Mindfulness

Improve Schizophrenia with Mindfulness

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Improve Schizophrenia with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness treatments do not aim to decrease the occurrence or severity of the symptoms of psychosis, but by helping to reduce the distress people experience.” – Tania Lecomte

 

Schizophrenia is the most common form of psychosis. It effects about 1% of the population worldwide. It appears to be highly heritable and involves changes in the brain. It is characterized by both positive and negative symptoms. Positive symptoms include hallucinations; seeing and, in some cases, feeling, smelling or tasting things that aren’t there, or delusions; unshakable beliefs that, when examined rationally, are obviously untrue. Negative symptoms include a reduced ability to function normally, neglect of personal hygiene, lack of emotion, blank facial expressions, speaking in a monotone, loss of interest in everyday activities, social withdrawal, an inability to experience pleasure, and a lack of insight into their symptoms. The symptoms of schizophrenia usually do not appear until late adolescence or early adulthood.

 

Schizophrenia is very difficult to treat with psychotherapy and is usually treated with antipsychotic drugs. These drugs, however, are not always effective, sometimes lose effectiveness, and can have some difficult side effects. In addition, even when effective, antipsychotic drugs only treat the positive symptoms of schizophrenia, leaving the negative symptom intact including the loss of functionality and a lack of insight. Hence, there is a need for safe and effective alternative treatments for schizophrenia that can treat the negative symptoms.

 

Mindfulness training has been shown to be beneficial for a variety of mental health problems, including psychosis. Mindfulness has also been shown to associated with lower symptom severity of schizophrenia. Another treatment, psychoeducation specific for schizophrenia, has also been shown to reduces relapse rates and improve medication adherence. Psychoeducation consists of working with individual patients and their families to improve schizophrenia survival skills, focusing on stressful situation and coping strategies, and problem-solving. Since both mindfulness training and psychoeducation appear to be effective their combination may be particularly effective in treating schizophrenia.

 

In today’s Research News article “An international multi-site, randomized controlled trial of a mindfulness-based psychoeducation group programme for people with schizophrenia.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5551382/, Chien and colleagues recruited patients who were diagnosed with schizophrenia and randomly assigned them to receive either treatment as usual, 6-weeks of psychoeducation alone, or 6-weeks of psychoeducation in combination with mindfulness training. The participants were measured before and after the treatment programs, and 6 and 18 weeks later for average number and length of re-hospitalizations, level of functioning, insight into illness, and schizophrenia symptoms.

 

They found that whereas the treatment as usual group had significant deterioration in all measures both intervention groups had significant improvements specifically in average length of rehospitalizations; patient functioning, including improvements in social and community functioning and self-management; patient mental state, including reductions in both positive and negative symptoms; and insight into their illness. In addition, there was a significant increase in complete remissions in the intervention groups. Importantly, in every case the psychoeducation in combination with mindfulness training produced significantly superior results to the psychoeducation alone condition.

 

These results suggest that psychoeducation alone is an effective treatment for schizophrenia, but the addition of mindfulness training markedly improves the outcomes. In the treatment as usual condition only 7% of the patients achieved remission while in the psychoeducation condition 27% achieved remission and with added mindfulness training 39% remissions were achieved. These are remarkable improvements in a very difficult condition to treat. The results suggest that teaching schizophrenia patients the skills to cope with their disease is very useful but that making them more mindful greatly improves this coping. It would appear that being able to look at and experience the symptoms of their disease in the present moment non-judgmentally improves the patients’ ability to cope with and alter their symptoms.

 

So, improve schizophrenia with mindfulness.

 

“mindfulness-based psycho-educational intervention expressly designed for patients with schizophrenia can be well tolerated and result in better illness outcomes than either standard treatment alone or standard treatment supplemented by a more typical psycho-educational approach. This is an important finding because of the widely held belief that psychotic patients can neither tolerate nor benefit from mindfulness-based interventions.” – American Mindfulness Research Association

 

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

 

Chien, W. T., Bressington, D., Yip, A., & Karatzias, T. (2017). An international multi-site, randomized controlled trial of a mindfulness-based psychoeducation group programme for people with schizophrenia. Psychological Medicine, 47(12), 2081–2096. http://doi.org/10.1017/S0033291717000526

 

Abstract

Background

We aimed to test a mindfulness-based psychoeducation group (MBPEG), v. a conventional psychoeducation group (CPEG) v. treatment as usual (TAU), in patients with schizophrenia-spectrum disorders over a 24-month follow-up.

Method

This single-blind, multi-site, pragmatic randomized controlled trial was conducted in six community treatment facilities across three countries (Hong Kong, mainland China and Taiwan). Patients were randomly allocated to one of the treatment conditions, and underwent 6 months of treatment. The primary outcomes were changes in duration of re-hospitalizations and mental state (Positive and Negative Syndrome Scale; PANSS) between baseline and 1 week, and 6, 12 and 18 months post-treatment.

Results

A total of 300 patients in each country were assessed for eligibility between October 2013 and 30 April 2014, 38 patients per country (n = 342) were assigned to each treatment group and included in the intention-to-treat analysis. There was a significant difference in the length of re-hospitalizations between the three groups over 24 months (F2,330 = 5.23, p = 0.005), with MBPEG participants having a shorter mean duration of re-hospitalizations than those in the other groups. The MBPEG and CPEG participants had significant differential changes in proportional odds ratios of complete remission (all individual PANSS items <3) over the 24-month follow-up (37 and 26%, respectively), as opposed to only 7.2% of the TAU group (χ2 = 8.9 and 8.0, p = 0.001 and 0.003, relative risk = 3.5 and 3.1, 95% confidence interval 2.0–7.2 and 1.6–6.3).

Conclusions

Compared with TAU and CPEG, MBPEG improves remission and hospitalization rates of people with schizophrenia spectrum disorders over 24 months.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5551382/

Mindful and Resilient Therapists have Better Patient Outcomes

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Mindful and Resilient Therapists have Better Patient Outcomes

 

By John M. de Castro, Ph.D.

 

“Current studies suggest that in successful treatment alliances, therapists are perceived as warm, understanding, and accepting, approaching their patients with an open, collaborative attitude. Mindfulness can help us develop these qualities.” – Susal Pollak

 

Psychotherapy is an interpersonal transaction. Its effectiveness in treating the ills of the client is to some extent dependent upon the chemistry between the therapist and the client, termed the therapeutic alliance. Research has demonstrated that there is a positive relationship with moderate effect sizes between treatment outcomes and the depth of the therapeutic alliance. The personality and characteristics of the therapist are essential ingredients in forming a therapeutic alliance. Research has shown that effective therapists are able to express themselves well. They are astute at sensing what other people are thinking and feeling. In relating to their clients, they show warmth and acceptance, empathy, and a focus on others, not themselves.

