to a brief mindfulness intervention among college student drinkers. Psychiatry Research, 242, 365–374. http://doi.org/10.1016/j.psychres.2016.04.115

Abstract

Mindfulness-based strategies show promise for targeting the construct of impulsivity and associated variables among problematic alcohol users. This study examined the moderating role of intervention (mindfulness vs relaxation vs control) on trait impulsivity and three outcomes examined post-intervention (negative affect, positive affect, and urge to drink) among 207 college students with levels of at-risk drinking. Moderation analyses revealed that the relationship between baseline impulsivity and the primary outcomes significantly differed for participants who underwent the mindfulness versus relaxation interventions. Notably, simple slope analyses revealed that negative urgency was positively associated with urge to drink following the mindfulness intervention. Among participants who underwent the relaxation intervention, analysis of simple slopes revealed that negative urgency was negatively associated with urge to drink, while positive urgency was positively associated with positive affect following the relaxation intervention. Findings suggest that level (low vs high) and subscale of impulsivity matter with regard to how a participant will respond to a mindfulness versus relaxation intervention.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4975969/

Reduce Medical Resident Burnout with Mindfulness

December 15, 2017 psyjdc Leave a comment

Reduce Medical Resident Burnout with Mindfulness

By John M. de Castro, Ph.D.

“Mindfulness meditation introduces a way of cultivating awareness of one’s relationship with the present moment. With practice, it may lead to healthier ways of working with stressful life experiences, including those inherent to residency training.” – Vincent Minichiello

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 it is a threat to the healthcare providers and their patients. 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 residency is an extremely stressful period and many express burnout symptoms. This would seem to be an ideal time to intervene.

In today’s Research News article “Mindfulness, burnout, and effects on performance evaluations in internal medicine residents.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5565254/, Braun and colleagues recruited medical residents and had them complete measures of mindfulness, burnout, depression, and stress. They were also rated by the staff for their level of professional development.

They found that 71% of the residents met the criterion for burnout and this was associated with poor performance in their residency. Importantly, dispositional mindfulness, particularly “acting with awareness,” was significantly, negatively associated with meeting the burnout criterion, such that low mindfulness predicted a high likelihood of burnout. Burned-out residents tended to be low in mindfulness while resilient residents tended to be high in mindfulness.

These are interesting results, but were correlational, so causal relationships cannot be determined. Nevertheless, previous studies have demonstrated that mindfulness training can reduce burnout. This combined with the present results suggest that being mindful and acting with awareness are helpful for preventing burnout. It remains for future research to demonstrate if mindfulness training can prevent burnout in medical residents.

So, reduce medical resident burnout with mindfulness.

“Having a greater ability to recognize what’s going on inside allows you to set aside distractions and really attend to the moment. Paradoxically, what you learn in meditation is that turning toward the distress and becoming curious about it rather than being swept away by it is a way to detoxify it. The more we try to escape the stress, the worse it becomes.” – Ron Epstein

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

Braun, S. E., Auerbach, S. M., Rybarczyk, B., Lee, B., & Call, S. (2017). Mindfulness, burnout, and effects on performance evaluations in internal medicine residents. Advances in Medical Education and Practice, 8, 591–597. http://doi.org/10.2147/AMEP.S140554

Abstract

Purpose

Burnout has been documented at high levels in medical residents with negative effects on performance. Some dispositional qualities, like mindfulness, may protect against burnout. The purpose of the present study was to assess burnout prevalence among internal medicine residents at a single institution, examine the relationship between mindfulness and burnout, and provide preliminary findings on the relation between burnout and performance evaluations in internal medicine residents.

Methods

Residents (n = 38) completed validated measures of burnout at three time points separated by 2 months and a validated measure of dispositional mindfulness at baseline. Program director end-of-year performance evaluations were also obtained on 22 milestones used to evaluate internal medicine resident performance; notably, these milestones have not yet been validated for research purposes; therefore, the investigation here is exploratory.

Results

Overall, 71.1% (n = 27) of the residents met criteria for burnout during the study. Lower scores on the “acting with awareness” facet of dispositional mindfulness significantly predicted meeting burnout criteria χ2(5) = 11.88, p = 0.04. Lastly, meeting burnout criteria significantly predicted performance on three of the performance milestones, with positive effects on milestones from the “system-based practices” and “professionalism” domains and negative effects on a milestone from the “patient care” domain.

Conclusion

Burnout rates were high in this sample of internal medicine residents and rates were consistent with other reports of burnout during medical residency. Dispositional mindfulness was supported as a protective factor against burnout. Importantly, results from the exploratory investigation of the relationship between burnout and resident evaluations suggested that burnout may improve performance on some domains of resident evaluations while compromising performance on other domains. Implications and directions for future research are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5565254/

Mindfulness is Associated with Reduced Inflexibility and Psychopathology in Adolescents

December 14, 2017 psyjdc 1 Comment

Mindfulness is Associated with Reduced Inflexibility and Psychopathology in Adolescents

By John M. de Castro, Ph.D.

