Addiction

Improve Psychological Health During Addiction Recovery with Qigong

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Improve Psychological Health During Addiction Recovery with Qigong

 

By John M. de Castro, Ph.D.

 

“For people in the early stages of recovery whose emotions may be all over the map, Tai Chi can help stabilize moods, provide mental focus and clarity, and smooth out the rough spots. “ – Pinnacle

 

Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use which includes unintentional overdoses, suicides, HIV and AIDS, and trauma. Obviously, there is a need to find effective methods to prevent and treat substance abuse. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers relapse and return to substance abuse. Hence, it is important to find an effective method to both treat substance abuse disorders and to prevent relapses.

 

Mindfulness practices have been shown to improve recovery from various addictions. Tai Chi is a mindfulness practice that has documented benefits for the individual’s psychological and physical health and well-being. Tai Chi and Qigong are ancient mindfulness practices involving slow prescribed movements. Since Tai Chi and Qigong are both mindfulness practices and gentle exercises, that may be an acceptable and effective treatment for patients recovering from addictions. Studies on the use of Tai Chi and Qigong practices to treat substance abuse have been accumulating and there is a need to pause and summarize what has been learned.

 

In today’s Research News article “The Impact of Qigong and Tai Chi Exercise on Drug Addiction: 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/PMC8957847/ ) Cui and colleagues review, summarize, and perform a meta-analysis of the published research studies on the effects of Tai Chi and Qigong practice during substance abuse treatment. They identified 11 studies including a total of 1072 participants.

 

They report that the published research found that Tai Chi and Qigong practices during substance abuse treatment produced significant reduction in depression, and anxiety, and significant improvements in quality of life, and sleep quality. Qigong practice appears to be superior to Tai Chi practice in producing these benefits.

 

Hence, the published research suggests that Tai Chi and Qigong practices improve the psychological health of the patients during addiction recovery.

 

 

“Tai chi can also be continued in life following treatment. It can serve as an important part of an aftercare plan that enhances well-being and reduces the likelihood of relapse.” – Footprints to Recovery

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Cui, J., Liu, F., Liu, X., Li, R., Chen, X., & Zeng, H. (2022). The Impact of Qigong and Tai Chi Exercise on Drug Addiction: A Systematic Review and Meta-Analysis. Frontiers in psychiatry, 13, 826187. https://doi.org/10.3389/fpsyt.2022.826187

 

Abstract

Background

Previous preliminary studies have found that qigong exercises produced significant effects in healthy people and in various clinical populations. The purpose of this study was to systematically review the effects of qigong and tai chi exercise on individuals with drug addiction.

Methods

A systematic search of seven English databases and three Chinese databases was conducted to identify randomized controlled trials (RCTs) and non-randomized comparative studies (NRS) assessing the effects of qigong and tai chi on drug addiction. Study quality was assessed using the Checklist for the Evaluation of Non-Pharmaceutical Trial Reports (CLEAR-NPT).

Results

Two RCTs and nine NRS studies were included in this study, including a total of 1072 patients with drug addiction (age range, 27–43 years). The results showed that qigong and tai chi exercise had a significant overall effect on depression (SMD = −0.353, 95%CI [−0.548, −0.159]), anxiety (SMD = −0.541, 95%CI [−0.818, −0.264]), quality of life (SMD = 0.673, 95%CI [0.438, 0.907]), and sleep quality (SMD = −0.373, 95%CI [−0.631, −0.116]). The subgroup analysis found that qigong outperformed tai chi on the improving depression, anxiety, and sleep quality.

Conclusion

Existing studies suggest that qigong and tai chi are effective at improving depression, anxiety, and quality of life in drug users; however, the evidence from rigorous randomized controlled group trials is lacking.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8957847/

 

Reduce Opioid Dependence in Chronic Pain Patients with Mindfulness

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Reduce Opioid Dependence in Chronic Pain Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

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

 

Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use. Obviously, there is a need to find effective methods to prevent and treat substance abuse. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers’ relapse and return to substance abuse.

 

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

 

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

 

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

 

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

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Key Points

Question

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

Findings

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

Meaning

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

Go to:

Abstract

Importance

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

Objective

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

Design, Setting, and Participants

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

Interventions

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

Main Outcomes and Measures

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

Results

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

Conclusions and Relevance

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

Mindfulness Reduces Smartphone Addiction

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Mindfulness Reduces Smartphone Addiction

 

By John M. de Castro, Ph.D.

 

“As a culture, we are slowly beginning to devalue wellness and prioritize productivity at the expense of our health. This creates an unhealthy reliance on digital devices.” – Alfred James

 

Over the last few decades, the internet has gone from a rare curiosity to the dominant mode of electronic communications. In fact, it has become a dominant force in daily life, occupying large amounts of time and attention. The dominant mode of accessing the internet is through smartphones creating smartphone addictions. Individuals with smartphone addiction develop greater levels of “tolerance” and experience “withdrawal” and distress when deprived. This phenomenon is so new that there is little understanding of its nature, causes, and consequences and how to treat it.

