Coping

Increase Positive Psychological States with Mindfulness

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Increase Positive Psychological States with Mindfulness

 

By John M. de Castro, Ph.D.

 

“state mindfulness was associated with positive experiences across the three outcomes: higher levels of autonomy, more intense and frequent pleasant affect, and less intense and less frequent unpleasant affect.” – Kirk Warren Brown

 

The primary focus of the majority of research on mindfulness has been on its ability to treat negative emotional states such as anxiety, depression, and perceived stress. As such, it has been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. But mindfulness training has also been shown to improve health and well-being in healthy individuals. Indeed, it is possible that the effectiveness of mindfulness training in relieving mental and physical illness may result from its ability to improve positive psychological states. There is accumulating research. So, it makes sense to review and summarize what has been learned

 

In today’s Research News article “Mindfulness-based positive psychology interventions: a systematic review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8344333/ ) Allen and colleagues review and summarize the published research studies of the effects of mindfulness-based interventions on positive psychological states. They identified 22 published research studies.

 

They report that the published research found that mindfulness-based interventions significantly increased eudaimonia, well-being, of children, adults, and couples. Mindfulness-based interventions were also found to significantly enhance hedonia, positive emotions (amusement, awe, contentment, joy, gratitude, hope, interest, love, and pride, collectively) and quality of life. They also report that mindfulness training produces significant increases in prosocial behavior, social competence, emotion regulation, flexibility, academic performance, delay of gratification, coping behavior, relaxation, self-compassion, and happiness.

 

Hence, the research published to date supports the conclusion that mindfulness-based interventions improve positive psychological states. So, these interventions are not only useful for the relief of negative psychological states in people who are suffering but can also enhance the psychological well-being of everyone.

 

So, increase positive psychological states with mindfulness.

 

 

“mindfulness is a fundamental part of a broad program of psycho-spiritual development, aiming to help people reach ‘enlightenment’. . .  it may be conceived of as the superlative state of happiness, equanimity and freedom that a human being is capable of experiencing.” – Itai Ivtzan

 

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

 

Allen, J. G., Romate, J., & Rajkumar, E. (2021). Mindfulness-based positive psychology interventions: a systematic review. BMC psychology, 9(1), 116. https://doi.org/10.1186/s40359-021-00618-2

 

Abstract

Background

There are hundreds of mindfulness-based interventions in the form of structured and unstructured therapies, trainings, and meditation programs, mostly utilized in a clinical rather than a well-being perspective. The number of empirical studies on positive potentials of mindfulness is comparatively less, and their known status in academia is ambiguous. Hence, the current paper aimed to review the studies where mindfulness-based interventions had integrated positive psychology variables, in order to produce positive functioning.

Methods

Data were obtained from the databases of PubMed, Scopus, and PsycNet and manual search in Google Scholar. From the 3831 articles, irrelevant or inaccessible studies were eliminated, reducing the number of final articles chosen for review to 21. Interventions that contribute to enhancement of eudaimonia, hedonia, and other positive variables are discussed.

Results

Findings include the potential positive qualities of MBIs in producing specific positive outcomes within limited circumstances, and ascendancy of hedonia and other positive variables over eudaimonic enhancement.

Conclusion

In conclusion, exigency of modifications in the existing MBIs to bring about exclusively positive outcomes was identified, and observed the necessity of novel interventions for eudaimonic enhancement and elevation of hedonia in a comprehensive manner.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8344333/

Yoga Practitioners Cope Better with the Stress and Psychological Distress During Covid-19 Pandemic

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Yoga Practitioners Cope Better with the Stress and Psychological Distress During Covid-19 Pandemic

 

By John M. de Castro, Ph.D.

 

“As the lockdown cannot last forever and workplaces will have to be functional soon, there is an increased possibility of recurrent infection. Therefore, Yoga can provide the necessary tool for risk reduction, amelioration of stress and anxiety and strengthening of the immune function.” – Kanupriya Sharma 

 

Mindfulness training and yoga practices have been shown to improve health and well-being in healthy individuals. They have 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. The COVID-19 pandemic has challenged the mental and physical health of the population. It has created intense stress both for frontline workers but also for people simply isolating at home. Mindfulness is known to decrease the psychological and physical responses to stress and yoga practice also produces similar improvements. So, yoga practice may be helpful in coping with the mental and physical challenges resulting from the lockdown during the COVID-19 pandemic.

 

In today’s Research News article “Yoga Practice Is Beneficial for Maintaining Healthy Lifestyle and Endurance Under Restrictions and Stress Imposed by Lockdown During COVID-19 Pandemic.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8257944/ ) Nagarathna and colleagues recruited adult (>18 years of age) participants in India online during the Covid-19 lockdown and had them complete a questionnaire measuring demographics, Covid-19 exposure, physical health, mental health, coping strategies, lifestyle, and physical activities.

 

They defined a yoga group as those participants who practiced yoga before and during the Covid-19 lockdown and the non-yoga group as those who did not. They report that the yoga group had a significantly greater proportion of females and students, were younger, were less likely to use alcohol, tobacco, or other substances and eat junk food, more likely to be vegetarian, were disciplined in their diet, and had greater sleep quality, physical strength and endurance, and energy, have lower levels of anxiety and fear, but did not differ in Covid-19 exposure. In addition, the yoga group indicated more adaptive coping strategies.

