contemplative practice

Improve the Psychological Well-Being of Sexual Minorities (LBGQ) with Mindfulness

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Improve the Psychological Well-Being of Sexual Minorities (LBGQ) with Mindfulness

 

By John M. de Castro, Ph.D.

 

“It is revolutionary for any trans person to choose to be seen and visible in a world that tells us we should not exist.” —Laverne Cox

 

Around 43,000 people take their own lives each year in the US. The problem is far worse than these statistics suggest as it has been estimated that for every completed suicide there were 12 unsuccessful attempts. In other words, about a half a million people in the U.S. attempt suicide each year. Indeed, suicide is the second leading cause of death in adolescents. Suicidality and self-injury are particularly problematic in sexual minorities (LBGTQ).

 

One of the few treatments that appears to be Dialectical Behavior Therapy (DBT). It is targeted at changing the problem behaviors characteristic including self-injury. Behavior change is accomplished through focusing on changing the thoughts and emotions that precede problem behaviors, as well as by solving the problems faced by individuals that contribute to problematic thoughts, feelings and behaviors. In DBT five core skills are practiced; mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness. DBT has been found to reduce suicidality. There is thus a need to study the effectiveness of DBT for the mental health of sexual minority adolescents.

 

In today’s Research News article “Dialectical behavior therapy for adolescents (DBT-A): Outcomes among sexual minorities at high risk for suicide.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9233065/ ) Poon and colleagues recruited heterosexual and sexual minority (LGBQ) adolescents (13-18 years of age). They received and 18-week program of Dialectical Behavior Therapy (DBT). They completed online measures before and after treatment of emotion regulation, anxiety, depression, coping, and borderline symptoms.

 

They found that after treatment the adolescents had significant decreases in depression, borderline symptoms, and dysfunctional coping and significant increases in emotion regulation and use of coping skills. There were no significant differences between the improvements seen with the sexual minority and heterosexual adolescents.

 

Hence, Dialectical Behavior Therapy (DBT) Produces significant improvements in the psychological well-being of sexual minority adolescents and is as effective as it is in heterosexual adolescents. Although not measured these improvements would predict a decrease in suicidality.

 

“Shame creates lies about how men should think and act, and when men don’t fulfill those roles, they have additional shame.” ― Liz Plank

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Poon J, Galione JN, Grocott LR, Horowitz KJ, Kudinova AY, Kim KL. Dialectical behavior therapy for adolescents (DBT-A): Outcomes among sexual minorities at high risk for suicide. Suicide Life Threat Behav. 2022 Jun;52(3):383-391. doi: 10.1111/sltb.12828. Epub 2022 Jan 12. PMID: 35019159; PMCID: PMC9233065.

 

Abstract

The alarming rates and pervasiveness of suicidal and self-destructive behaviors (e.g., non-suicidal self-injury) among young sexual minorities represent a major public health concern. We set out to examine whether an empirically driven treatment for suicide and self-harm, dialectical behavior therapy for adolescents (DBT-A), provides benefits for adolescents who identify as gay, lesbian, bisexual, or questioning (LGBQ). LGBQ adolescents (n = 16) were compared with non-LGBQ peers (n = 23). Psychological measures were collected before and after participation in a comprehensive DBT-A program. LGBQ participants demonstrated significant improvements in emotion regulation, depression, borderline symptoms, and coping strategies; changes were comparable to their heterosexual peers.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9233065/

 

Improve Female Sexual Dysfunction with Mindfulness

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Improve Female Sexual Dysfunction with Mindfulness

 

By John M. de Castro, Ph.D.

 

“No amount of talking about sex is going to diminish the mystery of the experience of it. Sex is Sacred, Not Secret.” ― Christine Laplante

 

Sex is a very important aspect of life. Problems with sex are very common and have negative consequences for relationships. While research suggests that sexual dysfunction is common, it is a topic that many people are hesitant or embarrassed to discuss. Women suffer from sexual dysfunction more than men with 43% of women and 31% of men reporting some degree of difficulty. Hence, sex has major impacts on people’s lives and relationships. Greater research attention to sexual activity and sexual satisfaction and the well-being of the individual is warranted.

 

Mindfulness trainings have been found to improve relationships and to be useful in treating sexual problems.  In today’s Research News article “Behavioral Therapies for Treating Female Sexual Dysfunctions: A State-of-the-Art Review.” (See summary below or view the full text of the study at:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9144766/ ) Mestre-Bach and colleagues review and summarize the published research studies on the effectiveness of psychotherapeutic for the treatment of female sexual dysfunction disorders including female orgasmic disorder, female sexual interest/arousal disorder, and genito-pelvic pain/penetration disorder.

 

They report that the published research demonstrate that psychotherapeutic treatments are effective for female sexual dysfunctions. But Cognitive Behavioral Therapy (CBT) and Mindfulness-Based Cognitive Therapy (MBCT) have been shown to be especially effective. Women with these disorders appear to helped by mindfulness and cognitive therapy allowing for more satisfying sexual relations.

