Addiction

Reduce Addictions Relapse in Minority Women with Mindfulness

psyjdc Leave a comment

Reduce Addictions Relapse in Minority Women with Mindfulness

 

By John M. de Castro, Ph.D.

 

“By being mindful the individual will be able to see that these cravings appear in the mind and then disappear. They are like clouds passing through the sky. Sometimes just acknowledging the craving will be enough to make it disappear.“ – Addiction Rehab

 

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. In the U.S. about 17 million people abuse alcohol. Drunk driving fatalities accounted for over 10,000 deaths annually  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 prevent these relapses.

 

Mindfulness practices have been shown to improve recovery from various addictions. Mindfulness-based Relapse Prevention (MBRP) has been developed to specifically assist in relapse prevention and has been shown to be effective. “MBRP integrates mindfulness practices with cognitive-behavioral Relapse Prevention therapy and aims to help participants increase awareness and acceptance of difficult thoughts, feelings, and sensations to create changes in patterns of reactive behavior that commonly lead to relapse. Mindfulness training in MBRP provides clients with a new way of processing situational cues and monitoring internal reactions to contingencies, and this awareness supports proactive behavioral choices in the face of high-risk relapse situation.” – Grow et al. 2015

 

In today’s Research News article “Mindfulness-based relapse prevention with racial and ethnic minority women.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5441877/, Witkiewitz and colleagues recruited adult women in a residential substance abuse treatment facility for criminal offenders.   All of the women were abstinent at the time of treatment. Substance abuse included “methamphetamines (15%), alcohol (12%), heroin (11%), marijuana (10%), crack cocaine (9%), and hallucinogens (2%).” The women were randomly assigned to receive twice weekly 50-minute sessions over 8 weeks of either standard relapse prevention treatment or Mindfulness-based Relapse Prevention (MBRP). They were measured before treatment and 6 months later for drug use and addiction severity.

 

They compared the effectiveness of standard relapse prevention treatment to Mindfulness-based Relapse Prevention (MBRP) and compared minority women to non-hispanic white women. They found that (MBRP) produced significantly better relapse prevention for the minority women including less drug use and addiction severity. In fact, the minority women treated with (MBRP) had no drug use at all in the 6 months following treatment.

 

These are interesting results that (MBRP) is effective in preventing relapse but also that it is most effective for minority women. The improved addiction severity scores were due primarily to fewer health problems in the minority women. It is not known exactly why (MBRP) is more effective for minority women in producing improved abstinence and better general health. Nevertheless, the study does demonstrate that (MBRP) is an effective treatment preventing relapse after addiction recovery especially with minority women.

 

So, reduce addictions relapse in minority women with mindfulness.

 

“the classical Buddhist meditation literature and recent scientific findings appear to agree that when correctly practised and administered, mindfulness meditation is a safe, non-invasive, and cost-effective tool for treating behavioral addictions and for improving psychological health more generally.” – Mark Griffiths

 

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

 

Witkiewitz, K., Greenfield, B. L., & Bowen, S. (2013). Mindfulness-based relapse prevention with racial and ethnic minority women. Addictive Behaviors, 38(12), 2821–2824. http://doi.org/10.1016/j.addbeh.2013.08.018

 

Highlights

  • Results from a trial of relapse prevention (RP) and mindfulness-based RP (MBRP)
  • MBRP was more efficacious than RP for racial or ethnic minority female clients.
  • At follow-up, minorities in MBRP had no drug use days and lower addiction severity.

Abstract

Racial and ethnic disparities in the treatment of addiction have been acknowledged for several years, yet little is known about which empirically supported treatments for substance use disorders are more or less effective in treating racial and ethnic minority clients. The current study was a secondary analysis of a randomized clinical trial of two evidence-based treatments, mindfulness-based relapse prevention (MBRP) and relapse prevention (RP), as part of a residential addiction treatment program for women referred by the criminal justice system (n = 70). At 15-week follow-up, regression analyses found that racial and ethnic minority women in MBRP, compared to non-Hispanic and racial and ethnic minority women in RP, reported significantly fewer drug use days (d = .31) and lower addiction severity (d = .65), based on the Addiction Severity Index. Although the small sample size is a limitation, the results suggest that MBRP may be more efficacious than traditional treatments for racial and ethnic minority women.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5441877/

Stay Abstinent from Smoking Mindfully

psyjdc Leave a comment

Stay Abstinent from Smoking Mindfully

 

By John M. de Castro, Ph.D.

 

“I liken it to having weeds in your garden. Standard treatments—for example, avoiding triggers such as ashtrays and lighters or using substitutes such as eating carrot sticks and chewing on your pen—just pull the heads off the weeds, so they grow back. These treatments don’t uproot the craving itself. In contrast, mindfulness really gets in there and pulls up the roots.” – Judson Brewer

 

“Tobacco use remains the single largest preventable cause of death and disease in the United States.” (Centers for Disease Control and Prevention). So, treating nicotine addiction and producing smoking cessation could greatly improve health. But, smoking has proved devilishly difficult to treat. There are a wide variety of methods and strategies to quit smoking which are to only a very limited extent effective. According to the National Institutes of Health, about 40% of smokers who want to quit make a serious attempt to do so each year, but fewer than 5% actually succeed. Most people require three or four failed attempts before being successful.

 

One problem is that nicotine is one of the most addictive substances known and withdrawal from nicotine is very stressful, producing many physical and psychological problems, including negative emotional states and depression. In essence, the addict feels miserable without the nicotine. This promotes relapse to relieve the discomfort. Better methods to quit which can not only promote quitting but also prevent relapse are badly needed. Mindfulness practices have been found to be helpful in treating addictions, including nicotine addiction, and reducing the risk of relapse.

 

In today’s Research News article “Dispositional Mindfulness Predicts Enhanced Smoking Cessation and Smoking Lapse Recovery.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4867253/, Heppner and colleagues recruited African American smokers who smoked at least 5 cigarettes per day for at least one year and enrolled in a smoking cessation treatment program. They were measured 19 and 5 days before quitting smoking and 3 days, 31 days, and 26 weeks after quitting for cigarettes smoked per day, smoking abstinence, mindfulness, positive and negative emotions, dependence and withdrawal symptoms, self-efficacy, and social support.

 

They found that the number of participants remaining abstinent dropped precipitously over 26 weeks but mindfulness mattered. Abstinence dropped to around 7% of participants who were low in mindfulness but to only 14% of participants who were high in mindfulness. Of those participants who relapsed at day 3 after treatment high mindfulness participants were significantly more likely to recover abstinence by day 31 and week 26. They also found that the improvement in abstinence at day 3 produced by mindfulness occurred primarily as a result of mindfulness producing lower levels of sadness, anger, and depression, lower use of smoking to control emotions, and more social support which in turn were associated with better abstinence rates.