 

It would seem that mindfulness would be an important contributor to therapist effectiveness. Communications involve not only talking but listening, a mindfulness skill. Being able to look at things as they are without judgement, another mindfulness skill, would appear to be essential to this relationship. The mindfulness component of being in the present moment would also seem essential to focusing on and being responsive to the client’s immediate experience and reactions.

 

Resilience is a personal characteristic that “enable one to thrive in the face of adversity.” The therapeutic process is not a linear progression from psychological problems to mental health. It contains many setbacks, resistances, and reversals that must be weathered in order to progress. The ability to withstand this adversity, resilience, is an essential characteristic of an effective therapist. So, it would be reasonable to suspect that the mindfulness and resilience of the therapist would be related to the successful outcome of the therapy.

 

In today’s Research News article “The Role of Practitioner Resilience and Mindfulness in Effective Practice: A Practice-Based Feasibility Study.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5550533/, Pereira and colleagues recruited psychotherapy practitioners and measured them for resilience and mindfulness. In addition, they recorded data of the therapists’ depressed patients from a database of patient outcomes. In particular, they recorded improvements in depression and work and social adjustment.

 

They separated therapists into two groups based upon their success in treating depression, less or more effective therapists. They found that the more effective therapists had significantly higher scores for mindfulness and resilience. In addition, the more mindful and the more resilient the therapist the greater the therapist’s effectiveness. Hence, therapist mindfulness and resilience were significant contributors to effective treatment for depression.

 

It should be kept in mind that this study was correlational and care must be taken in interpreting causation. But, the results are suggestive that therapist mindfulness and resilience are important for effective treatment of depression. It is interesting that mindfulness training has been shown to improve resilience. So, mindfulness may be the key. This suggests that therapist training should incorporate training in mindfulness to improve their resilience and effectiveness as mindful and resilient therapists have better patient outcomes.

 

“Doing psychotherapy is an opportunity to practice mindfulness in everyday life. The therapy office can be like a meditation room in which we invite our moment-to-moment experience to become known to us, openly and wholeheartedly. As the therapist learns to identify and disentangle from his or her own conditioned patterns of thought and feeling that arise in the therapy relationship, the patient may discover the same emotional freedom.” – Christopher Germer

 

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

 

Pereira, J.-A., Barkham, M., Kellett, S., & Saxon, D. (2017). The Role of Practitioner Resilience and Mindfulness in Effective Practice: A Practice-Based Feasibility Study. Administration and Policy in Mental Health, 44(5), 691–704. http://doi.org/10.1007/s10488-016-0747-0

 

 

Abstract

A growing body of literature attests to the existence of therapist effects with little explanation of this phenomenon. This study therefore investigated the role of resilience and mindfulness as factors related to practitioner wellbeing and associated effective practice. Data comprised practitioners (n = 37) and their patient outcome data (n = 4980) conducted within a stepped care model of service delivery. Analyses employed benchmarking and multilevel modeling to identify more and less effective practitioners via yoking of therapist factors and nested patient outcomes. A therapist effect of 6.7 % was identified based on patient depression (PHQ-9) outcome scores. More effective practitioners compared to less effective practitioners displayed significantly higher levels of mindfulness as well as resilience and mindfulness combined. Implications for policy, research and practice are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5550533/

Reduce Suspiciousness and Excessive Social Anxiety with Mindfulness

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Reduce Suspiciousness and Excessive Social Anxiety with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Our nervous system is like the soundtrack for every scene in life that we encounter. It is all but impossible to experience a scene as safe and happy when the music tells us otherwise. With a mindful, body-based approach, clients can learn to change their music.” – Jeena Cho

 

Meditation began as a spiritual practice and as such involves thoughts of an ultimate reality that transcends the mundane reality of everyday life. The beginning of such realizations can produce thinking that appears magical, that is not based in physical reality. This can appear to be magical thinking which can be confused with the types of ungrounded thinking that appears in schizophrenia. In addition, meditation practice, especially at meditation retreats, can unleash troubling thoughts often related to past trauma or emotional upheaval. As a result, vulnerable individuals may have serious psychological symptoms arise as a result of meditation practice. There has been very little study of these phenomena. Yet, such study may be quite important as meditation is generally seen as a safe practice, yet, in fact, meditation may lead to a state that resembles mental illnesses, such as schizophrenia, and meditators may be misdiagnosed.

 

In today’s Research News article “Schizotypy and mindfulness: Magical thinking without suspiciousness characterizes mindfulness meditators.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5514306/, Antonova and colleagues study symptoms of schizotypy in meditators and its relationship to mindfulness. “Schizotypy is a psychological construct, encompassing a range of personality traits and cognitions that are similar to psychosis but less severe in nature . . . schizotypy is characterized by nine dimensions: ideas of reference, excessive social anxiety, magical thinking, unusual perceptual experiences, eccentric behavior or appearance, no close friends or confidants, odd speech, constricted affect and suspiciousness. Schizotypy clearly encompasses both psychosis-like symptoms and symptoms related to anxiety and depression.” They recruited male experienced meditators who had been practicing consistently for at least 2 years (average 7.5 years) and a group of male meditation naïve participants. Participants completed scales measuring mindfulness and symptoms of schizotypy.

 

They found that, although the two groups did not differ in total schizotypy symptoms, the meditation group scored significantly higher on the mindfulness facets of Observe, Non-judgment and Non-reactivity, and higher on the schizotypy symptom of magical thinking and significantly lower on suspiciousness and excessive social anxiety. They also found that the higher the levels of the mindfulness facets of Observe, Non-judgment and Non-reactivity the lower the levels of social anxiety and total schizotypy symptoms.

 

These are interesting results that support the contention that meditation training does not necessarily lead to the kinds of symptoms that reflect early stages of schizophrenia. To the contrary, meditation appears to be associated with stronger mental health as mindfulness was associated with lower levels of schizotypy, including suspiciousness and social anxiety. The increase in magical thinking is expected in that all of the meditators engaged in meditation as a spiritual practice in the Buddhist traditions. Hence, there were no indications of any meditation effects that would tend to precipitate psychosis.

 

It should be kept in mind that the results were correlational and as such causation cannot be concluded. In addition, only males were studied. It is also possible that meditators who would be susceptible to negative consequences of meditation practice would have dropped out from meditation practice and so not be represented in a sample of long-term meditators. So, more research is needed investigating the effects of meditation on schizotypy symptoms in beginning meditators and in females.

 

So, reduce suspiciousness and excessive social anxiety with mindfulness.