 

“We are the embodiment of the Love behind and beyond lovemaking.” – Michael Mirdad

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Mestre-Bach G, Blycker GR, Potenza MN. Behavioral Therapies for Treating Female Sexual Dysfunctions: A State-of-the-Art Review. J Clin Med. 2022 May 16;11(10):2794. doi: 10.3390/jcm11102794. PMID: 35628920; PMCID: PMC9144766.

 

Abstract

Many possible factors impact sexual wellbeing for women across the lifespan, and holistic approaches are being utilized to promote health and to address sexual concerns. Female sexual dysfunction disorders, including female orgasmic disorder, female sexual interest/arousal disorder and genito-pelvic pain/penetration disorder, negatively impact quality of life for many women. To reduce distress and improve sexual functioning, numerous behavioral therapies have been tested to date. Here, we present a state-of-the-art review of behavioral therapies for female sexual dysfunction disorders, focusing on empirically validated approaches. Multiple psychotherapies have varying degrees of support, with cognitive-behavioral and mindfulness-based therapies arguably having the most empirical support. Nonetheless, several limitations exist of the studies conducted to date, including the frequent grouping together of multiple types of sexual dysfunctions in randomized clinical trials. Thus, additional research is needed to advance treatment development for female sexual dysfunctions and to promote female sexual health.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9144766/

 

Mindfulness Reduces Stress and Negative Emotions in College Students

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Mindfulness Reduces Stress and Negative Emotions in College Students

 

By John M. de Castro, Ph.D.

 

“Nowhere can man find a quieter or more untroubled retreat than in his own soul.” – Marcus Aurelius

 

In the modern world education is a key for success. Where a high school education was sufficient in previous generations, a college degree is now required to succeed in the new knowledge-based economies. There is a lot of pressure on students to excel so that they can be admitted to the best universities and there is a lot of pressure on university students to excel so that they can get the best jobs after graduation. This stress might in fact be counterproductive as the increased pressure can lead to stress and anxiety which can impede the student’s physical and mental health, well-being, and school performance and lead to burnout.

 

It is, for the most part, beyond the ability of the individual to change the environment to reduce stress, so it is important that methods be found to reduce the college students’ responses to stress; to make them more resilient when high levels of stress occur. Contemplative practices including meditation, mindfulness training, and yoga practice have been shown to reduce the psychological and physiological responses to stress. Indeed, these practices have been found to reduce stress and improve psychological health in college students.

 

In today’s Research News article “Investigating the effect of Mindfulness-Based Stress Reduction on stress level and brain activity of college students.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9121238/ ) An and colleagues recruited college students and randomly assigned them to either a no-treatment control condition or to receive 8 weekly 1.5-hour sessions of Mindfulness-Based Stress Reduction (MBSR) along with home practice. MBSR consists of meditation, yoga, and body scan practices along with group discussion. They were measured before and after training and 2 months later for perceived stress, anxiety, and depression. They also had their electroencephalogram (EEG) measured while performing a stressful task (easy, moderate, and hard mental arithmetic, and the Stroop task).

 

They found that in comparison to baseline and the no-treatment group, the students who received Mindfulness-Based Stress Reduction (MBSR) training had significantly reduced levels of perceived stress, anxiety, and depression that were maintained 2 months later with the exception of perceived stress which continued to significantly decline from the end of training to 2 months later. They also found that during the stressful tasks that the alpha rhythm power in the EEG was significantly increased in the frontal, temporal, and occipital areas after MBSR.

 

Alpha power is reflective of relaxation. These findings then suggest that mindfulness training improves psychological well-being and the ability to relax under stress. Although not investigated, the improvements should translate into better academic performance. Nevertheless, mindfulness training is highly beneficial to college students and should be recommended.

 

“We are shaped by our thoughts; we become what we think. When the mind is pure, joy follows like a shadow that never leaves.” – Buddha

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

An A, Hoang H, Trang L, Vo Q, Tran L, Le T, Le A, McCormick A, Du Old K, Williams NS, Mackellar G, Nguyen E, Luong T, Nguyen V, Nguyen K, Ha H. Investigating the effect of Mindfulness-Based Stress Reduction on stress level and brain activity of college students. IBRO Neurosci Rep. 2022 May 14;12:399-410. doi: 10.1016/j.ibneur.2022.05.004. PMID: 35601693; PMCID: PMC9121238.