 

These results are interesting but correlational, so causation cannot be determined. But, prior research has shown that mindfulness training improves treatment for nicotine addiction. So, it is likely that the relationships between mindfulness and smoking cessation observed in the present study were due to mindfulness causing the improved abstinence. Mindfulness acted through intermediaries of improved emotion regulation and improved social support to support abstinence. These results suggest that mindfulness is very helpful in remaining abstinent after quitting smoking and should become a component of all smoking cessation treatment packages.

 

So, stay abstinent from smoking mindfully.

 

“each time the individual does not succumb to the craving, the craving becomes weaker until eventually it no longer gets triggered. Moreover, with each moment of mindfulness, the smoker regains a sense of control and understanding regarding their mind and body, which can be empowering.” – Azadeh Aalai

 

 

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

 

Heppner, W. L., Spears, C. A., Correa-Fernández, V., Castro, Y., Li, Y., Guo, B., … Wetter, D. W. (2016). Dispositional Mindfulness Predicts Enhanced Smoking Cessation and Smoking Lapse Recovery. Annals of Behavioral Medicine : A Publication of the Society of Behavioral Medicine, 50(3), 337–347. http://doi.org/10.1007/s12160-015-9759-3

 

Abstract

Background

Although mindfulness has been hypothesized to promote health behaviors, no research has examined how dispositional mindfulness might influence the process of smoking cessation.

Purpose

The current study investigated dispositional mindfulness, smoking abstinence, and recovery from a lapse among African American smokers.

Methods

Participants were 399 African Americans seeking smoking cessation treatment (treatments did not include any components related to mindfulness). Dispositional mindfulness and other psychosocial measures were obtained pre-quit; smoking abstinence was assessed 3 days, 31 days, and 26 weeks post-quit.

Results

Individuals higher in dispositional mindfulness were more likely to quit smoking both initially and over time. Moreover, among individuals who had lapsed at day 3, those higher in mindfulness were more likely to recover abstinence by the later time points. The mindfulness-early abstinence association was mediated by lower negative affect, lower expectancies to regulate affect via smoking, and higher perceived social support.

Conclusions

Results suggest that mindfulness might enhance smoking cessation among African American smokers by operating on mechanisms posited by prominent models of addiction.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4867253/

Reduce Drinking Motives and Problematic Drinking with Mindfulness

psyjdc Leave a comment

Reduce Drinking Motives and Problematic Drinking with Mindfulness

 

By John M. de Castro, Ph.D.

 

“It may not be possible for people to completely escape cravings, but they can learn to live with them. Mindfulness meditation is an excellent tool that allows the individual to have increased control over their mind. There is a saying that, the mind is a wonderful servant but a terrible master.” – Alcoholrehab.com

 

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.

 

Alcohol abuse often develops during adolescence and it on display with college students where about four out of five college students drink alcohol and about half of those consume alcohol through binge drinking. About 25 percent of college students report academic consequences of their drinking including missing class, falling behind, doing poorly on exams or papers, and receiving lower grades overall. More than 150,000 students develop an alcohol-related health problem. This drinking has widespread consequence for not only the students but also the college communities, and families. More than 690,000 students are assaulted by another student who has been drinking. More than 97,000 students are victims of alcohol-related sexual assault or date rape. 599,000 students receive unintentional injuries while under the influence of alcohol. Significantly, 1,825 college students die each year from alcohol-related unintentional injuries and between 1.2 and 1.5 percent of students indicate that they tried to commit suicide within the past year due to drinking or drug use.

 

These are striking and alarming statistics and indicate that controlling alcohol intake is an important priority for the individual and society. There are a wide range of treatment programs for alcohol abuse, with varying success. Recently, mindfulness training has been successfully applied to treatment. One attractive feature of this training is that it appears to increase the ability of the drinker to control their intake, resulting in less binge drinking and dangerous inebriation. It appears that one way that mindfulness increases the control of intake is by reducing the desire to use alcohol to cope with emotional problems. Since, mindfulness appears to hold promise as a treatment for excessive alcohol intake, there is a need to better understand its mechanisms of action in order to maximize its effectiveness.

 

In today’s Research News article “Drinking Motives Mediate the Relationship between Facets of Mindfulness and Problematic Alcohol Use.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4998974/. Vinci and colleagues recruited college students and had them complete measures of problem drinking, drinking characteristics, including frequency, quantity, and binge drinking, drinking motives including coping, enhancement, social, and conformity, and mindfulness. They performed regression and structural modelling analyses on these data.

 

They found that the higher the level of the mindfulness facet of acting with awareness that the students had the lower the levels of problem drinking. In addition, the association of acting with awareness with lower problem drinking occurred through two routes, a direct effect of acting with awareness on problem drinking and indirect effects through lower levels of using drinking for coping with negative emotions and lower levels of drinking to conform to the social situation. Hence, mindfulness is directly associated with less problem drinking and with lower levels of susceptibility to use drinking to sooth negative feelings and to conform to the behaviors of others.

 

Since, problem drinking is such a major societal and individual problem that develops during adolescence, the fact that mindfulness may help to lower problem drinking in college students suggests that mindfulness training may be an important intervention during these formative years. It remains for future research to determine if  active mindfulness training in college students can lead to decreased problem drinking.

 

So, reduce drinking motives and problematic drinking with mindfulness.

 

“Mindfulness also helps people learn to relate to discomfort differently. When an uncomfortable feeling like a craving or anxiety arises, people are able to recognize their discomfort, and observe it with presence and compassion, instead of automatically reaching for a drug to make it go away. Awareness of our experience and the ability to relate to our experience with compassion gives us more freedom to choose how we respond to discomfort, rather than defaulting to automatic behaviors.” – Sarah Bowen

 

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

 

Vinci, C., Spears, C. A., Peltier, M. R., & Copeland, A. L. (2016). Drinking Motives Mediate the Relationship between Facets of Mindfulness and Problematic Alcohol Use. Mindfulness, 7(3), 754–763. http://doi.org/10.1007/s12671-016-0515-y

 

