contemplative practice

Improve Posttraumatic Stress Disorder (PTSD) with Compassion Meditation

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Improve Posttraumatic Stress Disorder (PTSD) with Compassion Meditation

 

By John M. de Castro, Ph.D.

 

“self-compassion provides a promising vision for trauma treatment . . . Self-compassion is strongly linked to emotional well-being, is an important mechanism of change in psychotherapy, and touches the core of trauma related symptomatology.” – Christopher Germer

 

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime. But only a fraction will develop Post-Traumatic Stress Disorder (PTSD). But this still results in a frightening number of people with 7%-8% of the population developing PTSD at some point in their life.

 

PTSD involves a number of troubling symptoms including reliving the event with the same fear and horror in nightmares or with a flashback. PTSD sufferers avoid situations that remind them of the event this may include crowds, driving, movies, etc. and may avoid seeking help because it keeps them from having to think or talk about the event. They often experience negative changes in beliefs and feelings including difficulty experiencing positive or loving feelings toward other people, avoiding relationships, memory difficulties, or see the world as dangerous and no one can be trusted. Sufferers may feel hyperarousal, feeling keyed up and jittery, or always alert and on the lookout for danger. They may experience sudden anger or irritability, may have a hard time sleeping or concentrating, may be startled by a loud noise or surprise.

 

Obviously, these are troubling symptoms that need to be addressed. There are a number of therapies that have been developed to treat PTSD. One of which, mindfulness training has been found to be particularly effective. Increasing self-compassion is important for improvement in PTSD symptoms. Mindfulness has been shown to increase self-compassion. So, it makes sense to explore the relationships between mindfulness, self-compassion, and PTSD symptoms.

 

In today’s Research News article “Compassion Meditation for Veterans with Posttraumatic Stress Disorder (PTSD): a Nonrandomized Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223870/) Lang and colleagues recruited veterans who were diagnosed with PTSD. They were provided with 8-10 sessions of 1.5-2 hours of group Cognitively Based Compassion Training (CBCT) with daily meditation homework. CBCT was developed with a standardized manual and includes a set of meditation practices designed to increase attention to the present moment and compassion for self and others. The participants were measured before and after the training for PTSD symptoms, emotional experiences, social connectedness, and self-compassion including self-kindness, common humanity, mindfulness, self-judgment, isolation, and over-identification subscales. They were measured after the intervention for satisfaction with the intervention and semi-structured interviews about the understandability, applicability, and efficacy of the intervention.

 

They found that in comparison to baseline after treatment there was a large significant reduction in PTSD symptoms and depression. Surprisingly, there were no significant changes in positive and negative emotions or self-compassion. 61% of the veterans completed 6 or more sessions and they indicated overall satisfaction with the Cognitively Based Compassion Training (CBCT) intervention.

 

This was a pilot feasibility study without a control group. So, conclusions have to be reached cautiously. But the intent of the study was to establish feasibility and acceptability of the new intervention and was successful at that. It also provided preliminary evidence that the Cognitively Based Compassion Training (CBCT) intervention was safe and effective for veterans diagnosed with Posttraumatic Stress Disorder (PTSD). These results provide the empirical basis justifying a large randomized controlled trial in the future.

 

So, improve Posttraumatic Stress Disorder (PTSD) with compassion meditation.

 

“increases in self-compassion, notably self-kindness and mindfulness, were associated with decreases in PTSD symptoms.” – NICABM

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Lang, A. J., Casmar, P., Hurst, S., Harrison, T., Golshan, S., Good, R., Essex, M., & Negi, L. (2020). Compassion Meditation for Veterans with Posttraumatic Stress Disorder (PTSD): a Nonrandomized Study. Mindfulness, 11(1), 63–74. https://doi.org/10.1007/s12671-017-0866-z

 

Abstract

Compassion meditation (CM) is a contemplative practice that is intended to cultivate the ability to extend and sustain compassion toward self and others. Although research documents the benefits of CM in healthy populations, its use in the context of psychopathology is largely unexamined. The purpose of this study was to refine and initially evaluate a CM protocol, Cognitively Based Compassion Training (CBCT®), for use with Veterans with PTSD. To this end, our research team developed and refined a manualized protocol, CBCT-Vet, over 4 sets of groups involving 36 Veterans. This protocol was delivered in 8–10 sessions, each lasting 90–120 min and led by a CBCT®-trained clinical psychologist. Quantitative and qualitative data were used to identify areas to be improved and to assess change that occurred during the treatment period. Based on pooled data from this series of groups, CM appears to be acceptable to Veterans with PTSD. Group participation was associated with reduced symptoms of PTSD (partial eta squared = .27) and depression (partial eta squared = .19), but causality should not be inferred given the nonrandomized design. No change was observed in additional outcomes, including positive emotion and social connectedness. The results of this open trial support additional exploration of CM as part of the recovery process for Veterans with PTSD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223870/

 

Meditation and Yogic Breathing Techniques Improve Respiration and Psychological Well-Being

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Meditation and Yogic Breathing Techniques Improve Respiration and Psychological Well-Being

 

By John M. de Castro, Ph.D.

 

“Yoga, meditation and other relaxation techniques all depend on focusing on the breath. There are many benefits of meditation and proper breathing is an important part of learning how to calm the mind and body.” – Home Care Assistance

 

Breathing is essential for life and generally occurs automatically. It’s easy to take for granted as it’s been there our entire lives. Nevertheless, we become more aware of it when it varies with circumstances, such as when we exercise and also in emotional states, especially fear and anxiety. But we rarely notice it during everyday ongoing life. Yet, its characteristics are associated with our state of well-being. Slow deep breathing is characteristic of a healthy relaxed state. Breathing exercises are common in yoga and meditation practices and have been found to have a number of beneficial effects.

 

Modern medicine has also developed respiratory therapies for the treatment of patients with cardiovascular and pulmonary diseases. Many of these techniques are similar to those practiced in meditation and yoga. In today’s Research News article “Analogy between classical Yoga/Zen breathing and modern clinical respiratory therapy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7429199/) Tobe and Saito examine the similarities of meditation and yoga breathing exercises and respiratory therapies and their relative effects.