 

Abstract

Financial constraints usually hinder students, especially those in low-middle income countries (LMICs), from seeking mental health interventions. Hence, it is necessary to identify effective, affordable and sustainable counter-stress measures for college students in the LMICs context. This study examines the sustained effects of mindfulness practice on the psychological outcomes and brain activity of students, especially when they are exposed to stressful situations. Here, we combined psychological and electrophysiological methods (EEG) to investigate the sustained effects of an 8-week-long standardized Mindfulness-Based Stress Reduction (MBSR) intervention on the brain activity of college students. We found that the Test group showed a decrease in negative emotional states after the intervention, compared to the no statistically significant result of the Control group, as indicated by the Perceived Stress Scale (PSS) (33% reduction in the negative score) and Depression, Anxiety, Stress Scale (DASS-42) scores (nearly 40% reduction of three subscale scores). Spectral analysis of EEG data showed that this intervention is longitudinally associated with increased frontal and occipital lobe alpha band power. Additionally, the increase in alpha power is more prevalent when the Test group was being stress-induced by cognitive tasks, suggesting that practicing MBSR might enhance the practitioners’ tolerance of negative emotional states. In conclusion, MBSR intervention led to a sustained reduction of negative emotional states as measured by both psychological and electrophysiological metrics, which supports the adoption of MBSR as an effective and sustainable stress-countering approach for students in LMICs.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9121238/

 

Reduce Psychological Distress by Increasing Emotion Regulation with Mindfulness

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Reduce Psychological Distress by Increasing Emotion Regulation with Mindfulness

 

By John M. de Castro, Ph.D.

 

“When the chest is opening, the mind is opening, and we feel emotionally shiny and stability comes.” – Vanda Scaravelli

 

Mindfulness practice has been shown to improve emotion regulation. Practitioners demonstrate the ability to fully sense and experience emotions but respond to them in more appropriate and adaptive ways. The ability of mindfulness training to improve emotion regulation is thought to be the basis for a wide variety of benefits that mindfulness provides to mental health and the treatment of mental illness especially depression and anxiety disorders. It appears to be able to prevent or relieve psychological distress. So, it is important to examine the mechanisms by which mindfulness improves emotion regulation and psychological well-being.

 

In today’s Research News article “Mindfulness as a Protective Factor Against Depression, Anxiety and Psychological Distress During the COVID-19 Pandemic: Emotion Regulation and Insomnia Symptoms as Mediators.” (See summary below or view the full text of the study at:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9010863/ ) Mamede and colleagues had adult from the general population answer an online questionnaire regarding their mindfulness, emotion regulation, and psychological states.

 

They report that the higher the levels of mindfulness the lower the levels of psychological distress, including anxiety and depression. These were direct effects of mindfulness. But, in addition, mindfulness had indirect effects by improving emotion regulation which in turn decreased psychological distress. Also, the higher the levels of mindfulness, the lower the levels of insomnia which were in turn associated with lower levels of psychological distress.

 

The findings suggest that mindfulness works directly to improve psychological well-being but also indirectly by improving the emotion regulation and reducing insomnia. This clearly suggests that improving mindfulness levels is a good method to improve psychological health.

 

“Mindfulness isn’t about escaping negative emotions or painful experiences but learning how to feel peace amidst them.” – Charlotte Hilton Anderson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Mamede A, Merkelbach I, Noordzij G, Denktas S. Mindfulness as a Protective Factor Against Depression, Anxiety and Psychological Distress During the COVID-19 Pandemic: Emotion Regulation and Insomnia Symptoms as Mediators. Front Psychol. 2022 Apr 1;13:820959. doi: 10.3389/fpsyg.2022.820959. PMID: 35432084; PMCID: PMC9010863.

 

Abstract

Objectives

Research has linked mindfulness to improved mental health, yet the mechanisms underlying this relationship are not well understood. This study explored the mediating role of emotion regulation strategies and sleep in the relationship between mindfulness and symptoms of depression, anxiety and psychological distress during the COVID-19 pandemic.

Methods

As detailed in this study’s pre-registration (osf.io/k9qtw), a cross-sectional research design was used to investigate the impact of mindfulness on mental health and the mediating role of emotion regulation strategies (i.e., cognitive reappraisal, rumination and suppression) and insomnia. A total of 493 participants from the general population answered an online survey and were included in the final analysis. The online survey consisted of the short form of the Five-Facets Mindfulness Questionnaire (FFMQ-SF), the Impact of Event Scale-revised (IES-R), the Generalised Anxiety Disorder Scale (GAD-7), the Patient Health Questionnaire (PHQ-8), the Emotion Regulation Questionnaire (ERQ), the short form of the Rumination Response Scale (RSS-SF), and the Insomnia Severity Index (ISI).

Results

Structural equation modelling revealed that mindfulness was related to lower symptoms of depression, anxiety and psychological distress, both directly and indirectly. Mindfulness was negatively associated with rumination and insomnia. As hypothesised, models revealed that the associations between mindfulness and depression, anxiety and psychological distress were significantly mediated by its negative associations with rumination and insomnia. Our findings also demonstrated that rumination was related to increased insomnia symptoms, which in turn was associated with increased mental health problems, indicating a mediated mediation. Mindfulness was also positively associated with cognitive reappraisal and negatively associated with suppression, which were, respectively, negatively and positively associated with depressive symptoms, and thus functioned as specific mediators of the association between mindfulness and depression.

