Mindfulness

Different Mindfulness Facets Have Differing Associations with Depersonalization Symptoms

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Different Mindfulness Facets Have Differing Associations with Depersonalization Symptoms

 

By John M. de Castro, Ph.D.

 

“Depersonalization symptoms can be tough to deal with, especially when you’re experiencing them 24/7. But just remember they’re caused by anxiety, and they’re part of your body’s defense mechanism to protect you from a traumatic experience.” – Shaun O’Conner

 

Depersonalization is defined as “Depersonalization/derealization disorder involves a persistent or recurring feeling of being detached from one’s body or mental processes, like an outside observer of one’s life (depersonalization), and/or a feeling of being detached from one’s surroundings (derealization).” – Merck Manuals. It is not known what the relationship is between mindfulness and depersonalization. In some ways it would be expected that mindfulness would be the antithesis of depersonalization. But in others it may actually exacerbate it as there are similarities with spiritual awakening.

 

In today’s Research News article Mindfulness and Depersonalization: a Nuanced Relationship.(See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9043097/ ) Levin and colleagues recruited healthy adults online and had them complete measures of depersonalization symptoms, anxiety, depression, perceived stress, and the five facets of mindfulness.

 

They found that the higher the levels of depersonalization symptoms the higher the levels of psychological distress and the observing and nonreactivity facets of mindfulness and the lower the levels of the acting with awareness and nonjudging facets. The relationships of depersonalization with the mindfulness facets were still significant even after controlling for the levels of psychological distress.

 

The reported relationships of depersonalization with the acting with awareness and nonjudging facets of mindfulness makes sense that they are clearly indicative of attachment with the outside environment. On the other hand, the positive relationships with observing internal experience and nonreactivity makes sense as they have internal focus and depersonalization involves detachment from the internal experiences. So, using mindfulness training as a treatment for depersonalization is probably not a good idea.

 

So, mindfulness has a complex relationship with depersonalization.

 

“Sufferers of depersonalization and long-term meditators make surprisingly similar reports about reductions in their experience of being agents of their actions and as owners of their thoughts and behaviors.” – George Deane

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Levin, K. K., Gornish, A., & Quigley, L. (2022). Mindfulness and Depersonalization: a Nuanced Relationship. Mindfulness, 1–11. Advance online publication. https://doi.org/10.1007/s12671-022-01890-y

 

Abstract

Objectives

Although depersonalization has been described as the antithesis of mindfulness, few studies have empirically examined this relationship, and none have considered how it may differ across various facets of mindfulness, either alone or in interaction. The present study examined the relationship between symptoms of depersonalization and facets of dispositional mindfulness in a general population sample.

Methods

A total of 296 adult participants (139 male, 155 female, 2 other) were recruited online via Qualtrics and completed the Cambridge Depersonalisation Scale; Depression, Anxiety, and Stress Scale; and Five Facet Mindfulness Questionnaire.

Results

Controlling for general distress, depersonalization symptoms were positively associated with Observe, Describe, and Nonreactivity facets and negatively associated with Acting with Awareness and Nonjudgment facets. After controlling for intercorrelations among the facets, depersonalization symptoms remained significantly associated with higher Nonreactivity and lower Acting with Awareness. The overall positive relationship between depersonalization symptoms and the Observe facet was moderated by both Nonjudgment and Nonreactivity. Specifically, higher Observing was related to increased depersonalization symptoms at low levels of Nonjudgment and to decreased symptoms at low levels of Nonreactivity.

Conclusions

The current study provides novel insight into the relationship between depersonalization symptoms and various aspects of mindfulness. Experiences of depersonalization demonstrated divergent relationships with mindfulness facets, alone and in interaction. The results may inform theoretical models of depersonalization and mindfulness-based interventions for depersonalization.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9043097/

 

Improve Anxiety and the Gut Microbiome with Mindfulness

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Improve Anxiety and the Gut Microbiome with Mindfulness

 

By John M. de Castro, Ph.D.

 

“A healthy gut can be different iterations of bacteria for different people, because it is this diversity that maintains wellness.” – Jennifer Wolkin

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. A characterizing feature of anxiety disorders is that the sufferer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Anxiety disorders have generally been treated with drugs. But there are considerable side effects, and these drugs are often abused. There are several psychological therapies for anxiety. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders.

 

The GI tract contains intestinal micro-organisms, flora, bacteria, known as the microbiome, that have major effects throughout the body through the bacteria-intestinal-brain axis. This can affect overall health and well-being including anxiety. So, it would make sense to investigate the relationship of mindfulness practice with anxiety and intestinal micro-organisms.

 

Mindfulness-Based Cognitive Therapy (MBCT) has been shown to be effective in treating anxiety disorders. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior. But whether MBCT affects both anxiety and the microbiome has not been investigated.

 

In today’s Research News article “Gut Microbiota Associated with Effectiveness And Responsiveness to Mindfulness-Based Cognitive Therapy in Improving Trait Anxiety.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8908961/ ) Wang and colleagues recruited young adults with high anxiety levels and a similar control group with normal anxiety levels. The high anxiety group were provided with 8 weekly 2.5 hour sessions of Mindfulness-Based Cognitive Therapy (MBCT). They were measured before and after treatment for anxiety, depression, resilience, and mindfulness. In addition, their feces were measured for microbiota.