 

Respiratory therapy has been shown to be essential in the treatment of respiratory diseases. But, breathing techniques are not new. They’ve been practiced for over 3000 years. Yoga incorporates a number of different techniques. Even the Buddha emphasized breathing techniques during meditation and these were greatly elaborated on in Zen meditation. There are considerable similarities with respiratory therapy and meditation and yogic breathing techniques. They all emphasize deep inhalation, slow exhalation with some resistance, low respiratory frequency, and even counting of breaths.

 

Tobe and Saito note that research has shown that meditation and yogic breathing techniques, like respiratory therapy, have considerable positive effects on respiration including improved “vital capacity, timed vital capacity, maximum voluntary ventilation, breath-hold time, maximal inspiratory and expiratory pressures and oxygen saturation.” They also increase the psychological well-being of practitioners including reducing panic attacks, depression, and headaches, relieving pain, and improving sleep.

 

Tobe and Saito conclude that meditation and yogic breathing techniques are effective in modern clinical practice improving respiratory function and psychological well-being, and relieving chronic pain. Indeed, research on meditation and yogic breathing techniques suggest that they improve physiological and respiratory function and are effective for the treatment of a number of diseases and psychological problems.

 

So, meditation and yogic breathing techniques improve respiration and psychological well-being.

 

“By inducing stress resilience, breath work enables us to rapidly and compassionately relieve many forms of suffering.” – Richard Brown

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Tobe, M., & Saito, S. (2020). Analogy between classical Yoga/Zen breathing and modern clinical respiratory therapy. Journal of anesthesia, 1–6. Advance online publication. https://doi.org/10.1007/s00540-020-02840-5

 

Abstract

Anesthesiologists and intensivists are modern-day professionals who provide appropriate respiratory care, vital for patient survival. Recently, anesthesiologists have increasingly focused their attention on the type of spontaneous breathing made by non-intubated patients with pulmonary disease cared for in an intensive care unit, and also patients with chronic pain receiving cognitive behavioral therapy. Prior to our modern understanding of respiratory physiology, Zen meditators recognized that breathing has a significant impact on a person’s mental state and general physical well-being. Examples of this knowledge regarding respiration include the beneficial effects of deep inhalation and slow exhalation on anxiety and general wellness. The classical literature has noted many suggestions for breathing and its psycho-physical effects. In the present review, we examine the effect of classical breathing methods and find an analogy between typical Yoga/Zen breathing and modern clinical respiratory therapy. Evidence is increasing about historical breathing and related meditation techniques that may be effective in modern clinical practice, especially in the field of anesthesiology, such as in improving respiratory function and reducing chronic pain. Clarification of the detailed mechanisms involved is anticipated.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7429199/

 

Improve Anxiety and Depression in Iranian Chronic Pain Patients with Mindfulness

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Improve Anxiety and Depression in Iranian Chronic Pain Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindful meditation can help ease psychological stresses like anxiety, depression, and pain.” – Julie Corliss

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain.

 

There is an accumulating volume of research findings to demonstrate that mindfulness practices, in general, are effective in treating pain. Chronic pain patients tend to also suffer from anxiety and depression and mindfulness has been shown to improve anxiety and depression. A lot of research has been done on various psychological treatments for chronic pain and its associated anxiety and depression. So, it makes sense to step back and take a look at what has been learned.

 

In today’s Research News article “Psychological interventions for depression and anxiety: a systematic review and meta-analysis of Iranian chronic pain trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7420174/) Jandaghi and colleagues review, summarize and perform a meta-analysis on treatments for chronic pain and its associated anxiety and depression in Iranian patients. They identified 30 randomized controlled trials with a total of 1021 participants.

 

They report that the published randomized controlled trials found that psychological interventions in general improve anxiety and depression in patients with chronic pain and these effects persist for at least several months. On average mindfulness-based therapies produced superior results to Cognitive Behavioral and other therapeutic approaches; producing greater relief of anxiety and depression.

 

Thus, the accumulated findings suggest that psychological treatments and especially mindfulness-based therapies are safe and effective treatment for anxiety and depression in chronic pain patients. This is important not only for the psychological well-being of the patients but also for their pain as anxiety and depression can amplify the levels of experienced pain in the patients.

 

So, improve anxiety and depression in Iranian chronic pain patients with mindfulness.

 

“Mindfulness exercises help people to focus their mind and body in the moment without judgment. . . Being able to focus on relaxing the body, noticing the breath and body sensations as being there just as they are, can help manage pain, as well as reduce depression and anxiety symptoms.” – Mayo Clinic

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Jandaghi, G., Firoozi, M., & Zia-Tohidi, A. (2020). Psychological interventions for depression and anxiety: a systematic review and meta-analysis of Iranian chronic pain trials. Health promotion perspectives, 10(3), 180–191. https://doi.org/10.34172/hpp.2020.31

 

Abstract

Background: Chronic pain is commonly associated with anxiety and depression, making it more challenging to be managed. Psychological interventions are suggested for such complicated issues which are well evident in the United States and Europe. However, generalizing the evidence to Iranian population – as a Middle Eastern society – might be questionable. We aimed to synthesize our evidence on the effectiveness of these interventions among Iranian populations.

Methods: This was a systematic review and meta-analysis. Persian and English literature were searched through Iran-doc, Elm-net, and PubMed until March 2019 using the following terms (or its Persian synonyms): chronic pain; persistent pain; chronic fatigue; fibromyalgia; neuropath*; LBP; irritable bowel; CFS; psycho*; cogniti*; acceptance; meaning; mindfulness; relaxation; biopsychosocial; rehabilitation; educat*. Eligible trials were randomized trials that evaluated the effectiveness of psychological interventions on Iranian adults with chronic pain. No setting restriction was considered. Risk of bias for each trial was assessed, and the random-effect model was used to pool summary effect across trials.