 

This study was a comparison between groups defined by whether they were yoga practitioners or not. Any observed differences could well be due to the types of people attracted to yoga practice versus those who are not. It cannot be concluded that the practice of yoga was responsible for the differences. But prior research has demonstrated in controlled trials that the practice of yoga produces many physical and psychological benefits. So, the differences observed here may well be due to causal effects of yoga practice. Regardless of causation, the results clearly show that during the Covid-19 lockdown, yoga practitioners have greater physical and mental well-being and have healthier lifestyles.

 

So, yoga practitioners cope better with the stress and psychological distress during Covid-19 pandemic.

 

“Yoga can be a powerful tool to deal with the lockdown’s uncertainty and isolation, as well as to maintain physical well-being.” – United Nations

 

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

Nagarathna, R., Anand, A., Rain, M., Srivastava, V., Sivapuram, M. S., Kulkarni, R., Ilavarasu, J., Sharma, M., Singh, A., & Nagendra, H. R. (2021). Yoga Practice Is Beneficial for Maintaining Healthy Lifestyle and Endurance Under Restrictions and Stress Imposed by Lockdown During COVID-19 Pandemic. Frontiers in psychiatry, 12, 613762. https://doi.org/10.3389/fpsyt.2021.613762

 

Abstract

Uncertainty about Coronavirus disease 2019 (COVID-19) and resulting lockdown caused widespread panic, stress, and anxiety. Yoga is a known practice that reduces stress and anxiety and may enhance immunity. This study aimed to (1) investigate that including Yoga in daily routine is beneficial for physical and mental health, and (2) to evaluate lifestyle of Yoga practitioners that may be instrumental in coping with stress associated with lockdown. This is a pan-India cross-sectional survey study, which was conducted during the lockdown. A self-rated scale, COVID Health Assessment Scale (CHAS), was designed by 11 experts in 3 Delphi rounds (Content valid ratio = 0.85) to evaluate the physical health, mental health, lifestyle, and coping skills of the individuals. The survey was made available digitally using Google forms and collected 23,760 CHAS responses. There were 23,290 valid responses (98%). After the study’s inclusion and exclusion criteria of yogic practices, the respondents were categorized into the Yoga (n = 9,840) and Non-Yoga (n = 3,377) groups, who actively practiced Yoga during the lockdown in India. The statistical analyses were performed running logistic and multinomial regression and calculating odds ratio estimation using R software version 4.0.0. The non-Yoga group was more likely to use substances and unhealthy food and less likely to have good quality sleep. Yoga practitioners reported good physical ability and endurance. Yoga group also showed less anxiety, stress, fear, and having better coping strategies than the non-Yoga group. The Yoga group displayed striking and superior ability to cope with stress and anxiety associated with lockdown and COVID-19. In the Yoga group, participants performing meditation reportedly had relatively better mental health. Yoga may lead to risk reduction of COVID-19 by decreasing stress and improving immunity if specific yoga protocols are implemented through a global public health initiative.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8257944/

 

Spirituality Modifies Coping with Covid-19 Evoked Psychological Distress

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Spirituality Modifies Coping with Covid-19 Evoked Psychological Distress

 

By John M. de Castro, Ph.D.

 

“COVID-19 . . . patients are suffering greatly from spiritual distress as well: existential distress, struggles with uncertainty, despair, hopelessness, isolation, feelings of abandonment by God or others, grief, and the need for reconciliation.” – GW School of Medicine

 

The COVID-19 pandemic has challenged the mental and physical health of the population. It has created intense stress for frontline workers but also for people simply isolating at home. Religion and spirituality have been promulgated as solutions to the challenges of life. There have been a number of studies of the influence of religiosity and spirituality on the physical and psychological well-being of practitioners mostly showing positive benefits, with spirituality encouraging personal growth and mental health. Perhaps, then, spirituality can be helpful in relieving stress and improve coping with the mental and physical challenges resulting from the COVID-19 pandemic.

 

In today’s Research News article “Coping with COVID-19: An Examination of the Role of (Non)Religiousness/(Non)Spirituality.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8140577/ ) Abbott and Franks recruited adults over the internet and had them complete measures of coping strategies, psychological distress (anxiety, depression, and perceived stress), religiousness, spirituality, and pandemic related trauma.

 

They found that the higher the levels of pandemic related trauma and dysfunctional coping, the higher the levels of psychological distress experienced by the participants. Trauma was found to be both directly and indirectly associated with psychological distress via dysfunctional coping. This was true for religious, non-religious, and high and moderate spirituality participants but not for low spirituality participants.

 

These results are correlational and as such caution must be exercised in forming conclusions regarding causation. But the relationship is clear between the trauma created by the pandemic and psychological distress, people who are traumatized experience high levels of anxiety, depression, and stress. The trauma is also related to dysfunctional coping suggesting that traumatized individual tend to engage in maladaptive coping strategies. Dysfunctional coping involves coping with difficulties by behavioral disengagement, denial, self-distraction, self-blame, substance use and venting and these strategies are associated with heightened levels of trauma. Finally, the analysis suggests that pandemic related trauma is associated with psychological distress directly and also indirectly by being associated with higher levels of dysfunctional coping which in turn is associated with higher levels of distress.

 

These results suggest that religion and spirituality are helpful in coping with trauma produced by the Covid-19 pandemic. But not with those having low levels of spirituality. Spirituality generally implies a feeling or belief in something beyond the physical. Conversely, low spirituality would imply a focus solely on the physical. So, the results suggest that trauma does not affect coping’s effects on psychological distress when there’s a belief that only physical forces are involved. This then suggests that spirituality increases the individual’s attempts to deal with trauma with coping strategies.