Conclusion

Our findings suggest that rumination and insomnia operate transdiagnostically as interrelated mediators of the effects of mindfulness on mental health, whereas cognitive reappraisal and suppression function as specific mediators for depression. These insights emphasise the importance of targeting emotion regulation and sleep in mindfulness interventions for improving mental health. Limitations and implications for practice are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9010863/

Reduce Dysfunctional Eating with Mindfulness

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Reduce Dysfunctional Eating with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The more you eat, the less flavor; the less you eat, the more flavor.” ~Chinese Proverb

 

Around 30 million people in the United States of all ages and genders suffer from an eating disorder: either anorexia nervosa, bulimia, or binge eating disorder. 95% of those who have eating disorders are between the ages of 12 and 26. Eating disorders are not just troubling psychological problems, they can be deadly, having the highest mortality rate of any mental illness. Two example of eating disorders are binge eating disorder (BED) and bulimia nervosa (BN). BED involves eating a large amount of food within a short time-period while experiencing a sense of loss of control over eating. BN involves binge-eating and purging (e.g., self-induced vomiting, compensatory exercise).

 

Eating disorders can be difficult to treat because eating is necessary and cannot be simply stopped as in smoking cessation or abstaining from drugs or alcohol. One must learn to eat appropriately not stop. So, it is important to find methods that can help prevent and treat eating disorders. Contemplative practices, mindfulness, and mindful eating have shown promise for treating eating disorders. It is not known however, if mindfulness training can improve dysregulated eating and in turn reduce the likelihood of eating disorders.

 

In today’s Research News article “Delivering Mindfulness-Based Interventions for Insomnia, Pain, and Dysfunctional Eating Through a Text Messaging App: Three Randomized Controlled Trials Investigating the Effectiveness and Mediating Mechanisms.” (See summary below or view the full text of the study at:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9115660/ ) Li and colleagues recruited adults over the internet and provided mindfulness training through text messaging. They measured insomnia, pain, and dysregulated eating.

 

They found that mindfulness training compared to a wait-list control condition resulted in resulted in significant decreases in anxiety, depression, insomnia, pain, and dysregulated eating and these improvements were sustained 3 months after the end of training. They found a wide array of improvements from mindfulness training. Particularly important from the perspective of eating disorders were the findings of reductions in depression and dysregulated eating. This suggests that mindfulness training reduces the likelihood of the development of an eating disorder.

 

“When walking, walk. When eating, eat.” rashaski · Zen Proverb

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Li AC, Wong KK, Chio FH, Mak WW, Poon LW. Delivering Mindfulness-Based Interventions for Insomnia, Pain, and Dysfunctional Eating Through a Text Messaging App: Three Randomized Controlled Trials Investigating the Effectiveness and Mediating Mechanisms. J Med Internet Res. 2022 May 3;24(5):e30073. doi: 10.2196/30073. PMID: 35503653; PMCID: PMC9115660.

 

Abstract

Background

Although text messaging has the potential to be the core intervention modality, it is often used as an adjunct only. To improve health and alleviate the distress related to insomnia, pain, and dysregulated eating of people living in urban areas, text messaging–based mindfulness-based interventions were designed and evaluated in 3 randomized controlled trials.

Objective

This study investigated the effectiveness and mediating mechanisms of text messaging–based mindfulness-based interventions for people with distress related to insomnia, pain, or dysregulated eating.

Methods

In these trials, 333, 235, and 351 participants were recruited online and randomized to intervention and wait-list control conditions for insomnia, pain, and dysregulated eating, respectively. Participants experienced 21 days of intervention through WhatsApp Messenger. Participants completed pre-, post-, 1-month follow-up, and 3-month follow-up self-report questionnaires online. The retention rates at postmeasurements were 83.2% (139/167), 77.1% (91/118), and 72.9% (129/177) for intervention groups of insomnia, pain, and dysregulated eating, respectively. Participants’ queries were answered by a study technician. Primary outcomes included insomnia severity, presleep arousal, pain intensity, pain acceptance, and eating behaviors. Secondary outcomes included mindfulness, depression, anxiety, mental well-being, and functional impairments. Mindfulness, dysfunctional beliefs and attitudes about sleep, pain catastrophizing, and reactivity to food cues were hypothesized to mediate the relationship between the intervention and outcomes.

Results

For all 3 studies, the intervention groups showed significant improvement on most outcomes at 1-month follow-up compared to their respective wait-list control groups; some primary outcomes (eg, insomnia, pain, dysregulated eating indicators) and secondary outcomes (eg, depression, anxiety symptoms) were sustained at 3-month follow-up. Medium-to-large effect sizes were found at postassessments in most outcomes in all studies. In the intervention for insomnia, mediation analyses showed that dysfunctional beliefs and attitudes about sleep mediated the effect of the intervention on all primary outcomes and most secondary outcomes at both 1-month and 3-month follow-ups, whereas mindfulness mediated the intervention effect on presleep arousal at 1-month and 3-month follow-ups. In the intervention for pain, pain catastrophizing mediated the effect of intervention on pain intensity and functioning at both 1-month and 3-month follow-ups, whereas mindfulness only mediated the effect of intervention on anxiety and depressive symptoms. In the intervention for dysregulated eating, power of food mediated the effect of intervention on both uncontrolled and emotional eating at both 1-month and 3-month follow-ups and mindfulness was found to mediate the effect on depressive symptoms at both 1-month and 3-month follow-ups.