Results: In all 30 eligible RCTs, the risk of bias for randomization was low except for one study. The pooled standardized mean difference (SMD) for depression and anxiety were 1.33 (95%CI: -1.42 to -0.68) and 1.25 (95% CI: -1.55 to -0.96), respectively.

Conclusion: This study suggests that psychological interventions are highly effective in reducing depression and anxiety in Iranian patients with chronic pain, compared to what observed in the U.S. and European studies. However, there are still some methodological issues to be addressed. Future research should focus on high-quality trials with considerations on the methodological issues reported in the present study.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7420174/

 

Improve Sleep and Social Anxiety with Mindfulness

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Improve Sleep and Social Anxiety with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Self-compassionate people tend to have lower levels of social anxiety—perhaps because self-compassion includes mindfulness, which soothes the stress associated with anxiety.” – Jill Suttie

 

It is a common human phenomenon that being in a social situation can be stressful and anxiety producing. Most people can deal with the anxiety and can become quite comfortable. But many do not cope well and the anxiety is overwhelming, causing the individual to withdraw. Social Anxiety Disorder (SAD) is characterized by a persistent, intense, and chronic fear of being watched and judged by others and feeling embarrassed or humiliated by their actions. This fear may be so severe that it interferes with work, school, and other activities and may negatively affect the person’s ability to form relationships.

 

Anxiety disorders have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for anxiety. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders including Social Anxiety Disorder (SAD).

 

Social Anxiety Disorder (SAD) has also been found to be associated with sleep disturbance. Mindfulness-based practices have been reported to improve sleep amount and quality and help with insomnia. So, it makes sense to explore the interactions of mindfulness training, sleep quality, and Social Anxiety Disorder (SAD).

 

In today’s Research News article “Sleep quality and treatment of social anxiety disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6698895/) Horenstein and colleagues recruited healthy control participants and adult patients diagnosed with Social Anxiety Disorder (SAD). The patients were randomly assigned to either a wait-list control condition or to receive 12 weekly 2.5 hour sessions of either Cognitive Behavioral Group Therapy (CBGT) or Mindfulness-Based Stress Reduction (MBSR) along with home readings and practices. MBSR training employs meditation, body scan, yoga, discussions, and home practice. CBGT explores and attempts to change inaccurate or negative thinking so the patient can view challenging situations more clearly and respond to them in a more effective way. They were measured before and after the 12-week treatment period and 12 months later for mental illness, sleep quality, and social anxiety.

 

They found that at baseline the patients diagnosed with Social Anxiety Disorder (SAD) had significantly poorer sleep quality than healthy control participants. After treatment both the Cognitive Behavioral Group Therapy (CBGT) or Mindfulness-Based Stress Reduction (MBSR) groups had significant improvements in Social Anxiety Disorder (SAD) compared to baseline and the wait-list control participants. In addition, the patients who received MBSR had significant improvement in sleep quality. But this did not significantly differ from patients receiving CBGT. Sleep quality, however, did not significantly modify the treatment responses and changes in sleep quality over treatment did not predict changes in social anxiety.

 

These results are interesting and demonstrate that both Cognitive Behavioral Group Therapy (CBGT) or Mindfulness-Based Stress Reduction (MBSR) effectively reduce social anxiety in patients with Social Anxiety Disorder (SAD) while MBSR also improves sleep quality in these patients. This replicates previous findings that mindfulness training improves SAD and sleep. The new contribution of the present study was that sleep quality was not related to improvements in SAD.

 

So, improve sleep and social anxiety with mindfulness.

 

“Lack of sleep, or poor quality sleep, can worsen social anxiety in those with the disorder and even trigger similar feelings in others.” – Relax Melodies

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Horenstein, A., Morrison, A. S., Goldin, P., Ten Brink, M., Gross, J. J., & Heimberg, R. G. (2019). Sleep quality and treatment of social anxiety disorder. Anxiety, stress, and coping, 32(4), 387–398. https://doi.org/10.1080/10615806.2019.1617854

 

Abstract

Background and Objectives:

Poor sleep is prevalent among individuals with social anxiety disorder (SAD) and may affect treatment outcome. We examined whether: (1) individuals with SAD differed from healthy controls (HCs) in sleep quality, (2) baseline sleep quality moderated the effects of treatment (Cognitive-behavioral group therapy [CBGT] vs. mindfulness-based stress reduction [MBSR] vs. waitlist [WL]) on social anxiety, (3) sleep quality changed over treatment, and (4) changes in sleep quality predicted anxiety 12-months post-treatment.

Design:

Participants were 108 adults with SAD from a randomized controlled trial of CBGT vs. MBSR vs. WL and 38 HCs.

Methods:

SAD and sleep quality were assessed pre-treatment and post-treatment, and SAD was assessed again 12-months post-treatment.

Results:

Participants with SAD reported poorer sleep quality than HCs. The effect of treatment condition on post-treatment social anxiety did not differ as a function of baseline sleep quality. Sleep quality improved in MBSR, significantly more than WL, but not CBGT. Sleep quality change from pre- to post-treatment in CBGT or MBSR did not predict later social anxiety.

Conclusions:

MBSR, and not CBGT, improved sleep quality among participants. Other results were inconsistent with prior research; possible explanations, limitations, and implications for future research are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6698895/

 

Improve the Symptoms of Lymphangioleiomyomatosis, a Rare Lung Disease, with Yoga

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Improve the Symptoms of Lymphangioleiomyomatosis, a Rare Lung Disease, with Yoga

 

By John M. de Castro, Ph.D.

 

“The daily practice of yoga can help in strengthening the muscles of the chest, increase lung capacity and boost oxygen intake.” – Ayurvalley

 

Lymphangioleiomyomatosis (LAM) is a very rare lung disease “caused by the abnormal growth of smooth muscle cells, especially in the lungs and lymphatic system. This abnormal growth leads to the formation of holes or cysts in the lung.” (Cleveland Clinic). It is a progressive disease that has symptoms similar to asthma and bronchitis. It is most prevalent in women during the prime of their lives, ages 20 to 40 years. There are no cures for LAM and treatment usually involves drugs that slow the disease progression.