 

“mindfulness meditation improves somatic, psychological, and spiritual wellbeing. Thus, although poorly-practiced or poorly-taught meditation can actually be harmful to a person’s health, where mindfulness meditation is taught by an experienced and authentic teacher who is aware of all of the risks, then adverse side effects are unlikely.” – Edo Shonin

 

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

 

Antonova, E., Amaratunga, K., Wright, B., Ettinger, U., & Kumari, V. (2016). Schizotypy and mindfulness: Magical thinking without suspiciousness characterizes mindfulness meditators. Schizophrenia Research: Cognition, 5, 1–6. http://doi.org/10.1016/j.scog.2016.05.001

 

Abstract

Despite growing evidence for demonstrated efficacy of mindfulness in various disorders, there is a continuous concern about the relationship between mindfulness practice and psychosis. As schizotypy is part of the psychosis spectrum, we examined the relationship between long-term mindfulness practice and schizotypy in two independent studies. Study 1 included 24 experienced mindfulness practitioners (19 males) from the Buddhist tradition (meditators) and 24 meditation-naïve individuals (all males). Study 2 consisted of 28 meditators and 28 meditation-naïve individuals (all males). All participants completed the Schizotypal Personality Questionnaire (Raine, 1991), a self-report scale containing 9 subscales (ideas of reference, excessive social anxiety, magical thinking, unusual perceptual experiences, odd/eccentric behavior, no close friends, odd speech, constricted affect, suspiciousness). Participants of study 2 also completed the Five-Facet Mindfulness Questionnaire which assesses observing (Observe), describing (Describe), acting with awareness (Awareness), non-judging of (Non-judgment) and non-reactivity to inner experience (Non-reactivity) facets of trait mindfulness. In both studies, meditators scored significantly lower on suspiciousness and higher on magical thinking compared to meditation-naïve individuals and showed a trend towards lower scores on excessive social anxiety. Excessive social anxiety correlated negatively with Awareness and Non-judgment; and suspiciousness with Awareness, Non-judgment and Non-reactivity facets across both groups. The two groups did not differ in their total schizotypy score. We conclude that mindfulness practice is not associated with an overall increase in schizotypal traits. Instead, the pattern suggests that mindfulness meditation, particularly with an emphasis on the Awareness, Non-judgment and Non-reactivity aspects, may help to reduce suspiciousness and excessive social anxiety.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5514306/

Reduce Burnout in Palliative Care Teams with Mindfulness

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Reduce Burnout in Palliative Care Teams with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The fullness of life, tuned-in “being” and focused work that result from mindfulness have significant health and well-being consequences for hospice and palliative care professionals.” – Ellen Langer

 

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. It is estimated that over 45% of healthcare workers experience burnout. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion, sometimes called compassion-fatigue. This can be particularly problematic in a palliative care setting where empathy and compassion are critical.

 

Regardless of the reasons for burnout or its immediate presenting consequences, 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. Hence, preventing existing healthcare workers from burning out has to be a priority. Mindfulness has been demonstrated to be helpful in treating and preventing burnout, increasing resilience, and improving sleep. Another factor that could affect healthcare workers’ responses to stress is self-compassion. By treating oneself with kindness and understanding the effects of stress can be mitigated. So, it makes sense to investigate the relationship of mindfulness and self-compassion to compassion-fatigue and burnout in palliative care workers.

 

In today’s Research News article “Mindfulness and compassion-oriented practices at work reduce distress and enhance self-care of palliative care teams: a mixed-method evaluation of an “on the job“ program.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501358/, Orellana-Rios and colleagues recruited staff members of a palliative care facility and provided for them a 10-week program of mindfulness training that was incorporated into their daily job duties. The training included discussions, loving kindness meditation, walking meditation and tong-len meditation. They were also encouraged and provided materials (CDs) for home practice. Participants were measured before and after treatment for burnout, anxiety, depression, somatization, emotion regulation, work satisfaction and enjoyment, and goal attainment. They also provided saliva samples for measurement of cortisol levels. After completion of the study, the participants were interviewed concerning the effectiveness of the program.

 

They found that following the training there was a significant decrease in burnout, perceived stress, and anxiety and a significant increase in emotional awareness, resilience, joy, goal attainment, and enjoyment of work. In the interviews, the participants generally reported improvements in feeling empowered to take care of themselves, including mindful pauses throughout their day, and lower levels of worry and rumination.

 

These are interesting and potentially significant preliminary results. This should be considered as a pilot study as there was no control or comparison condition included. The participants’ measurements before training were simply compared to those after training and there were no long-term follow-up measurements. But, the results are sufficiently interesting to justify the conduct of a large-scale randomized controlled clinical trial including an active control and long-term follow-up.

 

Taken together with previous research that has demonstrated that mindfulness training decreases burnout, anxiety, depression, and increases emotion regulation and resilience, the results suggest that mindfulness training is highly beneficial for the improvement of the emotional well-being of staff involved in palliative care. Although not measured, this suggests that staff turnover and importantly, the care for the patients was also improved.

 

So, reduce burnout in palliative care teams with mindfulness.

 

“in the end, talking to patients about palliative care can make a huge difference in their lives. It can restore their dignity and empower them to live the remainder of their lives on their own terms. And that’s why palliative care, which promotes quality of life through mindfulness, creativity, and compassion, is gaining widespread acceptance.” – Anne Bruce

 

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

 

Orellana-Rios, C. L., Radbruch, L., Kern, M., Regel, Y. U., Anton, A., Sinclair, S., & Schmidt, S. (2018). Mindfulness and compassion-oriented practices at work reduce distress and enhance self-care of palliative care teams: a mixed-method evaluation of an “on the job“ program. BMC Palliative Care, 17, 3. http://doi.org/10.1186/s12904-017-0219-7

 

Abstract

Background

Maintaining a sense of self-care while providing patient centered care, can be difficult for practitioners in palliative medicine. We aimed to pilot an “on the job” mindfulness and compassion-oriented meditation training for interdisciplinary teams designed to reduce distress, foster resilience and strengthen a prosocial motivation in the clinical encounter.

Methods

Our objective was to explore the feasibility and effectiveness of this newly developed training. The study design was an observational, mixed-method pilot evaluation, with qualitative data, self-report data, as well as objective data (cortisol) measured before and after the program.

Twenty-eight staff members of an interdisciplinary palliative care team participated in the 10-week training conducted at their workplace.

Measures were the Perceived Stress Questionnaire, the Maslach Burnout Inventory, the somatic complaints subscale of the SCL-90-R, the Emotion Regulation Skills Questionnaire, the Hospital Anxiety and Depression Scale, and a Goal Attainment Scale that assessed two individual goals. Semi-structured interviews were employed to gain insight into the perceived outcomes and potential mechanisms of action of the training. T-tests for dependent samples were employed to test for differences between baseline and post-intervention.

Results

Significant improvements were found in two of three burnout components (emotional exhaustion and personal accomplishment), anxiety, stress, two emotional regulation competences and joy at work. Furthermore, 85% of the individual goals were attained. Compliance and acceptance rates were high and qualitative data revealed a perceived enhancement of self-care, the integration of mindful pauses in work routines, a reduction in rumination and distress generated in the patient contact as well as an enhancement of interpersonal connection skills. An improvement of team communication could also be identified.