Conclusions

These 3 studies converged and provided empirical evidence that mindfulness-based interventions delivered through text messaging are effective in improving distress related to sleep, pain, and dysregulated eating. Text messaging has the potential to be a core intervention modality to improve various common health outcomes for people living a fast-paced lifestyle.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9115660/

 

Improve Flow, Communication Skills, and Safety Attitudes of Surgeons with Mindfulness

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Improve Flow, Communication Skills, and Safety Attitudes of Surgeons with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Once you can communicate with yourself, you’ll be able to communicate outwardly with more clarity. The way in is the way out.”― Thích Nhất Hạnh

 

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. Preventing burnout has to be a priority. 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. Mindfulness has also been shown to improve flow, a state of mind that is characterized by a complete absorption with the task at hand, often resulting in enhanced skilled performance. Thus, there is a need to investigate how mindfulness effects doctors’ well-being, performance, and flow.

 

In today’s Research News article “Focused-Attention Meditation Improves Flow, Communication Skills, and Safety Attitudes of Surgeons.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9099589/ ) Chen and colleagues recruited surgeons and randomly assigned them to either a wait-list control condition or to receive 50 minutes of focused meditation practice 3 times per week for 8 weeks. They were measured before and after training for work-related flow, communications skills, safety attitudes, and clinical adverse events.

 

They found that in comparison to baseline and the wait-list control group the surgeons who received mindfulness training had significantly increased levels of work-related flow, communications skills, and safety attitudes. Eight weeks after the training the mindfulness trained surgeons had significantly lower levels of clinical adverse events.

 

Hence, mindfulness training significantly improved surgeons’ flow and medical performance. This further suggests that mindfulness training should be recommended for physicians.

 

“physicians could use mindfulness as a stand-alone technique prior to engaging in bad news delivery to patients.” – AMRA

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Chen H, Liu C, Zhou F, Cao XY, Wu K, Chen YL, Liu CY, Huang DH, Chiou WK. Focused-Attention Meditation Improves Flow, Communication Skills, and Safety Attitudes of Surgeons. Int J Environ Res Public Health. 2022 Apr 27;19(9):5292. doi: 10.3390/ijerph19095292. PMID: 35564687; PMCID: PMC9099589.

 

Abstract

Objective: Patient safety is a worldwide problem and a focus of academic research. Human factors and ergonomics (HFE) is an approach to improving healthcare work systems and processes. From the perspective of the cognitive ergonomics of HFE, the aim of this study is to improve the flow level, communication skills, and safety attitudes of surgeons through focused-attention meditation (FAM) training, thus helping to reduce adverse clinical events. Methods: In total, 140 surgeons were recruited from three hospitals in China and randomly divided into two groups (FAM group and control group). The FAM group received 8 weeks of FAM training, while the control group was on the waiting list and did not receive any interventions. Three scales (WOLF, LCSAS, and SAQ-C) were used to measure the data of three variables (flow, communication skills, and safety attitude), respectively, at two times, before and after the intervention (pre-test and post-test). The incidence of adverse events during the intervention was also collected for both groups. Results: The ANOVA results showed that all three variables had a significant main effect of time and significant interactions between time and group. The independent-sample T-test results showed that the incidence of adverse events during the intervention was significantly lower in the FAM group than in the control group. Conclusions: The intervention of FAM could significantly improve surgeons’ flow levels, communication skills, and safety attitudes, potentially helping to reduce adverse clinical events.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9099589/

 

Improve Immune function with a Meditation Retreat

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Improve Immune function with a Meditation Retreat

 

By John M. de Castro, Ph.D.

 

“meditative practice enhanced immune function without activating inflammatory signals. This suggests that meditation, as a behavioral intervention, may be an effective component in treating diseases characterized by increased inflammatory responsiveness with a weakened immune system.” – Vijayendran Chandran

 

The immune system is designed to protect the body from threats like stress, infection, injury, and toxic chemicals. One of its tools is the Inflammatory response. This response works quite well for short-term infections and injuries. But when inflammation is protracted and becomes chronic, it can itself become a threat to health. It can produce autoimmune diseases such as colitis, Chron’s disease, arthritis, heart disease, increased cancer risk, lung disease, sleep disruption, gum disease, decreased bone health, psoriasis, and depression.

 

When the immune system attacks the liver, it produces autoimmune hepatitis which damages the liver. It is rare but affects women four times more often than men. Mind-body techniques such as yoga, Tai Chi and meditation have been shown to adaptively reduce the inflammatory response. So, it would seem reasonable that mindfulness training may be effective in treating autoimmune hepatitis.