 

Yoga has been shown to improve exercise tolerance and overall health and includes breathing exercises. Indeed, it has been shown that yoga practice improves the mental and physical health of patients with Chronic Obstructive Pulmonary Disease (COPD). So, it may be appropriate for patients with Lymphangioleiomyomatosis (LAM). Hence, there is a need for research into the effectiveness of yoga practice for LAM.

 

In today’s Research News article “Effects of yoga on exercise capacity in patients with lymphangioleiomyomatosis: a nonrandomized controlled study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075042/) Li and colleagues adult patients with lymphangioleiomyomatosis (LAM) who have stable disease and assigned them to either no-treatment or to receive Hatha yoga training for 90 minutes once a week for 24 weeks along with twice a week for 15 minutes home practice. They were measured before and after training for walking and afterward dyspnea, VO2peak and anaerobic threshold during an exercise test, lung function, activity, quality of life, anxiety and depression.

 

They found excellent participation and compliance with 92% attendance at the yoga training sessions and a median at how practice of 75 minutes per week. They found that in comparison to baseline and the no-treatment control group that the patients who received yoga training there was a significant large improvement in walking, and cardiopulmonary anerobic threshold, and peak workload.

 

These excellent results have to be tempered by the fact that the yoga and control groups were not randomly assigned. Rather patients within a city were compared to patients outside the city. But, as pilot results, they support a development of a large randomized control trial. The results suggest that yoga practice significantly improves motor function and cardiopulmonary function in patients with lymphangioleiomyomatosis (LAM). This would represent a significant improvement in the patients’ health.

 

So, improve the symptoms of lymphangioleiomyomatosis, a rare lung disease, with yoga.

 

“the beneficial effects of yoga on exercise capacity and pulmonary function were the most robust.” – Brandon May

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Li, X., Xu, W., Zhang, L., Zu, Y., Li, Y., Yang, Y., Xiang, Y., Xiang, Y., Chen, L., Liu, W., Chen, L., & Xu, K. F. (2020). Effects of yoga on exercise capacity in patients with lymphangioleiomyomatosis: a nonrandomized controlled study. Orphanet journal of rare diseases, 15(1), 72. https://doi.org/10.1186/s13023-020-1344-6

 

Abstract

Objective

To evaluate the effects of yoga on exercise capacity and quality of life in patients with lymphangioleiomyomatosis (LAM), a rare cystic lung disease in women.

Patients and methods

This was a nonrandomized, controlled study conducted in Beijing, China (August 27, 2017 – April 26, 2018). Twenty-six participants were allocated to the intervention (yoga) group (n = 13) or control group (n = 13). The yoga intervention involved a 24-week program of yoga class training for 90 min once a week and no fewer than 2 at-home sessions per week (at least 15 min per session). The 6-min walking distance (6MWD), lung function, serum vascular endothelial growth factor-D (VEGF-D) levels, quality of life, and symptoms of anxiety and depression were measured at baseline, 12-week and 24-week follow-up. An incremental cardiopulmonary exercise test was conducted at baseline and the 24-week follow-up.

Results

Eleven patients completed the yoga training program. The yoga group exhibited improvements in the following outcomes versus those of the control group: 6MWD (+ 55 ± 29 m vs + 18 ± 49 m, P = 0.04), anaerobic threshold (3.4 ± 2.4 ml/min/kg vs 1.6 ± 1.4 ml/min/kg, P = 0.035) and peak work load (11.7 ± 14.6 W vs 0.2 ± 9.1 W, P = 0.027). There was no significant difference in peak oxygen consumption (VO2peak), lung function, VEGF-D level, and quality of life between the yoga and control groups. No adverse effects were found in the yoga group.

Conclusion

Yoga is a feasible and safe intervention for pulmonary rehabilitation and potentially improves exercise capacity in patients with LAM.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075042/

 

Decrease Hypertension with Tai Chi

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Decrease Hypertension with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Tai chi may be just as effective as popular methods for lowering blood pressure, such as weight loss and lowered sodium intake. . . tai chi may positively affect blood cholesterol, related lipids and inflammation. This means that enjoying tai chi regularly may lower your chance of heart disease.” – Abbot

 

High Blood Pressure (Hypertension) is an insidious disease because there are no overt symptoms. The individual feels fine. But it can be deadly as more than 360,000 American deaths, roughly 1,000 deaths each day, had high blood pressure as a primary or contributing cause. In addition, hypertension markedly increases the risk heart attack, stroke, heart failure, and kidney disease.  It is also a very common disorder with about 70 million American adults (29%) having high blood pressure and only about half (52%) of people with high blood pressure have their condition under control. Treatment frequently includes antihypertensive drugs. But these medications often have adverse side effects. So, patients feel lousy when taking the drugs, but fine when they’re not. So, compliance is a major issue with many patients not taking the drugs regularly or stopping entirely.

 

Obviously, there is a need for alternative to drug treatments for hypertension. Mindfulness practices have been shown to aid in controlling hypertension. Mindful movement practices such Tai Chi and Qigong are ancient Chinese practices involving mindfulness and gentle movements. They are easy to learn, safe, and gentle. So, it may be appropriate for patients with hypertension who lack the ability to engage in strenuous exercises. Indeed, Qigong practice has been shown to reduce blood pressure. There have been a number of studies performed and it is useful to summarize what has been learned.

 

In today’s Research News article “The Efficacy of Tai Chi and Qigong Exercises on Blood Pressure and Blood Levels of Nitric Oxide and Endothelin-1 in Patients with Essential Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7414352/) Liu and colleagues review, summarize, and perform a meta-analysis of the effectiveness of Tai Chi practice in treating hypertension. They found 9 published randomized controlled trials including a total of 516 patients.

 

They report that the published research found that Tai Chi practice produced a significant reduction in both systolic and diastolic blood pressure and blood endothelin-1 levels and significant increases in blood nitrous oxide levels. Endothelin-1 is a powerful vasoconstrictor and Nitrous Oxide is a powerful vasodilator. So, the reduced levels of Endothelin-1 and increased levels of Nitrous Oxide in patients performing Tai Chi may be a physiological mechanism by which the practice lowers blood pressure.