Abstract

Mindfulness is a multi-faceted construct, and research suggests that certain components (e.g., Acting with Awareness, Nonjudging) are associated with less problematic alcohol use. Recent research has examined whether specific drinking motives mediate the relationship between facets of mindfulness and alcohol use. The current study sought to extend this research by examining whether certain drinking motives would mediate the relationship between facets of mindfulness and problematic alcohol use in a sample of 207 college students classified as engaging in problematic drinking. Participants completed the Five Facet Mindfulness Questionnaire (FFMQ), Drinking Motives Questionnaire-Revised (DMQ-R), and Alcohol Use Disorders Identification Test (AUDIT). Results indicated that lower levels of Coping motives significantly mediated the relationship between greater Acting with Awareness and lower AUDIT score and between greater Nonjudging and lower AUDIT score. Lower levels of Conformity motives significantly mediated the relationship between greater Acting with Awareness and lower AUDIT score. These findings offer insight into specific mechanisms through which mindfulness is linked to less problematic drinking, and also highlight associations among mindfulness, drinking motives, and alcohol use among a sample of problematic college student drinkers. Future research should determine whether interventions that emphasize Acting with Awareness and Nonjudging facets of mindfulness and/or target coping and conformity motives could be effective for reducing problematic drinking in college students.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4998974/

Improve Internet Gaming Disorder with Mindfulness

psyjdc Leave a comment

Improve Internet Gaming Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The conclusion to draw here is that though substances like cocaine are very effective at triggering changes in the brain that lead to addictive behavior and urges, they are not the only possible triggers: just about any deeply pleasurable activity — sex, eating, Internet use — has the potential to become addictive and destructive.” – Howard Markel

 

There are many addictions, from exercise, to alcohol, to sex, to drugs, to gambling, to cigarettes. There are a number of differences produced by the specific nature of each addiction. But, there are also some general features. The core components of addiction include an enhanced incentive for the activity or substance (craving), impaired self-control (impulsivity and compulsivity), emotional dysregulation (negative mood) and increased reactivity to stress. Mindfulness training has been shown to be helpful with each of these components, 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.

 

Video game addictions are very common. It is estimated that 72% of American households play some form of video games, with the average use of 20 hours per week. About 9% show signs of addiction to video games while 4% were classified as extreme players who played 50 hours per week or more. The consequences of video game addiction range from “impaired physical health, such as being overweight or obese due to lack of physical activity, sleep disorders, and heightened risk for seizures, depressive and somatic symptoms, social anxiety, and attention-deficit/hyperactivity disorder, substance misuse, driving while playing video games, suicidal ideation, hostility, violence, loss of relationships and employment, and financial debt.”

 

There is thus a need to find safe and effective treatments for gaming addiction that not only help stop the addiction but also prevent relapse.  In today’s Research News article “Mindfulness-Oriented Recovery Enhancement for Internet Gaming Disorder in U.S. Adults: A Stage I Randomized Controlled Trial.” (See summary below) Li and colleagues study the ability of mindfulness practices to treat gaming addiction. They recruited adults who met the requirements for clinical diagnosis of Internet Gaming Disorder and randomly assigned them to 8 weekly 2-hour group sessions of a support group or of Mindfulness-Oriented Enhancement (MORE). The treatment integrates training in mindfulness, cognitive reappraisal skills, and savoring natural rewards. MORE is designed to modify automatic behavioral habits and pleasure dysregulation associated with addictive behaviors. The participants are requested to continue mindfulness practices at home. The participants were measured before and after the 8-week treatment period and were followed-up 3-months later for internet gaming addiction, craving, maladaptive thoughts, mental distress, coping strategies, and mindfulness.

 

They found that both groups showed improvement in internet gaming addiction measures, but the Mindfulness-Oriented Enhancement (MORE) group showed significantly greater improvement than the support group, particularly at the 3-month follow-up. They also found that both groups showed reductions in craving, distraction, catastrophizing, loneliness, and depression, and improved impulse control, acceptance and socialization, but the MORE group showed significantly greater improvement than the support group in craving, loneliness, and depression, particularly at the 3-month follow-up.

 

These exciting results suggest that both a support group and a mindfulness based addition treatment program produced significant improvements in internet gaming addiction. But, the mindfulness treatment produced superior results for improving internet gaming along with reducing cravings for gaming, and improving mood. This was true particularly at the 3-month follow-up suggesting that the mindfulness based addition treatment program produces more long-lasting benefits. This further suggests that MORE may also be superior at preventing relapse.

 

The results add to the list of addictions that can be successfully treated with mindfulness practices. With the number of people engaged in internet gaming and the huge number who become addicted, it is heartening to see that a mindfulness based addition treatment program can be safe and effective, relieving addiction and cravings and improving mood.

 

So, improve internet gaming disorder with mindfulness.

 

“mindfulness can play an important role in ameliorating problem gambling symptomatology.” – Mark Griffiths

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Li, W., Garland, E. L., McGovern, P., O’Brien, J. E., Tronnier, C., & Howard, M. O. (2017, April 24). Mindfulness-Oriented Recovery Enhancement for Internet Gaming Disorder in U.S. Adults: A Stage I Randomized Controlled Trial. Psychology of Addictive Behaviors. Advance online publication. http://dx.doi.org/10.1037/adb0000269

 

Abstract

Empirical studies have identified increasing rates of Internet gaming disorder (IGD) and associated adverse consequences. However, very few evidence-based interventions have been evaluated for IGD or problematic video gaming behaviors. This study evaluated Mindfulness-Oriented Recovery Enhancement (MORE) as a treatment for IGD. Thirty adults (Mage 25.0, SD 5.4) with IGD or problematic video gaming behaviors were randomized to 8 weeks of group-based MORE or 8 weeks of a support group (SG) control condition. Outcome measures were administered at pre- and posttreatment and 3-months following treatment completion using self-report instruments. Linear mixed models were used for outcome analyses. MORE participants had significantly greater reductions in the number of Diagnostic and Statistical Manual of Mental Disorders–5 IGD criteria they met, craving for video gaming, and maladaptive cognitions associated with gaming than SG participants, and therapeutic benefits were maintained at 3-month follow-up. MORE is a promising treatment approach for IGD.

MORE Mindfulness for Stopping Smoking

psyjdc Leave a comment

MORE Mindfulness for Stopping Smoking

 

By John M. de Castro, Ph.D.

 

“I liken it to having weeds in your garden. Standard treatments—for example, avoiding triggers such as ashtrays and lighters or using substitutes such as eating carrot sticks and chewing on your pen—just pull the heads off the weeds, so they grow back. These treatments don’t uproot the craving itself. In contrast, mindfulness really gets in there and pulls up the roots.” – Judson Brewer

 

“Tobacco use remains the single largest preventable cause of death and disease in the United States. Cigarette smoking kills more than 480,000 Americans each year, with more than 41,000 of these deaths from exposure to secondhand smoke. In addition, smoking-related illness in the United States costs more than $300 billion a year. In 2013, an estimated 17.8% (42.1 million) U.S. adults were current cigarette smokers.”  (Centers for Disease Control and Prevention).