 

So, spirituality modifies coping with covid-19 evoked psychological distress.

 

“during a major crisis such as the Covid-19 pandemic, we need to make sure that everyone is getting spiritual care.” – Eric Hall

 

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

 

Abbott, D. M., & Franks, A. S. (2021). Coping with COVID-19: An Examination of the Role of (Non)Religiousness/(Non)Spirituality. Journal of religion and health, 60(4), 2395–2410. https://doi.org/10.1007/s10943-021-01284-9

 

Abstract

Psychological distress and coping strategies employed during collective trauma events may vary for theists and atheists, as well as others along the (non)religious spectrum. The present study explored these differences via data collected from a US-based sample during the COVID-19 pandemic. Statistical models suggested relationships between maladaptive coping and distress for all participants and potential differences in coping and, in turn, distress between participants high and low in institutional religiousness and individual spirituality. Additionally, all participants, though especially nonreligious participants, appeared less able to engage in adaptive emotion-focused coping strategies. Implications for future research are provided.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8140577/

 

Spirituality Improves Well-Being During the Covid-19 Pandemic

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Spirituality Improves Well-Being During the Covid-19 Pandemic

 

By John M. de Castro, Ph.D.

 

“It is now clear that meeting spiritual needs and supporting religious and spiritual coping can be a major contributor, not only to patient experience, but also to medical outcomes and cost savings,” – The Beryl Institute

 

Mindfulness training has been shown to improve health and well-being in healthy individuals. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. The COVID-19 pandemic has challenged the mental and physical health of the population. It has created intense stress for frontline workers but also for people simply isolating at home.

 

Religion and spirituality have been promulgated as solutions to the challenges of life. There have been a number of studies of the influence of religiosity and spirituality on the physical and psychological well-being of practitioners mostly showing positive benefits, with spirituality encouraging personal growth and mental health. Perhaps, then, spirituality can be helpful in relieving stress and improve coping with the mental and physical challenges resulting from the COVID-19 pandemic.

 

In today’s Research News article “Meaning-Based Coping and Spirituality During the COVID-19 Pandemic: Mediating Effects on Subjective Well-Being.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.646572/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1616048_69_Psycho_20210504_arts_A )   Arslan and colleagues recruited college students and had them complete measures of perceived coronavirus risk, stress because of coronavirus, subjective well-being, spiritual well-being, and meaning based coping.

 

They found that the higher the levels of spiritual well-being the lower the levels of stress because of coronavirus and the higher the levels of subjective well-being and meaning based coping. They also found that the higher the levels of stress because of coronavirus the lower the levels of subjective well-being, spiritual well-being, and meaning based coping. Structural Equation modelling revealed that perceived coronavirus risk was associated with higher levels of stress because of coronavirus which was, in turn, associated with lower levels of subjective well- being, not directly, but indirectly through associations with lower levels of spiritual well-being, and meaning based coping.

 

These results are correlational so no causal conclusions can be reached. But it is clear that the students’ perceptions of their personal risk of being infected was associated with feeling stressed and this was associated with lower levels of feelings of well-being. This is all very reasonable. This stress, however, appears to affect well-be being by being associated with lower spirituality and lower coping with the stress by finding meaning in life.

 

The pandemic and the associated stress are beyond the control of the students. But engaging in spirituality and searching for meaning are not. So, these findings suggest that the students, and by extension, everyone else, may be able to deal more effectively with the pandemic by engaging in spiritual practices to help find meaning in life. More research is needed to examine this hypothesis.

 

So, spirituality improves well-being during the Covid-19 pandemic

 

‘COVID-19 has generated a crisis of spiritual distress in healthcare settings that must prioritize urgent clinical symptom and infection control. That said, many patients are suffering greatly from spiritual distress as well: existential distress, struggles with uncertainty, despair, hopelessness, isolation, feelings of abandonment by God or others, grief, and the need for reconciliation.” – George Washington University

 

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

 

Arslan G and Yıldırım M (2021) Meaning-Based Coping and Spirituality During the COVID-19 Pandemic: Mediating Effects on Subjective Well-Being. Front. Psychol. 12:646572. doi: 10.3389/fpsyg.2021.646572

 

The coronavirus pandemic has significantly affected the Turkish population. During the pandemic, people with high coronavirus stress are at risk of experiencing poor subjective well-being. There is no research investigating the role of meaning-based coping and spirituality in explaining the link between coronavirus stress and subjective well-being. This study examined the mediating roles of meaning-based coping and spiritual well-being in the link between coronavirus stress and subjective well-being in young adults during the COVID-19 pandemic. The sample included 427 young adults (71% female), ranging in age between 18 and 48 years (M = 21.06; SD = 2.62). Turkish young adults completed an online survey, including measures of coronavirus stress, subjective well-being, meaning-based coping, and spiritual well-being. The results indicate that greater meaning-based coping and spiritual well-being mediated decreases in the adverse impacts of coronavirus stress on subjective well-being. These results suggest that the importance of a combination of meaning-based coping and spirituality processes mitigate the adverse effects of stress on well-being during the coronavirus pandemic. Interventions focusing on meaning-based coping and spirituality in those experiencing high coronavirus stress are urgently needed to improve the mental health and well-being of young adults.

https://www.frontiersin.org/articles/10.3389/fpsyg.2021.646572/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1616048_69_Psycho_20210504_arts_A

 

Improve Sleep Quality in People with Insomnia with Mindfulness

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Improve Sleep Quality in People with Insomnia with Mindfulness

 

By John M. de Castro, Ph.D.