 

These findings suggest that Tai Chi practice is a safe and effective treatment to lower blood pressure in patients with hypertension. Some advantages of Tai Chi include the facts that it is not strenuous, involves slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It can also be practiced without professional supervision and in groups making it inexpensive to deliver and fun to engage in. This makes Tai Chi practice an excellent treatment for hypertension.

 

So, decrease hypertension with Tai Chi.

 

“High blood pressure can precede cardiovascular complications, such as a heart attack, so it is important to keep it in check. If your blood pressure is too high, there is a simple exercise you can do at home. . . Evidence suggests tai chi, a mind-body practice that has its origin Chinese martial arts, can lower high blood pressure.” – Adam Chapman

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Liu, D., Yi, L., Sheng, M., Wang, G., & Zou, Y. (2020). The Efficacy of Tai Chi and Qigong Exercises on Blood Pressure and Blood Levels of Nitric Oxide and Endothelin-1 in Patients with Essential Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evidence-based complementary and alternative medicine : eCAM, 2020, 3267971. https://doi.org/10.1155/2020/3267971

 

Abstract

Objective

Tai Chi and Qigong are the two similar traditional Chinese wellness exercises. A strong body of published clinical randomized controlled trials (RCTs) has investigated the health benefits of Tai Chi and Qigong exercises (TCQE) in patients with essential hypertension (EH). This is the first meta-analysis to evaluate the efficacy of TCQE on blood pressure (BP) and blood levels of nitric oxide (NO) and endothelin-1 (ET-1) in EH patients and explore the potential antihypertensive mechanism of TCQE.

Methods

We conducted a literature retrieval for Chinese and English studies in seven databases from their respective inceptions until January 14, 2020. All RCTs examining clinical efficacy of TCQE for EH patients were considered. The major therapeutic outcomes of TCQE were changes in the blood levels of NO, ET-1, and BP in EH patients. Methodological quality of the included RCTs was detected via The Cochrane Risk of Bias tool. We evaluated the data reported and performed the meta-analysis by Review Manager 5.3 software.

Results

9 RCTs involving 516 EH patients were included. The intervention duration lasted from 1.5 months to 6 months. The results of comprehensive analysis showed that compared with control interventions, experimental interventions were more effective in reducing the systolic blood pressure and the diastolic blood pressure and contributed higher blood levels of NO and lower blood levels of ET-1.

Conclusions

TCQE could be an effective complementary and alternative therapy for EH. The lower BP in EH patients who practice TCQE may have some connection with exercise-related increased blood NO levels and decreased blood ET-1 levels. However, further research is needed to make clear the efficacy of TCQE in management of EH and the mechanism of lowering BP in TCQE.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7414352/

 

Mindfulness Trained Over the Internet Improves Stress Management in Healthy Adults

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Mindfulness Trained Over the Internet Improves Stress Management in Healthy Adults

 

By John M. de Castro, Ph.D.

 

“mindfulness gently builds an inner strength, so that future stressors have less impact on our happiness and physical well-being.” – Shamash Alidina

 

Mindfulness training has been shown to be effective in improving physical and psychological health. One reason for these benefits is that mindfulness training improves the individual’s physical and psychological reactions to stress. Stress is an integral part of life, that is actually essential to the health of the body. In moderation, it is healthful, strengthening, and provides interest and fun to life. If stress, is high or is prolonged, however, it can be problematic. It can significantly damage our physical and mental health and even reduce our longevity, leading to premature deaths.

 

It is important that we develop methods to either reduce or control high or prolonged stress or reduce our responses to it. Mindfulness practices have been found routinely to reduce the psychological and physiological responses to stress. and this appears to be important for health. The vast majority of the mindfulness training techniques, however, require a trained teacher. The participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with busy employee 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 this approach in inducing mindfulness and reducing stress and improving psychological well-being in healthy individuals in real-world work settings.

 

The evidence has been accumulating. So, it is reasonable to step back and summarize what has been learned about the effects of mindfulness provided over the internet on the individual’s ability to manage stress. In today’s Research News article “A meta-analysis: Internet mindfulness-based interventions for stress management in the general population.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7360300/) Zhang and colleagues reviewed, summarized, and performed a meta-analysis of the published research controlled trials investigating the effects of mindfulness training provided over the internet on the management of stress in healthy participants. They identified 16 controlled trials.

 

They report that the published research found that mindfulness training of healthy participants provided over the internet produced significant increases in mindfulness and significant decreases in perceived stress with moderate effect sizes and significant decreases in anxiety and depression with small effect sizes. These results occurred regardless of the method of delivery of mindfulness training and whether students, staff, or both were the subjects. In addition, they found that when therapist guidance was present the effect sizes were larger.

 

It has been well established the mindfulness training decreases perceived stress, anxiety, and depression in a variety of healthy and ill populations and with a variety of delivery methods. The present meta-analysis demonstrates that mindfulness training over the internet is effective in improving stress management and mental health in healthy individuals. The results also suggest that having some guidance from a therapist provided along with the internet-based training improves the effectiveness of the treatments.

 

These results suggest that mindfulness training is widely effective and can be delivered cheaply and conveniently to large numbers of geographically diffuse populations. Since, stress is so ubiquitous in modern society, mindfulness training may be a way to counter the effects of that stress on physical and mental health.

 

So, mindfulness trained over the internet improves stress management in healthy adults.

 

“Learning how to accept your present-moment experience is really important for reducing stress. It seems to be a key element of mindfulness training.” – Emily Lindsay

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Zhang, Y., Xue, J., & Huang, Y. (2020). A meta-analysis: Internet mindfulness-based interventions for stress management in the general population. Medicine, 99(28), e20493. https://doi.org/10.1097/MD.0000000000020493

 

Abstract

Background:

Psychological stress was an important mental health problem among the general population and warrant research to inform strategies for effective prevention. iMBIs provide a possibility to offer easily accessible, efficacious, convenient, and low-cost interventions on a wide scale. However, the efficacy of iMBIs in the general population remains unclear. The aim of this meta-analysis is to evaluate the effects of iMBIs for stress reduction in the general population.