 

In today’s Research News article “). Large-scale genomic study reveals robust activation of the immune system following advanced Inner Engineering meditation retreat.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8713789/ ) Chandran and colleagues recruited healthy participants in an 8-day meditation, yoga, and vegan diet retreat. Blood was drawn for genomic analysis 5 weeks before, immediately before and after the retreat and 3 months later.

 

They found that there was lessened activity in genes associated with oxidative stress, detoxification, and cell cycle regulation and increased activity in genes associated with the immune response but no change in genes associated with inflammation. Hence, participation in the meditation, yoga, and vegan diet retreat produced genetic expressions representative of improved immune response without inflammation.

 

So, improve immune function with a meditation retreat.

 

“multiple genes related to the immune system were activated — dramatically — when you do Inner Engineering practices,” – Vijayendran Chandran

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Chandran, V., Bermúdez, M. L., Koka, M., Chandran, B., Pawale, D., Vishnubhotla, R., Alankar, S., Maturi, R., Subramaniam, B., & Sadhasivam, S. (2021). Large-scale genomic study reveals robust activation of the immune system following advanced Inner Engineering meditation retreat. Proceedings of the National Academy of Sciences of the United States of America, 118(51), e2110455118. https://doi.org/10.1073/pnas.2110455118

 

SIGNIFICANCE

Several studies on the impact of yoga and meditation on mental and physical health have demonstrated beneficial effects. However, the potential molecular mechanisms and critical genes involved in this beneficial outcome have yet to be comprehensively elucidated. This study identified and characterized the transcriptional program associated with advanced meditation practice, and we bioinformatically integrated various networks to identify meditation-specific core network. This core network links several immune signaling pathways, and we showed that this core transcriptional profile is dysfunctional in multiple sclerosis and severe COVID-19 infection. Very importantly, we demonstrated that the meditative practice enhanced immune function without activating inflammatory signals. Together, these results make meditation an effective behavioral intervention for treating various conditions associated with a weakened immune system.

Keywords: meditation, immune, Isha yoga, Inner Engineering, COVID-19

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ABSTRACT

The positive impact of meditation on human well-being is well documented, yet its molecular mechanisms are incompletely understood. We applied a comprehensive systems biology approach starting with whole-blood gene expression profiling combined with multilevel bioinformatic analyses to characterize the coexpression, transcriptional, and protein–protein interaction networks to identify a meditation-specific core network after an advanced 8-d Inner Engineering retreat program. We found the response to oxidative stress, detoxification, and cell cycle regulation pathways were down-regulated after meditation. Strikingly, 220 genes directly associated with immune response, including 68 genes related to interferon signaling, were up-regulated, with no significant expression changes in the inflammatory genes. This robust meditation-specific immune response network is significantly dysregulated in multiple sclerosis and severe COVID-19 patients. The work provides a foundation for understanding the effect of meditation and suggests that meditation as a behavioral intervention can voluntarily and nonpharmacologically improve the immune response for treating various conditions associated with excessive or persistent inflammation with a dampened immune system profile.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8713789/

 

Improve Autism Spectrum Disorder in Adults with Mindfulness

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Improve Autism Spectrum Disorder in Adults with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Everyone has a mountain to climb and autism has not been my mountain, it has been my opportunity for victory.” – Rachel Barcellona

 

Autism spectrum disorder (ASD) is a developmental disability that tends to appear during early childhood and affect the individual throughout their lifetime. It affects a person’s ability to communicate, and interact with others, delays learning of language, makes eye contact or holding a conversation difficult, impairs reasoning and planning, narrows and intensifies interests, produces poor motor skills and sensory sensitivities, and is frequently associated with sleep and gastrointestinal problems. ASD is a serious disorder that impairs the individual’s ability to lead independent lives including complete an education, enter into relationships or find and hold employment. Mindfulness training has been shown to be helpful in treating ASD.

 

Dialectical Behavior Therapy (DBT) produces behavior change by focusing on changing the thoughts and emotions that precede problem behaviors, as well as by solving the problems faced by individuals that contribute to problematic thoughts, feelings, and behaviors. In DBT five core skills are practiced; mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness. Radically Open Dialectical Behavior Therapy (RO-DBT) is a modified form of DBT that focuses on social skills and emotional expression. It is not known whether RO-DBT would be effective in treating Autism spectrum disorder (ASD).

 

In today’s Research News article “Evaluation of radically open dialectical behaviour therapy in an adult community mental health team: effectiveness in people with autism spectrum disorders.” (See summary below or view the full text of the study at:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9059310/ ) Cornwall and colleagues examined the effectiveness of RO-DBT  in treating Autism spectrum disorder (ASD) in adults.

 

They found that after treatment the adults had significant improvement in global distress, including subjective well-being, problems or symptoms, social and life functioning, and risk of harm to self and others.

 

The findings suggest that Radically Open Dialectical Behavior Therapy (RO-DBT) improves the symptoms of Autism Spectrum Disorder in adults.