Conclusions

Our findings suggest that the training may be a feasible, effective and practical way of reducing caregiver-distress and enhancing the resources of palliative care teams.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501358/

Mindfulness Impairs the Formation of Automatic Habits

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Mindfulness Impairs the Formation of Automatic Habits

 

By John M. de Castro, Ph.D.

 

“The very fact of paying too much attention or being too aware of stimuli coming up in these tests might actually inhibit implicit learning. That suggests that mindfulness may help prevent formation of automatic habits — which is done through implicit learning — because a mindful person is aware of what they are doing.” – Chelsea Stillman

 

When people think of learning they’re usually visualizing learning information like historical facts, people’s names, mathematical formulas, etc. This is called explicit memory. But, there’s another very important form of learning, called implicit learning, which is learning how to perform automatic tasks rapidly and efficiently. Things like riding a bike, playing a musical instrument, serving a tennis ball and tying your shoelaces all require implicit learning and memory.

 

Implicit learning requires the person to actually perform and practice a task to master it. Many athletic skills fall into this category. The skills are mastered with repetition so that they can be performed instinctively and mindlessly when needed. Implicit learning also involves most mundane tasks that we perform constantly throughout our day. Walking, producing speech, even typing this sentence on a keyboard all involve implicitly learned skills. So, implicit learning is important and helps to reduce the cognitive load on our nervous system for everyday behaviors. We don’t have the think about them so we can devote our brain capacity to higher level thoughts and ideas.

 

It has been demonstrated that mindfulness helps with explicit learning, such as academic material. For example, mindfulness training can improve college entrance exam scores in students. But, mindfulness appears to disrupt implicit learning. In today’s Research News article “Task-Related Functional Connectivity of the Caudate Mediates the Association Between Trait Mindfulness and Implicit Learning in Older Adults.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4955759/, Stillman and colleagues examine this disruptive effect of mindfulness and the neural systems responsible.

 

They recruited a group of healthy young adults (aged 18-37 years) and a group of healthy older adults (aged 60-90 years). They were measured for mindfulness and they completed an established implicit learning task. The task, Triplets Learning Task, involves a presentation of three stimuli with, unbeknownst to the participant, some triplets occurring more frequently than others. In general, people learn to respond to the more frequent triplets faster without awareness that there’s any difference between sets. In other words, they learn implicitly. While they were performing this task, their brains were scanned with functional Magnetic Resonance Imaging (f-MRI).

 

The researchers found that for the younger group, there was no significant relationship between mindfulness and implicit learning. On the other hand, the older group had a significant relationship between mindfulness and implicit learning with the higher the mindfulness score, the lower the score on the Triplets Learning Task. Hence, mindfulness disrupted implicit learning in older but not younger participants.

 

Investigating the brain scans of this older group, they found that the degree of relationship between mindfulness and implicit learning was related to the level of connectivity between the Caudate Nucleus and the Medial Temporal Lobe, a system previously shown to be associated with implicit learning. In particular, the greater the connectivity the better the implicit learning, but the greater the mindfulness, the lower the connectivity. A further mediational analysis indicated that the negative influence of mindfulness on implicit learning was mediated by its negative effect on the connectivity. In other words, mindfulness changed the brain which resulted in disruption of implicit learning.

 

These are complicated findings. But, they are particularly interesting as they suggest that mindfulness effects the brain and this produces the behavioral effects. The results suggest that the disruptive influence of mindfulness on implicit learning occurs primarily in older adults and that it is mediated by mindfulness’ negative influence on the functional connectivity of the Caudate Nucleus with the Medial Temporal Lobe. It is known that there is deterioration in the Caudate Nucleus and the Medial Temporal Lobe with aging. It is possible, then, that mindfulness can only exert its disruptive effects when there is an already weakened Caudate Nucleus – Medial Temporal Lobe system present.

 

It is interesting that mindfulness did not disrupt implicit learning in the younger participants. This might explain why mindfulness training improves athletic performance. Athletes are generally young and the lack of disruption of implicit learning by mindfulness allows mindfulness to produce psychological enhancements that improve performance. This might not be true for older athletes.

 

Regardless, it is clear that mindfulness disrupts the establishment of automatic unconscious habits in older adults as a result of its negative effects on the interaction of two brain areas, Caudate Nucleus and the Medial Temporal Lobe.

 

“people reporting low on the mindfulness scale tended to learn more—their reaction times were quicker in targeting events that occurred more often within a context of preceding events than those that occurred less often.” – Georgetown University Medical Center

 

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

 

Stillman, C. M., You, X., Seaman, K. L., Vaidya, C. J., Howard, J. H., & Howard, D. V. (2016). Task-Related Functional Connectivity of the Caudate Mediates the Association Between Trait Mindfulness and Implicit Learning In Older Adults. Cognitive, Affective & Behavioral Neuroscience, 16(4), 736–753. http://doi.org/10.3758/s13415-016-0427-2

 

Abstract

Accumulating evidence shows a positive relationship between mindfulness and explicit cognitive functioning, i.e., that which occurs with conscious intent and awareness. However, recent evidence suggests that there may be a negative relationship between mindfulness and implicit types of learning, or those that occur without conscious awareness or intent. Here we examined the neural mechanisms underlying the recently reported negative relationship between dispositional mindfulness and implicit probabilistic sequence learning in both younger and older adults. We tested the hypothesis that the relationship is mediated by communication, or functional connectivity, of brain regions once traditionally considered to be central to dissociable learning systems: the caudate, medial temporal lobe (MTL), and prefrontal cortex (PFC). We first replicated the negative relationship between mindfulness and implicit learning in a sample of healthy older adults (60–90 years old) who completed three event-related runs of an implicit sequence learning task. Then, using a seed-based connectivity approach, we identified task-related connectivity associated with individual differences in both learning and mindfulness. The main finding was that caudate-MTL connectivity (bilaterally) was positively correlated with learning and negatively correlated with mindfulness. Further, the strength of task-related connectivity between these regions mediated the negative relationship between mindfulness and learning. This pattern of results was limited to the older adults. Thus, at least in healthy older adults, the functional communication between two interactive learning-relevant systems can account for the relationship between mindfulness and implicit probabilistic sequence learning.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4955759/

Reduce Pain with Mindfulness

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Reduce Pain with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is an effective practice for approaching chronic pain. It teaches individuals to observe their pain, and be curious about it. And, while counterintuitive, it’s this very act of paying attention that can help your pain.” –  Margarita Tartakovsky

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans and 1.5 billion people worldwide, have common chronic pain conditions. It is important to remember that pain is an important signal that there is something wrong or that damage is occurring. This signals that some form of action is needed to mitigate the damage. This is an important signal that is ignored at the individual’s peril. So, in dealing with pain, it’s pain signals should not be completely blocked or prevented. They need to be perceived. But, methods are needed to mitigate the pain and the psychological distress produced.