 

Mindfulness training has been shown to be helpful with addictions, decreasing cravings, impulsiveness, and psychological and physiological responses to stress, and increasing emotion regulation.  Mindfulness has also been shown to be effective for the treatment of a variety of addictions. Hence, there is a need to further explore how mindfulness affects smartphone addiction in adolescents.

 

In today’s Research News article “Preference for Solitude and Mobile Phone Addiction Among Chinese College Students: The Mediating Role of Psychological Distress and Moderating Role of Mindfulness.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.750511/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1796285_a0P58000000G0YfEAK_Psycho_20211223_arts_A ) Chen and colleagues recruited university students and had them complete a questionnaire measuring preference for solitude, psychological distress, including anxiety, depression, and perceived stress, mindfulness, mobile phone use, and mobile phone addiction.

 

They found that the higher the levels of mindfulness the lower the levels of preference for solitude, psychological distress, mobile phone addiction, and time spent per day on the mobile phone. On the other hand, the higher the preference for solitude the higher the levels of psychological distress. time spent per day on the mobile phone, and mobile phone addiction. Modelling analysis revealed that preference for solitude was associated with higher mobile phone addiction directly and indirectly by being associated with higher psychological distress that was in turn associated with greater mobile phone addiction. But this indirect association was only significant for students who were low in mindfulness. For students high in mindfulness the indirect association was not significant.

 

These results are correlative and as such causation cannot be determined. For example, reference for solitude may result from psychological distress and mobile phone addiction rather than the other way around. Regardless the importance of mindfulness is apparent. It is associated with lower levels of preference for solitude, psychological distress, mobile phone addiction. These associations are probably causal as previous controlled research has demonstrated that mindfulness training reduces preference for solitude, psychological distress, and mobile phone addiction. In addition, mindfulness may also disrupt mobile phone addiction by countering the relationship between preference for solitude and mobile phone addiction.

 

These results underscore the importance of mindfulness for the psychological health and well-being of university students. Indeed, mindfulness has been repeatedly shown in prior research to improve psychological well-being. The present study reveals another way that mindfulness may have these benefits by reducing the association of preference for solitude and mobile phone addiction. Mobile phone addiction can be problematic for the well-being and academic performance of university students and mindfulness may help to reduce the addiction and allow for better academic performance.

 

So, mindfulness reduces smartphone addiction.

 

“mindfulness training is beneficial to improve the ability of self-control and reduce rumination levels, thereby inhibiting the negative impact of smartphone addiction on college students.” – Shi-Shi Cheng

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Chen W-Y, Yan L, Yuan Y-R, Zhu X-W, Zhang Y-H and Lian S-L (2021) Preference for Solitude and Mobile Phone Addiction Among Chinese College Students: The Mediating Role of Psychological Distress and Moderating Role of Mindfulness. Front. Psychol. 12:750511. doi: 10.3389/fpsyg.2021.750511

 

Background: With the increasing incidence of mobile phone addiction, the potential risk factors of mobile phone addiction have attracted more and more researchers’ attention. Although various personality trait factors have been proven to be significant predictors of mobile phone addiction, limited attention has been paid to preference for solitude. Considering the adverse impacts of preference for solitude in the context of collectivistic societies and its possible negative effect on mobile phone addiction, this study was designed to examine the relationship between preference for solitude and mobile phone addiction, and to test the mediating role of psychological distress and the moderating role of mindfulness in this relationship.

Methods: Data were collected through convenience sampling from a comprehensive university in China. A total of 927 Chinese college students (371 males and 556 females), aged from 16 to 24 (Mage = 19.89 years, SD = 1.22), participated in this study. Their preference for solitude, psychological distress, mindfulness, and mobile phone addiction were measured using well-validated self-report questionnaires.

Results: Correlational analyses, sobel test, SPSS macro PROCESS (Model 8) and simple slopes analyses were used for major data analysis. Results showed that preference for solitude was significantly and positively associated with mobile phone addiction, and this link could be mediated by psychological distress. Moreover, the indirect effect of psychological distress in this link was moderated by mindfulness, with this effect being stronger for college students with lower levels of mindfulness. However, mindfulness can not moderate the direct relation between preference for solitude and mobile phone addiction.

Conclusion: The present study broadened our knowledge of how and when (or for whom) preference for solitude is related to mobile phone addiction. Education professionals and parents should pay special attention to the psychological distress and mobile phone addiction of college students with high levels of preference for solitude, particularly for those with lower levels of mindfulness.

https://www.frontiersin.org/articles/10.3389/fpsyg.2021.750511/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1796285_a0P58000000G0YfEAK_Psycho_20211223_arts_A

 

Improve the Psychological Well-Being of Opioid Users Undergoing Medicinal Therapy with Mindfulness

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Improve the Psychological Well-Being of Opioid Users Undergoing Medicinal Therapy with Mindfulness

 

By John M. de Castro, Ph.D.