Methods:

A systematic search in PubMed, Embase, Web of Science, Medline, Cochrane Library, CNKI, and Wanfang Data databases was performed up to April 10, 2019. The overall effect sizes of the iMBIs on stress, depression, anxiety, and mindfulness were recorded by the metric of Hedges’ g with 95% confidence interval (CI), Z-value, and P value.

Results:

Sixteen eligible studies were included in the meta-analysis. The overall results indicated that iMBIs had small to moderate effects on stress (Hedges’ g = −0.393) and mindfulness (Hedges’ g = −0.316) compared with the control group. Results from subgroup analyses revealed that the type of sample and delivery mode had a greater impact on heterogeneity across the studies. Meta-regression found that the overall effect might be moderated by guidance for iMBIs.

Conclusion:

The present meta-analysis suggested that iMBIs had small to moderate effects in reducing stress and improving mindfulness of the general population in comparison with the control group. Future research is needed to explore how iMBIs are remolded to improve adherence and suit specific individuals.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7360300/

 

Reduce Anxiety and Depression in College Student with an Online Mindfulness Virtual Community

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Reduce Anxiety and Depression in College Student with an Online Mindfulness Virtual Community

 

By John M. de Castro, Ph.D.

 

“Student life can be stressful, but that doesn’t mean students have to let stress take over their lives. By incorporating mindfulness and meditation into daily routines, students can not only relieve the pressure, but also improve their memory, focus and ultimately their grades.” – Kenya McCullum

 

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 actually lead to stress and anxiety which can impede the student’s physical and mental health, well-being, and school performance. Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health. Indeed, these practices have been found to improve psychological health in college students.

 

The vast majority of the mindfulness training techniques, however, require a trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. As an alternative, mindfulness training over the internet have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. In addition, research has indicated that mindfulness training online can be effective for improving the health and well-being of the participants.

 

In today’s Research News article “Effectiveness of an 8-Week Web-Based Mindfulness Virtual Community Intervention for University Students on Symptoms of Stress, Anxiety, and Depression: Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7395254/) El Morr and colleagues recruited undergraduate students and randomly assigned them to either a wait-list control condition or to receive an 8 week online mindfulness virtual community program. The program incorporated brief online modules on mindfulness and student issues, online group discussions, and moderated 20-minute online videoconferences on mindfulness. The participants were measured before and after training for depression, anxiety, perceived stress, and mindfulness.

 

They found that compared to baseline and the waitlist control condition, participants in the online mindfulness virtual community had significantly higher mindfulness and significantly lower levels of depression and anxiety, with medium to large effect sizes. These findings suggest that online group training in mindfulness improves the mental health of college students.

 

College can be a difficult and stressful time for the students. There is pressure to perform academically while in a novel environment outside of the family with social pressures. This study suggests that the students can be helped in their adjustment with online mindfulness training, improving their psychological health. More research is needed, however, to determine if the mindfulness training produces not just short-term but lasting benefits for the students.

 

So, reduce anxiety and depression in college student with an online mindfulness virtual community.

 

“Learning how to meditate and be more mindful was one of the best things I’ve done as a student here. I’ve struggled with anxiety for many years, and became really overwhelmed by everything by my sophomore year. My grades started to fall as I slept less and tried to take on more and more. I’m so thankful for the skills I learned in this class. It’s not only made me a better student, but it’s also made me a happier person!”

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

El Morr, C., Ritvo, P., Ahmad, F., Moineddin, R., & MVC Team (2020). Effectiveness of an 8-Week Web-Based Mindfulness Virtual Community Intervention for University Students on Symptoms of Stress, Anxiety, and Depression: Randomized Controlled Trial. JMIR mental health, 7(7), e18595. https://doi.org/10.2196/18595

 

Abstract

Background

A student mental health crisis is increasingly acknowledged and will only intensify with the COVID-19 crisis. Given accessibility of methods with demonstrated efficacy in reducing depression and anxiety (eg, mindfulness meditation and cognitive behavioral therapy [CBT]) and limitations imposed by geographic obstructions and localized expertise, web-based alternatives have become vehicles for scaled-up delivery of benefits at modest cost. Mindfulness Virtual Community (MVC), a web-based program informed by CBT constructs and featuring online videos, discussion forums, and videoconferencing, was developed to target depression, anxiety, and experiences of excess stress among university students.

Objective

The aim of this study was to assess the effectiveness of an 8-week web-based mindfulness and CBT program in reducing symptoms of depression, anxiety, and stress (primary outcomes) and increasing mindfulness (secondary outcome) within a randomized controlled trial (RCT) with undergraduate students at a large Canadian university.

Methods

An RCT was designed to assess undergraduate students (n=160) who were randomly allocated to a web-based guided mindfulness–CBT condition (n=80) or to a waitlist control (WLC) condition (n=80). The 8-week intervention consisted of a web-based platform comprising (1) 12 video-based modules with psychoeducation on students’ preidentified life challenges and applied mindfulness practice; (2) anonymous peer-to-peer discussion forums; and (3) anonymous, group-based, professionally guided 20-minute live videoconferences. The outcomes (depression, anxiety, stress, and mindfulness) were measured via an online survey at baseline and at 8 weeks postintervention using the Patient Health Questionnaire-9 (PHQ9), the Beck Anxiety Inventory (BAI), the Perceived Stress Scale (PSS), and the Five Facets Mindfulness Questionnaire Short Form (FFMQ-SF). Analyses employed generalized estimation equation methods with AR(1) covariance structures and were adjusted for possible covariates (gender, age, country of birth, ethnicity, English as first language, paid work, unpaid work, relationship status, physical exercise, self-rated health, and access to private mental health counseling).

