contemplative practice

Reduce Inflammation in Psychiatric Patients with Mindfulness

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Reduce Inflammation in Psychiatric Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness practice was not directly linked to lower inflammation levels, but that it may have bolstered stress resilience among at-risk adults by preventing an increase in inflammatory biomarker levels.” – Grace Bullock

 

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. In the elderly it is associated with the onset of dementia.

 

Needless to say, chronic inflammation can create major health problems. Indeed, the presence of chronic inflammation is associated with reduced longevity. So, it is important for health to control the inflammatory response, allowing it to do its job in fighting off infection but reducing its activity when no external threat is apparent. Of course, it is far better to prevent chronic inflammation in the first place than to treat it later. Mind-body techniques such as yoga, Tai Chi and meditation have been shown to adaptively reduce the inflammatory response. In addition, mindfulness training, has been shown to be effective in treating psychiatric disorders. It is possible that mindfulness acts, in part, to improve psychiatric disorders by decreasing inflammation in these patients.

 

In today’s Research News article “Effects of Mindfulness-Based Interventions on Biomarkers and Low-Grade Inflammation in Patients with Psychiatric Disorders: A Meta-Analytic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177919/), Sanada and colleagues review, summarize, and perform a meta-analysis of the effectiveness of mindfulness-based interventions in reducing biomarkers of the inflammatory response in psychiatric patients. They discovered 10 published research studies with a total of 998 participants. They included patients diagnosed with anxiety disorders, depression, alcohol abuse, sleep disorders, PTSD, and ADHD.

 

They report that the published research studies found that mindfulness-based interventions improved the levels of a variety of biomarkers of inflammation with a variety of psychiatric problems. These included event-related potentials, methylation of serotonin transporter genes, IL-6, TNF-α, and adrenocorticotropic hormone. These biomarkers suggest that psychiatric disorders are associated with mild levels of inflammation and that mindfulness-based interventions reduce the levels of these biomarkers.

 

Hence the published research literature suggests that mindfulness-based interventions are effective in reducing the levels of inflammation in psychiatric patients and improving their health status. These results provide an explanation for the effectiveness of mindfulness for the improvement of anxiety disorders, depression, alcohol abuse, sleep disorders, PTSD, and ADHD. They did not report on the mechanisms by which mindfulness reduces inflammation. But high on the list of possibilities has to be the ability of mindfulness training to reduce the physiological and psychological responses to stress as stress can increase inflammatory responses.

 

So, reduce inflammation in psychiatric patients with mindfulness.

 

“mindfulness techniques may be more effective in relieving inflammatory symptoms than other activities that promote well-being.” – ScienceDaily

 

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

 

Sanada, K., Montero-Marin, J., Barceló-Soler, A., Ikuse, D., Ota, M., Hirata, A., Yoshizawa, A., Hatanaka, R., Valero, M. S., Demarzo, M., Campayo, J. G., & Iwanami, A. (2020). Effects of Mindfulness-Based Interventions on Biomarkers and Low-Grade Inflammation in Patients with Psychiatric Disorders: A Meta-Analytic Review. International journal of molecular sciences, 21(7), 2484. https://doi.org/10.3390/ijms21072484

 

Abstract

Mindfulness-Based Interventions (MBIs) present positive effects on mental health in diverse populations. However, the detailed associations between MBIs and biomarkers in patients with psychiatric disorders remain poorly understood. The aim of this study was to examine the effects of MBIs on biomarkers in psychiatric illness used to summarise the effects of low-grade inflammation. A systematic review of PubMed, EMBASE, PsycINFO, and the Cochrane Library was conducted. Effect sizes (ESs) were determined by Hedges’ g and the number needed to treat (NNT). Heterogeneity was evaluated. A total of 10 trials with 998 participants were included. MBIs showed significant improvements in the event-related potential amplitudes in attention-deficit hyperactivity disorder, the methylation of serotonin transporter genes in post-traumatic stress disorder, the salivary levels of interleukin 6 (IL-6) and tumour necrosis factor alpha (TNF-α) in depression, and the blood levels of adrenocorticotropic hormone (ACTH), IL-6, and TNF-α in generalised anxiety disorder. MBIs showed low but significant effects on health status related to biomarkers of low-grade inflammation (g = −0.21; 95% confidence interval (CI) –0.41 to −0.01; NNT = 8.47), with no heterogeneity (I2 = 0; 95% CI 0 to 79). More trials are needed to establish the impact of MBIs on biomarkers in psychiatric illness.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177919/

 

Improve Health Care Professional Self-Compassion with Mindfulness

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Improve Health Care Professional Self-Compassion with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is especially suited to physicians, because it can help counteract the worrying, perfectionism and self-judgment that are so common among doctors.” – WellMD

 

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

 

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

 

One way that mindfulness may help reduce burnout is by improving self-compassion. Self-compassion is “treating oneself with kindness and understanding when facing suffering, seeing one’s failures as part of the human condition, and having a balanced awareness of painful thoughts and emotions” (Kristin Neff). This may reduce the perfectionism and self-judgement that is common among physicians and thereby reduce burnout.

 

In today’s Research News article “Effects of Mindfulness-Based Interventions on Self-compassion in Health Care Professionals: a Meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223423/), Wasson and colleagues review summarize and perform a meta-analysis of the effectiveness of mindfulness training in improving self-compassion in physicians. They identified 28 published research studies.

 

They found that the published research reports that mindfulness-based interventions produced significant improvements in self-compassion in a variety of health care professionals. The effects sizes were moderate and there were no indications of publication bias. These results are important as having compassion for oneself is a prerequisite to having true compassion for others and this is essential for patient treatment. In addition, self-compassion may inoculate the health care worker from burnout. Hence, mindfulness training is important for health care professionals.

 

So, improve health care professional self-compassion with mindfulness.