 

There are a wide variety of methods and strategies to quit smoking which are to only a very limited extent effective. According to the National Institutes of Health, about 40% of smokers who want to quit make a serious attempt to do so each year, but fewer than 5% actually succeed. Most people require three or four failed attempts before being successful. One problem is that nicotine is one of the most addictive substances known and withdrawal from nicotine is very stressful, producing many physical and psychological problems, including negative emotional states and depression. In essence the addict feels miserable without the nicotine. This promotes relapse to relieve the discomfort.

 

Better methods to quit which can not only promote quitting but also prevent relapse are badly needed. Mindfulness practices have been found to be helpful in treating addictions, including nicotine addiction, and reducing the risk of relapse. But, it is not known how mindfulness produces these beneficial effects. One possibility is that mindfulness training helps to alter how rewarding smoking is, called restructuring reward processes.

 

In today’s Research News article “Restructuring Reward Mechanisms in Nicotine Addiction: A Pilot fMRI Study of Mindfulness-Oriented Recovery Enhancement for Cigarette Smokers.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5360937/

Froeliger and colleagues examine whether restructuring reward processes is involved in mindfulness training’s effectiveness in aiding smoking cessation. They recruited nicotine-dependent adult smokers who reported smoking more than 10 cigarettes/day for a minimum of 2 years. They separated them into a mindfulness training group and a matched no-treatment control group. Mindfulness training, called Mindfulness-Oriented Recovery Enhancement (MORE) involved 8 weekly sessions, including mindful breathing and body scan meditations, cognitive reappraisal to decrease negative emotions and craving, and savoring to augment natural reward processing and positive emotion. They were also encouraged to practice at home for 15 minutes per day. The groups were measured for smoking by self-report and breath CO2 measurement, craving to smoke, positive and negative emotions, and mindfulness. Both groups underwent functional Magnetic Resonance Imaging (fMRI) before and after the 8-week training. During scanning they were instructed to imagine feeling positive emotions in response to a picture or to simply look at neutral or smoking related images.

 

They found that MORE mindfulness training significantly reduced cigarette consumption and improved positive emotions following treatment. The fMRI scans revealed significant changes in brain structure and connectivity in the MORE mindfulness training group. While imagining positive reactions to pictures, after, but not before training, the MORE mindfulness trained group evidenced a significantly greater response than the control group in the rostral anterior cingulate cortex and ventral striatum. Conversely, while viewing smoking related images, the MORE mindfulness trained group evidenced a significantly lower response than the control group in the rostral anterior cingulate cortex and ventral striatum. Hence, MORE mindfulness training appeared to restructure the brain increasing brain responses to positive thoughts while decreasing them to smoking stimuli. So, treatment appeared to change the brain making it react more positively to everyday stimuli and more negatively to smoking images, reducing the emotional rewards of smoking.

 

They also found that the larger the brain response to imagining positive emotions to everyday stimuli in the rostral anterior cingulate cortex and ventral striatum the greater the positive emotions and the smaller the craving for cigarettes and the greater the reduction in cigarettes smoked. So, mindfulness training increased the response of these structures resulting in greater positive mood and a lowering of cigarette craving and consumption. This suggests that MORE mindfulness training reduces craving and smoking by changing the brain to produce less positive emotional responses to smoking.

 

These are fascinating results and encourage further, better controlled work than this pilot study that did not have an active control condition. But, the results clearly suggest that mindfulness training is effective in helping nicotine addicts stop smoking and does so by altering the brain to be more positive normally and less positive to smoking. The mindfulness training appeared to restructure the brain making smoking less rewarding and the rest of life more so, leading to reduced smoking.

 

So, MORE mindfulness for stopping smoking.

 

“Early evidence suggests that exercises aimed at increasing self-control, such as mindfulness meditation, can decrease the unconscious influences that motivate a person to smoke,” – Nora Volkow

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Froeliger, B., Mathew, A. R., McConnell, P. A., Eichberg, C., Saladin, M. E., Carpenter, M. J., & Garland, E. L. (2017). Restructuring Reward Mechanisms in Nicotine Addiction: A Pilot fMRI Study of Mindfulness-Oriented Recovery Enhancement for Cigarette Smokers. Evidence-Based Complementary and Alternative Medicine : eCAM, 2017, 7018014. http://doi.org/10.1155/2017/7018014

 

Abstract

The primary goal of this pilot feasibility study was to examine the effects of Mindfulness-Oriented Recovery Enhancement (MORE), a behavioral treatment grounded in dual-process models derived from cognitive science, on frontostriatal reward processes among cigarette smokers. Healthy adult (N = 13; mean (SD) age 49 ± 12.2) smokers provided informed consent to participate in a 10-week study testing MORE versus a comparison group (CG). All participants underwent two fMRI scans: pre-tx and after 8-weeks of MORE. Emotion regulation (ER), smoking cue reactivity (CR), and resting-state functional connectivity (rsFC) were assessed at each fMRI visit; smoking and mood were assessed throughout. As compared to the CG, MORE significantly reduced smoking (d = 2.06) and increased positive affect (d = 2.02). MORE participants evidenced decreased CR-BOLD response in ventral striatum (VS; d = 1.57) and ventral prefrontal cortex (vPFC; d = 1.7) and increased positive ER-BOLD in VS (dVS = 2.13) and vPFC (dvmPFC = 2.66). Importantly, ER was correlated with smoking reduction (r’s = .68 to .91) and increased positive affect (r’s = .52 to .61). These findings provide preliminary evidence that MORE may facilitate the restructuring of reward processes and play a role in treating the pathophysiology of nicotine addiction.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5360937/

 

Improve Addiction Rehabilitation with Acceptance and Commitment Group Therapy

psyjdc Leave a comment

Improve Addiction Rehabilitation with Acceptance and Commitment Group Therapy

 

By John M. de Castro, Ph.D.