 

“As individuals with [Substance Use Disorders] engage in mindfulness practices within [Mindfulness-Based Interventions], they learn to cultivate trait mindfulness, providing a bulwark against substance use and relapse.” – Sarah E Priddy

 

Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use which includes unintentional overdoses, suicides, HIV and AIDS, and trauma. Obviously, there is a need to find effective methods to prevent and treat substance abuse. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers’ relapse and return to substance abuse.

 

Hence, it is important to find an effective method to treat substance abuse and prevent relapse, but an effective treatment has been elusive. Most programs and therapies to treat addictions have poor success rates. Recently, mindfulness training has been found to be effective in treating addictions and preventing relapses. Medicinal therapies with drugs such as buprenorphine/naloxone have also been effective. But there is a need to study the effectiveness of mindfulness training in combination with medicinal therapy on relapse prevention.

 

In today’s Research News article “Testing Mindfulness-Based Relapse Prevention with Medications for Opioid Use Disorder Among Adults in Outpatient Therapy: a Quasi-experimental Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8504564/ ) Zullig and colleagues recruited patients who were addicted to opioids and after treatment had been opioid free for at least 90 days. They continued on receiving treatment with daily injections of buprenorphine/naloxone and attending Narcotics Anonymous meetings. Patients who volunteered underwent additional 24 weeks of twice weekly 60-minute sessions of Mindfulness-Based Relapse Prevention (MBRP) treatment. The participants were measured before, at midpoint, and after treatment and 12 weeks later for relapse, craving symptoms, anxiety, depression, and mindfulness.

 

They found that 73% of the participants were retained through the entire 36 weeks with no differences between groups. Relapse occurred in 45% of the participants but there were no differences between groups. Cravings declined throughout the 36 weeks but again there were no differences between groups. On the other hand, the decline in anxiety and depression and increase in mindfulness was significantly greater for the group that received Mindfulness-Based Relapse Prevention (MBRP).

 

The findings suggest that adding Mindfulness-Based Relapse Prevention (MBRP) to medicinal therapy for opioid relapse prevention produced significantly lower levels of anxiety and depression in the patients. But it did not appear to improve relapses or cravings. More research is needed to ascertain whether the additional cost and staff support involved in implementing MBRP is justified by the additional improvements in psychological well-being.

 

So, improve the psychological well-being of opioid users undergoing medicinal therapy with mindfulness.

 

“Mindfulness-Based Relapse Prevention (MBRP) has been shown to help with physical and psychological well-being, reduce craving, and help with anxiety and depression.” – Keith Zullig

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Zullig, K. J., Lander, L. R., Tuscano, M., Garland, M., Hobbs, G. R., & Faulkenberry, L. (2021). Testing Mindfulness-Based Relapse Prevention with Medications for Opioid Use Disorder Among Adults in Outpatient Therapy: a Quasi-experimental Study. Mindfulness, 1–11. Advance online publication. https://doi.org/10.1007/s12671-021-01763-w

 

Abstract

Objectives

This study aimed to explore the effectiveness of mindfulness-based relapse prevention (MBRP) with individuals receiving medication for opioid use disorder (MOUD) in a naturalistic, open-ended outpatient group treatment setting.

Methods

Eighty participants (mean age 36.3) who had at least 90 consecutive days substance free self-selected into treatment (MBRP, n = 35) or comparison groups (treatment as usual, TAU, n = 45). Outcomes tracked included treatment retention and relapse, and self-reported craving, anxiety, depression, and mindfulness at baseline, 12 weeks, 24 weeks, and 36 weeks post-recruitment. MBRP group participants attended biweekly 60-min sessions for 24 weeks. A linear mixed model analysis of variance determined the significance of the MBRP intervention on changes in craving, anxiety, depression, and mindfulness.

Results

No significant differences in sex, education level, insurance status, relationship status, or employment status were detected at baseline between groups. The 36-week retention (74%, MBRP/MOUD; 71%, TAU/MOUD) and relapse rates (43%, MBRP/MOUD; 47%, TAU/MOUD) were similar for the groups. There were only four relapses on opioids. Significant reductions (p < .05) were observed in the MBRP/MOUD group for craving, anxiety, and depression in addition to significant increases in mindfulness compared to those in TAU/MOUD.

Conclusions

Although state and federal resources are available to expand MOUD, no standard of behavioral therapy has been established as most complimentary to MOUD. The current study results suggest MBRP can be implemented as an outpatient therapy for individuals in MOUD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8504564/

 

Reduce Opioid Dosage in Chronic Pain Patients with Mindfulness

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Reduce Opioid Dosage in Chronic Pain Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“It’s clear that when it comes to tackling pain, it takes all of the tools in the toolkit. And when it comes to opioids, the approach needn’t be all or nothing. . .  the combination of medicine plus mind-body therapies works best.” – Allison Aubrey

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to improve the individual’s ability to cope with the pain. There is an accumulating volume of research findings that demonstrate that mindfulness practices, in general, are effective in treating pain and reducing opioid use. How mindfulness works to produce these benefits is not known.