 

They found that after Mindfulness-Based Cognitive Therapy (MBCT) there were significant decreases in anxiety and depression and significant increases in resilience and mindfulness. The gut microbiome significantly differed between the high anxiety group and the controls before trteatment in that the high anxiety participants had less bacterial diversity in the gut. But after MBCT the bacterial diversity levels increased to the levels of the healthy controls.

 

Hence, mindfulness training improves the psychological health of highly anxious young adults and simultaneously normalizes the deficiency in the bacterial diversity in the gut.

 

Mindfulness training is good for both physical and mental health.

 

“During stress, an altered gut microbial population affects the regulation of neurotransmitters mediated by the microbiome and gut barrier function. Meditation helps regulate the stress response, thereby suppressing chronic inflammation states and maintaining a healthy gut-barrier function.” – Ayman Mukerji Househam

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Wang, Z., Liu, S., Xu, X., Xiao, Y., Yang, M., Zhao, X., Jin, C., Hu, F., Yang, S., Tang, B., Song, C., & Wang, T. (2022). Gut Microbiota Associated With Effectiveness And Responsiveness to Mindfulness-Based Cognitive Therapy in Improving Trait Anxiety. Frontiers in cellular and infection microbiology, 12, 719829. https://doi.org/10.3389/fcimb.2022.71982

 

Abstract

Objective

Mindfulness-based interventions have been widely demonstrated to be effective in reducing stress, alleviating mood disorders, and improving quality of life; however, the underlying mechanisms remained to be fully understood. Along with the advanced research in the microbiota-gut-brain axis, this study aimed to explore the impact of gut microbiota on the effectiveness and responsiveness to mindfulness-based cognitive therapy (MBCT) among high trait anxiety populations.

Design

A standard MBCT was performed among 21 young adults with high trait anxiety. A total of 29 healthy controls were matched for age and sex. The differences in gut microbiota between the two groups were compared. The changes in fecal microbiota and psychological indicators were also investigated before and after the intervention.

Results

Compared with healthy controls, we found markedly decreased bacterial diversity and distinctive clusters among high trait anxiety populations, with significant overgrowth of bacteria such as Streptococcus, Blautia, and Romboutsia, and a decrease in genera such as Faecalibacterium, Coprococcus_3, and Lachnoclostridium. Moreover, MBCT attenuated trait anxiety and depression, improved mindfulness and resilience, and increased the similarity of gut microbiota to that of healthy controls. Notably, a high presence of intestinal Subdoligranulum pre-MBCT was associated with increased responsiveness to MBCT. Decreases in Subdoligranulum post-MBCT were indicative of ameliorated trait anxiety. The tryptophan metabolism pathways were significantly over-represented among high responders compared to low responders.

Conclusion

The significantly increased diversity post-MBCT added evidence to gut-brain communication and highlighted the utility of mycobiota-focused strategies for promoting the effectiveness and responsiveness of the MBCT to improve trait anxiety.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8908961/

 

Improve College Students’ Well-Being with Balanced Time Perspective and Mindfulness

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Improve College Students’ Well-Being with Balanced Time Perspective and Mindfulness

 

By John M. de Castro, Ph.D.

 

“a higher level of mindfulness promotes a more balanced time perspective, with a reduced focus on negative aspects of the past and negative anticipations of the future.” – Michael Rönnlund

 

Mindfulness stresses present moment awareness, minimizing focus on past memories and

future planning. But, to effectively navigate the environment it is necessary to remember past experiences and project future consequences of behavior. So, there is a need to be balanced such that the amount of attention focused on the past, present, and future is balanced. This has been termed as balance time perspective. Mindfulness helps improve balanced time perspective and improve well-being. The relationship of mindfulness and balanced time perspective with psychological well-being needs further investigation.

 

In today’s Research News article “Mindfulness and Balanced Time Perspective: Predictive Model of Psychological Well-Being and Gender Differences in College Students.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8946884/ ) Fuentes and colleagues recruited university students and had them complete measures of mindfulness, psychological well-being, and time perspective, including measures of past positive, past negative, present hedonistic, present fatalistic, and future.

 

They found that the higher the levels of mindfulness, the higher the levels of psychological well-being future, balanced time perspective and past positive time perspectives, and the lower the levels of balanced time perspective, past negative, and present fatalistic. In addition, the higher the levels of psychological well-being the higher the levels of balanced time perspective, future, and past positive time perspectives, and the lower the levels of past negative and present fatalistic. They also found that women had higher levels of past positive time perspective while men had higher levels of present hedonistic time perspective.

 

“It appears that, together, mindfulness and [balanced time perspective] promote optimal psychological functioning beyond alleviating or reducing discomfort.” – Authors conclusion. In other word when mindfulness is high and the amount of attention focused on the past, present, and future is balanced there are greater levels of psychological well-being. It remains to be seen if training in balanced time perspective will result in greater psychological health.