 

The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and prescription opioid overdoses kill more than 14,000 people annually. The situation in the U.S. with opioid overdoses has become so severe that it’s taken on epidemic proportions. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the patient’s ability to cope with the pain. Pain involves both physical and psychological issues. The stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. So, reducing perceived stress and the emotional reactions to pain may be helpful in pain management. Indeed, mindfulness practices have been shown to reduce the physiological and psychological responses to stress and to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. As a result, mindfulness practices have been shown to be effective in treating pain.

 

In today’s Research News article “Mindfulness meditation–based pain relief: a mechanistic account.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4941786/, Zeidan and Vago review the published research literature on the effectiveness of mindfulness practices in the treatment of pain. They report that the scientific research finds that mindfulness practices are safe and effective in treating perceived pain from a wide variety of conditions, including fibromyalgia, migraine, chronic pelvic pain, irritable bowel syndrome, and chronic low back pain.

 

Further, they report that the reduction in perceived pain appears to result from alterations of the nervous system. In particular, long-term meditators have significant increased activation of sensory processing–related brain regions (thalamus, insula) and reduced activation in brain areas that process the evaluation of pain (Medial Prefrontal Cortex), Orbital Frontal Cortex). There was also a significant relationship between meditative experience, lower perceived pain, and greater deactivation of the Medial Prefrontal Cortex / Orbital Frontal Cortex. Even after only brief meditation practice changes can be detected in brain areas that process pain stimuli (insula and anterior cingulate cortex) and the psychological appreciation of pain (Orbital Frontal Cortex).

 

These findings strongly suggest that in response to mindfulness practices multiple areas of the brain change, resulting in reduced subjective pain. These benefits can be obtained by short-term mindfulness practice but are further improved with long-term practice. Hence, mindfulness practices appear to be safe and effective alternative treatments to drugs and thereby may be useful in addressing the opioid epidemic.

 

So, reduce pain with mindfulness.

 

“When it comes to chronic pain, the key is learning to live with it rather than vainly trying to avoid or eradicate it . . .  Mindfulness practice is a wonderful opportunity to do just that. It helps to shift the locus of control from the outside (“this is happening to me and there is nothing I can do about it”) to the inside (“this is happening to me but I can choose how I relate to it”).” -Christiane Wolf

 

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

 

Zeidan, F., & Vago, D. (2016). Mindfulness meditation–based pain relief: a mechanistic account. Annals of the New York Academy of Sciences, 1373(1), 114–127. http://doi.org/10.1111/nyas.13153

 

Abstract

Pain is a multidimensional experience that involves sensory, cognitive, and affective factors. The constellation of interactions between these factors renders the treatment of chronic pain challenging and financially burdensome. Further, the widespread use of opioids to treat chronic pain has led to an opioid epidemic characterized by exponential growth in opioid misuse and addiction. The staggering statistics related to opioid use highlight the importance of developing, testing, and validating fast-acting nonpharmacological approaches to treat pain. Mindfulness meditation is a technique that has been found to significantly reduce pain in experimental and clinical settings. The present review delineates findings from recent studies demonstrating that mindfulness meditation significantly attenuates pain through multiple, unique mechanisms—an important consideration for the millions of chronic pain patients seeking narcotic-free, self-facilitated pain therapy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4941786/

What is Mindfulness

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What is Mindfulness

 

By John M. de Castro, Ph.D.

 

 “Mindfulness is the aware, balanced acceptance of the present experience. It isn’t more complicated than that. It is opening to or receiving the present moment, pleasant or unpleasant, just as it is, without either clinging to it or rejecting it.” ~Sylvia Boorstein

 

Mindfulness has become a buzzword that is used in many contexts with many different meanings. There is no single definition that is agreed upon by the research and practitioner communities.  In fact, there are many different definitions. Arguably the most commonly used definition and the one that I prefer, is the definition proposed by Jon Kabat-Zinn. “Mindfulness means paying attention in a particular way; on purpose, in the present moment, and nonjudgmentally.”

 

This definition contains a number of important components that help to better understand exactly what mindfulness is. Firstly, mindfulness is “paying attention.” But, not just letting the mind settle somewhere passively, but “on purpose.” That makes it an active process; a willful choice. With mindfulness, the mind is not aimlessly wandering. Rather it is focused.

 

The problem comes up, though, that our minds are unruly. In fact, the mind is often referred to as a “monkey mind,” implying that it jumps around in an untamed and unruly fashion. This is without a doubt true. Matt Killingsworth sampled people’s thinking at unpredictable times during the day and discovered that 47% of the time people’s minds were off-topic, that is, they were thinking about something else other than what was going on at the moment. They were not mindful almost half the time.

 

It is often a shock for people to discover that a large amount of the time they are not controlling their minds. Rather, the mind appears to be some extent controlling what they are experiencing. Most people suffer from the illusion that they are in control. So, it is eye opening to discover that frequently they are not. To get control of the mind and keep it paying attention to what is going on in the moment requires a degree of effort. But, even then the mind tends to wander off, thinking about past events, planning for the future, or simply day dreaming. Fortunately, mind wandering can be reduced with practice. But, even highly trained mindfulness practitioners have frequent lapses where the mind goes off by itself into topics far removed from the present. So, no one should expect to be able to completely control the mind, just hope to control it better.

 

A second important aspect of the definition is that, in mindfulness, attention is directed to what is occurring in the “present moment.” That seems straightforward until one tries to define exactly what portion in time is the present moment. Our first inclination is to think of the present moment as instantaneous, exactly this particular moment only. But with a little reflection it becomes obvious that what we experience as the present moment actually extends back in time a short ways and also forward slightly into the future. If it didn’t extend back in time we could never see motion, as we wouldn’t be aware of a change from a previously seen position. For that matter, we wouldn’t be able to hear a full word, only the immediate sound. Obviously this is not the case, because the present moment actually contains a little bit of the past. Demonstrating that the present actually extends a little into the future is more difficult and subtle to detect. But, if we interrupt speech in the middle of a sentence, you will find that you seemingly “hear” the next syllable or word that the mind is expecting to appear or if we interrupt a movie you seemingly “see” the next frame.

 

The total amount of time constituted by the present moment is difficult to precisely define. Marc Wittmann asserts that before we can answer that question of how long is now we must first define exactly what we mean by the present moment. He identifies three different ideas of the present moment; functional moment, experienced moment, and mental presence. The most pertinent for our discussion of mindfulness is the experienced moment, the subjective present. It is an experienced now within an ongoing stream of events. For example, while listening to music a note does not stand alone in consciousness but is joined by the prior note and the expected future note. In speech, each word is perceived in reference to past and expected words, as in the phrase “how are you”. When we hear “are” we process it recognizing that it’s in reference to a question, “How” and due to our learning we also experience the “are” with the expectation of a following word “you”. It’s been estimated that the experienced moment lasts somewhere up to 3 seconds. So, when we refer to present moment awareness we are referring not to an instant but to the approximately 3 seconds that we experience as the present.