Results

Of the 159 students who provided T1 data, 32 were males and 125 were females with a mean age of 22.55 years. Participants in the MVC (n=79) and WLC (n=80) groups were similar in sociodemographic characteristics at T1 with the exception of gender and weekly hours of unpaid volunteer work. At postintervention follow-up, according to the adjusted comparisons, there were statistically significant between-group reductions in depression scores (β=–2.21, P=.01) and anxiety scores (β=–4.82, P=.006), and a significant increase in mindfulness scores (β=4.84, P=.02) compared with the WLC group. There were no statistically significant differences in perceived stress for MVC (β=.64, P=.48) compared with WLC.

Conclusions

With the MVC intervention, there were significantly reduced depression and anxiety symptoms but no significant effect on perceived stress. Online mindfulness interventions can be effective in addressing common mental health conditions among postsecondary populations on a large scale, simultaneously reducing the current burden on traditional counseling services.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7395254/

 

Reduce Anxiety and Depression in Cancer Patients with Mindfulness

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Reduce Anxiety and Depression in Cancer Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Practicing mindfulness can assist with uncertainty about the future, depression, fear of recurrence and anxiety as well as mitigate physical symptoms such as fatigue, pain, and sleep disturbance.” – Erin Murphy-Wilczek

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress,  sleep disturbance, fear, and anxiety and depression. There has been considerable research conducted on the effectiveness of mindfulness practices in treating the psychological issues associated with cancer. So, it makes sense to step back and summarize what has been learned about the effectiveness of mindfulness in treating anxiety in cancer patients.

 

In today’s Research News article “Association of Mindfulness-Based Interventions With Anxiety Severity in Adults With Cancer: A Systematic Review and Meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7414391/) Oberoi and colleagues review, summarize, and perform a meta-analysis of the published research on the effectiveness of mindfulness in reducing anxiety in adult cancer patients. They found 28 published trials. The most common forms of mindfulness treatment were Mindfulness-Based Stress Reduction (MBSR) (13 studies) and Mindfulness-Based Cognitive Therapy (MBCT) (6 studies).

 

They report that the published research found that mindfulness training reduced anxiety and depression and increased quality of life over the short and medium term (up to 6 months post-treatment) with moderate effect sizes. The reduction in anxiety and depression may be responsible for the improvement in the patients’ quality of life. But 2 trials had longer term follow up measures (over 6 months) and did not find significant reductions. The fact that the effects do not appear to last beyond 6 months suggests that continued mindfulness practice or periodic booster sessions may be needed.

 

Fighting cancer is very stressful and amplifies negative emotions like anxiety and depression. The stress produced by these emotions can in turn interfere with the body’s ability to fight the cancer. So, treating these negative emotional states may be very important not only for the individual’s mental health but also to their physical well-being. So, mindfulness training may be important to the overall health of the cancer patient by reducing anxiety and depression.

 

So, reduce anxiety and depression in cancer patients with mindfulness.

 

“In summary, results show promise for mindfulness-based interventions to treat common psychological problems such as anxiety, stress, and depression in cancer survivors and to improve overall quality of life.” – Linda Carlson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Oberoi, S., Yang, J., Woodgate, R. L., Niraula, S., Banerji, S., Israels, S. J., Altman, G., Beattie, S., Rabbani, R., Askin, N., Gupta, A., Sung, L., Abou-Setta, A. M., & Zarychanski, R. (2020). Association of Mindfulness-Based Interventions With Anxiety Severity in Adults With Cancer: A Systematic Review and Meta-analysis. JAMA network open, 3(8), e2012598. https://doi.org/10.1001/jamanetworkopen.2020.12598

 

Abstract

Importance

Mindfulness-based interventions (MBIs), grounded in mindfulness, focus on purposely paying attention to experiences occurring at the present moment without judgment. MBIs are increasingly used by patients with cancer for the reduction of anxiety, but it remains unclear if MBIs reduce anxiety in patients with cancer.

Objective

To evaluate the association of MBIs with reductions in the severity of anxiety in patients with cancer.

Data Sources

Systematic searches of MEDLINE, Embase, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and SCOPUS were conducted from database inception to May 2019 to identify relevant citations.

Study Selection

Randomized clinical trials (RCTs) that compared MBI with usual care, waitlist controls, or no intervention for the management of anxiety in cancer patients were included. Two reviewers conducted a blinded screening. Of 101 initially identified studies, 28 met the inclusion criteria.

Data Extraction and Synthesis

Two reviewers independently extracted the data. The Cochrane Collaboration risk-of-bias tool was used to assess the quality of RCTs, and the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline was followed. Summary effect measures were reported as standardized mean differences (SMDs) and calculated using a random-effects model.

Main Outcomes and Measures

Our primary outcome was the measure of severity of short-term anxiety (up to 1-month postintervention); secondary outcomes were the severity of medium-term (1 to ≤6 months postintervention) and long-term (>6 to 12 months postintervention) anxiety, depression, and health-related quality of life of patients and caregivers.

Results

This meta-analysis included 28 RCTs enrolling 3053 adults with cancer. None of the trials were conducted in children. Mindfulness was associated with significant reductions in the severity of short-term anxiety (23 trials; 2339 participants; SMD, −0.51; 95% CI, −0.70 to −0.33; I2 = 76%). The association of mindfulness with short-term anxiety did not vary by evaluated patient, intervention, or study characteristics. Mindfulness was also associated with the reduction of medium-term anxiety (9 trials; 965 participants; SMD, −0.43; 95% CI, −0.68 to −0.18; I2 = 66%). No reduction in long-term anxiety was observed (2 trials; 403 participants; SMD, −0.02; 95% CI, −0.38 to 0.34; I2 = 68%). MBIs were associated with a reduction in the severity of depression in the short term (19 trials; 1874 participants; SMD, −0.73; 95% CI; −1.00 to −0.46; I2 = 86%) and the medium term (8 trials; 891 participants; SMD, −0.85; 95% CI, −1.35 to −0.35; I2 = 91%) and improved health-related quality of life in patients in the short term (9 trials; 1108 participants; SMD, 0.51; 95% CI, 0.20 to 0.82; I2 = 82%) and the medium term (5 trials; 771 participants; SMD, 0.29; 95% CI, 0.06 to 0.52; I2 = 57%).