 

“I used to think, when I was first diagnosed with Asperger’s Syndrome – a form of autism, about what I can’t do, rather than what I can do, which was a mistake in thinking” – Merrick Egber

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Cornwall PL, Simpson S, Gibbs C, Morfee V. Evaluation of radically open dialectical behaviour therapy in an adult community mental health team: effectiveness in people with autism spectrum disorders. BJPsych Bull. 2021 Jun;45(3):146-153. doi: 10.1192/bjb.2020.113. PMID: 33261708; PMCID: PMC9059310.

 

Abstract

Aims and method

Radically open dialectical behaviour therapy (RO DBT) is a transdiagnostic treatment designed to address disorders associated with overcontrol, including autism spectrum disorders (ASD). To date, no studies have reported on the effectiveness of RO DBT for people with ASD. Forty-eight patients were referred to a RO DBT programme, of whom 23 had a diagnosis of ASD. Outcome was measured using the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE) and the Questionnaire about the Process of Recovery.

Results

The intervention was effective, with a medium effect size of 0.53 for improvement in CORE global distress. End-point CORE global distress score was predicted from initial severity and a diagnosis of ASD. Participants with a diagnosis of ASD who completed the therapy had significantly better outcomes than completing participants without an ASD diagnosis.

Clinical implications

These findings provide preliminary support for RO DBT as an effective intervention for ASD in routine settings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9059310/

 

Reduce Distress with Diabetes with Mindfulness

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Reduce Distress with Diabetes with Mindfulness

 

By John M. de Castro, Ph.D.

 

“I fight a battle against my body every day. One that doesn’t end, with no breaks, and no finish line. I keep fighting even when I’m tired, weak, or when I feel I’ve had enough. I fight for my health in more ways than others understand. Until there is a cure.” – The Diabetic Journal

 

Diabetes is a major health issue. It is estimated that 30 million people in the United States and nearly 600 million people worldwide have diabetes, and the numbers are growing. Diabetes is heavily associated with other diseases such as cardiovascular disease, heart attacks, stroke, blindness, kidney disease, and circulatory problems leading to amputations. As a result, diabetes doubles the risk of death of any cause compared to individuals of the same age without diabetes.

 

Dealing with diabetes causes considerable distress in the patient. Mindfulness practices have been shown to be helpful in managing diabetes. This predicts that mindfulness training should reduce diabetes distress.

 

In today’s Research News article “Effects of an integrated mindfulness intervention for veterans with diabetes distress: a randomized controlled trial.” (See summary below or view the full text of the study at:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8961140/ ) DiNardo and colleagues studied the effectiveness of online mindfulness raining in reducing diabetes distress in military veterans who were receiving education and support with diabetes self-management.

 

They found that the education and support program produced significant improvements in both the psychological and physical symptoms of diabetes. But the additional mindfulness training produced a greater reduction in diabetes distress and improvements in dietary behaviors. This suggests that mindfulness training should be incorporated into diabetes management programs.

 

“Diabetes is like a roller coaster. It has its ups and downs, but it’s your choice to scream or enjoy the ride.” – Melissa Skrocki

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

DiNardo MM, Greco C, Phares AD, Beyer NM, Youk AO, Obrosky DS, Morone NE, Owen JE, Saba SK, Suss SJ, Siminerio L. Effects of an integrated mindfulness intervention for veterans with diabetes distress: a randomized controlled trial. BMJ Open Diabetes Res Care. 2022 Mar;10(2):e002631. doi: 10.1136/bmjdrc-2021-002631. PMID: 35346971; PMCID: PMC8961140.

 

Abstract

Introduction

US military veterans have disproportionately high rates of diabetes and diabetes-related morbidity in addition to being at risk of comorbid stress-related conditions. This study aimed to examine the effects of a technology-supported mindfulness intervention integrated into usual diabetes care and education on psychological and biobehavioral outcomes.

Research design and methods

Veterans (N=132) with type 1 or 2 diabetes participated in this two-arm randomized controlled efficacy trial. The intervention arm received a one-session mindfulness intervention integrated into a pre-existing program of diabetes self-management education and support (DSMES) plus one booster session and 24 weeks of home practice supported by a mobile application. The control arm received one 3-hour comprehensive DSMES group session. The primary outcome was change in diabetes distress (DD). The secondary outcomes were diabetes self-care behaviors, diabetes self-efficacy, post-traumatic stress disorder (PTSD), depression, mindfulness, hemoglobin A1C (HbA1C), body weight, and blood pressure. Assessments were conducted at baseline, 12 weeks, and 24 weeks. Participant satisfaction and engagement in home practice were assessed in the intervention group at 12 and 24 weeks.

Results

Intention-to-treat group by time analyses showed a statistically significant improvement in DD in both arms without significant intervention effect from baseline to 24 weeks. Examination of distal effects on DD between weeks 12 and 24 showed significantly greater improvement in the intervention arm. Improvement in DD was greater when baseline HbA1C was <8.5%. A significant intervention effect was also shown for general dietary behaviors. The secondary outcomes diabetes self-efficacy, PTSD, depression, and HbA1C significantly improved in both arms without significant intervention effects. Mindfulness and body weight were unchanged in either group.