 

“Mindfulness is growing in popularity as a way of promoting self-compassion among physicians. “This is all about being aware and in tune with yourself, learning to listen to your body and your mind so you know what you need and can give that to yourself.” – Kevin Teoh

 

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

 

Rachel S. Wasson, Clare Barratt, William H. O’Brien, Effects of Mindfulness-Based Interventions on Self-compassion in Health Care Professionals: a Meta-analysis. Mindfulness (N Y) 2020 Mar 5 : 1–21. doi: 10.1007/s12671-020-01342-5

 

Abstract

Objectives

Health care professionals have elevated rates of burnout and compassion fatigue which are correlated with poorer quality of life and patient care, and inversely correlated with self-compassion. Primary studies have evaluated the extent to which mindfulness-based interventions increase self-compassion with contradictory findings. A meta-analytic review of the literature was conducted to quantitatively synthesize the effects of mindfulness-based interventions on self-compassion among health care professionals.

Methods

Twenty-eight treatment outcome studies were identified eligible for inclusion. Five cumulative effect sizes were calculated using random-effects models to evaluate differences of changes in self-compassion for treatment and control groups. Within and between group comparisons were evaluated. Sub-group and moderator analyses were conducted to explore potential moderating variables.

Results

Twenty-seven articles (k = 29, N = 1020) were utilized in the pre-post-treatment meta-analysis. Fifteen samples (52%) included health care professionals and fourteen (48%) professional health care students. Results showed a moderate effect size between pre-post-treatment comparisons (g = .61, 95% CI = .47 to .76) for self-compassion and a strong effect size for pre-treatment to follow-up (g = .76, 95% CI = .41 to 1.12). The effect size comparing post-treatment versus post-control was moderate. One exploratory moderator analysis was significant, with stronger effects for interventions with a retreat component.

Conclusions

Findings suggest mindfulness-based interventions improve self-compassion in health care professionals. Additionally, a variety of mindfulness-based programs may be useful for employees and trainees. Future studies with rigorous methodology evaluating effects on self-compassion and patient care from mindfulness-based interventions are warranted to extend findings and explore moderators.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223423/

 

Improve Sleep Quality in Women with Sleep Disturbance with Yoga

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Improve Sleep Quality in Women with Sleep Disturbance with Yoga

 

By John M. de Castro, Ph.D.

 

“When people who have insomnia perform yoga on a daily basis, they sleep for longer, fall asleep faster, and return to sleep more quickly if they wake up in the middle of the night.” – Sleep Foundation

 

Modern society has become more around-the-clock and more complex producing considerable pressure and stress on the individual. The advent of the internet and smart phones has exacerbated the problem. The resultant stress can impair sleep. Indeed, it is estimated that over half of Americans sleep too little due to stress. As a result, people today sleep 20% less than they did 100 years ago. Not having a good night’s sleep has adverse effects upon the individual’s health, well-being, and happiness. It has been estimated that 30 to 35% of adults have brief symptoms of insomnia, 15 to 20% have a short-term insomnia disorder, and 10% have chronic insomnia

 

Sleep difficulties are associated with decreased alertness and a consequent reduction in performance of even simple tasks, decreased quality of life, increased difficulties with memory and problem solving, increased likelihood of accidental injury including automobile accidents, and increased risk of dementia and Alzheimer’s disease. It also can lead to anxiety about sleep itself. This is stressful and can produce even more anxiety about being able to sleep. About 4% of Americans revert to sleeping pills. But these do not always produce high quality sleep and can have problematic side effects. So, there is a need to find better methods to treat insomnia. Mindfulness-based practices have been reported to improve sleep amount and quality and help with insomnia. It makes sense to explore the effectiveness of different mindfulness techniques to improve sleep quality.

 

In today’s Research News article “The effect of yoga on sleep quality and insomnia in women with sleep problems: 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/PMC7193366/), Wang and colleagues review, summarize, and perform a meta-analysis of the published research literature on the effectiveness of yoga practice for the improvement of sleep in women with sleep problems. They found 19 randomized controlled trials with a total of 1832 participants.

 

They report that the published studies found that yoga practice produced a significant reduction in sleep problems but not insomnia and a significant increase in sleep quality. Healthy patients had greater improvements in sleep quality than breast cancer patients and peri/postmenopausal women had significantly less improvement in sleep quality.

 

The review found that in general yoga practice improves sleep in women with sleep problems except insomnia. The included studies did not have a control condition involving exercise. So, it is not clear if the exercise provided by yoga or a yoga specific factor was responsible for the sleep improvements. Future research should compare yoga practice to another form of exercise, e.g. brisk walking, in improving sleep. In addition, yoga practice does not appear to improve sleep when the disturbance is caused by a physical issue such as breast cancer or menopause. This suggests that yoga works best with sleep disturbances caused by psychological issues.

 

So, improve sleep quality in women with sleep disturbance with yoga.

 

“As a result of the activity’s physical, emotional, and mental relaxation, practitioners of yoga nidra report sleeping better at night, and tend to suffer less with issues such as racing thoughts.” – Sleep.org

 

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

 

Wang, W. L., Chen, K. H., Pan, Y. C., Yang, S. N., & Chan, Y. Y. (2020). The effect of yoga on sleep quality and insomnia in women with sleep problems: a systematic review and meta-analysis. BMC psychiatry, 20(1), 195. https://doi.org/10.1186/s12888-020-02566-4

 

Abstract

Background

To examine the effectiveness and safety of yoga of women with sleep problems by performing a systematic review and meta-analysis.

Methods

Medline/PubMed, ClinicalKey, ScienceDirect, Embase, PsycINFO, and the Cochrane Library were searched throughout the month of June, 2019. Randomized controlled trials comparing yoga groups with control groups in women with sleep problems were included. Two reviewers independently evaluated risk of bias by using the risk of bias tool suggested by the Cochrane Collaboration for programming and conducting systematic reviews and meta-analyses. The main outcome measure was sleep quality or the severity of insomnia, which was measured using subjective instruments, such as the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), or objective instruments such as polysomnography, actigraphy, and safety of the intervention. For each outcome, a standardized mean difference (SMD) and confidence intervals (CIs) of 95% were determined.