 

In today’s Research News article “Endogenous theta stimulation during meditation predicts reduced opioid dosing following treatment with Mindfulness-Oriented Recovery Enhancement.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8026958/ ) Hudak and colleagues recruited veterans with chronic pain and at least 30 days of opioid use and randomly assigned them to receive 8 weekly 2-hour sessions of either supportive group psychotherapy or Mindfulness-Oriented Recovery Enhancement (MORE) involving mindful breathing and body scan meditations, cognitive reappraisal to decrease negative emotions and craving, and savoring to augment natural reward processing and positive emotion. All participants completed a lab-based mindfulness session while simultaneously having their Electroencephalogram (EEG) recorded. During the programs and for 4 months after they reported their daily opioid use.

 

They found in comparison to baseline and the supportive group psychotherapy group that during the meditation the Mindfulness-Oriented Recovery Enhancement (MORE) group had significantly greater power in the EEG of the frontal cortex in the alpha (9-13 cycles per second) and theta (4-8 cycles per second) bands and also theta spectral coherence. They also found that the MORE group had significantly greater reductions in opioid use over the treatment period. In addition. They found that the greater the increase in theta band power in the EEG the greater the reduction in opioid use and this continued for 4 months after the program. Finally, they found that MORE was associated with reduced opioid use both directly and also indirectly by being associated with increased frontal theta power.

 

These findings suggest that Mindfulness-Oriented Recovery Enhancement (MORE) is effective in reducing opioid dosage in chronic pain patients. This is in line with previous findings that mindfulness training produces reductions in opioid dependence. Mindfulness training has also been shown to alter brain activity and the present findings indicate that theta power in the frontal lobe is a marker of these changes. Finally, the results suggest that MORE directly reduces opioid dependence and at the same time increase brain activity which is associated with further reductions in opioid use.

 

So, reduce opioid dosage in chronic pain patients with mindfulness.

 

“We also teach people how to use mindfulness to reclaim a sense of healthy pleasures, joy, and meaning in life, in spite of pain.” – Eric Garland

 

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

 

Hudak, J., Hanley, A. W., Marchand, W. R., Nakamura, Y., Yabko, B., & Garland, E. L. (2021). Endogenous theta stimulation during meditation predicts reduced opioid dosing following treatment with Mindfulness-Oriented Recovery Enhancement. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 46(4), 836–843. https://doi.org/10.1038/s41386-020-00831-4

 

Abstract

Veterans experience chronic pain at greater rates than the rest of society and are more likely to receive long-term opioid therapy (LTOT), which, at high doses, is theorized to induce maladaptive neuroplastic changes that attenuate self-regulatory capacity and exacerbate opioid dose escalation. Mindfulness meditation has been shown to modulate frontal midline theta (FMT) and alpha oscillations that are linked with marked alterations in self-referential processing. These adaptive neural oscillatory changes may promote reduced opioid use and remediate the neural dysfunction occasioned by LTOT. In this study, we used electroencephalography (EEG) to assess the effects of a mindfulness-based, cognitive training intervention for opioid misuse, Mindfulness-Oriented Recovery Enhancement (MORE), on alpha and theta power and FMT coherence during meditation. We then examined whether these neural effects were associated with reduced opioid dosing and changes in self-referential processing. Before and after 8 weeks of MORE or a supportive psychotherapy control, veterans receiving LTOT (N = 62) practiced mindfulness meditation while EEG was recorded. Participants treated with MORE demonstrated significantly increased alpha and theta power (with larger theta power effect sizes) as well as increased FMT coherence relative to those in the control condition—neural changes that were associated with altered self-referential processing. Crucially, MORE significantly reduced opioid dose over time, and this dose reduction was partially statistically mediated by changes in frontal theta power. Study results suggest that mindfulness meditation practice may produce endogenous theta stimulation in the prefrontal cortex, thereby enhancing inhibitory control over opioid dose escalation behaviors.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8026958/

 

Improve Alcohol Treatment Completion with Spirituality

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Improve Alcohol Treatment Completion with Spirituality

 

By John M. de Castro, Ph.D.

 

“spiritual experiences and spiritual practices, including prayer and mindfulness meditation, may be helpful in reducing hazardous drinking and in the treatment of [Alcohol Use Disorder].” – Katie Witkiewitz

 

Inappropriate use of alcohol is a major societal problem. In fact, about 25% of US adults have engaged in binge drinking in the last month and 7% have what is termed an alcohol use disorder. Alcohol abuse is very dangerous and frequently fatal. Nearly 88,000 people in the US and 3.3 million globally die from alcohol-related causes annually, making it the third leading preventable cause of death in the United States. Drunk driving accounted for over 10,000 deaths; 31% of all driving fatalities. Excessive alcohol intake has been shown to contribute to over 200 diseases including alcohol dependence, liver cirrhosis, cancers, and injuries. It is estimated that over 5% of the burden of disease and injury worldwide is attributable to alcohol consumption.

 

An effective treatment for this addiction has been elusive. Alcoholics Anonymous has been as effective as any other treatment devised. Why is it somewhat effective when many other programs fail? Why is it effective for some, but not all? One reason could be the emphasis on spirituality present in AA. So, it is important to investigate the role of spirituality in successful treatment for alcohol abuse.