Conclusions

A technology-supported mindfulness intervention integrated with DSMES showed stronger distal effects on DD compared with DSMES control. Examination of longer-term outcomes, underlying mechanisms, and the feasibility of virtual delivery is warranted.

Significance of this study

What is already known about this subject?

Diabetes distress related to the burden of diabetes self-care is an independent predictor of diabetes outcomes.

Emerging studies of mindfulness-based interventions have shown efficacy in reducing diabetes distress, but research is limited in populations at risk, including US military veterans.

What are the new findings?

A targeted mindfulness intervention integrated into conventional diabetes care is feasible, acceptable, and more efficacious for improving general dietary behaviors and for reducing diabetes distress after 12 weeks compared with conventional care.

Reductions in diabetes distress were greater with baseline hemoglobin A1C <8.5% (69 mol/mol), which may be relevant in selecting appropriate patients for mindfulness-based diabetes interventions.

Use of mobile technologies may help persons remain engaged in mindfulness practice and contribute to longer-term positive diabetes outcomes.

How might these results change the focus of research or clinical practice?

These results might influence standards of diabetes care to include mindfulness training as an adjunct to diabetes self-management education and support for suitable candidates.

Replication of these results with virtual delivery might help expand access to mindfulness-based educational programs for veterans and other persons at risk of diabetes and diabetes distress.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8961140/

 

Mindfulness is Associated with Less Relapse and Recurrence of Major Depressive Disorder

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Mindfulness is Associated with Less Relapse and Recurrence of Major Depressive Disorder

 

By John M. de Castro, Ph.D.

 

“Fall seven times, stand up eight.” – Japanese Proverb

 

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.

 

Relapsing into depression 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 to study the factors that lead to relapse and recurrence. Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail. So, it makes sense to study the relationship of mindfulness with relapse and recurrence of Major Depressive Disorder.

 

In today’s Research News article “Factors associated with relapse and recurrence of major depressive disorder in patients starting mindfulness-based cognitive therapy.” (See summary below or view the full text of the study at:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9298927/ ) de Klerk-Sluis and colleagues studied patients who were in remission for Major Depressive Disorder and the factors that predicted relapse and recurrence.

 

They found that the higher the levels of mindfulness the lower the risk of relapse and recurrence. They also found that the greater the ability of mild emotions to reactivate negative thinking patterns (cognitive reactivity) the greater the likelihood of relapse and recurrence. Finally, they found that rumination was associated with relapse and recurrence in patients who were not taking antidepressant drugs but not in patients on the drugs.

 

It appears that thought processes have large effects on relapse and recurrence of Major Depressive Disorder. But mindful thinking is helpful in preventing relapse. This suggests that mindfulness training should be recommended for patients in remission from Major Depressive Disorder. Indeed, mindfulness training has been shown to reduce the likelihood of relapse.

 

“But if you’ve fought depression or know somebody who has, you know that no amount of money can fix it. No amount of fame. No logic. The continuing stigma around suicide and mental illness tells me that not enough people truly understand it. I don’t really blame them—its impossible unless you’ve lived it.”-  David Chang

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

de Klerk-Sluis JM, Huijbers MJ, Löcke S, Spijker J, Spinhoven P, Speckens AEM, Ruhe HG. Factors associated with relapse and recurrence of major depressive disorder in patients starting mindfulness-based cognitive therapy. Depress Anxiety. 2022 Feb;39(2):113-122. doi: 10.1002/da.23220. Epub 2021 Nov 9. PMID: 34752681; PMCID: PMC9298927.

 

Abstract

Background

Mindfulness‐based cognitive therapy (MBCT) is effective for relapse prevention in major depressive disorder (MDD). It reduces cognitive reactivity (CR) and rumination, and enhances self‐compassion and mindfulness. Although rumination and mindfulness after MBCT are associated with relapse, the association of CR, rumination, self‐compassion, and mindfulness with relapse before initiation of MBCT has never been investigated.

Methods

Data were drawn from two randomized controlled trials, including a total of 282 remitted MDD participants (≥3 depressive episodes) who had been using maintenance antidepressant medication (mADM) for at least 6 months before baseline. All participants were offered MBCT while either their mADM was maintained or discontinued after MBCT. CR, rumination, self‐compassion, and mindfulness were assessed at baseline by self‐rated questionnaires and were used in Cox proportional hazards regression models to investigate their association with relapse.

Results

CR and mindfulness were associated with relapse, independent of residual symptoms, previous depressive episodes, and mADM‐use. Higher CR and lower mindfulness increased the risk of relapse. Self‐compassion was not associated with relapse. For rumination, a significant interaction with mADM‐use was found. Rumination was associated with relapse in patients who discontinued their mADM, while this effect was absent if patients continued mADM.

Conclusions

These results show that CR, rumination, and mindfulness are associated with relapse in remitted MDD‐patients before initiation of MBCT, independent of residual symptoms and previous depressive episodes. This information could improve decisions in treatment planning in remitted individuals with a history of depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9298927/