 

“Both mindfulness and Balanced Time Perspective (BTP) are well confirmed and robust predictors of various aspects of well-being.” – Maciej Stolarsk

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Fuentes, A., Oyanadel, C., Zimbardo, P., González-Loyola, M., Olivera-Figueroa, L. A., & Peñate, W. (2022). Mindfulness and Balanced Time Perspective: Predictive Model of Psychological Well-Being and Gender Differences in College Students. European journal of investigation in health, psychology and education, 12(3), 306–318. https://doi.org/10.3390/ejihpe12030022

 

Abstract

Background: The aims of the study were to establish an adjustment model to analyze the relationship among mindfulness, balanced time perspective (BTP) and psychological well-being (PWB) in college students and to explore gender differences among the variables. Method: The sample consisted of 380 college students, 220 women and 160 men, uniformly distributed according to the university’s faculties. Results: The results indicate that the synergy between mindfulness and BTP predicts the variance of PWB by 55%. Regarding gender differences, it was found that women have a greater tendency towards Past Positive than men and men a higher tendency towards Present Hedonistic than women. In addition, in the group of women, a stronger relationship was found among the variables and, consequently, a greater predictive value for PWB (58%), displaying an enhanced disposition to high PWB compared to men. Conclusions: Together, mindfulness and BTP promote optimal psychological functioning and alleviate or reduce discomfort. Thus, their promotion and training in universities is especially important given the high prevalence of anxiety and depressive symptoms in college students.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8946884/

 

Reduce the Ability of Impulsivity to Increase Competitive Anxiety in Female Athletes with Mindfulness

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Reduce the Ability of Impulsivity to Increase Competitive Anxiety in Female Athletes with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Awareness and acceptance of the present moment may allow athletes to focus less on negative thoughts, which may provide athletes with more energy and focus for the athletic tasks at hand.” – Crystal Chariton

 

Athletic performance requires the harmony of mind and body. Excellence is in part physical and in part psychological. That is why an entire profession of sports psychology has developed. “In sport psychology, competitive athletes are taught psychological strategies to better cope with a number of demanding challenges related to psychological functioning.” They use a number of techniques to enhance performance including mindfulness training. It has been shown to improve attention and concentration and emotion regulation and reduces anxiety and worry and rumination, and the physiological and psychological responses to stress. As a result, mindfulness training has been employed by athletes and even by entire teams to enhance their performance.

 

Impulsivity can be a negative characteristic for athletes and is associated with increased injury frequency. Anxiety is also a problem for athletes and can interfere with optimum performance. Mindfulness has been shown to reduce both impulsivity and anxiety. So, it makes sense to study the interactions of impulsivity, anxiety, and mindfulness in female athletes.

 

In today’s Research News article “Effects of Impulsivity on Competitive Anxiety in Female Athletes: The Mediating Role of Mindfulness Trait.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8951821/ ) Terres-Barcala and colleagues recruited adult female athletes and had the complete measures of physical activity pre-competition anxiety, impulsivity, self-efficacy, and mindfulness.

 

They found that the athletes with the most vigorous physical activity had significantly lower levels of impulsiveness and significantly higher levels of mindfulness. They also found that impulsiveness was positively related to anxiety and negatively associated with mindfulness such that mindfulness mitigated the relationship between impulsivity and both cognitive and somatic anxiety. In addition, impulsiveness was negatively related to self-efficacy and negatively associated with mindfulness such that mindfulness mitigated the relationship between impulsivity and self-efficacy.

 

Although the study was correlational and causation cannot be determined, the results suggest that impulsivity has a negative impact on female athletes’ mental state, but that mindfulness can reduce this impact. This further suggests that mindfulness may in part improve athletic performance by reducing impulsiveness and anxiety and increasing self-confidence and by mitigating the effect of impulsiveness on anxiety and self-confidence.

 

“When people are able simply to watch experiences come and go, rather than latch onto and overthink them, they are better able to intentionally shift their focus to their performance rather than distracting negative experiences such as anxiety.” – Keith Kaufman

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Terres-Barcala, L., Albaladejo-Blázquez, N., Aparicio-Ugarriza, R., Ruiz-Robledillo, N., Zaragoza-Martí, A., & Ferrer-Cascales, R. (2022). Effects of Impulsivity on Competitive Anxiety in Female Athletes: The Mediating Role of Mindfulness Trait. International journal of environmental research and public health, 19(6), 3223. https://doi.org/10.3390/ijerph19063223

 

Abstract

It has been demonstrated that athletes in competitive sports suffer from high levels of competitive anxiety, especially in the case of females. In this sense, it is necessary to identify possible risk and protective factors of those athletes in this collective who suffer from this type of anxiety. However, few studies analyze the relationship between Physical Activity (PA) and anxiety, identifying the possible mediation effect of trait variables such as impulsivity and mindfulness in female athletes. Hence, the aims of this study were: to determine differences between PA levels with anxiety, mindfulness, and impulsiveness; to identify the predictive value of sociodemographic factors and physical activity, impulsivity, and mindfulness on anxiety factors; and to analyze the possible mediating effects of mindfulness on the relationship between impulsivity and anxiety. A total of 242 female athletes underwent an assessment of physical activity, anxiety, mindfulness traits, and impulsivity using validated questionnaires. Data were analyzed according to (1) individual or collective sport, and (2) PA levels according to energy expended (METs min/day). Participants were grouped by light, moderate, and vigorous PA levels. There were 30.5% elite athletes and 73.2% collective sports athletes. Mean age was 22.1 years and mean light, moderate, and vigorous PA were 86.1 ± 136.2, 114.4 ± 159.8, and 370.1 ± 336.3 METs min/day, respectively. Those athletes performing vigorous PA exhibited lower levels of impulsiveness and higher mindfulness traits. As expected, the mindfulness trait was a mediating factor in the relationship between impulsiveness and each factor of competitive anxiety (cognitive, somatic, and self-efficacy). Female athletes could suffer competitive anxiety, especially those who present higher levels of impulsivity. However, higher levels of mindfulness traits seem to be a protective factor in the effects of impulsivity on anxiety in this population and have demonstrated to be significant mediators in this association. Further studies are needed with other female athletes to replicate these results and to determine the specific protective mechanisms of mindfulness traits in preventing competitive anxiety.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8951821/

 

Mindful Doctors are Better Doctors

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Mindful Doctors are Better Doctors

 

By John M. de Castro, Ph.D.