 

In today’s Research News article “The Effect of Baseline Patterns of Spiritual Coping, Forgiveness, and Gratitude on the Completion of an Alcohol Addiction Treatment Program.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8137607/ ) Charzyńska and colleagues recruited adults undergoing outpatient treatment for alcohol dependence and had them complete measures of spiritual coping, forgiveness, gratitude, and whether they completed the therapy program.

 

They report that 52.6% of the participants completed the therapy program. They found that the patients who had positive spiritual coping, forgiveness, and gratitude, and a low level of negative spiritual coping were most likely to complete the program. They also found that patients who employed negative spiritual coping had the lowest likelihood of completing the program.

 

Positive spiritual coping involves the search for inner peace and harmony, deep relationships with other people, seeking peace in nature, and seeking support from a higher being. The results suggest that this kind of coping makes it more likely that the patient will complete therapy for alcohol abuse. On the other hand, negative spiritual coping involves questioning life’s meaning, seeing others as hypocritical and egoistic, and questioning god’s love for humans. The results suggest that this kind of coping makes it less likely that the patient will complete therapy.

 

These findings suggest that people who use spirituality to make their lives better, richer, and more meaningful are more likely to be successful in alcohol abuse treatment, while those who use it as an excuse for their behavior, projecting their failures onto god and others, are less likely to be successful. Hence, spirituality is helpful for patients undergoing treatment for alcohol abuse if it used in a positive life affirming way.

 

So, improve alcohol treatment completion with spirituality.

 

“Spiritual and faith-based treatments greatly soothe the psyche and emotions and carry little to no risk of adverse impact for patients.” – Krystina Murray

 

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

 

Charzyńska E. (2021). The Effect of Baseline Patterns of Spiritual Coping, Forgiveness, and Gratitude on the Completion of an Alcohol Addiction Treatment Program. Journal of religion and health, 60(3), 1796–1817. https://doi.org/10.1007/s10943-021-01188-8

 

Abstract

The purpose of this study was to identify distinct profiles of persons beginning alcohol addiction therapy with similar baseline configurations of spiritual coping, forgiveness, and gratitude. The associations between latent profile membership and the completion of therapy were also examined. The sample was composed of 358 alcohol-dependent persons receiving an outpatient treatment program. The Spiritual Coping Questionnaire, the Forgiveness Scale, and the Gratitude Questionnaire were used to assess the baseline levels of spirituality-related variables. Using latent profile analysis, five profiles were identified: (1) both moderately positive and negative dimensions of spirituality (33.2%), (2) moderately positive dimensions of spirituality (21.0%), (3) predominantly negative dimensions of spirituality (20.2%), (4) mixed dimensions of spirituality with the lowest positive religious coping (14.0%), and (5) highly positive dimensions of spirituality (11.6%). Notably, the latent profiles differed in terms of the treatment completion rates. The results suggest the need to carry out a multidimensional assessment of spiritual functioning of persons beginning alcohol addiction therapy to provide treatment that is adjusted to patients’ spiritual potential and deficits.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8137607/

 

Mindfulness Improve Social Media Control While Social Media Control Improves Mindfulness

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Mindfulness Improve Social Media Control While Social Media Control Improves Mindfulness

 

By John M. de Castro, Ph.D.

 

“social media overuse is increasingly commonplace today, and it may have some serious repercussions to your physical and mental health.” – Kristeen Cherney

 

Over the last few decades, the internet has gone from a rare curiosity to the dominant mode of electronic communications. In fact, it has become a dominant force in daily life, occupying large amounts of time and attention. As useful as the internet may be, it can also produce negative consequences. “Problematic Internet Use” is now considered a behavioral addiction, with almost half of participants in one study considered “Internet addicts”, developing greater levels of “tolerance” and experiencing “withdrawal” and distress when deprived. This phenomenon is so new that there is little understanding of its nature, causes, and consequences and how to treat it.

 

Mindfulness training has been shown to be helpful with each of the components of addictions, decreasing cravings, impulsiveness, and psychological and physiological responses to stress, and increasing emotion regulation.  It is no wonder then that mindfulness training has been found to be effective for the treatment of a variety of addictions. It also has been found to be helpful in overcoming internet and smartphone addictions. But there is a need to further explore the effectiveness of mindfulness training on one form of internet addiction, social media addiction.

 

In today’s Research News article “The reciprocal relationships between social media self-control failure, mindfulness and wellbeing: A longitudinal study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8336798/ ) Du and colleagues recruited participants online between the ages of 16 to 60 years of age and had them complete measures of social media control, mindfulness, well-being, and life satisfaction. They completed the measures three times at four-month intervals.

 

They found that the higher the levels of mindfulness at all measurements the higher the levels of social media control, well-being, and life satisfaction at all measurements. They also found evidence that social media control at the first measurement was associated with better mindfulness at the second measurement which was, in turn, associated with better social media control at the third measurement.