Results

Nineteen studies in this systematic review included 1832 participants. The meta-analysis of the combined data conducted according to Comprehensive Meta-Analysis showed a significant improvement in sleep (SMD = − 0.327, 95% CI = − 0.506 to − 0.148, P < 0.001). Meta-analyses revealed positive effects of yoga using PSQI scores in 16 randomized control trials (RCTs), compared with the control group in improving sleep quality among women using PSQI (SMD = − 0.54; 95% CI = − 0.89 to − 0.19; P = 0.003). However, three RCTs revealed no effects of yoga compared to the control group in reducing insomnia among women using ISI (SMD = − 0.13; 95% CI = − 0.74 to 0.48; P = 0.69). Seven RCTs revealed no evidence for effects of yoga compared with the control group in improving sleep quality for women with breast cancer using PSQI (SMD = − 0.15; 95% CI = − 0.31 to 0.01; P = 0.5). Four RCTs revealed no evidence for the effects of yoga compared with the control group in improving the sleep quality for peri/postmenopausal women using PSQI (SMD = − 0.31; 95% CI = − 0.95 to 0.33; P = 0.34). Yoga was not associated with any serious adverse events.

Discussion

This systematic review and meta-analysis demonstrated that yoga intervention in women can be beneficial when compared to non-active control conditions in term of managing sleep problems. The moderator analyses suggest that participants in the non-breast cancer subgroup and participants in the non-peri/postmenopausal subgroup were associated with greater benefits, with a direct correlation of total class time with quality of sleep among other related benefits.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7193366/

 

Meditation Produces Mental Emptiness by Lowering Phasic Relationships in the EEG

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Meditation Produces Mental Emptiness by Lowering Phasic Relationships in the EEG

 

By John M. de Castro, Ph.D.

 

“Meditation research explores how the brain works when we refrain from concentration, rumination and intentional thinking. Electrical brain waves suggest that mental activity during meditation is wakeful and relaxed.” – ScienceDaily

 

Meditation training has been shown to improve health and well-being. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. A characterizing feature of meditation is that it can produce periods of thoughtless awareness also known as mental emptiness where thinking is minimized. Little is known, however, about the underlying brain activity during thoughtless awareness relative to cognitive processing, thinking.

 

One way to observe the effects of meditation is to measure changes in the electroencephalogram (EEG), the rhythmic electrical activity that can be recorded from the scalp. The recorded activity can be separated into frequency bands. Delta activity consists of oscillations in the 0.5-3 cycles per second band. Theta activity in the EEG consists of oscillations in the 4-8 cycles per second band. Alpha activity consists of oscillations in the 8-12 cycles per second band. Beta activity consists of oscillations in the 13-30 cycles per second band while Gamma activity occurs in the 30-100 cycles per second band.

 

In today’s Research News article “From thoughtless awareness to effortful cognition: alpha – theta cross-frequency dynamics in experienced meditators during meditation, rest and arithmetic.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7096392/), Rodriguez-Larios and colleagues recruited adult, highly experienced, meditators and recorded the electroencephalogram (EEG) while they were at rest, engaged in breath following focused meditation, and doing mental arithmetic (counting backward by 7. They analyzed the EEG signals for alpha and theta rhythms and investigated the phasic relationships between them.

 

They found that during meditation the phasic relationships between alpha and theta rhythms in the brain were at a minimum where they were at a maximum during mental arithmetic. Since during the cognitive task of mental arithmetic the phasic relationships were high, it appears that these phasic relationships between alpha and theta rhythms are associated with cognitive processes, thinking. The fact that they’re minimized during meditation suggests that during meditation cognition, thinking, is minimized. This suggests that awareness is occurring without thought; thoughtless awareness.

 

These results make sense in that the goal of breath following meditation is to relax the mind and focus it on simple sensory signals and thereby minimize thinking. Meditation focuses the mind on the present moment and the sensory experiences occurring in the moment. The deeper the focus, the less room there is for thought to occur. The present results indicate that this thoughtless awareness can be seen in the electrical activity of the brain during meditation.

 

So, meditation produces mental emptiness by lowering phasic relationships in the EEG.

 

“A theta wave cycle lasts about as long as the human eye blinks, or about 4/10 of a second! They are also associated with deep meditation. . . Theta waves are associated with dreaming sleep, super learning, creativity, daydreaming, and deep meditation. And with emotional surges, self-reprogramming, and spiritual experiences.” – Mindvalley

 

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

 

Rodriguez-Larios, J., Faber, P., Achermann, P., Tei, S., & Alaerts, K. (2020). From thoughtless awareness to effortful cognition: alpha – theta cross-frequency dynamics in experienced meditators during meditation, rest and arithmetic. Scientific reports, 10(1), 5419. https://doi.org/10.1038/s41598-020-62392-2

 

Abstract

Neural activity is known to oscillate within discrete frequency bands and the synchronization between these rhythms is hypothesized to underlie information integration in the brain. Since strict synchronization is only possible for harmonic frequencies, a recent theory proposes that the interaction between different brain rhythms is facilitated by transient harmonic frequency arrangements. In this line, it has been recently shown that the transient occurrence of 2:1 harmonic cross-frequency relationships between alpha and theta rhythms (i.e. falpha ≈ 12 Hz; ftheta ≈ 6 Hz) is enhanced during effortful cognition. In this study, we tested whether achieving a state of ‘mental emptiness’ during meditation is accompanied by a relative decrease in the occurrence of 2:1 harmonic cross-frequency relationships between alpha and theta rhythms. Continuous EEG recordings (19 electrodes) were obtained from 43 highly experienced meditators during meditation practice, rest and an arithmetic task. We show that the occurrence of transient alpha:theta 2:1 harmonic relationships increased linearly from a meditative to an active cognitive processing state (i.e. meditation < rest < arithmetic task). It is argued that transient EEG cross-frequency arrangements that prevent alpha:theta cross-frequency coupling could facilitate the experience of ‘mental emptiness’ by avoiding the interaction between the memory and executive components of cognition.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7096392/

 

Lower Heart Rate and Increase its Variability with Meditation

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Lower Heart Rate and Increase its Variability with Meditation

 

By John M. de Castro, Ph.D.