 

“Mindfulness enables doctors to listen to a patient without judging, to be present, responding to what the patient is saying and feeling and also aware of what they’re feeling.”- Ron Epstein

 

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

 

Preventing burnout has to be a priority. Unfortunately, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout. So, it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices have been shown to reduce the psychological and physiological responses to stress and improve well-being. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, and improving sleep. Thus there is a need to investigate how mindfulness effects doctors’ well-being and the well-being of their patients.

 

In today’s Research News article “). Effects of Mindfulness Meditation on Doctors’ Mindfulness, Patient Safety Culture, Patient Safety Competency and Adverse Event.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8954148/ ) Liu and colleagues recruited doctors from hospitals and randomly assigned them to receive either 8-weekly 90-minute sessions of mindfulness meditation along with home practice or to a no-treatment control condition. They were measured before and after training for mindfulness, patient safety competency, hospital safety culture, and adverse medical events.

 

They found that in comparison to baseline and the no-treatment control doctors, the group that received mindfulness training had significantly greater levels of mindfulness, patient safety competency, and hospital safety culture and significantly lower rates or adverse medical events.

 

Hence mindful meditation made the doctors better at patient safety including lower rates of bad outcomes. In other words, mindful doctors are better doctors.

 

“Anyone whose work involves immense human suffering needs to be aware of their inner life. The nature of the work that physicians do makes [them] more vulnerable to negative emotions or making errors,” – Ron Epstein

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Liu, C., Chen, H., Cao, X., Sun, Y., Liu, C. Y., Wu, K., Liang, Y. C., Hsu, S. E., Huang, D. H., & Chiou, W. K. (2022). Effects of Mindfulness Meditation on Doctors’ Mindfulness, Patient Safety Culture, Patient Safety Competency and Adverse Event. International journal of environmental research and public health, 19(6), 3282. https://doi.org/10.3390/ijerph19063282

 

Abstract

Objective: This study investigated the effects of mindfulness meditation on doctors’ mindfulness, patient safety culture, patient safety competency, and adverse events. Methods: We recruited 91 doctors from a hospital in China and randomized them to mindfulness meditation group (n = 46) and a waiting control group (n = 45). The mindfulness meditation group underwent an 8-week mindfulness meditation intervention, while the control group underwent no intervention. We measured four main variables (mindfulness, patient safety culture, patient safety competency, and adverse event) before and after the mindfulness meditation intervention. Results: In the experimental group, mindfulness, patient safety culture and patient safety competency were significantly higher compared with those of the control group. In the control group, there were no significant differences in any of the three variables between the pre-test and post-test. Adverse events in the experimental group were significantly lower than in the control group. Conclusions: The intervention of mindfulness meditation significantly improved the level of mindfulness, patient safety culture and patient safety competency. During the mindfulness meditation intervention, the rate of adverse events in the meditation group was also significantly lower than in the control group. As a simple and effective intervention, mindfulness meditation plays a positive role in improving patient safety and has certain promotional value.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8954148/

 

Reduce Opioid Dependence in Chronic Pain Patients with Mindfulness

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Reduce Opioid Dependence in Chronic Pain Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“meditation involves endogenous opioid pathways, mediating its analgesic effect and growing resilient with increasing practice to external suggestion.” – Haggai Sharon

 

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. 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 treat substance abuse and prevent relapse, but an effective treatment has been elusive. Most programs and therapies to treat addictions have poor success rates. Recently, mindfulness training has been found to be effective in treating addictions and preventing relapses. Mindfulness-Oriented Recovery Enhancement (MORE) was developed to treat patients with opioid addictions. It involves mindful breathing and body scan meditations, cognitive reappraisal to decrease negative emotions and craving, and savoring to augment natural reward processing and positive emotion.

 

In today’s Research News article “Mindfulness-Oriented Recovery Enhancement vs Supportive Group Therapy for Co-occurring Opioid Misuse and Chronic Pain in Primary Care: A Randomized Clinical Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8886485/ ) Garland and colleagues recruited chronic pain patients being treated with opioid drugs who were misusing opioids. They were randomly assigned to receive 8 weekly 2-hour sessions of Mindfulness-Oriented Recovery Enhancement (MORE) or supportive psychotherapy. They were measured before and after treatment and 3, 6, and 9 months later for chronic pain, opioid misuse, daily opioid dose, opioid craving, anxiety, depression, perceived stress, and adverse events.

 

They found that at the 9 month follow up 45% of the Mindfulness-Oriented Recovery Enhancement (MORE) were no longer misusing opioids while only 24% of the supportive psychotherapy were no longer misusing. The MORE group also had significantly greater reductions in pain severity, opioid dosage, depression, and pain-related functional interference.

 

The finding support the ability of Mindfulness-Oriented Recovery Enhancement (MORE) to improve opioid misuse and improve the psychological well-being of chronic pain patients.

 

“That is not because pain is psychological. It’s because all pain is processed in the brain and mindfulness changes how the brain processes the signals of damage from the body,” – Eric Garland

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Garland, E. L., Hanley, A. W., Nakamura, Y., Barrett, J. W., Baker, A. K., Reese, S. E., Riquino, M. R., Froeliger, B., & Donaldson, G. W. (2022). Mindfulness-Oriented Recovery Enhancement vs Supportive Group Therapy for Co-occurring Opioid Misuse and Chronic Pain in Primary Care: A Randomized Clinical Trial. JAMA internal medicine, 182(4), 407–417. https://doi.org/10.1001/jamainternmed.2022.0033

 

Key Points

Question

Does a mindfulness-based intervention reduce comorbid chronic pain and opioid misuse in the primary care setting more than supportive psychotherapy?