“As present-moment focused, mindfulness, acceptance, and defusion interventions alter the context, behavioral flexibility emerges and, with it, increased sensitivity to context, including that aspect of context we call consequences.” – Kelly Wilson

Adolescence should be a time of mental, physical, social, and emotional growth. It is during this time that higher levels of thinking, sometimes called executive function, develops. These executive functions are an important foundation for success in the complex modern world. But, adolescence can be a difficult time, fraught with challenges. During this time the child transitions to young adulthood; including the development of intellectual, psychological, physical, and social abilities and characteristics. There are so many changes occurring during this time that the child can feel overwhelmed and unable to cope with all that is required.

Making these profound changes successfully requires a good deal or flexibility, adapting and changing with the physical, psychological, and social changes of adolescence. In today’s Research News article “Inflexible Youngsters: Psychological and Psychopathological Correlates of the Avoidance and Fusion Questionnaire for Youths in Nonclinical Dutch Adolescents.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605724/, Muris and colleagues examined the relationships between mindfulness, inflexibility and mental health in adolescents. They recruited youths aged 12 to 16 years and had them complete measures of mindfulness, psychological inflexibility, thought suppression self-compassion, self-worth, self-efficacy, somatization, psychopathological symptoms, anxiety, depression, and aggression.

They found that the higher the levels of mindfulness the lower the levels of inflexibility, thought suppression, somatization, anxiety, depression, emotional problems, aggression, oppositional conduct, and the higher the levels of self-worth and self-efficacy. They also found that psychological inflexibility was inversely related to the same variables, with higher levels of inflexibility associated with higher levels of thought suppression, somatization, anxiety, depression, emotional problems, aggression, oppositional conduct, and the lower the levels of self-worth and self-efficacy. In other words, mindfulness was associated with positive mental health while inflexibility was associated with negative mental health in these youths.

They further investigated the effectiveness of psychological inflexibility to affect the mental health of the adolescents while holding mindfulness mathematically constant. They found that each had independent contributions to the levels of anxiety and depression, with mindfulness associated with lower values and inflexibility associated with higher values. So, mindfulness and psychological inflexibility appear to be independently associated with emotional health in adolescents.

It is important to keep in mind that this study was correlational and did not manipulate the levels of any variables. So, causal connections cannot be determined between the variables. The associations though suggest that both mindfulness and psychological flexibility are important contributors to the psychological development of adolescents. It will be interesting to investigate in future research whether training in mindfulness and flexibility will help to promote healthy mental health in youths.

“While psychological inflexibility was most strongly associated with Neuroticism , as expected, mindfulness demonstrated the strongest association with consciousness, a trait reflecting impulse control abilities and attention to detail.” – Robert Latzman

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

Muris, P., Meesters, C., Herings, A., Jansen, M., Vossen, C., & Kersten, P. (2017). Inflexible Youngsters: Psychological and Psychopathological Correlates of the Avoidance and Fusion Questionnaire for Youths in Nonclinical Dutch Adolescents. Mindfulness, 8(5), 1381–1392. http://doi.org/10.1007/s12671-017-0714-1

Abstract

The present study examined psychological and psychopathological correlates of psychological inflexibility as measured by the Avoidance and Fusion Questionnaire for Youth (AFQ-Y) in two independent samples of nonclinical Dutch adolescents aged between 12 and 18 years (Ns being 184 and 157). Participants completed a survey containing the AFQ-Y and scales assessing mindfulness, thought suppression, self-compassion, self-worth, self-efficacy, and internalizing/externalizing symptoms. In both samples, the AFQ-Y was found to be a reliable measure of psychological inflexibility that correlated in a theoretically meaningful way with other psychological constructs. Most importantly, AFQ-Y scores correlated positively with internalizing and externalizing symptoms, and in most cases, these associations remained significant when controlling for other measures. These findings suggest that psychological inflexibility is an important factor in youth psychopathology that needs to be further investigated in future research.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605724/

Improve Emotions of Ethnically Diverse At-Risk Students with Mindfulness

December 13, 2017 psyjdc Leave a comment

Improve Emotions of Ethnically Diverse At-Risk Students with Mindfulness

By John M. de Castro, Ph.D.