 

These results are correlative and as such caution must be exercised in interpreting causation. But mindfulness training has been found in prior research to reduce internet addictions. In addition, the associations found between variables and other variables 4 months later prohibit a reverse causation explanation. So, the associations reported here may well be due to causal connections. Hence, it could be tentatively concluded that being able to control participation in social media improves mindfulness and mindfulness improves the individual’s ability to control their participation in social media.

 

This is potentially important as participation in social media often gets out of control to the point where it interferes in everyday activities to the detriment of the individual. It can even become an addiction. That being mindful can help keep it under control may be very helpful allowing attention to other life activities. Although it was not explored in the present study this suggests that mindfulness training may help make the individual resistant to losing control of participation in social media.

 

So, mindfulness improve social media control while social media control improves mindfulness.

 

“Social media addiction is becoming an increasing problem. . . One cure is mindfulness meditation. . . a powerful tool for kicking addictions ranging from drugs, to social media” – Elise Bialylew

 

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

 

Du, J., Kerkhof, P., & van Koningsbruggen, G. M. (2021). The reciprocal relationships between social media self-control failure, mindfulness and wellbeing: A longitudinal study. PloS one, 16(8), e0255648. https://doi.org/10.1371/journal.pone.0255648

 

Abstract

This paper aims to shed light on the question whether, and how, social media self-control failure is related to mindfulness and wellbeing. Using a 3-wave longitudinal design, the present study among 594 daily social media users examined the reciprocal relationships between social media self-control failure and mindfulness, and between social media self-control failure and wellbeing (as assessed by subjective vitality and life satisfaction). Results of the random-intercept cross-lagged panel model showed that social media self-control failure has a time-invariant negative association with mindfulness and subjective vitality. No full reciprocal influence was found between social media self-control failure and mindfulness, yet part of this trajectory was observed, suggesting that social media self-control failure could impair mindfulness, which, in turn, might increase future social media self-control failure. For wellbeing, life satisfaction was found to predict subsequent drops in social media self-control failure.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8336798/

 

Effectively Treat Substance Use Disorder with Mindfulness

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Effectively Treat Substance Use Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness is likely an effective tool in helping people with addiction because it’s a single, simple skill that a person can practice multiple times throughout their day, every day, regardless of the life challenges that arise.” – James Davis

 

Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use which includes unintentional overdoses, suicides, HIV and AIDS, and trauma. Obviously, there is a need to find effective methods to prevent and treat substance abuse. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers relapse and return to substance abuse.

 

Hence, it is important to find an effective method to treat substance abuse and prevent relapse but an effective treatment has been elusive. Most programs and therapies to treat addictions have poor success rates. Recently, mindfulness training has been found to be effective in treating addictions. The research has been accumulating. So, it makes sense to pause and take a look at what has been learned.

 

In today’s Research News article “A Narrative Review of Third-Wave Cognitive-Behavioral Therapies in Addiction.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8080172/ ) Balandeh and colleagues review and summarize the published research studies of the effectiveness of mindfulness-based therapies for the treatment of addictions.

 

They report that the published research demonstrates that the mindfulness-based therapies of Mindfulness-Based Relapse Prevention (MBRP), Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), Mindfulness-Based Stress Reduction (MBSR), and Mindfulness-Based Cognitive Therapy (MBCT) are all effective for the treatment of addictions. These therapies vary greatly in emphasis and techniques. The major common thread is mindfulness training. This would suggest that it’s developing mindfulness per se that is effective in treating addictions.

 

They report that on a number of explanations for the effectiveness of mindfulness-based therapies for the treatment of addictions. These include the ability of mindfulness training to change the individual’s responses to the usual triggers for drug use, changing the brain’s response to cravings, and sensing cravings as just another physical sensation. Regardless of the mechanism or mechanisms, it is clear that mindfulness training is effective for the treatment of substance use disorder.

 

So, effectively treat substance use disorder with mindfulness.

 

“One reason addiction is so hard to beat is that it’s a pattern of conditioned responses. The part of your brain responsible for higher reasoning essentially gets cut out of the decision-making process and you react reflexively to stimuli associated with drugs and alcohol. Practicing mindfulness gradually undoes this conditioning.” – Renewal Lodge

 

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

 

Balandeh, E., Omidi, A., & Ghaderi, A. (2021). A Narrative Review of Third-Wave Cognitive-Behavioral Therapies in Addiction. Addiction & health, 13(1), 52–65. https://doi.org/10.22122/ahj.v13i1.298

 

Abstract

Substance use disorder (SUD) is a prevalent health issue with serious social and personal consequences. SUDs are linked to numerous physical health problems. In the Diagnostic and Statistical Manual of Mental Disorders-5th Edition (DSM-V), the essential characteristic of a SUD is a collection of cognitive, behavioral, and psychological manifestations indicative of the subject’s unbaiting substance use despite experiencing significant problems due to continued use. Several alternative interventions have been indicated. Among them, mindfulness-based therapies are receiving growing attention. This article reviews evidence for the use of third-wave cognitive-behavioral therapies (CBTs) in addiction treatment. We have reviewed the literature published from 1990 to 2019. Further research is required to better understand the types of mindfulness-based interventions that work best for specific types of addiction, patients, and situations. Current findings increasingly support third-wave CBTs as a promising complementary therapy for the treatment and prevention of addiction.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8080172/

 

Mindfulness Improves Physical and Mental Well-Being

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Mindfulness Improves Physical and Mental Well-Being

 

By John M. de Castro, Ph.D.