Findings

In this randomized clinical trial that included 250 adults with both chronic pain and opioid misuse, 45.0% of participants receiving Mindfulness-Oriented Recovery Enhancement (MORE) were no longer misusing opioids after 9 months of follow-up compared with 24.4% of participants receiving supportive group psychotherapy. Participants receiving MORE also reported significant improvements in chronic pain symptoms compared with those receiving supportive psychotherapy.

Meaning

In this study, MORE appeared to be an efficacious treatment for opioid misuse among adults with chronic pain.

Go to:

Abstract

Importance

Successful treatment of opioid misuse among people with chronic pain has proven elusive. Guidelines recommend nonopioid therapies, but the efficacy of mindfulness-based interventions for opioid misuse is uncertain.

Objective

To evaluate the efficacy of Mindfulness-Oriented Recovery Enhancement (MORE) for the reduction of opioid misuse and chronic pain.

Design, Setting, and Participants

This interviewer-blinded randomized clinical trial enrolled patients from primary care clinics in Utah between January 4, 2016, and January 16, 2020. The study included 250 adults with chronic pain receiving long-term opioid therapy who were misusing opioid medications.

Interventions

Treatment with MORE (comprising training in mindfulness, reappraisal, and savoring positive experiences) or supportive group psychotherapy (control condition) across 8 weekly 2-hour group sessions.

Main Outcomes and Measures

Primary outcomes were (1) opioid misuse assessed by the Drug Misuse Index (self-report, interview, and urine screen) and (2) pain severity and pain-related functional interference, assessed by subscale scores on the Brief Pain Inventory through 9 months of follow-up. Secondary outcomes were opioid dose, emotional distress, and ecological momentary assessments of opioid craving. The minimum intervention dose was defined as 4 or more completed sessions of MORE or supportive group psychotherapy.

Results

Among 250 participants (159 women [63.6%]; mean [SD] age, 51.8 [11.9] years), 129 were randomized to the MORE group and 121 to the supportive psychotherapy group. Overall, 17 participants (6.8%) were Hispanic or Latino, 218 (87.2%) were White, and 15 (6.0%) were of other races and/or ethnicities (2 American Indian, 3 Asian, 1 Black, 2 Pacific Islander, and 7 did not specify). At baseline, the mean duration of pain was 14.7 years (range, 1-60 years), and the mean (SD) morphine-equivalent opioid dose was 101.0 (266.3) mg (IQR, 16.0-90.0 mg). A total of 203 participants (81.2%) received the minimum intervention dose (mean [SD], 5.7 [2.2] sessions); at 9 months, 92 of 250 participants (36.8%) discontinued the study. The overall odds ratio for reduction in opioid misuse through the 9-month follow-up period in the MORE group compared with the supportive psychotherapy group was 2.06 (95% CI, 1.17-3.61; P = .01). At 9 months, 36 of 80 participants (45.0%) in the MORE group were no longer misusing opioids compared with 19 of 78 participants (24.4%) in the supportive psychotherapy group. Mixed models demonstrated that MORE was superior to supportive psychotherapy through 9 months of follow-up for pain severity (between-group effect: 0.49; 95% CI, 0.17-0.81; P = .003) and pain-related functional interference (between-group effect: 1.07; 95% CI, 0.64-1.50; P < .001). Participants in the MORE group reduced their opioid dose to a greater extent than those in the supportive psychotherapy group. The MORE group also had lower emotional distress and opioid craving.

Conclusions and Relevance

In this randomized clinical trial, among adult participants in a primary care setting, the MORE intervention led to sustained improvements in opioid misuse and chronic pain symptoms and reductions in opioid dosing, emotional distress, and opioid craving compared with supportive group psychotherapy. Despite attrition caused by the COVID-19 pandemic and the vulnerability of the sample, MORE appeared to be efficacious for reducing opioid misuse among adults with chronic pain.

Improve Parent Well-Being and Child Behavior with Mindfulness

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Improve Parent Well-Being and Child Behavior with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindful parenting means that you bring your conscious attention to what’s happening, instead of getting hijacked by your emotions.” – Jill Ceder

 

Raising children, parenting, is very rewarding. But it can also be challenging. Children test parents frequently. They test the boundaries of their freedom and the depth of parental love. They demand attention and seem to especially when parental attention is needed elsewhere. They don’t always conform to parental dictates or aspirations for their behavior. The challenges of parenting require that the parents be able to deal with stress, to regulate their own emotions, and to be sensitive and attentive their child. These skills are exactly those that are developed in mindfulness training. It improves the psychological and physiological responses to stress. It improves emotion regulation. It improves the ability to maintain attention and focus in the face of high levels of distraction.

 

Mindful parenting involves the parents having emotional awareness of themselves and compassion for the child and having the skills to pay full attention to the child in the present moment, to accept parenting non-judgmentally and be emotionally non-reactive to the child. Mindful parenting has been shown to have positive benefits for both the parents and the children. The research has been accumulating. So, it’s important to summarize what has been learned.