 

“ACT looks at a psychological problem in terms of something “physical” in the way, such as a rock that can be moved, or a detour taken around, or a garden plot that needs to be weeded so plants can grow.” – Edie Weinstein

 

Substance abuse and addiction is a terrible problem. It isn’t just illicit drugs but includes many prescriptions drugs especially opioid pain relievers. The over prescription of opioid painkillers in the United States has become a major problem. Opioid abuse, can be deadly. It has become so bad that drug overdose is now the leading cause of injury death, causing more deaths than motor vehicle accidents. This is a problem both of illegal drug use but even more so of abuse of legally obtained prescription drugs. Of the over 44,000 drug overdose deaths in the United States 52% were from prescription drugs. These statistics, although startling, are only the tip of the iceberg. Drug use is associated with suicide, homicide, motor-vehicle injury, HIV infection, pneumonia, violence, mental illness, and hepatitis. It can render the individual ineffective at work, it tears apart families, it makes the individual dangerous both driving and not. It also reduces life expectancy by about 15-20 years from the moment of addiction. An effective treatment for addiction has been elusive. Most programs and therapies to treat addictions have poor success rates.

 

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 Narcotics 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 not only produce abstinence but also prevent relapses. Mindfulness training has been shown to be a safe and effective treatment for reducing addiction relapse.

 

Acceptance and Commitment Therapy (ACT) is a mindfulness based psychotherapy technique that focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. Additionally, it teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. On the face of it, ACT would appear to address the kinds of defective thought processes that occur in addiction. But, the effectiveness of ACT for opioid addiction has not been adequately tested.

 

In today’s Research News article “Comparing Acceptance and Commitment Group Therapy and 12-Steps Narcotics Anonymous in Addict’s Rehabilitation Process: A Randomized Controlled Trial.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5206327/

Azkhosh and colleagues recruited individuals who were addicted to opiates and randomly assigned them to receive either a group administered Acceptance and Commitment Therapy (ACT), Narcotics Anonymous 12-step program, or usual treatment. Treatment occurred for 12 weeks, meeting once a week for 90 minutes. Before and after treatment and 6 weeks later the participants were measured for psychological wellbeing, and psychological flexibility.

 

They found that at the end of treatment and at follow-up, both treatment groups showed improvements relative to the control group on psychological well-being and psychological flexibility, including the self-acceptance, autonomy, purpose in life, and personal growth subscales. Hence, both Acceptance and Commitment Therapy (ACT) and Narcotics Anonymous 12-step programs improve the psychological components that are needed for successful treatment of opioid addiction. It remains for future research to determine if these effects translate into successful primary treatment and relapse prevention of opioid addiction.

 

So, improve the psychological characteristics needed for addiction rehabilitation with Acceptance and Commitment Therapy.

 

“ACT encourages people to simply notice and accept their thoughts and feelings for what they are: merely thoughts and feelings of no particular importance other than the importance we assign them. People learn to say to themselves, “Oh, I’m having a thought about cocaine. I’m having a feeling it would be fun to use again.” From this perspective, there is no impetus to use cocaine, nor is cocaine fun. It is merely a thought about those things.” – Tom Horvath

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Azkhosh, M., Farhoudianm, A., Saadati, H., Shoaee, F., & Lashani, L. (2016). Comparing Acceptance and Commitment Group Therapy and 12-Steps Narcotics Anonymous in Addict’s Rehabilitation Process: A Randomized Controlled Trial. Iranian Journal of Psychiatry, 11(4), 244–249.

 

Abstract

Objective: Substance abuse is a socio-psychological disorder. The aim of this study was to compare the effectiveness of acceptance and commitment therapy with 12-steps Narcotics Anonymous on psychological well-being of opiate dependent individuals in addiction treatment centers in Shiraz, Iran.

Method: This was a randomized controlled trial. Data were collected at entry into the study and at post-test and follow-up visits. The participants were selected from opiate addicted individuals who referred to addiction treatment centers in Shiraz. Sixty individuals were evaluated according to inclusion/ exclusion criteria and were divided into three equal groups randomly (20 participants per group). One group received acceptance and commitment group therapy (Twelve 90-minute sessions) and the other group was provided with the 12-steps Narcotics Anonymous program and the control group received the usual methadone maintenance treatment. During the treatment process, seven participants dropped out. Data were collected using the psychological well-being questionnaire and AAQ questionnaire in the three groups at pre-test, post-test and follow-up visits. Data were analyzed using repeated measure analysis of variance.

Results: Repeated measure analysis of variance revealed that the mean difference between the three groups was significant (P<0.05) and that acceptance and commitment therapy group showed improvement relative to the NA and control groups on psychological well-being and psychological flexibility.

Conclusion: The results of this study revealed that acceptance and commitment therapy can be helpful in enhancing positive emotions and increasing psychological well-being of addicts who seek treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5206327/

 

Improve Substance Abuse Treatment with Mindfulness

psyjdc Leave a comment

Improve Substance Abuse Treatment with Mindfulness

 

By John M. de Castro, Ph.D.

 

“It is most often the mind’s interpretation of a stressful life event, not the event itself, that creates the urgent need to get instant relief and leads to substance use or other unwanted behaviors. Mindfulness practices provide a break from stress, teach the client to listen to his/her mind, body, and emotions, and improve the self-acceptance that leads to greater hope and self-efficacy.“ – NAADAC

 

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. Drug abuse is often more complex than a simple addiction to a substance. Addiction frequently is accompanied by other mental health issues, comorbidities. They include mood and anxiety disorders, antisocial and conduct disorder, smoking and alcohol abuse, and post-traumatic stress disorder (PTSD).

 

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, possibility because of the failure to address comorbidities. Hence, it is important to find an effective method to treat both addiction but also accompanying conditions. Mindfulness training has been shown to be a safe and effective treatment of addiction and relapse prevention. It has also been shown to be effective for a variety of other mental health issues including anxiety, depression, antisocial and conduct disorder, smoking and alcohol abuse, and post-traumatic stress disorder (PTSD). Hence, mindfulness training would appear to be a potential treatment that can be added to traditional substance abuse treatment programs to both address addiction and accompanying comorbid disorders.

 

In today’s Research News article “Mindfulness-Oriented Recovery Enhancement Versus CBT for Co-Occurring Substance Dependence, Traumatic Stress, and Psychiatric Disorders: Proximal Outcomes from a Pragmatic Randomized Trial.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752876/

Garland and colleagues compared the effectiveness of a mindfulness-based addiction treatment program with another well-established therapy, cognitive behavioral therapy (CBT), and with the usual treatment for addiction. They recruited homeless men with a substance abuse disorder and comorbid mental health issues and randomly assigned them to either receive 10 weeks of a group-based Mindfulness-Oriented Recovery Enhancement (MORE) program, group-based cognitive behavioral therapy (CBT), or usual treatment. At the beginning and end of the 10-week treatment, they measured the participants’ trauma history, drug cravings, post-traumatic stress symptoms, psychiatric distress, mindfulness, positive and negative feelings, and readiness to change.