 

“If a person’s system is in more of a fight-or-flight mode, the variation between subsequent heartbeats is low. If one is in a more relaxed state, the variation between beats is high. In other words, the healthier the ANS the faster you are able to switch gears, showing more resilience and flexibility. Over the past few decades, research has shown a relationship between low HRV and worsening depression or anxiety. A low HRV is even associated with an increased risk of death and cardiovascular disease.” – Marcelo Campos

 

In our lives we are confronted with a variety of situations and environments. In order to successfully navigate these differing situations, we must be able to adapt and self-regulate. The Autonomic Nervous System (ANS) is designed to adapt physiologically to the varying demands on us. It is composed of 2 divisions; the sympathetic division underlies activation, including increases in heart rate and blood pressure, while the parasympathetic division underlies relaxation, including decreases in heart rate and blood pressure. A measure of the balance between these systems is provided by the variability of the heart rate.

 

Heart Rate Variability (HRV) refers to the change in the time intervals between consecutive heart beats. Higher levels of HRV are indicative of flexibility in the Autonomic Nervous System and are associated with adaptability to varying environments. Mindfulness has been associated with psychological flexibility and a greater ability to adapt appropriately to differing situations. It makes sense then to investigate the relationship of mindfulness to and Heart Rate Variability (HRV).

 

In today’s Research News article “Meditation Practice Improves Short-Term Changes in Heart Rate Variability.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7142551/), Chang and colleagues performed 2 experiments. In the first, they recruited healthy meditation naïve adults and presented them with a 90-minute class on meditation including practice in a face to face setting once a week for 4 weeks. In the second experiment experienced meditators were recruited and received once a week for 4 weeks the 90-minute class on meditation including practice presented on video. The participants wore wrist heart rate monitors and were measured over the course of the study for heart rate, heart rate variability, and blood pressure.

 

They found that both the meditation naïve participants with face to face instruction and the experienced meditators with video instruction had significant decreases over the course of the study in heart rate and significant increases in heart rate variability. Increased heart rate variability signals greater relaxation in the autonomic nervous system with a predominance of parasympathetic (relaxation) activity over sympathetic (activation) activity. The results make sense as parasympathetic activity tends to decrease heart rate. This all signals greater physiological relaxation

 

There was no control condition in the present study. So, the experiment is open to confounding by demand characteristics, experimenter bias, expectancy (placebo) effect etc. But prior randomized controlled studies have also observed that mindfulness training reduces heart rate and increases heart rate variability. So, the present results are likely due to the meditation practice. This increase in parasympathetic activity produced by meditation training may explain why mindfulness training is effective in treating cardiovascular diseases, in overall reducing the deleterious effects of stress and producing increased relaxation.

 

So, lower heart rate and increase its variability with meditation.

 

“meditation may improve your heart’s recovery from stress as demonstrated by improved Heart Rate Variability (HRV).” – Sam Sly

 

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

 

Chang, K. M., Wu Chueh, M. T., & Lai, Y. J. (2020). Meditation Practice Improves Short-Term Changes in Heart Rate Variability. International journal of environmental research and public health, 17(6), 2128. https://doi.org/10.3390/ijerph17062128

 

Abstract

Background: It is well known that meditation improves the physical and psychological condition of its practitioners. This study investigated the heart rate variability response of meditation practitioners in two Chan master teaching environments, namely face-to-face and video classes. Methods: Experimental sessions were conducted, one featuring face-to-face classes and the other featuring video classes. The difference in participants’ physiological parameters (blood pressure and heart rate variability) between the two experimental sessions was determined. In the first session, physiological parameters were recorded twice, before and after one teaching course, and the second session took place one month after the first. The first and second sessions had 45 and 27 participants, respectively. Those involved in the first experiment had no experience with meditation, whereas participants in the second experiment had practiced meditation for an average of 9 years (range = 1 to 27 years). Both experiments were conducted once a week, with each session lasting 1.5 h. Results: For both experiments, both heart rate and heart rate variability by age significantly decreased after one teaching course. Conclusions: Chan meditation practitioners benefit from receiving both face-to-face and video class teaching from a Chan master.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7142551/

 

Reduce Hypertension with a Mindfulness Smartphone App

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Reduce Hypertension with a Mindfulness Smartphone App

 

By John M. de Castro, Ph.D.

 

“Investigators found mindfulness was associated with a significant decrease in systolic blood pressure at 1 year and had other gains including better adherence to a recommended diet, lower salt intake, reduced alcohol consumption, and increased physical activity.” – Damian McNamara

 

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. The vast majority of the mindfulness training techniques, however, require a trained teacher. This results in costs that many patients 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, Apps for smartphones 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 today’s Research News article “Impact of 12-Month Smartphone Breathing Meditation Program upon Systolic Blood Pressure among Non-Medicated Stage 1 Hypertensive Adults.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7143262/), Chandler and colleagues recruited adults with non-medicated stage 1 systolic hypertension; systolic blood pressure of 121–139 mmHg. They were randomly assigned to receive via smartphone app 3 months of either mindfulness training or health education. The mindfulness training app, Tension Tamer, employed twice daily practice of focused meditation for 10-15 minutes. The health education app, Runkeeper, delivered lifestyle health education messages focusing on exercise. They were measured before during and after training and 3 and 9 months later for systolic and diastolic blood pressure.

 

They found that the mindfulness trained group had greater reductions in systolic and diastolic blood pressure at the end of training and 9 months later. In addition, a greater proportion of mindfulness trained participants achieved reductions sufficient to remove them from being classified as having stage 1 systolic hypertension.