 

“If you suffer from insomnia, mindfulness helps you be more accepting of your experience when you have difficulty sleeping. It may seem paradoxical, but this willingness to accept the experience of poor sleep can lead to less anxiety and better rest.” – Polan Orzech

 

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

 

Insomnia is more than just an irritant. Sleep deprivation is 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.

 

Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT). ACT 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 would seem reasonable to expect that Acceptance and Commitment Therapy (ACT) might improve sleep and relieve insomnia.

 

In today’s Research News article “Acceptance and Commitment Therapy (ACT) Improves Sleep Quality, Experiential Avoidance, and Emotion Regulation in Individuals with Insomnia-Results from a Randomized Interventional Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916154/ ) Zakiei and colleagues recruited adults with clinical insomnia and randomly assigned them to receive 8 weekly sessions of 70 minutes of either Acceptance and Commitment Therapy (ACT) or group meetings to discuss daily activities and daily problems (active control condition). They were measured before and after treatment and 12 weeks later for experiential avoidance, sleep quality, sleep characteristics, dysfunctional thoughts on sleep, sleep problem acceptance, and emotion regulation.

 

They found that over training and the 12-week follow-up in comparison to the active control condition, the group that received Acceptance and Commitment Therapy (ACT) had significant reductions in experiential avoidance, dysfunctional thoughts on sleep, and significant increases in sleep quality, total sleep time, feelings of being restored by sleep, sleep problem acceptance, and emotion regulation. In addition, the greater the reduction in experiential avoidance the lower the levels of dysfunctional thoughts on sleep and the higher the levels of emotion regulation, sleep quality, and sleep problem acceptance.

 

These results demonstrate that Acceptance and Commitment Therapy (ACT) provided to patients with insomnia produces large improvements in sleep and decreases in cognitive-emotional processes related to insomnia. Although not demonstrated in the study, the results suggest that the improvements in sleep may occur due to ACT’s ability to alter dysfunctional thought processes and strengthen adaptive thinking. Mindfulness-based practices have been previously reported to improve sleep amount and quality and help with insomnia. The fact that ACT works so well for insomnia suggests that correcting dysfunctional thinking about sleep adds to the effectiveness of mindfulness in improving sleep. The effects were large, significant, and lasting suggesting that ACT should be prescribed for patients with clinical insomnia.

 

So, improve sleep quality in people with insomnia with mindfulness.

 

“mindfulness improves regulation of stress and increases a sense of calm that results in a better ability to sleep.” – Melli O’Brien

 

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

Zakiei, A., Khazaie, H., Rostampour, M., Lemola, S., Esmaeili, M., Dürsteler, K., Brühl, A. B., Sadeghi-Bahmani, D., & Brand, S. (2021). Acceptance and Commitment Therapy (ACT) Improves Sleep Quality, Experiential Avoidance, and Emotion Regulation in Individuals with Insomnia-Results from a Randomized Interventional Study. Life (Basel, Switzerland), 11(2), 133. https://doi.org/10.3390/life11020133

 

Abstract

Insomnia is a common problem in the general population. To treat insomnia, medication therapies and insomnia-related cognitive-behavioral interventions are often applied. The aim of the present study was to investigate the influence of acceptance and commitment therapy (ACT) on sleep quality, dysfunctional sleep beliefs and attitudes, experiential avoidance, and acceptance of sleep problems in individuals with insomnia, compared to a control condition. A total of 35 participants with diagnosed insomnia (mean age: 41.46 years old; 62.9% females) were randomly assigned to the ACT intervention (weekly group therapy for 60–70 min) or to the active control condition (weekly group meetings for 60–70 min without interventional and psychotherapeutic character). At baseline and after eight weeks (end of the study), and again 12 weeks later at follow-up, participants completed self-rating questionnaires on sleep quality, dysfunctional beliefs and attitudes about sleep, emotion regulation, and experiential avoidance. Furthermore, participants in the intervention condition kept a weekly sleep log for eight consecutive weeks (micro-analysis). Every morning, participants completed the daily sleep log, which consisted of items regarding subjective sleep duration, sleep quality, and the feeling of being restored. Sleep quality, dysfunctional beliefs and attitudes towards sleep, emotion regulation, and experiential avoidance improved over time, but only in the ACT condition compared to the control condition. Improvements remained stable until follow-up. Improvements in experiential avoidance were related to a favorable change in sleep and cognitive-emotional processing. Micro-analyses showed that improvements occurred within the first three weeks of treatment. The pattern of results suggests that ACT appeared to have improved experiential avoidance, which in turn improved both sleep quality and sleep-related cognitive-emotional processes at longer-term in adults with insomnia.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916154/

 

Mindfulness is Associated with Improved Coping and Mental Well-Being During the Covid-19 Pandemic

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Mindfulness is Associated with Improved Coping and Mental Well-Being During the Covid-19 Pandemic

 

By John M. de Castro, Ph.D.