 

They found that all treatments improved depression, but Mindfulness-Oriented Recovery Enhancement (MORE) treatment produced improvements in drug cravings, post-traumatic stress symptoms, mindfulness, and negative feelings, that were significantly greater than cognitive behavioral therapy (CBT), or usual treatment. In addition, mediation analysis revealed that the improvements in drug cravings and post-traumatic stress symptoms was mediated by increases in mindfulness. That is the Mindfulness-Oriented Recovery Enhancement (MORE) treatment significantly improved mindfulness which, in turn, produced significant improvements in drug cravings and post-traumatic stress symptoms.

 

These are particularly compelling findings as MORE was found to be superior to a well-established treatment technique, cognitive behavioral therapy (CBT). This is a powerful research design that controls for most sources of confounding. So, it appears clear that adding mindfulness practice to addiction treatment significantly improves outcomes.

 

So, improve substance abuse treatment with mindfulness.

 

“mindfulness enhances our ability to be non-reactive. This is key in drug treatment because oftentimes we seek immediate gratification; we want to feel good right now, or we want the negative feeling we’re experiencing to stop right now. This leads to reactive thinking, feeling, and behaving, and can be a catapult for drug use. When we practice mindfulness we practice responding to our experience with a non-reactive, non-judgmental attitude. This helps us maintain autonomy over our behavior. We may not have control over whether a craving for a drug arises, but we can control how we respond to such a craving. The irony is that when we practice simply observing the craving; letting it arise and letting it pass away (rather than actively trying to push it away or avoid it), we are left with more of an ability to regulate ourselves.´- Center for Adolescent Studies

 

 

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

Garland, E. L., Roberts-Lewis, A., Tronnier, C. D., Graves, R., & Kelley, K. (2016). Mindfulness-Oriented Recovery Enhancement Versus CBT for Co-Occurring Substance Dependence, Traumatic Stress, and Psychiatric Disorders: Proximal Outcomes from a Pragmatic Randomized Trial. Behaviour Research and Therapy, 77, 7–16. http://doi.org/10.1016/j.brat.2015.11.012

 

Abstract

In clinical settings, there is a high comorbidity between substance use disorders, psychiatric disorders, and traumatic stress. As such, transdiagnostic therapies are needed to address these co-occurring issues efficiently. The aim of the present study was to conduct a pragmatic randomized controlled trial comparing Mindfulness-Oriented Recovery Enhancement (MORE) to group Cognitive-Behavioral Therapy (CBT) and treatment-as-usual (TAU) for previously homeless men residing in a therapeutic community. Men with co-occurring substance use and psychiatric disorders, as well as extensive trauma histories, were randomly assigned to 10 weeks of group treatment with MORE (n=64), CBT (n=64), or TAU (n=52). Study findings indicated that from pre- to post-treatment MORE was associated with modest yet significantly greater improvements in substance craving, post-traumatic stress, and negative affect than CBT, and significantly greater improvements in post-traumatic stress and positive affect than TAU. A significant indirect effect of MORE on decreasing craving and post-traumatic stress by increasing dispositional mindfulness was observed, suggesting that MORE may target these issues via enhancing mindful awareness in everyday life. This pragmatic trial represents the first head-to-head comparison of MORE against an empirically-supported treatment for co-occurring disorders. Results suggest that MORE, as an integrative therapy designed to bolster self-regulatory capacity, may hold promise as a treatment for intersecting clinical conditions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752876/

 

Improve Emotions in Quitting Smokers by Increasing Relaxation with Mindfulness

psyjdc Leave a comment

Improve Emotions in Quitting Smokers by Increasing Relaxation with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Depressed individuals tend to smoke at higher rates; at the same time, depressive symptoms make it more difficult to quit. Consequently, depressed individuals suffer from a higher rate of smoking-related diseases. Developing and implementing effective smoking cessation interventions for this vulnerable population is a public health priority.” – Haruka Minami

 

“Tobacco use remains the single largest preventable cause of death and disease in the United States. Cigarette smoking kills more than 480,000 Americans each year, with more than 41,000 of these deaths from exposure to secondhand smoke. In addition, smoking-related illness in the United States costs more than $300 billion a year. In 2013, an estimated 17.8% (42.1 million) U.S. adults were current cigarette smokers.”  (Centers for Disease Control and Prevention).

 

There are a wide variety of methods and strategies to quit smoking which are to only a very limited extent effective. According to the National Institutes of Health, about 40% of smokers who want to quit make a serious attempt to do so each year, but fewer than 5% actually succeed. Most people require three or four failed attempts before being successful. One problem is that nicotine is one of the most addictive substances known and withdrawal from nicotine is very stressful, producing many physical and psychological problems, including negative emotional states and depression. In essence the addict feels miserable without the nicotine. This promotes relapse to relieve the discomfort.

 

Better methods to quit which can not only promote quitting but also prevent relapse are badly needed. Mindfulness practices have been found to be helpful in treating addictions, including nicotine addiction, and reducing the risk of relapse. But, it is not known how mindfulness produces these beneficial effects. One possibility is that mindfulness training helps to relieve the stress, negative emotions, and depression that accompanies nicotine withdrawal. In today’s Research News article “Coping Mediates the Association of Mindfulness with Psychological Stress, Affect, and Depression Among Smokers Preparing to Quit.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5296771/

Vidrine and colleagues examine this issue by studying the relationship of mindfulness to stress, negative emotions, and depression in smokers entering a smoking cessation treatment program. They recruited adult smokers from an urban population who were willing to partake in a mindfulness-based quitting smoking program. Prior to the therapy program the participants completed measures of nicotine dependence, mindfulness, coping mechanisms, positive and negative emotions, and depression.

 

Analyzing these responses, they found that the higher the levels of mindfulness the lower the levels of perceived stress, negative emotions, and depression and the higher the levels of positive emotions. In other words, being mindful was associated with better emotional health. In addition, they found that that the higher the levels of mindfulness the greater use of coping methods of catharsis, seeking social support, religion, and relaxation. Hence, mindful people used adaptive methods to cope with discomfort and stress. Employing a sophisticated statistical technique of mediation analysis, they were able to demonstrate that mindfulness increased coping through relaxation which resulted in reduced perceived stress and depression, and higher positive emotions. They were also able to demonstrate that coping with catharsis was able to magnify the association of mindfulness with lower negative emotions.