 

A third important aspect of the definition is that, in mindfulness there is no judgment of experience. This indicates that when we are mindful we are simply experiencing things as they are without evaluation. It is important to note that it is value judgments that are absent. Making judgments about the likely course of events and what actions are needed is actually a part of mindfulness. If we’re driving mindfully we are constantly judging whether we need to slow down or turn to avoid hitting another car, whether we can safely make it through a traffic light that is about to change, whether a car may pull out in front of us. If we are driving mindfully we’re making these judgments but totally aware the whole time of what is happening.

 

The non-judgmental aspect of mindfulness involves value judgments about what we’re experiencing. Things are not good or bad, pleasant or unpleasant, liked or disliked, happy or sad, worthwhile or worthless, etc. They simply are. Although seemingly simple, this is actually devilishly difficult to do. The mind has been trained pretty much since birth to judge everything. This is actually quite good and adaptive, allowing us to decide if we should approach and acquire things we need or to avoid things that could do us harm. But, the judgment goes on even when it has little consequence toward survival. So, we see another person and classify them as attractive, or smart, or boring, or obnoxious, or rich, or a fool, or friendly, or a rival, etc. We hear a loud sound and we immediately think it’s threatening, or unnecessary noise, or enjoyable, or someone being inconsiderate, etc. We taste a food and immediately think that it’s delicious, or sour, or nauseating, or healthful, etc. We are constantly judging.

 

Being non-judgmental requires quieting the mind. If left to itself, the mind will always judge. So, to be mindful we need to shut off the evaluating chatter. Just experiencing everything as it is, as a pure and simple experience. It’s actually quite amazing what happens when judgment is turned off. Suddenly, we begin to appreciate even the simplest of things which begin to shine and stand out in their own unique way. Another person is simply seen as another human being with needs and desires, and a consciousness, just like us, a reflection of our own humanness. An odor can be experienced as a unique sensation that will never be repeated exactly the same again. Just breathing can be experienced fully as a series of movements and sensations that arise and fall away and the repeat over and over again, automatically, without direction or thought, each time revitalizing and nourishing our physical being, leading to a recognition of physiology at work. These are just some of the fruits of mindfulness.

 

It is very difficult to stop the judging even for brief periods of time. But, again practice comes to the rescue. Over time, if the effort is expended, judging slowly decreases and stops for longer and longer periods of time. Don’t expect to ever be able to stop judging completely. This would be a battle with you mind that can’t be won. Just expect that you can become better at looking at things as they are without value judgments and be able to maintain it for a longer period of time.

 

The final aspect of the definition that needs amplification and discussion is the notion that mindfulness involves paying attention in “a particular way.” Unfortunately, this is a rather ambiguous phrase that actually refers to a very important component of mindfulness. The “particular way” refers to attention primarily to immediate sensory experience. It could be focused on a particular component, aspect, or thing, or it could be broadly on all that is immediately present. The key is that it is a total appreciation of what is without any attempt to hold onto it, letting it arise, and fall away without grasping at it or attempting to change it. The experiences can include feelings, bodily sensations, and the surrounding environment and even thoughts. But observing the thoughts as just another thing arising, and falling away, with no attempt to hold onto them, elaborate on them, judge them, or associate them with any other thoughts just letting them flow through awareness and fall away like a cloud passing over the horizon. In other words, thinking can be mindful if we are completely aware of what we are doing and not getting carried away and lost in the thoughts.

 

This is a rather idealized conception of mindfulness. In practice, one can be very mindful without coming even close to this description. This discourse should be looked on as describing the model, the ideal, with it understood that reality will in fact be a diluted or compromised version of this ideal. One can be very mindful and still judge the experience, as long as there’s a recognition that that is what is happening. One can be very mindful and still bring in memories from the past or plans for the future, as long as there’s an awareness that these are not an essential part of the experience but the minds embellishments. One can be very mindful and still

Try to maintain a feeling or keep an enjoyable experience going, as long as one recognizes that what you are doing is simply another part of present moment experience. It is even possible, albeit difficult, to daydream mindfully as long as you are completely aware that this is what you’re engaging in completely under willful control. In other words, mindfulness need not be perfect, it only experiencing things as they are, in the present moment, without judgment.

 

One problem with the definition is that it specifies the processes involved in mindfulness but neglects to specify exactly what entity is being mindful. It doesn’t specify who or what is attending, who or what is producing the purpose, who or what is not judging, who or what is having the immediate experience. When these questions arise, it’s a sign that the issue has moved from mindfulness to the spiritual side of mindfulness, who or what is aware. This is not the place for a discussion of these aspects of mindfulness. But, it is important to recognize that this definition and description of mindfulness only scratches the surface. There are deeper levels to mindfulness to be explored.

 

“Mindfulness is the process of actively noticing new things. When you do that, it puts you in the present. It makes you more sensitive to context and perspective. It’s the essence of engagement.” – Ellen Langer

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

Reduce Compulsive Sexual Behavior with Mindfulness

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Reduce Compulsive Sexual Behavior with Mindfulness

 

By John M. de Castro, Ph.D.

 

“ve Sexual Behavior with Mindfulnessfeeling ashamed of one’s sexual desires, interests, fetishes, and so on, only makes one feel more obsessive and compulsive about them, rather than the opposite. . .. Mindfulness practice helps my clients to observe their reactions to themselves in accepting and non-judgmental ways. Also, they learn to catch and become aware of the negative thoughts and emotions that arise that make them feel compelled to act out.” – Michael Aaron

 

Sexual behavior is a very important aspect of human behavior, especially for reproduction. In fact, Sigmund Freud made it a centerpiece of his psychodynamic theory. At its best, it is the glue that holds families and relationships together. But, it is a common source of dysfunction and psychosocial problems. Compulsive sexual behavior “encompasses problems with preoccupation with thoughts surrounding sexual behavior, loss of control over sexual behavior, disturbances in relationships due to sexual behavior, and disturbances in affect (e.g., shame) due to sexual behavior.” It is also called sex addiction and hypersexuality. It is chronic and remarkably common affecting 3% to 17% of the population. In addition, it is associated with substance abuse in around half of people with compulsive sexual behavior.

 

Compulsive sexual behavior is frequently treated with psychotherapy, Cognitive Behavioral, Therapy, or drugs with mixed success. Since, it is also looked at as an addiction and mindfulness treatment has been found to be effective for both sexual dysfunction and for addictions, mindfulness may be affective for individuals with both substance abuse and compulsive sexual behavior. As a first step in evaluation this possibility, the relationship between mindfulness and compulsive sexual behavior needs to be investigated in these individuals.