Conclusions and Relevance

In this study, MBIs were associated with reductions in anxiety and depression up to 6 months postintervention in adults with cancer. Future trials should explore the long-term association of mindfulness with anxiety and depression in adults with cancer and determine its efficacy in more diverse cancer populations using active controls.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7414391/

 

Improve Painful Diabetic Neuropathy with Mindfulness

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Improve Painful Diabetic Neuropathy with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness specifically can also potentially improve quality of life for patients with neuropathy. . . Research indicates that in addition to improving pain, mindfulness also addresses the psychological consequences of chronic pain, including depression symptoms.” – Foundation for Peripheral Neuropathy

 

Diabetes can lead to a very painful condition known as diabetic neuropathy. The high blood glucose levels associated with diabetes can damage nerves and result in a burning pain and numbness, particularly from the legs and feet. It affects the majority of long-term diabetes patients. This is not only painful but is also disruptive to the normal life functions of these patients. There are no cures, but diabetic neuropathy can be prevented by blood glucose control in the diabetic patient with a rigorous program of measured diet and exercise. Treatment for diabetic neuropathy usually involves pain management with drugs.

 

Mindfulness practices have been shown to help with pain management and with quality of life in diabetes patients. and has been shown to improve the symptoms of diabetic neuropathy. A therapeutic technique that contains mindfulness training is Acceptance and Commitment Therapy (ACT). It is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT) and focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

It is important, then, to study the effectiveness of Acceptance and Commitment Therapy (ACT) for reducing pain and improving quality of life in patients with diabetic neuropathy. In today’s Research News article “The Effectiveness of Acceptance and Commitment Therapy on Pain Acceptance and Pain Perception in Patients with Painful Diabetic Neuropathy: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376796/) Taheri and colleagues recruited patients diagnosed with diabetic peripheral neuropathy, aged 35 to 65 years, and randomly assigned them to either receive 8 sessions of ACT or to a no-treatment control condition. They were measured before and after training and 3 months later for sensory pain, psychological pain, and chronic pain acceptance.

 

They found that in comparison to the baseline and the no-treatment control group the patients who received Acceptance and Commitment Therapy (ACT) had significant decreases in pain and significant increases in pain acceptance. These benefits of ACT were still significant at the 3-month follow up. So ACT were appears to produce significant and lasting improvements in diabetic peripheral neuropathy pain and its acceptance.

 

The trial did not have an active control group. So, the design is not the strongest and may be open to confounding. In addition, Acceptance and Commitment Therapy (ACT) is a complex therapy that includes mindfulness and Cognitive Behavioral Therapy (CBT), along with other therapeutic components. So, it cannot be determined which of these components or which combination of components were responsible for the effects. Previous research has shown that mindfulness training improves the symptoms of diabetic neuropathy. So, it is reasonable to conclude that the mindfulness component of ACT is effective. Hence, the study suggests that ACT is a safe, effective, and lasting treatment for diabetic peripheral neuropathy pain.

 

So, improve painful diabetic neuropathy with mindfulness.

 

“by activating and reinforcing some areas of the brain used in pain processing, meditation has the overall effect of helping to reduce pain intensity in patients. Other theories on how meditation affects pain, including that it decreases stress, which in turn decreases pain.” – Foundation for Peripheral Neuropathy

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Taheri, A. A., Foroughi, A. A., Mohammadian, Y., Ahmadi, S. M., Heshmati, K., Hezarkhani, L. A., & Parvizifard, A. A. (2020). The Effectiveness of Acceptance and Commitment Therapy on Pain Acceptance and Pain Perception in Patients with Painful Diabetic Neuropathy: A Randomized Controlled Trial. Diabetes therapy : research, treatment and education of diabetes and related disorders, 11(8), 1695–1708. https://doi.org/10.1007/s13300-020-00851-9

 

Abstract

Introduction

Neuropathic pain is a complex phenomenon in patients with diabetes. These patients have many problems, such as psychological problems, high-level pain perception, and pain acceptance. This study aimed to evaluate the effectiveness of acceptance and commitment therapy on pain acceptance and pain perception in patients with painful diabetic neuropathy.

Methods

This study was performed according to the clinical trial method. The sample size was 50 participants. In this study, participants were divided into interventional and control groups. According to the diagnosis of neurologists, all participants received conventional medications to manage neuropathic pain. The intervention group received acceptance and commitment therapy for eight sessions. The results in the three phases of pre-test, post-test, and follow-up were evaluated. After completing the study, to comply with ethical standards, the control group received psycho-education. The tools used were the McGill Pain Questionnaire (MPQ) and the Chronic Pain Acceptance Questionnaire (CPAQ). Statistical analysis includes mean, standard deviation, and repeated-measures (ANOVA) conducted by SPSS software version 22.

Results

The results demonstrated that in the post-test and follow-up phases, acceptance and commitment therapy could improve pain acceptance and reduce pain perception in the intervention group compared to the control group (P < 0.01).

Conclusion

The results indicated that acceptance and commitment therapy could be used as a psychological intervention besides pharmacotherapy to improve pain acceptance and reduce pain perception in patients with painful diabetic neuropathy.

Key Summary Points

Why carry out this study?
Patients with painful diabetic neuropathy endure severe and excruciating pain that adversely affects their function. According to Melzack theory, one of the most important factors in pain perception is psychological factors.
Before this study, no clinical trial study had been performed to measure the effectiveness of psychological therapy in reducing the severity of pain perception in patients with painful diabetic neuropathy.
The main purpose of this study was to investigate the effectiveness of acceptance and commitment therapy (ACT) therapy on improving pain acceptance and subsequently reduction of pain perception.
What was learned from the study?
The results showed that compared to the control group, the interventional group had significant improvement in pain acceptance and also a major reduction in pain perception in the post-test phase. The same results were observed after a 3-month follow-up.

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376796/