 

“Right now it’s very easy to let your brain spin out with the frightening possibilities. Practicing mindfulness helps bring us back to the present, and away from the brink.” – David Anderson

 

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

 

he COVID-19 pandemic is extremely stressful particularly during a lockdown and hence has challenged the mental and physical health of the population. It has created intense stress both for frontline workers but also for people simply isolating at home. So, mindfulness, because of its ability to improve stress responding, may be helpful in coping with the mental and physical challenges resulting from the COVID-19 pandemic.

 

In today’s Research News article “Coping with COVID-19 – Longitudinal analysis of coping strategies and the role of trait mindfulness in mental well-being.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7843110/ )  Götmann and colleagues recruited online adults during a Covid-19 lockdown in Germany. At 13 different points in time, they completed measures of mindfulness, coping strategies, well-being, savoring, resilience, and depression.

 

They found that the higher the levels of trait mindfulness the higher the levels of well-being, savoring, and problem solving coping and the lower the levels of distraction and denial and blaming coping. But of the mindfulness facets only self-regulated attention was associated with higher levels of problem solving and savoring and only orientation toward experience was associated with lower levels of distraction and denial and blaming and higher levels of well-being. Further they found that well-being was positively related to problem solving coping was negatively related to blaming.

 

Using structural equation modelling, they were able to show that mindfulness was positively related to well-being as a result of self-regulated attention which was positively related to problem solving coping and in turn well-being. On the other hand, they found that mindfulness was positively related to well-being as a result of orientation to experience being negative related to distraction and denial and blaming and in turn higher well-being.

 

These results are interesting but correlational and as such causation cannot be determined. But prior research has demonstrated that mindfulness produces higher well-being and positive coping. So, the present results are likely due to causal connections between these variables. The findings additionally suggest that mindfulness has a twofold connection with well-being via two mindfulness facets. Attention promoted a positive coping mechanism which in turn improved well-being while non-judging of experience interfered with negative coping mechanisms’ ability to detract from well-being.

 

These findings were produced by people experiencing a Covid-19 lockdown. They suggest that mindfulness is very beneficial during stressful times. It promotes the ability to cope with the situation in a constructive manner and suppresses non-constructive coping. It thus leads to better well-being in the midst of a public health crisis.

 

So, mindfulness is associated with improved coping and mental well-being during the Covid-19 pandemic.

 

“During the current pandemic, there is so much uncertainty concerning the future, and many threats to our security (physical, social, emotional, and financial). It is totally natural and normal to feel anxious, fearful, and frustrated. . . Mindfulness can help us acknowledge this situation, without allowing us to be carried away with strong emotions; it can, in turn, help bring ourselves back to a centered calm. Only then can we see more clearly what it is we have control over and what it is that we do not. “ – Michigan Medicine

 

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

 

Götmann, A., & Bechtoldt, M. N. (2021). Coping with COVID-19 – Longitudinal analysis of coping strategies and the role of trait mindfulness in mental well-being. Personality and individual differences, 175, 110695. https://doi.org/10.1016/j.paid.2021.110695

 

Abstract

Policy interventions intended to fight COVID-19 forced people to cope with several restrictions on their personal freedom. The present work addressed the question of how people dealt with stressors during a lockdown period and investigated the role of trait mindfulness and its subcomponents in coping and mental well-being. We recruited a sample of 93 participants to study coping reactions using a multi-wave study over a period of two-months with 13 measurement points. Multilevel analysis revealed that engagement-related coping such as problem-solving was positively related to well-being; the opposite was true for disengagement coping such as blaming. The mindfulness facet orientation towards experience (being open and accepting experiences without judgment) was negatively related to disengagement coping, while the facet self-regulated attention (awareness of the present moment) was positively related to engagement coping. Self-regulated attention but not orientation towards experience was associated with savoring positive aspects of COVID-related changes over time. Engagement-related coping mediated the effects of trait mindfulness on well-being. The findings point to the differential effects of subcomponents of trait mindfulness in the context of coping and mental well-being. Further implications are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7843110/

 

Mindfulness is Associated with Medication Adherence in Older Adults

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Mindfulness is Associated with Medication Adherence in Older Adults

 

By John M. de Castro, Ph.D.

 

“Keep a watch…on the faults of the patients, which often make them lie about the taking of things prescribed. For through not taking disagreeable drinks, purgative or other, they sometimes die.” – Hippocrates, Decorum

 

“Integrating mindfulness into our practices may help foster the therapeutic alliance and ultimately medication adherence.” – Michael Ascher

 

In order for prescriptive medications to be effective in treating disease they must be taken. But about 50% of older patients do not take their medications as prescribed and many do not even fill their prescriptions. This is a shockingly high degree of non-compliance that can lead to poorer health and potentially death. Indeed, it has been stated that “increasing the effectiveness of adherence interventions may have a far greater impact on the health of the population than any improvement in specific medical treatments” (R. Brian Haynes). Mindfulness, on the other hand has been shown to be associated with better compliance with therapy and greater health related behaviors. So, it makes sense to study the role of mindfulness in medication adherence in older individuals.

 

In today’s Research News article “Selected psychological predictors of medication adherence in the older adults with chronic diseases.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7729554/ ) Gruszczyńska and colleagues recruited older adults, over 60 year of age, who were diagnosed with a chronic disease. They completed measures of medication adherence, health locus of control, stress coping, and mindfulness.

 

They found that the higher the levels of medication adherence, the higher the levels of internal locus of control, influence of others locus of control, and mindfulness and the lower the levels of emotion-oriented coping and distraction seeking. Regression analysis revealed that the strongest positive predictors of medication adherence were influence of others locus of control, and mindfulness while the most powerful negative predictor was emotion-oriented coping.