 

There were no significant differences found in perceived stress. Even though mindfulness training has been shown in prior studies to reduce perceived stress, it does not appear to be responsible for decrease blood pressure in the present study. Measures of heart rate during the meditation practice revealed significant decreases in heart rate over the session. This suggests that the mindfulness training was successful in reducing blood pressure by increasing relaxation perhaps by increasing the activity of the parasympathetic component of the autonomic nervous system.

 

So, reduce hypertension with a mindfulness smartphone app.

 

“mindfulness meditation in combination with conventional medication treatment reduces blood pressure and stress levels, while improving mindfulness and mood more than medication coupled with health education.” – goamra.org

 

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

 

Chandler, J., Sox, L., Diaz, V., Kellam, K., Neely, A., Nemeth, L., & Treiber, F. (2020). Impact of 12-Month Smartphone Breathing Meditation Program upon Systolic Blood Pressure among Non-Medicated Stage 1 Hypertensive Adults. International journal of environmental research and public health, 17(6), 1955. https://doi.org/10.3390/ijerph17061955

 

Abstract

(1) Background: Hypertension (HTN) affects ~50% of adults and is a major risk factor for stroke and cardiovascular disease. In 2017, the SPRINT trial outcomes led to lowering of HTN cutoffs by the American College of Cardiology (ACC) and American Heart Association (AHA). The Joint National Committee (JNC8) and National High BP Education Program recommend that lifestyle modifications be used as first-line HTN treatment. Chronic stress is a risk factor for HTN and cardiovascular disease. A recently completed 12 month randomized controlled trial (RCT) of a breathing meditation smart phone app (Tension Tamer, TT) involving JNC8 designated pre-HTN adults provided an opportunity to examine its impact upon individuals now classified as having stage 1 HTN. The TT app captures continuous real-time heart rate (HR) from a user’s fingertip placed over a video camera lens during sessions. Users receive immediate feedback graphs after each session, showing their HR changes. They also receive motivational and social reinforcement SMS text messages the following day based upon levels of adherence. We conducted ancillary analyses of a 2-arm, 12-month, small-scale efficacy RCT among a subgroup of our total sample of participants, who are now classified as having stage 1 non-medicated systolic HTN. Primary outcome was change in resting systolic blood pressure (SBP). Secondary outcomes were change in resting diastolic blood pressure, adherence to the TT protocol, and perceived stress levels. (2) Methods: 30 adults (mean age: 45.0 years; 15 males; 16 White; 14 Black) with ACC/AHA 2017 defined systolic HTN (130–139 mmHg) on 3 consecutive sessions (mean SBP: 132.6 mmHg) were randomly assigned to TT or lifestyle education program delivered via smartphone (SPCTL). Each group received a twice-daily dosage schedule of TT or walking (month 1: 15 min; months 2 and 3: 10 min; months 4–12: 5 min). (3) Results: Mixed modeling results revealed a significant group x time effect for SBP (p<.01). The TT group showed greater SBP reductions at months 3 (−8.0 vs. −1.9), 6 (−10.0 vs. −0.7), and 12: (−11.6 vs. −0.4 mmHg; all p-values <0.04). (4) Conclusion: The TT app was beneficial in reducing SBP levels among adults with stage 1 systolic HTN. The TT app may be a promising, scalable first-line tactic for stage 1 HTN. Preparations are underway for an efficacy RCT involving uncontrolled stage 1 HTN patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7143262/

 

Different Meditation Practices Have Specific Electrencepholographic Signatures

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Different Meditation Practices Have Specific Electrencepholographic Signatures

 

By John M. de Castro, Ph.D.

 

“the most general and consistently observed EEG correlate of meditation is an increase in the power of lower frequencies between 4 and 10 Hz corresponding to the theta band (4-8 Hz) and the lower end of the alpha band (8-10 Hz).” – Aaron Nitzkin

 

Meditation training has been shown to improve health and well-being. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. One problem with understanding meditation effects is that there are, a wide variety of meditation techniques. Classically they’ve been characterized on a continuum with the degree and type of attentional focus. In focused attention meditation, the individual practices paying attention to a single meditation object. In open monitoring meditation, the individual opens up awareness to everything that’s being experienced including thoughts regardless of its origin. In Loving Kindness Meditation the individual systematically pictures different individuals from self, to close friends, to enemies and wishes them happiness, well-being, safety, peace, and ease of well-being.

 

One way to observe the effects of meditation techniques is to measure the effects of each technique on the brain’s activity. This can be done by recording the electroencephalogram (EEG). The brain produces rhythmic electrical activity that can be recorded from the scalp. It is usually separated into frequency bands. Delta activity consists of oscillations in the 0.5-3 cycles per second band. Theta activity in the EEG consists of oscillations in the 4-8 cycles per second band. Alpha activity consists of oscillations in the 8-12 cycles per second band. Beta activity consists of oscillations in the 13-30 cycles per second band while Gamma activity occurs in the 30-100 cycles per second band.

 

In today’s Research News article “Common and distinct lateralised patterns of neural coupling during focused attention, open monitoring and loving kindness meditation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7198563/), Yordanova and colleagues recruited Buddhist monk, nuns, and novices who practiced focused, open monitoring, and loving kindness meditation. Their electroencephalogram (EEG) was taken during 3-minute periods of rest, focused, open monitoring, and loving kindness meditations.

 

They found that during all meditation conditions there was an increase in the synchronization of Delta activity throughout the brain, in Theta activity in the left hemisphere, and slow and fast Alpha activity in the right hemisphere. Hence, all three types of meditations produce common changes in the electrical activity of the brain. In addition, they also identified specific patterns of brain activity that differentiated the three meditation types. In particular, Beta activity synchronization was greatest in the right hemisphere during focused meditation and in the left hemisphere during open monitoring meditation, while during loving kindness meditation there were reduction in fast Alpha activity in the left hemisphere.