 

In today’s Research News article “The relationship between mindfulness and compulsive sexual behavior in a sample of men in treatment for substance use disorders.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4996480/, Shorey and colleagues recruited men in a residential treatment center for substance abuse. Upon admission to the facility and after withdrawal from drugs the men completed a battery of tests including measures of mindfulness, alcohol use, drug use, and compulsive sexual behavior, including preoccupation, loss of control, relationship disturbance, and affect (emotional) disturbance.

 

They found that the higher the level of mindfulness that the men had the lower the levels of drug use, alcohol use, and compulsive sexual behavior, including preoccupation, loss of control, relationship disturbance, and affect disturbance. These relationships with compulsive sexual behavior remained significant and negative even when drug and alcohol use were factored in. In contrast, drug use was not related to compulsive sexual behavior, except for a positive relationship with relationship disturbance. So, although there’s high comorbidity between substance abuse and compulsive sexual behavior, they don’t appear to be highly related.

 

These are encouraging results that suggest that mindfulness may be an antidote for compulsive sexual behavior in patients with substance abuse. These results, however, are correlative and so causation cannot be concluded and are only applicable to men. The next step, of course, will be to form a randomized clinical trial of the effects of mindfulness training on compulsive sexual behavior in patients with substance abuse in both men and women to establish the efficacy of mindfulness training as a treatment. It is possible that mindfulness training will be effective for the treatment of both substance abuse and compulsive sexual behavior in both genders.

 

So, reduce compulsive sexual behavior with mindfulness.

 

“findings tentatively support the usefulness of mindfulness in the effective treatment of sex addiction. In addition to helping bring about a reduction in dysfunctional sex-related actions, fantasies and thoughts, mindfulness training may help affected individuals gain improved emotional control, an increased ability to handle stressful situations and improved resistance to any potentially damaging sex-related urges that arise.” – The Ranch

 

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

 

Shorey, R. C., Elmquist, J., Gawrysiak, M. J., Anderson, S., & Stuart, G. L. (2016). The relationship between mindfulness and compulsive sexual behavior in a sample of men in treatment for substance use disorders. Mindfulness, 7(4), 866–873. http://doi.org/10.1007/s12671-016-0525-9

 

Abstract

Substance use disorders (SUDs) are a serious worldwide problem. Despite years of research on the treatment of SUDs, relapse remains high. One factor that may complicate SUDs treatment for some patients is compulsive sexual behavior. Factors that are related to both SUDs and compulsive sexual behavior could be targeted in SUDs treatment. In the current study, we examined dispositional mindfulness, a protective factor for a range of mental health problems, and its relationship to compulsive sexual behavior in a SUDs treatment sample. This is the first study to examine this relationship in a SUDs sample. Medical records from men in residential SUDs treatment were reviewed for the current study (N = 271). Upon admission to treatment, men completed self-report measures on alcohol and drug use, dispositional mindfulness, and compulsive sexual behavior. Bivariate correlations demonstrated dispositional mindfulness to be negatively associated with a variety of indicators of compulsive sexual behavior. After controlling for alcohol and drug use and problems in hierarchical regression analyses, which were both associated with compulsive sexual behaviors, dispositional mindfulness remained negatively associated with all of the compulsive sexual behavior indicators. Our results provide the first empirical association between dispositional mindfulness and compulsive sexual behavior in a SUDs sample. Although continued research is needed in this area, our findings suggest that it may be beneficial for SUDs treatment to incorporate mindfulness-based interventions for individuals with comorbid compulsive sexual behavior.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4996480/

Change the Brain with Mindfulness

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Change the Brain with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The picture we have is that mindfulness practice increases one’s ability to recruit higher order, pre-frontal cortex regions in order to down-regulate lower-order brain activity. In other words, our more primal responses to stress seem to be superseded by more thoughtful ones.” – Tom Ireland

 

There has accumulated a large amount of research demonstrating that meditation has significant benefits for psychological, physical, and spiritual wellbeing. 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 mood and happiness to severe mental and physical illnesses. This raises the question of how meditation could do this. 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 results of the research concerning the changes in the brain that occur with mindfulness practice have not presented a consistent picture. One issue may be the way that mindfulness is measured. This issue was explored in today’s Research News article “A distinction between two instruments measuring dispositional mindfulness and the correlations between those measurements and the neuroanatomical structure.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5524689/, Zhuang and colleagues compared Magnetic Resonance Images (MRIs), depression, and emotion regulation, between college students who had been measured for mindfulness with Mindful Attention Awareness Scale (MAAS) to those measured with the Five Factor Mindfulness Questionnaire (FFMQ).

 

They found that higher MAAS scores and FFMQ Describing, Acting with Awareness, and Non-judging scores the lower levels of depression. In addition, higher FFMQ Describing scores were significantly associated with higher emotion regulation. In regard to the brain scans they found that the higher the MAAS score the greater the size of the Precuneus area of the cortex. Mediation analysis demonstrated that the higher the volume of the precuneus cortical region the higher the MAAS score which in turn was associated with lower depression. So, mindfulness as measured by the MAAS was associated greater volume of the precuneus and was responsible for the relationship of the Precuneus volume with depression.

 

In regard to mindfulness measured with the FFMQ and the brain scans they found that the larger the size of the Superior Prefrontal Cortex, the higher the Describing and Non-judging facets and the lower the Non-reacting facet. In addition, the larger the size of the dorsolateral prefrontal cortex and the inferior parietal cortex the higher the Describing FFMQ facet. Mediation analysis demonstrated that the higher the volume of the Superior Prefrontal Cortex the higher the Describing FFMQ facet which in turn predicted higher emotion regulation. So, mindfulness as measured with the Describing FFMQ facet was associated greater size of the Superior Prefrontal Cortex and was responsible for the relationship of the Superior Prefrontal Cortex size with emotion regulation.

 

These results are interesting and suggest that the kind of relationship observed between changes in the brain and mindfulness is affected by the way mindfulness is measured. This could account for some of the conflicting findings in the published research. Also, since the Precuneus is associated with awareness of self, the results suggest that mindfulness as measured by the MAAS mainly measures self-awareness while since the inferior parietal cortex is also associated with awareness of self, the results suggest that mindfulness as measured by the Describing FFMQ facet also measures self-awareness. But the FFMQ mindfulness measure goes further and also documents other abilities. Since, the Prefrontal cortex is associated with attention control and emotion regulation, the results suggest that mindfulness as measured by the Describing and Non-reacting FFMQ facets also measure attention control and emotion regulation.

 

Clearly, mindfulness is associated with different sizes of areas in the brain’s cortical regions. But, even though the brain is different with mindfulness, the types of differences observed depends upon how mindfulness is measured. The Five Factor Mindfulness Questionnaire (FFMQ) measure appears to be superior to the Mindful Attention Awareness Scale (MAAS) as it breaks mindfulness down into component parts providing greater refinement in observed brain changes. These results will be helpful in future research unravelling the relationship of mindfulness to the characteristics of the nervous system.