 

In today’s Research News article “Mindful Parent Training for Parents of Children Aged 3-12 Years with Behavioral Problems: a Scoping Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8741537/ ) Donovan and colleagues review and summarize the published research findings of the effects of mindful parenting training on the parents and their children. They identified 16 published studies.

 

They report that in general mindful parenting programs produce small but significant improvements in the parenting style and parent’s levels of mindfulness and perceived stress and improvements in their children’s externalizing behavior. Hence, mindful parenting training improves family life including the parent’s well being and the children’s problem behaviors.

 

“Parenting kids with special needs can be even more stressful, and it can cause anxiety, depression and marital problems. A mindfulness practice can help alleviate stress and prevent these problems. And it can make you a better parent.” – Juliann Garey

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Donovan, M. O., Pickard, J. A., Herbert, J. S., & Barkus, E. (2022). Mindful Parent Training for Parents of Children Aged 3-12 Years with Behavioral Problems: a Scoping Review. Mindfulness, 1–20. Advance online publication. https://doi.org/10.1007/s12671-021-01799-y

 

Abstract

Objectives

While mindfulness-based parenting programs (MPPs) are increasingly popular for reducing child behavior problems, the evidence for the advantages of MPP over existing behavioral parent training is unclear. Existing systematic reviews have largely excluded the breadth of MPP protocols, including those that integrate behavioral skills components. Therefore, a scoping review was conducted to map the nature and extent of research on MPPs for parents of children aged 3 to 12 years with behavioral problems.

Methods

PRISMA-ScR guidelines were used to conduct an encompassing peer literature review of cross-disciplinary databases. Studies were included if they reported mindfulness interventions for parents of children aged between 3 and 12 years with externalizing behavior problems and had an outcome measure of child behavioral problems that could be represented as an effect size. Randomized controlled trials as well as quasi-experimental, pre-post studies and unpublished dissertations were included.

Results

Sixteen studies met the inclusion criteria (N = 1362). The majority of MPPs delivered mindfulness adapted to parenting based on the Bögels’ protocol within clinical settings. There was a dearth of fully integrated mindfulness and behavioral programs. MPPs generally produced pre-to-post-intervention improvements with small effect sizes across child behavior and parent style, stress, and mindfulness measures. Examining longer follow-up periods compared to pre-intervention, effects reached a moderate size across most outcome measures.

Conclusions

MPPs continue to show promise in improving child behavior and parental mindfulness, well-being, and style. Further research is needed to determine how to best leverage the advantages of mindfulness in augmenting the well-established effectiveness of behavioral programs.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8741537/

 

Live Mindfulness Training is More Effective than Recorded Training in Reducing Stress.

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Live Mindfulness Training is More Effective than Recorded Training in Reducing Stress.

 

By John M. de Castro, Ph.D.

 

“You get to a point in your meditation practice, when guided meditation just isn’t helpful or necessary. But until you reach that point, it can be incredibly useful to have someone giving you instructions as you meditate.” – Hannah Knapp

 

Mindfulness training has been shown to improve health and well-being in healthy individuals. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. One of the primary effects of mindfulness that may be responsible for many of its benefits is that it improves the physiological and psychological responses to stress.

 

The vast majority of the mindfulness training techniques, however, require a trained teacher. The participants must be available to attend multiple sessions at scheduled times that may or may not be compatible with their schedules and at locations that may not be convenient. As an alternative, training over the internet has been developed. This has tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. But the question arises as to the effectiveness of internet training versus live instruction in reducing stress and improving psychological well-being.

 

In today’s Research News article “The Relative Contributions of Live and Recorded Online Mindfulness Training Programs to Lower Stress in the Workplace: Longitudinal Observational Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8817217/ ) Wolever and colleagues examined the perceived stress scores of participants of a 30-day online mindfulness program the contained live instruction and recordings of the live trainings.

 

They found that the greater the practice over the month the greater the reduction in perceived stress. But this was true for live trainings and not for recorded trainings. Participants who engaged in live trainings had significant reductions in stress while those who viewed recorded teachings did not.

 

These results suggest that live trainings, even when presented over the internet, have greater impact on stress than the same trainings presented as recordings. It is possible that highly stressed participants don’t have the flexibility in their schedules to attend trainings at scheduled times (live trainings) but can attend trainings at times conducive to their own schedules.

 

“online mindfulness-based treatment was considered as an innovative and effective approach in terms of the reduction of . . . stress among the general population.” – Yun Zhang

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Wolever, R. Q., Finn, M., & Shields, D. (2022). The Relative Contributions of Live and Recorded Online Mindfulness Training Programs to Lower Stress in the Workplace: Longitudinal Observational Study. Journal of medical Internet research, 24(1), e31935. https://doi.org/10.2196/31935

 

Abstract

Background

Despite numerous gaps in the literature, mindfulness training in the workplace is rapidly proliferating. Many “online” or “digital mindfulness” programs do not distinguish between live teaching and recorded or asynchronous sessions, yet differences in delivery mode (eg, face-to-face, online live, online self-guided, other) may explain outcomes.

Objective

The aim of this study was to use existing data from an online mindfulness solutions company to assess the relative contribution of live and recorded mindfulness training to lower perceived stress in employees.

Methods

Perceived stress and the amount of live and recorded online mindfulness training accessed by employees were assessed during eMindful’s One-Percent Challenge (OPC). The OPC is a 30-day program wherein participants are encouraged to spend 1% of their day (14 minutes) practicing mindfulness meditation on the platform. We used linear mixed-effects models to assess the relationship between stress reduction and usage of components of the eMindful platform (live teaching and recorded options) while controlling for potential reporting bias (completion) and sampling bias.