 

These are complex but interesting results that indicate that various meditation techniques have common changes in brain activity. That shouldn’t be surprising as these different meditation techniques produce very similar physical and mental changes in the practitioner. On the other hand, there were detected different patterns of activity for each meditation type. This again should not be surprising as there are differences in the effects of the meditation types. So, the electrical activity of the brain during these techniques correlates with their similarities and differences in their effects.

 

So, different meditation practices have similar and specific electrencepholographic signatures.

 

“Connectivity measures between EEG channels are also currently being studied to measure meditation. Some connectivity evidences are the synchronisation of anterior and posterior channels or alpha phase synchronicity.” – David Ibañez

 

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

 

Juliana Yordanova, Vasil Kolev, Federica Mauro, Valentina Nicolardi, Luca Simione, Lucia Calabrese, Peter Malinowski, Antonino Raffone. Common and distinct lateralised patterns of neural coupling during focused attention, open monitoring and loving kindness meditation. Sci Rep. 2020; 10: 7430. Published online 2020 May 4. doi: 10.1038/s41598-020-64324-6

 

Abstract

Meditation has been integrated into different therapeutic interventions. To inform the evidence-based selection of specific meditation types it is crucial to understand the neural processes associated with different meditation practices. Here we explore commonalities and differences in electroencephalographic oscillatory spatial synchronisation patterns across three important meditation types. Highly experienced meditators engaged in focused attention, open monitoring, and loving kindness meditation. Improving on previous research, our approach avoids comparisons between groups that limited previous findings, while ensuring that the meditation states are reliably established. Employing a novel measure of neural coupling – the imaginary part of EEG coherence – the study revealed that all meditation conditions displayed a common connectivity pattern that is characterised by increased connectivity of (a) broadly distributed delta networks, (b) left-hemispheric theta networks with a local integrating posterior focus, and (c) right-hemispheric alpha networks, with a local integrating parieto-occipital focus. Furthermore, each meditation state also expressed specific synchronisation patterns differentially recruiting left- or right-lateralised beta networks. These observations provide evidence that in addition to global patterns, frequency-specific inter-hemispheric asymmetry is one major feature of meditation, and that mental processes specific to each meditation type are also supported by lateralised networks from fast-frequency bands.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7198563/

 

Improve the Physical and Mental Health of Patients with COPD with Tai Chi

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Improve the Physical and Mental Health of Patients with COPD with Tai Chi

 

By John M. de Castro, Ph.D.

 

“The gentle movements of Sun-style tai chi (SSTC) can improve the lives and boost the exercise endurance of people with chronic obstructive pulmonary disease.” – Matt McMillen

 

Chronic Obstructive Pulmonary Diseases (COPD) are progressive lung diseases that obstruct airflow. The two main types of COPD are chronic bronchitis and emphysema. COPD is very serious being the third leading cause of death in the United States, over 140,000 deaths per year and the number of people dying from COPD is growing. More than 11 million people have been diagnosed with COPD, but an estimated 24 million may have the disease without even knowing it. COPD causes serious long-term disability and early death.

 

There is no cure for COPD. Treatments include lifestyle changes, medicine, bronchodilators, steroids, pulmonary rehabilitation, oxygen therapy, and surgery. They all attempt to relieve symptoms, slow the progress of the disease, improve exercise tolerance, prevent and treat complications, and improve overall health. Gentle mind-body exercise such as Yoga, Tai Chi and Qigong practices could improve COPD symptoms. 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 COPD. 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 COPD who lack the ability to engage in strenuous exercises to engage in these gentle mind-body practices.

 

In today’s Research News article “Effects of Tai Chi training on the physical and mental health status in patients with chronic obstructive pulmonary disease: 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/PMC7139037/), Guo and colleagues review, summarize, and perform a meta-analysis of the published research studies on the effectiveness of Tai Chi practices for the treatment of Chronic Obstructive Pulmonary Diseases (COPD).

 

They found 16 published research studies that report that Tai Chi practice results in improvements in lung function including forced volume capacity, forced expiratory volume in 1 s, and degree of lung function recovery. It also increased exercise ability as measured by the distance walked in 6 minutes, improved mood by decreasing anxiety and depression, and improved the patient’s quality of life.

 

The results are striking and important. Tai Chi practice improves the lung function, exercise capacity, mood, and quality of life in patients with Chronic Obstructive Pulmonary Diseases (COPD). It is safe and effective mindfulness practice. It is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It is inexpensive to administer, can be performed in groups or alone, at home or in a facility, and can be quickly learned. In addition, it can be practiced in social groups. This can make it fun, improving the likelihood of long-term engagement in the practice. Hence, Tai Chi practice would appear to be an excellent practice to be added to routine treatment of COPD.

 

So, improve the physical and mental health of patients with COPD with Tai Chi.

 

“We conclude that tai chi is equivalent to [pulmonary rehabilitation] and may confer more sustained benefit.” – Yuan-Ming Luo

 

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

 

Guo, C., Xiang, G., Xie, L., Liu, Z., Zhang, X., Wu, Q., Li, S., & Wu, Y. (2020). Effects of Tai Chi training on the physical and mental health status in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. Journal of thoracic disease, 12(3), 504–521. https://doi.org/10.21037/jtd.2020.01.03

 

Abstract

Background

Tai Chi is a systematic whole body movement developed in ancient China. It plays an increasingly important role in the field of pulmonary rehabilitation for patients with chronic obstructive pulmonary disease (COPD). Our review aimed to explore the impact of Tai Chi on the physical and mental health of patients with COPD.

Methods

We searched several English and Chinese databases and used the combination of subject words and free words to search for available literature from the establishment of the library until August 28, 2018. Two researchers screened studies and collected the data independently. The study inclusion criteria included: (I) patients diagnosed with COPD; (II) Tai Chi or Tai Chi Qigong as an intervention in addition to routine treatment; (III) routine treatment with or without exercises as control group. The primary outcomes were lung function, exercise capacity and health status; (IV) randomized controlled trials.