 

It should be recognized that this study is correlational and as such causation cannot be determined. But these results make sense as ascribing the control of one’s health to other powerful people would suggest that the individual would be more likely to follow the direction of a physician and comply with the medicinal directions. That people who cope with stress emotionally would not adhere to medicinal directions also make sense as the invocation of strong emotions associated with the stress of the disease would be aversive and lead to avoidding or ignoring medicines associated with the source of stress.

 

Finally, mindfulness was found to be influential on medication adherence. Being more aware of and attentive to the needs of the body should lead to tending to those needs and taking prescribed medications to help. Indeed, mindfulness tends to promote health related behaviors in general. In other words, mindful people tend to do things that are beneficial for their health including taking prescribed medications as directed.

 

Since elderly people taking prescribed medications is one of the single most important contributors to their overall health and longevity, improving adherence is extremely important. Perhaps if training in mindfulness was prescribed along with medications, medication adherence may be improved leading to better health outcomes.

 

So, mindfulness is associated with medication adherence in older adults.

 

“Mindfulness interventions have been proven effective on several predictors of poor adherence (i.e., sleep, cognitive impairment, depression, and stress) and thus hold great potential to improve medication adherence.“ – Elena Salmoirago-Blotcher

 

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

 

Gruszczyńska, M., Wyszomirska, J., Daniel-Sielańczyk, A., & Bąk-Sosnowska, M. (2020). Selected psychological predictors of medication adherence in the older adults with chronic diseases. Nursing open, 8(1), 317–326. https://doi.org/10.1002/nop2.632

 

Abstract

Aim

The main goal of the study was to assess the significance of selected psychological factors related to the adherence to medication recommendations among the older adults with chronic diseases.

Design

It was designed as a cross‐sectional study, aimed at assessing the importance of selected psychological factors in complying with medication recommendations among older adults.

Methods

The study involved 345 older adults with chronic diseases, assessed the importance of selected psychological factors, such as: health locus of control, stress coping and mindfulness in adhering to medication recommendations older persons. To answer the research questions, we performed frequency analyses, basic descriptive statistics analyses together with the Kolmogorov–Smirnov test, Student’s t tests for independent samples, monofactorial analysis of variance in the intergroup diagram, analysis correlation with the Pearson correlation coefficient, Spearman’s rank correlation ρ analysis and stepwise linear regression analysis.

Results

The study identified psychological predictors of medication adherence, which explained 12% of the variability. An emotion‐oriented coping proved to be the most important factor. Additionally, powerful other health locus of control and mindful attention were shown to have a positive effect.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7729554/

 

Lower Stress and Improve the Psychological Health of Healthcare Workers with Mind-Body Practices

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Lower Stress and Improve the Psychological Health of Healthcare Workers with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

“mind-body programs. . . emphasize the importance of mindfulness, getting more sleep and reducing stress. Not long ago, those life strategies were viewed as irrelevant to a person’s health care. But these are all things that boost one’s mood. An added bonus? They make a huge difference in improving physical health.” – Hal Paz

 

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. These stressors have been vastly amplified during the Covid-19 pandemic. Improving the psychological health of health care professionals, then, has to be a priority.

 

Contemplative practices have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, and improving sleep.  Hence, it is reasonable to examine the ability of mind-body practices as a means to improve the well-being of healthcare professionals.

 

In today’s Research News article “Long-term beneficial effects of an online mind-body training program on stress and psychological outcomes in female healthcare providers: A non-randomized controlled study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7593019/ ) Lee and colleagues recruited female healthcare workers and randomly assigned them to a wait-list control condition or to receive an 8-week online program of mind-body training. The participants practiced at home for 10 minutes, 5 days per week, for 8 weeks. The training included relaxation training, breathing exercises, and meditation. The participants were measured before and after training and 4 weeks later for occupational stress, stress responses, emotional intelligence, resilience, coping strategies, positive and negative emotions, and anxiety.

 

They found that in comparison to baseline and the wait-list control group, the mind-body training group had significant reduction in overall stress levels, anger, and depression and a significant increase in a social support coping strategy that were maintained 4 weeks after the end of training. They also found that the mind-body group had a significant increase in emotion regulation, a problem-solving coping strategy ,and resilience and a significant decrease in negative emotions at the end of training but these improvements were no longer significant 4 weeks later.

 

This is an interesting study but conclusions must be tempered by the fact that the comparison condition was passive, leaving open the possibility for contaminants such as experimenter bias or participant expectancy, or attentional effects as alternative explanations. But the results are similar to other controlled studies that mindfulness training decreases stress, anger, negative emotions. and depression and increases emotion regulation and adaptive coping. So, it would appear that the mind-body training improves the psychological health of female healthcare workers with lasting improvements in stress levels, anger, depression and social support coping but transitory improvements in emotion regulation, resilience, negative emotions and problem-solving coping.

 

An important characteristic of the mind-body training in the present study was that it was provided online and only involved 10 minutes of daily practice. This type of program is convenient and doesn’t add a major time commitment to the healthcare workers’ already very busy schedule. So, it is easy to inexpensively and conveniently provide it to large numbers of healthcare workers without adding extra stress. Such a program, then, can improve the well-being of these stressed workers, potentially reducing burnout and improving job effectiveness. This is particularly important during the Covid-19 pandemic.