 

These results are very interesting and suggest that mindfulness may be able to assist in smoking cessation by reducing the negative consequences of nicotine withdrawal, in particular by increasing relaxation which in turn reduces perceived stress and depression, and heightens positive feelings. They also suggest that the coping strategy of catharsis acts by amplifying the ability of mindfulness to reduce negative feelings. These findings have implications for smoking cessation. They suggest that including relaxation and catharsis practices in a mindfulness-based smoking cessation treatment program might strengthen its ability to assist the smoker to quit.

 

So, improve emotions in quitting smokers by increasing relaxation with mindfulness.

 

“Mindfulness seems to be beneficial by helping smokers cope with craving. Cigarette craving can be a powerful motivator, and one of the major reasons for relapse. But mindfulness is effective at helping people cope with strong emotions, such as those experienced with depression, anxiety, and pain.” – Cecilia Westbrook

 

 

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

Jennifer Irvin Vidrine, Michael S. Businelle, Lorraine R. Reitzel, Yumei Cao, Paul M. Cinciripini, Marianne T. Marcus, Yisheng Li, David W. Wetter. Coping Mediates the Association of Mindfulness with Psychological Stress, Affect, and Depression Among Smokers Preparing to Quit. Mindfulness (N Y),  2015 Jun; 6(3): 433–443. doi: 10.1007/s12671-014-0276-4

 

Abstract

It is not surprising that smoking abstinence rates are low given that smoking cessation is associated with increases in negative affect and stress that can persist for months. Mindfulness is one factor that has been broadly linked with enhanced emotional regulation. This study examined baseline associations of self-reported trait mindfulness with psychological stress, negative affect, positive affect, and depression among 158 smokers enrolled in a smoking cessation treatment trial. Several coping dimensions were evaluated as potential mediators of these associations. Results indicated that mindfulness was negatively associated with psychological stress, negative affect and depression, and positively associated with positive affect. Furthermore, the use of relaxation as a coping strategy independently mediated the association of mindfulness with psychological stress, positive affect, and depression. The robust and consistent pattern that emerged suggests that greater mindfulness may facilitate cessation and attenuate vulnerability to relapse among smokers preparing for cessation. Furthermore, relaxation appears to be a key mechanism underlying these associations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5296771/

 

 

Improve Mental Health with Mindfulness

psyjdc Leave a comment

Image may contain: 1 person, sitting and indoor

 

By John M. de Castro, Ph.D.

 

“Mindfulness-Based Cognitive Therapy (MBCT) is designed to help people who suffer repeated bouts of depression and chronic unhappiness. It combines the ideas of cognitive therapy with meditative practices and attitudes based on the cultivation of mindfulness. The heart of this work lies in becoming acquainted with the modes of mind that often characterize mood disorders while simultaneously learning to develop a new relationship to them.” – MBCT.com

 

About one out of every five people suffers from a mental disorder. In the U.S. that amounts to over 44 million people. For the U.S. adults about 1.1% live with schizophrenia, 2.6% with bipolar disorder.  6.9% with major depression, 18.1% with anxiety disorders, and 3% with substance use disorders. This places a tremendous burden on the individual, their families, and the health care system. Obviously there is a critical need to find safe, effective, and affordable treatments for these disorders.

 

Mindfulness training has been shown to be helpful in treating many of these disorders, including schizophrenia, depression, anxiety, and substance abuse. One form of therapy that includes mindfulness training is Mindfulness-Based Cognitive Therapy (MBCT). It was developed specifically to treat depression and has been found to reduce depression alone or in combination with antidepressive drugs. MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate depression. It has proved so effective for depression that it has also begun to be applied to a variety of other mental disorders.

 

In today’s Research News article “Effects of mindfulness-based cognitive therapy on mental disorders: a systematic review and meta-analysis of randomised controlled trials..” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1444323605591561/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5030069/

Galante and colleagues review the published research literature on the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for a variety of mental disorders. They found 11 published randomized controlled trials 10 of which compared MBCT to treatment as usual. There were only a sufficient number of studies to perform a meta-analysis for depression, depression relapse rates, and anxiety. They found that overall the research has demonstrated significant treatment effects for MBCT for the reduction in anxiety and depression. Importantly, MBCT had long-term beneficial effects as evidenced by a significant lowering of the relapse rates from depression on average by 40%.

 

These are important findings that strongly support the application of MBCT for the treatment of depression and anxiety disorders. The effects were not only robust but lasting, still being significantly better then treatment as usual a year after the end of treatment. It is unfortunate that there were not a greater number of studies of the effectiveness of MBCT for other mental disorders. This underscores the need for more research into the application of MBCT to disorders other than anxiety and depression. It has such powerful and lasting effects on anxiety and depression that it would be predicted that it would also be effective for other disorders.

 

It is not known exactly how MBCT relieves anxiety and depression. But, it can be speculated that MBCT, by shifting attention away from the past or future to the present moment, interrupts the kinds of thinking that are characteristic of and support anxiety and depression. These include rumination about past events, worry about future events, and catastrophizing about potential future events. Mindfulness has been shown to interrupt rumination, worry, and catastrophizing and focus the individual on what is transpiring in the present. By interrupting these forms of thinking that support anxiety and depression, shifting attention to the present moment where situations are actually manageable, mindfulness may disrupt depression. MBCT also improves the ability to see thoughts as objects of awareness and not something personal. This may be the most important change to improve anxiety and depression. This changes the relationship of the patients with their thoughts, making them less personal and thereby easier to cope with and change.

 

So, improve mental health with mindfulness.

 

“People at risk for depression are dealing with a lot of negative thoughts, feelings and beliefs about themselves and this can easily slide into a depressive relapse MBCT helps them to recognize that’s happening, engage with it in a different way and respond to it with equanimity and compassion.” – Willem Kuyken

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Galante, J., Iribarren, S. J., & Pearce, P. F. (2013). Effects of mindfulness-based cognitive therapy on mental disorders: a systematic review and meta-analysis of randomised controlled trials. Journal of Research in Nursing : JRN, 18(2), 133–155. http://doi.org/10.1177/1744987112466087

 

Key points for policy, practice and research

  • Patients with recurrent depression (three episodes or more) treated with additive MBCT have on average 40% fewer relapses at one year of follow-up compared to patients undergoing treatment as usual.
  • Improvements in depression and anxiety with additive MBCT were significant at one year of follow-up but unstable in sensitivity analyses.
  • More studies with active control groups and long-term follow-ups are needed to better understand the specific effects of MBCT.
  • Depression is a symptom that is present in many conditions. More high quality RCTs are needed to evaluate MBCT in populations with varying depression severity as well as diagnosis with multiple co-morbidities.