Results

Sixteen articles were included from 2009 to 2018 (n=1,096). The average time duration of Tai Chi program was 53.4 minutes each session, 4.13 sessions a week for a total of 4.13 months. Comparing with control group, Tai Chi group improved some lung function (forced volume capacity: mean difference =0.12, 95% CI: 0.03–0.21), (forced expiratory volume in 1s: mean difference =0.15, 95% CI: 0.08–0.21), enhanced 6-minute walking distance score (mean difference =30.78, 95% CI: 15.15–46.42), decreased COPD Assessment Test score (mean difference =−5.00, 95% CI: −7.51 to −2.50), decreased St. George’s Respiratory Questionnaire score (mean difference =−8.66, 95% CI: −14.60 to −2.72), enhanced Chronic Respiratory Disease Questionnaire score (mean difference =2.16, 95% CI: 1.49–2.83), decreased Hospital Anxiety and Depression Scale score(anxiety: mean difference =−1.04, 95% CI: −1.58 to −0.51; depression: mean difference =−1.25, 95% CI: −1.77 to −0.73). Comparing with exercise group, Tai Chi group statistically enhanced 6-minute walking distance score (mean difference =7.77, 95% CI: 2.63–12.91).

Conclusions

Tai Chi may represent an appropriate alternative or complement to standard rehabilitation programs. However, whether Tai Chi is better than pulmonary rehabilitation exercise has not been determined.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7139037/

 

Improve Cardiovascular and Metabolic Symptoms of Type 2 Diabetes with Yoga

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Improve Cardiovascular and Metabolic Symptoms of Type 2 Diabetes with Yoga

 

By John M. de Castro, Ph.D.

 

“Yoga practices such as cleansing processes, asanas, pranayama, mudras, bandha, meditation, mindfulness, and relaxation are known to reduce blood glucose levels and to help in the management of comorbid disease conditions associated with type 2 diabetes mellitus, resulting in significant positive clinical outcomes.” – Arkiath Veettil Raveendran

 

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. Type II Diabetes results from a resistance of tissues, especially fat tissues, to the ability of insulin to promote the uptake of glucose from the blood. As a result, blood sugar levels rise producing hyperglycemia. 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.

 

Type 2 diabetes is a common and increasingly prevalent illness that is largely preventable. One of the reasons for the increasing incidence of Type 2 Diabetes is its association with overweight and obesity which is becoming epidemic in the industrialized world. A leading cause of this is a sedentary life style. Unlike Type I Diabetes, Type II does not require insulin injections. Instead, the treatment and prevention of Type 2 Diabetes focuses on diet, exercise, and weight control. Recently, mindfulness practices have been shown to be helpful in managing diabetes. A mindfulness practice that combines mindfulness with exercise is yoga and it has been shown to be helpful in the treatment of Type II Diabetes.

 

In today’s Research News article “Yoga-based lifestyle treatment and composite treatment goals in Type 2 Diabetes in a rural South Indian setup- a retrospective study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7156497/), Arumugam and colleagues recruited adults with Type 2 Diabetes in rural India and randomly assigned them to either standard care or to 6 months of 1 hour daily supervised yoga practice “comprised of loosening practices, asanas, pranayama, relaxation techniques, and meditation.” They were measured before and after treatment for blood levels of A1c, LDL and HDL-cholesterol, fasting blood glucose, postprandial blood glucose, systolic and diastolic blood pressure, weight, total cholesterol, triglyceride, and body mass index (BMI).

 

They found that for the most part the control group had deterioration of most measures of their cardiovascular and metabolic health while the yoga group had significant improvements in all measures, including blood fats and glucose, blood pressure, and body weight, except total triglycerides. Hence, the patients with Type 2 Diabetes markedly reduced their risk factors for cardiovascular disease while the control group increased their risk.

 

These are very encouraging results that yoga practice can improve the health of patients with Type 2 Diabetes in rural India and lower their risk of developing serious cardiovascular disease. It would be important in future research to include another condition of perhaps aerobic exercise to evaluate if yoga practice confers extra benefits beyond its exercise effects. Regardless, the results suggest that yoga practice improves the physical well-being of patients with Type 2 Diabetes in rural settings.

 

So, improve cardiovascular and metabolic symptoms of Type 2 Diabetes with yoga.

 

“Yoga is considered to be a promising, cost-effective option in the treatment and prevention of diabetes, with data from several studies suggesting that yoga and other mind-body therapies can reduce stress-related hyperglycemia and have a positive effect on blood glucose control.” – Diabetes UK

 

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

 

Arumugam, G., Nagarathna, R., Majumdar, V., Singh, M., Srinivasalu, R., Sanjival, R., Ram, V. S., & Nagendra, H. R. (2020). Yoga-based lifestyle treatment and composite treatment goals in Type 2 Diabetes in a rural South Indian setup- a retrospective study. Scientific reports, 10(1), 6402. https://doi.org/10.1038/s41598-020-63133-1

 

Abstract

This multicentre retrospective study examined the effects of adjunct yoga-treatment in achieving composite cardiovascular goals for type 2 diabetes (T2D), set forth by the American Diabetes Association (ADA) in rural Indian settings. Records were extracted for 146 T2D patients, aged ≥20–70 years, and treated under the “Apollo Total Health Programme” for rural diabetes management, for the period April 2016 to November 2016. The study cohort comprised of two treatment groups (n = 73 each); non-yoga group (standard of care) and yoga group (adjunct yoga-treatment). Propensity score matching was applied between the study groups to define the cohort. Composite cardiovascular scores were based on the combination of individual ADA goals; A1c < 7%, blood pressure (BP) < 140/90 mmHg, stringent BP (<130/80 mmHg) and lipid, LDL-C < 100 mg/dl [risk factor for atherosclerotic cardiovascular disease]. Logistic regression was used to compare between the two treatment groups. Compared to standard of care, adjunct yoga-treatment was found to significantly facilitate the attainment of ADA composite score by 8-fold; A1c, ~2-fold; LDL-C, ~2-fold; BP < 140/90 mmHg and <130/80 mmHg by ~8-and ~6-fold respectively. This study provides the first evidence for significant efficacy of adjunct yoga-treatment for the attainment of favourable treatment goals for T2D in rural Indian settings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7156497/