 

“The practice of mindfulness can train our brains to have a new default. Instead of automatically falling into the stream of past or future rumination that ignites the depression loop, mindfulness draws our attention to the present moment. As we practice mindfulness, we actually start wiring neurons that balance the brain in a way that is naturally an antidepressant. “ – Debbie Hampton

 

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

 

Zhuang, K., Bi, M., Li, Y., Xia, Y., Guo, X., Chen, Q., … Qiu, J. (2017). A distinction between two instruments measuring dispositional mindfulness and the correlations between those measurements and the neuroanatomical structure. Scientific Reports, 7, 6252. http://doi.org/10.1038/s41598-017-06599-w

 

Abstract

The most widely used measurements of mindfulness are the Mindful Attention Awareness Scale (MAAS) and the Five Facet Mindfulness Questionnaire (FFMQ). However, controversies exist regarding the application of these scales. Additionally, the neural mechanisms of dispositional mindfulness have become a topic of interest. In the current study, we used surface-based methodology to identify the brain regions underlying individual differences in dispositional mindfulness in a large non-clinical sample and compared the two instruments for measuring the dispositional mindfulness. The results indicated that the MAAS scores were significantly associated with increased grey matter volumes in the right precuneus and the significant association between the precuneus and depression symptomatology was mediated by MAAS scores. Regarding the FFMQ, the Describing, Nonjudging, and Nonreactivity facets were selectively associated with the cortical volume, thickness and surface area of multiple prefrontal regions as well as the inferior parietal lobule. Importantly, Describing mediated the association between the dorsolateral PFC volume and the cognitive reappraisal strategies of emotion regulation. These results suggested that the MAAS were mainly associated with self-awareness, while the FFMQ facets were selectively involved in emotion regulation, attention control and self-awareness. Therefore, this study characterized the differences in inter-individual variability between the two typical measurements of dispositional mindfulness and the correlations between those measurements and imaging analyses.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5524689/

Reduce Depression and Anxiety Around Pregnancy with Mindfulness

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Reduce Depression and Anxiety Around Pregnancy with Mindfulness

 

By John M. de Castro, Ph.D.

 

“By learning mindfulness skills as part of their childbirth education, expectant mothers can reappraise the impending birth as something they can handle instead of viewing it as something to fear.” – Larissa Duncan

 

The perinatal period, from the onset of pregnancy to the end of the infants first year, is a time of intense physiological and psychological change in both the mother and the infant. Anxiety, depression, and fear are quite common during pregnancy. More than 20 percent of pregnant women have an anxiety disorder, depressive symptoms, or both during pregnancy. A debilitating childbirth fear has been estimated to affect about 6% or pregnant women and 13% are sufficiently afraid to postpone pregnancy. It is difficult to deal with these emotions under the best of conditions but in combinations with the stresses of pregnancy can turn what could be a joyous experience of creating a human life into a horrible worrisome, torment.

 

The psychological health of pregnant women has consequences for fetal development, birthing, and consequently, child outcomes. Depression during pregnancy is associated with premature delivery and low birth weight. Childbirth fear is associated with “low childbirth self-efficacy, greater use of pain medication during labor, more unwanted obstetric interventions in labor, as well as increased risk of postpartum depression.” Hence, it is clear that there is a need for methods to treat childbirth fear, depression, and anxiety during pregnancy. Since the fetus can be negatively impacted by drugs, it would be preferable to find a treatment that did not require drugs. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy. So, it would make sense to study the effects of mindfulness training during the perinatal period.

 

In today’s Research News article “The Effectiveness of Mindfulness-Based Interventions on Maternal Perinatal Mental Health Outcomes: a Systematic Review.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506176/, Shi & MacBeth reviewed the published research literature on the effectiveness of mindfulness training on the emotional states of women in the perinatal period. They found 18 published studies that employed Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), or mindful yoga as the treatment for anxiety and depression during the perinatal period.

 

They found that the research indicated that mindfulness-based treatments were particularly effective for anxiety and to a lesser extent for depression and its recurrence. The treatments were reported to be safe, with no appreciable negative side effects, and acceptable, with low drop out rates. They note that there is a need for more highly controlled randomized controlled trials that include active control conditions in the future.

 

The results from the summarized 18 studies suggest that mindfulness based interventions are safe and effective treatment for perinatal anxiety and depression. Mindfulness practices have been shown to increase the focus on the present moment. Anxiety tends to revolve around the future while depression appears to revolve around the past. By focusing the individual on what is occurring in the present moment mindfulness training appears to decrease thinking about the past or the future and may thereby reduce anxiety and depression. Mindfulness training has also been shown to reduce the physiological and psychological responses to stress. The reduction in stress responses during the high stress perinatal period may also contribute to the women’s improved mood.

 

So, reduce depression and anxiety around pregnancy with mindfulness.

 

“Since mindfulness has a lot to do with being in touch with the sensations in your body, and being aware, new moms are in a prime state to learn it! In fact, pregnancy and early motherhood, nursing and sleep disturbance, weight gain and weight loss-these all in some way force you to be in your body. For those of us who live most of our lives above our necks, this can actually be a great blessing.” – Cassandra Vieten

 

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

 

Shi, Z., & MacBeth, A. (2017). The Effectiveness of Mindfulness-Based Interventions on Maternal Perinatal Mental Health Outcomes: a Systematic Review. Mindfulness, 8(4), 823–847. http://doi.org/10.1007/s12671-016-0673-y

 

Presenting with common mental health difficulties, particularly depression and anxiety, there is also preliminary evidence that mindfulness-based interventions (MBIs) including mindfulness-based cognitive therapy (MBCT), mindfulness-based stress reduction (MBSR) and integrated mindfulness yoga practices may also be effective in reducing common mental health difficulties during pregnancy. We systematically reviewed and synthesized the current literature on the effectiveness of MBIs in reducing severity of perinatal anxiety and depression. Databases including PubMed, Cochrane Library, IndMED and PsychoInfo were searched for relevant studies. Manual searches were conducted in relevant articles and Google Scholar. Seventeen cohorts representing 18 studies were included. Pre-post effect sizes were reported for both treatment and control groups. Seven randomized controlled trials (RCTs), two non-randomized controlled trials and nine treatment evaluations were included. Maternal participation in an MBI was associated with reductions in perinatal anxiety of moderate to large magnitude. Results for the effect of MBIs on depression were less consistent, with pre-post treatment reductions of moderate magnitude, but no significant differences in depression scores when MBI was compared with a control group. There was some evidence that MBIs were associated with increased mindfulness. Risk of bias in studies was variable. Our review offers preliminary evidence for the effectiveness of MBIs in reducing perinatal anxiety, with more equivocal findings with regard to perinatal depressive symptoms. Further methodologically rigorous evaluation using RCTs and longer follow-up periods are recommended.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506176/