 

So, lower stress and improve the psychological health of healthcare workers with min-body practices.

 

“Mind-body therapies are safe, noninvasive techniques that have been shown to reduce stress and anxiety . . . Furthermore, they have demonstrated preliminary effects in improving psychological outcomes in physicians and health-care providers.” – Ting Bao

 

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

 

Lee, D., Lee, W. J., Choi, S. H., Jang, J. H., & Kang, D. H. (2020). Long-term beneficial effects of an online mind-body training program on stress and psychological outcomes in female healthcare providers: A non-randomized controlled study. Medicine, 99(32), e21027. https://doi.org/10.1097/MD.0000000000021027

 

Abstract

Mind-body training (MBT) programs are effective interventions for relieving stress and improving psychological capabilities. To expand our previous study which demonstrated the short-term effects of an 8-week online MBT program, the present study investigated whether those short-term effects persist up to a month after the end of the intervention.

Among previous participants, 56 (64%) participated in this follow-up study, 25 in the MBT group and 31 in the control group. Outcome measures included the stress response, emotional intelligence, resilience, coping strategies, positive and negative affect, and anger expression of both groups at baseline, at 8 weeks (right after the training or waiting period), and at 12 weeks (a month after the training or waiting period).

The MBT group showed a greater decrease in stress response at 8 weeks, and this reduction remained a month after the end of the intervention. The effect of MBT on resilience and effective coping strategies was also significant at 8 weeks and remained constant a month later. However, the improvement to emotional intelligence and negative affect did not persist a month after training.

These findings suggest that the beneficial short-term effects of MBT may last beyond the training period even without continuous practice, but the retention of these benefits seems to depend on the outcome variables. Through a convenient, affordable, and easily accessible online format, MBT may provide cost-effective solutions for employees at worksites.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7593019/

 

Improve Refractory Depression with Mindfulness

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Improve Refractory Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness and other meditations, particularly combined with cognitive therapy, work just as well for anxiety or depression as the medications do, but they don’t have those side effects,” – Daniel Goleman

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. Depression can be difficult to treat and is usually treated with anti-depressive medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients do not respond to treatment. This is called refractory depression.

 

Mindfulness training has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail. Dialectical Behavior Therapy (DBT)  is a mindfulness-based therapeutic technique that produces behavior change by focusing on changing the thoughts and emotions that precede problem behaviors, as well as by solving the problems faced by individuals that contribute to problematic thoughts, feelings and behaviors. In DBT five core skills are practiced; mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness. DBT has been shown to be effective in treating depression. So, it makes sense, then, to study the effectiveness of Dialectical Behavior Therapy (DBT) for refractory depression.

 

In today’s Research News article “Refractory depression – mechanisms and efficacy of radically open dialectical behaviour therapy (RefraMED): findings of a randomised trial on benefits and harms.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282863/ ) Lynch and colleagues recruited adults with refractory major depressive disorder and randomly assigned them to either treatment as usual or to receive 29 weekly 1 hour sessions of Dialectical Behavior Therapy (DBT). They were measured before and after treatment and 5 months and 11 months later for depressive symptoms, psychosocial functioning, suicidal ideation, psychological inflexibility, emotional coping, and social support.

 

They found that compared to baseline both groups continuously improved with reduced depressive symptoms, but the group that received Dialectical Behavior Therapy (DBT) demonstrated significantly greater reductions but they were only statistically significant immediately after treatment but not at the 5 and 11 month follow ups. Also remission rates were higher in the DBT group. In addition, the DBT group had significantly greater psychological flexibility, emotional coping after treatment and all follow-up measurements.

 

These are interesting results that suggest that Dialectical Behavior Therapy (DBT) is an effective treatment for refractory major depressive disorder. In other words, it helps the patients who are not helped by any other treatments; the most difficult to treat patients. The fact that the relief of depressive symptoms is not significantly different from the treatment as usual group at the 5 and 11-month follow ups suggests that booster session may be necessary. But it should be recognized that the patients were markedly improved relative to their baselines. It was just that the treatment as usual group improved as well. So, the DBT produced a large and sustained reduction in depression in these refractory patients.

 

So, improve refractory depression with mindfulness.

 

“Meditation helped me realize that the misery I feel is temporary. It sucks, but if I can wade my way through it, I know I’ll probably have a better day tomorrow.” – Stacey Neglia

 

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

 

Lynch, T. R., Hempel, R. J., Whalley, B., Byford, S., Chamba, R., Clarke, P., Clarke, S., Kingdon, D. G., O’Mahen, H., Remington, B., Rushbrook, S. C., Shearer, J., Stanton, M., Swales, M., Watkins, A., & Russell, I. T. (2020). Refractory depression – mechanisms and efficacy of radically open dialectical behaviour therapy (RefraMED): findings of a randomised trial on benefits and harms. The British journal of psychiatry : the journal of mental science, 216(4), 204–212. https://doi.org/10.1192/bjp.2019.53

 

Abstract

Background

Individuals with depression often do not respond to medication or psychotherapy. Radically open dialectical behaviour therapy (RO DBT) is a new treatment targeting overcontrolled personality, common in refractory depression.

Aims

To compare RO DBT plus treatment as usual (TAU) for refractory depression with TAU alone (trial registration: ISRCTN 85784627).