Results

A total of 8341 participants from 44 companies registered for the OPC, with 7757 (93.00%) completing stress assessments prior to the OPC and 2360 (28.29%) completing the postassessment. Approximately one-quarter of the participants (28.86%, 2407/8341) completed both assessments. Most of the completers (2161/2407, 89.78%) engaged in the platform at least once. Among all participants (N=8341), 8.78% (n=707) accessed only recorded sessions and 33.78% (n=2818) participated only in the live programs. Most participants engaged in both live and recorded options, with those who used any recordings (2686/8341, 32.20%) tending to use them 3-4 times. Controlling for completer status, any participation with the eMindful OPC reduced stress (B=–0.32, 95% CI –0.35 to –0.30, SE=0.01, t2393.25=–24.99, P<.001, Cohen d=–1.02). Participation in live programs drove the decrease in stress (B=–0.03, SE=0.01, t3258.61=–3.03, P=.002, d=–0.11), whereas participation in recorded classes alone did not. Regular practice across the month led to a greater reduction in stress.

Conclusions

Our findings are in stark contrast to the rapid evolution of online mindfulness training for the workplace. While the market is reproducing apps and recorded teaching at an unprecedented pace, our results demonstrate that live mindfulness programs with recorded or on-demand programs used to supplement live practices confer the strongest likelihood of achieving a significant decrease in stress levels.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8817217/

Improve Teacher Well-Being and Immune Function with Mindfulness

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Improve Teacher Well-Being and Immune Function with Mindfulness

 

By John M. de Castro, Ph.D.

 

“learning and cultivating skills of mindfulness . . .can help us to promote the calm, relaxed, but enlivened classroom environment that children need to learn. Mindfulness can also help us to be more effective at reducing conflict and developing more positive ways of relating in the classroom, which can help us feel more job satisfaction.” – Patricia Jennings

 

Stress is epidemic in the workplace with almost two thirds of workers reporting high levels of stress at work. This often produces burnout; fatigue, cynicism, emotional exhaustion, and professional inefficacy. In a school setting, this burnout and exhaustion not only affects teachers personally, but also the students and schools, as it produces a loss of enthusiasm, empathy, and compassion. Hence, there is a need to identify methods of reducing stress and improving teachers’ psychological health. Mindfulness has been demonstrated to be helpful in reducing the psychological and physiological responses to stress and for treating and preventing burnout. This suggests that mindfulness would improve the psychological and physiological well-being of teachers,

 

In today’s Research News article “Fostering emotional self-regulation in female teachers at the public teaching network: A mindfulness-based intervention improving psychological measures and inflammatory biomarkers.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881415/ ) Wilson and colleagues recruited public school teachers and provided them with either 8 weeks of mindfulness training or neuroscience education. Measurements were taken before and after training of reactivity, emotions, stress, resilience, and psychological well-being as well as blood inflammatory markers.

 

Compared to controls, the teachers who received mindfulness training had significant decreases in stress levels and negative emotions and significant increases in resilience, positive emotions and psychological well-being. Blood inflammatory markers also showed significant improvements. These results suggest that mindfulness training improves immune function, reduces stress, and increases psychological well-being in teachers.

 

This suggests that teachers should receive mindfulness training to make them better able to withstand the stresses of the job.

 

“In the last decade, many professional development programs have sprung up that use mindfulness as a key tool to alleviate teacher stress.” – Catherine Gewertz

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Wilson, D., Rodrigues de Oliveira, D., Palace-Berl, F., de Mello Ponteciano, B., Fungaro Rissatti, L., Piassa Pollizi, V., Sardela de Miranda, F., D’Almeida, V., & Demarzo, M. (2022). Fostering emotional self-regulation in female teachers at the public teaching network: A mindfulness-based intervention improving psychological measures and inflammatory biomarkers. Brain, behavior, & immunity – health, 21, 100427. https://doi.org/10.1016/j.bbih.2022.100427

 

Abstract

Objective

To examine the effect of a mindfulness-based program specifically designed for teachers in reducing perceived stress and improving the quality of experienced emotion in female active working teachers. A second outcome evaluated is the associated change in cellular inflammatory activity, measured by peripheral blood levels of cytokines.

Method

Eighty-eight female active teachers from public schools from São Paulo Municipality were recruited, and randomly allocated to an eight-week Mindfulness-Based Health Program for Educators (MBHP-Educa) or to Neuroscience for Education Program (Neuro-Educa: active control group). The venue of both programs were several public school facilities, where many of the teachers actually worked. Both groups received activities during eight weeks in a 2 ​h/week regimen, totalizing 16 ​h. Sixty-five participants completed the program and pre- and post-interventions measures were taken from the following scales: Interpersonal Multidimensional Reactivity Scale (IRI), Positive-and-Negative Affects Scale (PANAS), Perceived Stress Scale (PSS), Connor-Davidson Resilience Scale (CD-RISC), and a primary outcome in Ryff’s Psychological Well-Being Scale (PBWS). At pre-and post-intervention, blood samples were collected for the measurement of several important inflammatory biomarkers, Tumor Necrosis Factor – α (TNF-α), Interleukin 1β (IL-1β), Interleukin 6 (IL-6), Interleukin 8 (IL-8), Interleukin 10 (IL-10) and Interleukin 12p70 (IL-12P70) through flow cytometry assay. Intervention effects were analyzed via Generalized mixed models (GLMM).