“There is plenty of evidence available now that demonstrates the value of teaching mindfulness to young people, and many of the benefits of mindfulness are skills and dispositions that are especially helpful in the context of education. Mindfulness practices help children improve their ability to pay attention, by learning to focus on one thing (e.g., breath, sound) while filtering out other stimuli. Mindfulness also provides kids with skills for understanding their emotions and how to work with them.” – Sarah Beach

At-risk youth confront unique pressures that have been linked to poor psychosocial outcomes, impaired academic performance, and maladaptive behaviors such as substance use and delinquency. These risk factors may include language barriers, low SES, parents’ own involvement in high risk or illegal behavior, restrictive or neglectful parenting, and home environments that expose children to alcohol and substance abuse. Mindfulness training has been found to be helpful for adolescents and also to improve performance in school. So, it is possible that mindfulness training would be helpful for at-risk adolescents.

In today’s Research News article “A School-Based Mindfulness Pilot Study for Ethnically Diverse At-Risk Adolescents.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4809539/pdf/nihms652885.pdf, Bluth and colleagues recruited adolescents who were attending an alternative high school for troublesome and at-risk students. They were randomly assigned to receive either and 11-week class of mindfulness training or substance abuse training. The mindfulness training included body scan, sitting meditation, lovingkindness practice, walking meditation and mindful movement. The substance abuse training consisted of lectures designed to help adolescents address drug use and co-occurring life problems. The students were measured before and after the trainings for class attendance, retention, program acceptability, mindfulness, self-compassion, social connectedness, anxiety, depression, and perceived stress.

At the beginning of the mindfulness training there was considerable resistance and acting out. But, by the end of training the students responded that the class was helpful and wanted it to continue. They also found that the mindfulness training produced significant improvements in the students’ depression and anxiety levels. Mindfulness training has in the past been repeatedly shown to help relieve depression and anxiety. But, it is an important finding that it can do so in these difficult to treat at-risk adolescents. So, the study showed that mindfulness training was feasible and acceptable to these at-risk adolescents and produced improvements in their negative emotions.

The results are encouraging. These troubled youths are extremely difficult to work with and treat and that was reflected in the negative behaviors at the beginning of the class. But, by the end of the class the students found the mindfulness training useful and there were fairly large improvements in anxiety and depression. There were trends for other improvements and a larger future trial may be able to demonstrate other benefits of the mindfulness training. Although it was clear that mindfulness training is not a panacea for troubled youths, it can be helpful and provide space for them to destress and explore their inner lives.

So, improve emotions of ethnically diverse at-risk students with mindfulness.

“But a growing body of evidence suggests that mindfulness practice could be beneficial to teens, helping them cultivate empathy, as well as skills for concentration and impulse control. In short, mindfulness can help adolescents navigate the challenges of adolescence.” Sarah Beach

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

Bluth, K., Campo, R. A., Pruteanu-Malinici, S., Reams, A., Mullarkey, M., & Broderick, P. C. (2016). A School-Based Mindfulness Pilot Study for Ethnically Diverse At-Risk Adolescents. Mindfulness, 7(1), 90–104. http://doi.org/10.1007/s12671-014-0376-1

Adolescence is a transitional period marked by rapid physical, behavioral, emotional, and cognitive developmental changes. In addition to these normative development changes, adolescents also face a multitude of contextual stressors such as academic pressures at school, changing relationships with peers, and all too often, unstable family life characterized by divorce, frequent moves, income and occupational changes, and disruptions in family routines. Up to a quarter of adolescents suffer from depression or anxiety disorders, and an even larger proportion struggle with subclinical symptoms. Anxiety and depression during this stage can lead to impaired academic, social, and family functioning, and have long-term adverse outcomes.

Given the need to better understand both the implementation and potential benefit of mindfulness programs for at-risk youth, we conducted a randomized pilot study to investigate the feasibility and acceptability of such an intervention with ethnically diverse, primarily Hispanic youth enrolled in an alternative high school. We specifically examine intervention effects on psychosocial wellbeing and school performance relative to the control group, a class which focused on substance abuse prevention.

this study contributes to the literature by confirming the feasibility and acceptability of a mindfulness intervention with this population, and expands our knowledge on what works.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4809539/pdf/nihms652885.pdf

Slightly Improve Substance Use Disorder with Mindfulness

December 11, 2017 psyjdc Leave a comment

Slightly Improve Substance Use Disorder with Mindfulness

By John M. de Castro, Ph.D.

“though it may seem paradoxical, by increasing your ability to accept and tolerate the present moment, you become more able to make needed changes in your life. . . Also, practicing balanced emotional responses can reduce your stress level, and anxiety and stress are often triggers for substance abuse and addictive behavior. In addition, when you choose a neutral rather than a judgmental response to your thoughts and feelings, you can increase your sense of self-compassion rather than beating yourself up, which is often associated with addictive behaviors.” – Adi Jaffe

Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use which includes unintentional overdoses, suicides, HIV and AIDS, and trauma. In the U.S. about 17 million people abuse alcohol. Drunk driving fatalities accounted for over 10,000 deaths annually. Obviously, there is a need to find effective methods to prevent and treat substance abuse. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers relapse and return to substance abuse. Hence, it is important to find an effective method to prevent these relapses.