Method

RO DBT comprised 29 therapy sessions and 27 skills classes over 6 months. Our completed randomised trial evaluated RO DBT for refractory depression over 18 months in three British secondary care centres. Of 250 adult participants, we randomised 162 (65%) to RO DBT. The primary outcome was the Hamilton Rating Scale for Depression (HRSD), assessed masked and analysed by treatment allocated.

Results

After 7 months, immediately following therapy, RO DBT had significantly reduced depressive symptoms by 5.40 points on the HRSD relative to TAU (95% CI 0.94–9.85). After 12 months (primary end-point), the difference of 2.15 points on the HRSD in favour of RO DBT was not significant (95% CI –2.28 to 6.59); nor was that of 1.69 points on the HRSD at 18 months (95% CI –2.84 to 6.22). Throughout RO DBT participants reported significantly better psychological flexibility and emotional coping than controls. However, they reported eight possible serious adverse reactions compared with none in the control group.

Conclusions

The RO DBT group reported significantly lower HRSD scores than the control group after 7 months, but not thereafter. The imbalance in serious adverse reactions was probably because of the controls’ limited opportunities to report these.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282863/

 

Improve Psychological Well-Being, Sleep, and Performance in College Athletes with Mindfulness

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Improve Psychological Well-Being, Sleep, and Performance in College Athletes with Mindfulness.

By John M. de Castro, Ph.D.

 

“How much time do you spend training your body, getting to peak performance?  With mindfulness training you can now train your mind. Learn how to focus more effectively, worry less, be more present and increase your ability to respond and react quickly.” – Blair Bowker

 

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

 

In today’s Research News article “Mindfulness-Based Stress Reduction Benefits Psychological Well-Being, Sleep Quality, and Athletic Performance in Female Collegiate Rowers.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2020.572980/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1437459_69_Psycho_20200922_arts_A ) Jones and colleagues recruited women members of a college rowing team and randomly assigned them to a no-treatment control condition or to receive 8 weekly 75 minutes group sessions of Mindfulness-Based Stress Reduction (MBSR). This training includes meditation, body scan, yoga, and discussion with daily home practice. They were measured before and after training for athletic coping skills, anxiety, depression, perceived stress, mindfulness, sleepiness, sleep quality, activity during sleep, rumination, and psychological well-being. They were also measured before the treatment and 6 weeks into the 8-week program for rowing performance.

 

They found that in comparison to baseline and the control group, after Mindfulness-Based Stress Reduction (MBSR) training there were significant increases in mindfulness, psychological well-being, sleep quality, activity during sleep, athletic coping skills, and rowing performance and significant decreases in daytime sleepiness. In addition, they report that the greater the increase in mindfulness the greater the increase in psychological well-being, sleep quality, and athletic coping skills and the greater the decrease in daytime sleepiness.

 

These are interesting results suggesting that mindfulness training improves the psychological well-being and athletic performance in athletes. But the comparison to a no-treatment condition leaves open alternative interpretations of participant expectancy effects, experimenter bias, attentional effects, etc. In addition, only female athletes were included in the study. Future research should include male athletes and employ an active control comparison condition such as group discussions of college life without mindfulness training.

 

The results from  previous studies have demonstrated that mindfulness training improves the psychological well-being and athletic performance in athletes. So, it is likely that the improvements seen in the present study were also due to the mindfulness training. In addition, the fact that in the group that received Mindfulness-Based Stress Reduction (MBSR) training that the amount of increase in mindfulness was associated with the degree of improvement in the psychological well-being and athletic performance, suggests that mindfulness was the key determinant of the improvements. So, it would appear likely that increasing mindfulness is of great benefit to athletes.

 

So, improve psychological well-being, sleep, and performance in college athletes with mindfulness.

 

“mindfulness meditation for athletes can help them control negative thoughts and sports anxiety which allows them to focus on their skills in the present moment and perform better.’ – Ertheo

 

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

 

Jones BJ, Kaur S, Miller M and Spencer RMC (2020) Mindfulness-Based Stress Reduction Benefits Psychological Well-Being, Sleep Quality, and Athletic Performance in Female Collegiate Rowers. Front. Psychol. 11:572980. doi: 10.3389/fpsyg.2020.572980

 

Factors such as psychological well-being, sleep quality, and athletic coping skills can influence athletic performance. Mindfulness-based interventions, including mindfulness-based stress reduction (MBSR), have been shown to benefit these factors, suggesting they may, at least indirectly, benefit athletic performance. Moreover, while mindfulness training has been linked to better accuracy in some high-precision sports, whether it can improve non-precision elements of athletic performance is unclear. The objective of this study was to investigate the influence of MBSR on psychological well-being, sleep, athletic coping skills, and rowing performance in collegiate rowers in a controlled experimental design. Members of a Division I NCAA Women’s Rowing team completed either an 8-week MBSR course along with their regular athletic training program (Intervention group) or the athletic training program alone (Control group). Measurements of interest were taken at baseline and again either during or shortly following the intervention. In contrast to the Control group, the Intervention group showed improvements in psychological well-being, subjective and objective sleep quality, athletic coping skills, and rowing performance as measured by a 6,000-m ergometer test. Improvements in athletic coping skills, psychological well-being, and subjective sleep quality were all correlated with increases in mindfulness in the Intervention group. These results suggest that mindfulness training may benefit non-precision aspects of athletic performance. Incorporating mindfulness training into athletic training programs may benefit quality of life and performance in student athletes.

https://www.frontiersin.org/articles/10.3389/fpsyg.2020.572980/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1437459_69_Psycho_20200922_arts_A