Results

According to the GLMM, MBHP-Educa significantly reduced the scores of perceived stress (p ​< ​0.0001), and negative affect (p ​< ​0.0001) compared to active control group (Neuro-Educa). Conversely, an increase was observed on Psychological Well Being Scale in dimensions of Self-acceptance (p ​< ​0.0001), and Autonomy (p ​= ​0.001), as well as improvements in Resilience (p ​< ​0.0001), and Positive Affect (p ​< ​0.0001). MBHP-Educa also promoted a reduction in the levels of IL-6 (p ​= ​0.003), IL-8 (p ​= ​0.036), and increase in the levels of IL-10 (p ​< ​0.0001) and IL-12p70 (p ​< ​0.044). TNF-α, IL-1β, and IL-10p70 showed results below theoretical limit of detection accepted for CBA kit.

Conclusions

Our data suggest that mindfulness-based interventions introduced as a strategy for reducing stress, promoting well-being and improve immune function can be a useful asset in promoting psychological health among teachers in Basic Education.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881415/

 

Mindfulness Changes Neural Activity and Improves Major Depressive Disorder

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Mindfulness Changes Neural Activity and Improves Major Depressive Disorder

 

By John M. de Castro, Ph.D.

 

“People at risk for depression are dealing with a lot of negative thoughts, feelings and beliefs about themselves and this can easily slide into a depressive relapse. . . MBCT helps them to recognize that’s happening, engage with it in a different way and respond to it with equanimity and compassion.” – Willem Kuyken

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. Depression can be difficult to treat and is usually treated with anti-depressive medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression. Even after remission some symptoms of depression may still be present (residual symptoms).

 

Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering. Mindfulness training has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail.

 

The most commonly used mindfulness technique for the treatment of depression is Mindfulness-Based Cognitive Therapy (MBCT).  MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. MBCT has been shown to be as effective as antidepressant drugs in relieving the symptoms of depression and preventing depression reoccurrence and relapse. In addition, it appears to be effective as either a supplement to or a replacement for these drugs. It is not known how MBCT produces its effects on major depression.

 

One way to observe the effects of MBCT on neural activity is to measure changes in the electroencephalogram (EEG), the rhythmic electrical activity that can be recorded from the scalp. The recorded activity can be separated into frequency bands. Delta activity consists of oscillations in the 0.5-3 cycles per second band. Theta activity in the EEG consists of oscillations in the 4-8 cycles per second band. Alpha activity consists of oscillations in the 8-12 cycles per second band. Beta activity consists of oscillations in the 15-25 cycles per second band while Gamma activity occurs in the 35-45 cycles per second band. Changes in these brain activities can be compared during different depths of meditation.

 

In today’s Research News article “Mindfulness-Based Cognitive Therapy in Recurrent MDD Patients With Residual Symptoms: Alterations in Resting-State Theta Oscillation Dynamics Associated With Changes in Depression and Rumination.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8936084/ ) Wang and colleagues recruited patients with major depressive disorder being treated with drugs but with residual symptoms. They were provided with an 8-week program of Mindfulness-Based Cognitive Therapy (MBCT). Before and after training they were measured for mindfulness, depression, and rumination and had their resting state electroencephalogram (EEG) recorded.

 

After completing Mindfulness-Based Cognitive Therapy (MBCT) there were significant reductions in depression which produced an 88% remission rate. There were also significant increases in mindfulness and reductions in brooding rumination. In addition, there was a significant increase in the theta rhythm power in the electroencephalogram (EEG). Finally, the greater the increase in theta power the greater the reductions in depression and rumination.

 

Hence, they found that Mindfulness-Based Cognitive Therapy (MBCT) is effective in treating depression even in patients under treatment with drugs. They also found that these improvements were related to increased theta power in the electroencephalogram (EEG). So, MBCT appears to change brain activity along with depression. The changes in the neural activity may be a mechanism by which MBCT helps improve depression symptoms.

 

“mindfulness is added to the standard depression treatment protocols, relapse rates decline.” – Sara Altshul

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Wang, J., Ren, F., Gao, B., & Yu, X. (2022). Mindfulness-Based Cognitive Therapy in Recurrent MDD Patients With Residual Symptoms: Alterations in Resting-State Theta Oscillation Dynamics Associated With Changes in Depression and Rumination. Frontiers in psychiatry, 13, 818298. https://doi.org/10.3389/fpsyt.2022.818298

 

Abstract

Many patients with major depressive disorder (MDD) suffer from residual symptoms. Rumination is a specific known risk factor for the onset, severity, prolongation, and relapse of MDD. This study aimed to examine the efficacy and EEG substrates of mindfulness-based cognitive therapy (MBCT) in alleviating depression and rumination in an MDD population with residual symptoms. We recruited 26 recurrent MDD individuals who had residual symptoms with their current antidepressants to participate in the 8-week MBCT intervention. We evaluated the efficacy and changes in the dynamics of resting-state theta rhythm after the intervention, as well as the associations between theta alterations and improvements in depression and rumination. The participants showed reduced depression, enhanced adaptive reflective rumination, and increased theta power and phase synchronization after MBCT. The increased theta-band phase synchronizations between the right occipital regions and the right prefrontal, central, and parietal regions were associated with reduced depression, while the increase in theta power in the left parietal region was associated with improvements in reflective rumination. MBCT could alleviate depression and enhance adaptive, reflective rumination in recurrent MDD individuals with residual symptoms through the modulation of theta dynamics in specific brain regions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8936084/