 

“scientists have found that practicing mindfulness is associated with changes in the structure and function of the brain as well as changes in our body’s response to stress, suggesting that this practice has important impacts on our physical and emotional health.” –  University of Minnesota

 

Over the last several decades, research and anecdotal experiences have accumulated an impressive evidential case that the development of mindfulness has positive benefits for the individual’s mental, physical, and spiritual life. Mindfulness appears to be beneficial both for healthy people and for people suffering from a myriad of mental and physical illnesses. It appears to be beneficial across ages, from children, to adolescents, to the elderly. And it appears to be beneficial across genders, personalities, race, and ethnicity. The breadth and depth of benefits is unprecedented. There is no other treatment or practice that has been shown to come anyway near the range of mindfulness’ positive benefits.

 

Research on mindfulness effects on mental and physical health has exploded over the last few decades. So, it makes sense to pause and examine what has been learned. In today’s Research News article “Mindfulness-based interventions: an overall review” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8083197/ )  Zhang and colleagues reviewed and summarized the randomized controlled trials and meta-analyses of the effects of mindfulness-based practices on mental and physical health.

 

They report that the published research studies and meta-analyses found that mindfulness-based practices produced significant improvements in mental health including anxiety, depression, anger, prosocial behavior, loneliness, physiological and psychological indicators of stress, insomnia, eating disorders, addictions, psychoses, Post-Traumatic Stress Disorder (PTSD), attention-deficit hyperactivity disorder (ADHD), and autism. They also report that mindfulness-based practices produced significant improvements in physical health including pain, hypertension, cardiovascular disease, obesity, diabetes, cancer, asthma, chronic obstructive pulmonary disease (COPD), aggression, and violence.

 

In addition, mindfulness-based practices produced safe, cost-effective improvements in professional and healthcare settings, in schools, and in the workplace. Further they report that mindfulness-based practices produced significant changes in the structure and activity of the nervous system, improvements in immune functioning and physiological markers of stress.

 

The review of the published research has provided a compelling case for the utilization of mindfulness-based practices for a myriad of psychological and physical problems in humans of all ages with and without disease. The range and depth of effects are unprecedented making a strong case for the routine training in mindfulness for the improvement of their well-being.

 

So, mindfulness improves physical and mental well-being.

 

“engaging in mindfulness meditation cultivates our ability to both focus and broaden our attention, which is a practical way to elicit psychological well-being.” – Jennifer Wolkin

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Zhang, D., Lee, E., Mak, E., Ho, C. Y., & Wong, S. (2021). Mindfulness-based interventions: an overall review. British medical bulletin, ldab005. Advance online publication. https://doi.org/10.1093/bmb/ldab005

 

Abstract

Introduction

This is an overall review on mindfulness-based interventions (MBIs).

Sources of data

We identified studies in PubMed, EMBASE, CINAHL, PsycINFO, AMED, Web of Science and Google Scholar using keywords including ‘mindfulness’, ‘meditation’, and ‘review’, ‘meta-analysis’ or their variations.

Areas of agreement

MBIs are effective for improving many biopsychosocial conditions, including depression, anxiety, stress, insomnia, addiction, psychosis, pain, hypertension, weight control, cancer-related symptoms and prosocial behaviours. It is found to be beneficial in the healthcare settings, in schools and workplace but further research is warranted to look into its efficacy on different problems. MBIs are relatively safe, but ethical aspects should be considered. Mechanisms are suggested in both empirical and neurophysiological findings. Cost-effectiveness is found in treating some health conditions.

Areas of controversy

Inconclusive or only preliminary evidence on the effects of MBIs on PTSD, ADHD, ASD, eating disorders, loneliness and physical symptoms of cardiovascular diseases, diabetes, and respiratory conditions. Furthermore, some beneficial effects are not confirmed in subgroup populations. Cost-effectiveness is yet to confirm for many health conditions and populations.

Growing points

Many mindfulness systematic reviews and meta-analyses indicate low quality of included studies, hence high-quality studies with adequate sample size and longer follow-up period are needed.

Areas timely for developing research

More research is needed on online mindfulness trainings and interventions to improve biopsychosocial health during the COVID-19 pandemic; Deeper understanding of the mechanisms of MBIs integrating both empirical and neurophysiological findings; Long-term compliance and effects of MBIs; and development of mindfulness plus (mindfulness+) or personalized mindfulness programs to elevate the effectiveness for different purposes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8083197/

Improve Physical and Mental Well-Being with Mindfulness Meditation-Based Interventions

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Improve Physical and Mental Well-Being with Mindfulness Meditation-Based Interventions

 

By John M. de Castro, Ph.D.