Mindfulness practices have been shown to improve recovery from various addictions. Mindfulness-based Relapse Prevention (MBRP) has been developed to specifically assist in relapse prevention and has been shown to be effective. “MBRP integrates mindfulness practices with cognitive-behavioral Relapse Prevention therapy and aims to help participants increase awareness and acceptance of difficult thoughts, feelings, and sensations to create changes in patterns of reactive behavior that commonly lead to relapse. Mindfulness training in MBRP provides clients with a new way of processing situational cues and monitoring internal reactions to contingencies, and this awareness supports proactive behavioral choices in the face of high-risk relapse situation.” – Grow et al. 2015

In today’s Research News article “Mindfulness-based Relapse Prevention for Substance Use Disorders: 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/PMC5636047/, Grant and colleagues review and perform a meta-analysis of the published research literature on the effectiveness of Mindfulness-based Relapse Prevention (MBRP) in treating substance use disorder. They identified 9 randomized controlled trials and examined the effects of MBRP on relapse, frequency and quantity of substance use, withdrawal/craving symptoms, treatment dropout, depressive and anxiety symptoms, negative consequences from substance use, and health-related quality of life and also its safety

They found that the summarized published research literature reported few and small positive effects. On most of the outcome measures there were no significant improvements produced by MBRP. Small significant improvements were found for withdrawal effects and cravings and the negative effects of substance use. They found that there were no adverse effects of MBRP. These are disappointing results that suggest that Mindfulness-based Relapse Prevention (MBRP) is safe but only slightly effective in treating substance use disorder.

These are surprising results as individual trials have reported significant effects. But, it appears that the different trials reported significant effects on different variables with some finding effects on a measure while others finding no effects on the same measure but reporting effects on different measures. When summarized, the reported effects appear to average away. Substance use disorder is such an important social and health issue where there are few viable treatment options, that further research on Mindfulness-based Relapse Prevention (MBRP) is warranted to investigate what components are effective and which not and how to optimize effectiveness.

So, slightly improve substance use disorder with mindfulness.

“Modeled after mindfulness-based cognitive therapy for depression and mindfulness-based stress reduction, MBRP tackles the very roots of addictive behavior by targeting two of the main predictors of relapse: negative emotions and cravings.” – Carolyn Gregoire

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

Sean Grant, Benjamin Colaiaco, Aneesa Motala, Roberta Shanman, Marika Booth, Melony Sorbero, Susanne Hempel. Mindfulness-based Relapse Prevention for Substance Use Disorders: A Systematic Review and Meta-analysis. J Addict Med. 2017 Sep; 11(5): 386–396. Published online 2017 Jul 19. doi: 10.1097/ADM.0000000000000338

Abstract

Objectives:

Substance use disorder (SUD) is a prevalent health issue with serious personal and societal consequences. This review aims to estimate the effects and safety of Mindfulness-based Relapse Prevention (MBRP) for SUDs.

Methods:

We searched electronic databases for randomized controlled trials evaluating MBRP for adult patients diagnosed with SUDs. Two reviewers independently assessed citations, extracted trial data, and assessed risks of bias. We conducted random-effects meta-analyses and assessed quality of the body of evidence (QoE) using the Grading of Recommendations Assessment, Development, and Evaluation approach.

Results:

We identified 9 randomized controlled trials comprising 901 participants. We did not detect statistically significant differences between MBRP and comparators on relapse (odds ratio [OR] 0.72, 95% confidence interval [CI] 0.46–1.13, low QoE), frequency of use (standardized mean difference [SMD] 0.02, 95% CI −0.40 to 0.44, low QoE), treatment dropout (OR 0.81, 95% CI 0.40 to 1.62, very low QoE), depressive symptoms (SMD −0.09, 95% CI −0.39 to 0.21, low QoE), anxiety symptoms (SMD −0.32, 95% CI −1.16 to 0.52, very low QoE), and mindfulness (SMD −0.28, 95% CI −0.72 to 0.16, very low QoE). We identified significant differences in favor of MBRP on withdrawal/craving symptoms (SMD −0.13, 95% CI −0.19 to −0.08, I2 = 0%, low QoE) and negative consequences of substance use (SMD −0.23, 95% CI −0.39 to −0.07, I2 = 0%, low QoE). We found negligible evidence of adverse events.

Conclusions:

We have limited confidence in estimates suggesting MBRP yields small effects on withdrawal/craving and negative consequences versus comparator interventions. We did not detect differences for any other outcome. Future trials should aim to minimize participant attrition to improve confidence in effect estimates.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5636047/