 

Improve Borderline Personality Disorder with Mindfulness

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Improve Borderline Personality Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness meditation training may help individuals with BPD be more effective in applying healthy coping skills in the midst of emotional pain. Mindfulness skills allow you to get just a little bit of space to be able to notice the emotion and be more strategic in terms of how you will act in the face of the emotion.” – Kristalyn Salters-Pedneault

 

Borderline Personality Disorder (BPD) is a very serious mental illness that is estimated to affect 1.6% of the U.S. population. It involves unstable moods, behavior, and relationships, problems with regulating emotions and thoughts, impulsive and reckless behavior, and unstable relationships. BPD is associated with high rates of co-occurring depression, anxiety disorders, substance abuse, eating disorders, self-harm, suicidal behaviors, and completed suicides. Needless to say, it is widespread and debilitating.

 

One of the few treatments that appears to be effective for Borderline Personality Disorder (BPD) is Dialectical Behavior Therapy (DBT). It is targeted at changing the problem behaviors characteristic of BPD 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.

 

It is not known if Dialectical Behavior Therapy (DBT) is effective for a subset of patients with Borderline Personality Disorder (BPD) who are not suicidal or self-harming. In today’s Research News article “Dialectical behaviour therapy skills reconsidered: applying skills training to emotionally dysregulated individuals who do not engage in suicidal and self-harming behaviours.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6993331/), Kells and colleagues recruited patients with Borderline Personality Disorder (BPD) who had never attempted suicide or engaged in any self-harming and who had high levels of emotional dysregulation. They received a 24-week Dialectical Behavior Therapy (DBT) program that met once a week for 2.5 hours. They were measured before, during, and after treatment and 6 months later for emotion regulation, mindfulness, and DBT skills.

 

There was a 49% drop-out rate. They found that for those that completed the program at each time point during and after treatment including the 6-month follow-up there were significant reductions in dysfunctional coping and increases in emotion regulation, mindfulness, and DBT skills. The effects were quite large with changes of 22% to 50% from baseline.

 

The study has a number of interpretive problems as there wasn’t a control condition. Previous controlled research, however, has demonstrated that Dialectical Behavior Therapy (DBT) is effective for the treatment of Borderline Personality Disorder (BPD). So. the present results were probably due to the treatment and not a confounding influence. The drop-out rate in this study was very high. BPD is a very difficult condition to treat and high drop-out rates are common. Hence it is reasonable to conclude that the present study successfully demonstrated that DBT is an effective treatment for BPD in patients without a history of suicide attempts or self-harming behaviors.

 

These findings suggest that Dialectical Behavior Therapy (DBT) affects a core symptom of Borderline Personality Disorder (BPD), an inability to cope with and regulate emotions. The patients improved markedly in their ability to regulate their emotions and cope with them. It is possible that the observed improvements in mindfulness may have been responsible for the improvements as mindfulness has been shown repeatedly to improve emotion regulation and coping behavior. It remains for future research to investigate this idea.

 

So, improve Borderline Personality Disorder with mindfulness.

 

“Strong emotions disrupt a person’s ability to think and to be mindful. This is true for all of us. An inability to think can lead to even stronger and more dysregulated emotions. This is of particular concern in people with BPD, who often experience strong and difficult to control emotions.” = Blaise Aguirre

 

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

 

Kells, M., Joyce, M., Flynn, D., Spillane, A., & Hayes, A. (2020). Dialectical behaviour therapy skills reconsidered: applying skills training to emotionally dysregulated individuals who do not engage in suicidal and self-harming behaviours. Borderline personality disorder and emotion dysregulation, 7, 3. https://doi.org/10.1186/s40479-020-0119-y

 

Abstract

Background

Dialectical behaviour therapy (DBT) is an evidence-based intervention for borderline personality disorder (BPD) but is an intensive treatment with significant health service costs. Access to DBT can sometimes be restricted due to limited resources. Positive results have been reported for the use of DBT skills training (DBT-ST), one of the four modes of standard DBT, in the treatment of individuals with BPD who self-harm. This study evaluates DBT-ST for a subgroup of individuals attending community mental health services who may have a diagnosis of BPD (or emerging BPD traits) but who are not actively self-harming.

Methods

Participants in this study were 100 adults attending community mental health services with a diagnosis of BPD, emerging BPD traits or emotion dysregulation who were not actively self-harming. The majority of participants were female (71%), aged 25–34 years (32%), single (48%) and unemployed (34%). Participants partook in a 24-week DBT-ST intervention delivered by DBT therapists. Outcome measures included the Difficulties in Emotion Regulation Scale (DERS), the DBT Ways of Coping Checklist (DBT-WCCL) and the Five Facet Mindfulness Questionnaire (FFMQ). Measures were administered at pre-intervention, at the end of each skills module, and at post-intervention.

Results

Significant reductions in emotion dysregulation (DERS) and dysfunctional coping (DBT-WCCL) scores were reported from pre- to post-intervention (p < .001). A significant increase in mindfulness scores (FFMQ) and DBT skill use (DBT-WCCL) was also observed (p < .001). However, the drop-out rate was high (49% at post-intervention).

Discussion

The results of this uncontrolled study suggest that a standalone 24-week DBT-ST intervention may have a beneficial impact in terms of a reduction in emotion dysregulation and dysfunctional coping, and an increase in mindfulness and DBT skills use in patients with BPD/ emerging BPD traits who are not currently engaging in self-harm. Adequately powered randomised controlled trials are required to determine treatment efficacy in comparison to standard DBT for this population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6993331/