 

“mindfulness meditation is related to improved mental health across a variety of disorders, including different anxiety disorders, depression, eating disorders, substance abuse, and chronic pain symptom reduction.” – Jennifer Wolkin

 

Over the last several decades, research and anecdotal experiences have accumulated an impressive evidential case that the development of mindfulness has positive benefits for the individual’s mental, physical, and spiritual life. Mindfulness appears to be beneficial both for healthy people and for people suffering from a myriad of mental and physical illnesses. It appears to be beneficial across ages, from children to the elderly. And it appears to be beneficial across genders, personalities, race, and ethnicity. The breadth and depth of benefits is unprecedented. There is no other treatment or practice that has been shown to come anyway near the range of mindfulness’ positive benefits.

 

Over the last few decades, a vast amount of research has been published on the benefits of mindfulness practices on the mental and physical health of the practitioners. Many reviews, summarizations, and meta-analyses have been performed of these studies. So, it makes sense to step back and summarize what these meta-analyses have found.

 

In today’s Research News article “The empirical status of mindfulness-based interventions: A systematic review of 44 meta-analyses of randomized controlled trials.” (See summary below or view the full text of the study at: https://centerhealthyminds.org/assets/files-publications/Goldberg-the-empirical-status.pdf ) Goldberg and colleagues review, summarize, and perform a meta-analysis of previous meta-analyses of published randomized controlled studies on benefits of sustained meditation practices on mental and physical well-being. They identified 44 published meta-analyses, representing 336 randomized controlled trials, which included a total of 30,483 participants.

 

They report that the meta-analyses of published randomized controlled trials found that sustained mindfulness meditation practices in comparison to passive, no treatment, controls had a very wide range of beneficial effects across a wide range of participants from children to the elderly, over a variety of programs from Mindfulness-Based Stress Reduction (MBSR) to mobile health, over a variety of psychological issues from anxiety to psychoses, and over a wide range of diseases from chronic pain to cancer. These effects were present immediately post treatment and at later follow-ups (an average of 7 months after treatment).

 

Comparison of these mindfulness meditation practices to active control conditions such as attentional controls to evidence-based treatments, resulted in reduced effect sizes and many were non-significant. Mindfulness meditation practices had significantly superior effects than active controls for adults, children, employees, and health care professionals/trainees but not for students. They were superior for psychiatric disorders, substance use, smoking, and depression but not for physical health conditions, pain, weight/eating-related conditions, cancer, or anxiety. They were superior for stress, and psychiatric symptoms but not for sleep, physical health symptoms, objective measures, or physiological measures.

 

These findings are essentially summaries of summaries and are based upon a wide variety of different researchers, methodologies, cultures, and time frames. Yet, the results are fairly consistent. In comparison to doing nothing, passive controls, mindfulness meditation practices are very beneficial for a wide range of physical and psychological issues over a wide range of ages. But these practices when compared to other types of treatments, are less effective and at times not superior. Nevertheless, this meta-analysis of meta-analyses paints a clear picture of the wide-ranging efficacy of mindfulness meditation practices for the relief of physical and psychological issues. These results verify the unprecedented depth and breadth of benefits of mindfulness meditation practices.

 

So, improve physical and mental well-being with mindfulness meditation-based interventions.

 

“Practicing mindfulness exercises can have many possible benefits, including: reduced stress, anxiety and depression, less negative thinking and distraction, and improved mood,” -Mayo Clinic

 

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

 

Goldberg, S. B., Riordan, K., Sun, S., & Davidson, R. J. (2021). The empirical status of mindfulness-based interventions: A systematic review of 44 meta-analyses of randomized controlled trials. Perspectives on Psychological Science 1–23, DOI: 10.1177/1745691620968771

 

Abstract

In response to questions regarding the scientific basis for mindfulness-based interventions (MBIs), we evaluated their empirical status by systematically reviewing meta-analyses of randomized controlled trials (RCTs). We searched six databases for effect sizes based on ≥4 trials that did not combine passive and active controls. Heterogeneity, moderators, tests of publication bias, risk of bias, and adverse effects were also extracted. Representative effect sizes based on the largest number of studies were identified across a wide range of populations, problems, interventions, comparisons, and outcomes (PICOS). A total of 160 effect sizes were reported in 44 meta-analyses (k=336 RCTs, N=30,483 participants). MBIs showed superiority to passive controls across most PICOS (ds=0.10-0.89). Effects were typically smaller and less often statistically significant when compared to active controls. MBIs were similar or superior to specific active controls and evidence-based treatments. Heterogeneity was typically moderate. Few consistent moderators were found. Results were generally robust to publication bias, although other important sources of bias were identified. Reporting of adverse effects was inconsistent. Statistical power may be lacking in meta-analyses, particularly for comparisons with active controls. As MBIs show promise across some PICOS, future RCTs and meta-analyses should build upon identified strengths and limitations of this literature.

https://centerhealthyminds.org/assets/files-publications/Goldberg-the-empirical-status.pdf