Abstract

Objective: Mindfulness-based cognitive therapy (MBCT) is a programme developed to prevent depression relapse, but has been applied for other disorders. Our objective was to systematically review and meta-analyse the evidence on the effectiveness and safety of MBCT for the treatment of mental disorders.

Methods: Searches were completed in CENTRAL, MEDLINE, EMBASE, LILACS, PsychINFO, and PsycEXTRA in March 2011 using a search strategy with the terms ‘mindfulness-based cognitive therapy’, ‘mindfulness’, and ‘randomised controlled trials’ without time restrictions. Selection criteria of having a randomised controlled trial design, including patients diagnosed with mental disorders, using MBCT according to the authors who developed MBCT and providing outcomes that included changes in mental health were used to assess 608 reports. Two reviewers applied the pre-determined selection criteria and extracted the data into structured tables. Meta-analyses and sensitivity analyses were completed.

Results:Eleven studies were included. Most of them evaluated depression and compared additive MBCT against usual treatment. After 1 year of follow-up MBCT reduced the rate of relapse in patients with three or more previous episodes of depression by 40% (5 studies, relative risk [95% confidence interval]: 0.61 [0.48, 0.79]). Other meta-analysed outcomes were depression and anxiety, both with significant results but unstable in sensitivity analyses. Methodological quality of the reports was moderate.

Conclusion: Based on this review and meta-analyses, MBCT is an effective intervention for patients with three or more previous episodes of major depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5030069/

 

 

Reduce Cigarette Smoking and Cravings with Mindfulness

psyjdc Leave a comment

Image may contain: 1 person, closeup

 

By John M. de Castro, Ph.D.

 

“Mindfulness, which is commonly described as present-moment, nonjudgmental awareness, can be an effective tool for riding out cravings and “sitting with” the distress associated with the quitting process. Furthermore, mindfulness can help foster an attitude of acceptance of present-moment challenges and thoughts (such as, “Quitting feels extremely difficult, and sometimes I worry I can’t do this.”). Acceptance can help one to ride out these moments, understanding them as temporary, rather than being overwhelmed by them.” – Traci Stein

 

“Tobacco use remains the single largest preventable cause of death and disease in the United States. Cigarette smoking kills more than 480,000 Americans each year, with more than 41,000 of these deaths from exposure to secondhand smoke. In addition, smoking-related illness in the United States costs more than $300 billion a year. In 2013, an estimated 17.8% (42.1 million) U.S. adults were current cigarette smokers.”  (Centers for Disease Control and Prevention).

 

Nicotine is one of the most addictive substances known. But, its addictiveness is not just due to its pharmacological properties. Addiction to smoking also involves learned or conditioned factors, genetics, and social and environmental factors. This makes it easy to become addicted and very difficult to stop. To some extent this is why there still are high rates of smoking even though mostly everyone understands that it has very negative effects on health and longevity.

 

There are a wide variety of methods and strategies to quit smoking which are to some extent effective. According to the National Institutes of Health, about 40% of smokers who want to quit make a serious attempt to do so each year, but fewer than 5% actually succeed. Most people require three or four failed attempts before being successful. One problem is that after quitting if a single cigarette is smoked, going back to regular smoking is almost assured. As John Polito wrote “nicotine dependency recovery is one of the few challenges in life where being 99% successful all but assures 100% defeat.”

 

So, better methods to quit are badly needed. Mindfulness training has been shown to be helpful in treatment for addiction and prevention of relapse after recovery. In today’s Research News article “Effect of Brief Mindfulness Practice on Self-Reported Affect, Craving, and Smoking: A Pilot Randomized Controlled Trial Using Ecological Momentary Assessment.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1425084614182127/?type=3&theater

or see summary below, Ruscio and colleagues test the effectiveness of brief meditation in real life situations to assist in reducing smoking. They recruited a community sample of adult cigarette smokers and randomly assigned them to either a brief (2 week) meditation or sham meditation condition. Meditation group participants were instructed in meditation and required to meditate once per day for at least 20 minutes at a time and place of their choosing with pre-recorded guided meditations. The control group also “sham meditated” once a day with a recording that guided them to let their minds wander and judge experience. Both groups were given a Personal Digital Assistant (PDA) that was programmed to prompt them at four random times during each day to complete assessments of smoking, craving, and positive and negative feelings.

 

They found that the meditation group reported significantly lower cravings after meditation and fewer negative emotions. Importantly, the meditation group significantly and progressively decreased the number of cigarettes smoked per day over the 2 weeks while the sham meditation group did not. These findings are particularly striking because real-world smoking was followed and assessed and there was a truly comparable control condition. Hence, the findings are not due to experimental contamination and are applicable to the kinds of situations where smoking normally occurs. The importance of this should not be underestimated. The lab or the clinic is not the real world. Smoking is prompted by many situations and signals present in the everyday environment that are not present in the lab. So, it is particularly important to test potential therapies against real world smoking behavior.

 

These are interesting and potentially important findings. A brief daily meditation is capable of reducing craving to smoke and the number of cigarettes smoked per day. If this could be maintained for longer periods it might lead to complete cessation of smoking and possibly prevention of relapse. It will require future research to examine these possibilities. Regardless meditation appears to reduce smoking over the short-term.

 

So, reduce cigarette smoking and cravings with mindfulness.

 

“With mindful awareness, patients are no longer at the mercy of their cravings. Instead, they can build awareness for their cravings and choose how to respond.. . mindfulness may also allow patients to build healthier behaviors. . .  everyone knows smoking and eating too much is bad for them, but mere knowledge doesn’t change behavior. It’s when they actually begin to pay attention to how smoking tastes, they want to change on a visceral level.” – Jamie Zimmerman

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Ruscio AC, Muench C, Brede E, Waters AJ. Effect of Brief Mindfulness Practice on Self-Reported Affect, Craving, and Smoking: A Pilot Randomized Controlled Trial Using Ecological Momentary Assessment. Nicotine Tob Res. 2016 Jan;18(1):64-73. doi: 10.1093/ntr/ntv074.

 

Abstract

Introduction: Despite efficacious pharmacological and behavioral treatments, most smokers attempt to quit without assistance and fail to quit. Mindfulness practice may be useful in smoking cessation.

Methods: This ecological momentary assessment (EMA) study was a pilot parallel group randomized controlled trial of a brief mindfulness practice (Brief-MP) intervention on self-reported smoking behavior delivered to smokers on a Personal Digital Assistant (PDA) in the field. Adult community smokers (N = 44) were randomly assigned to a Brief-MP (n = 24) or Control (sham meditation; n = 20) group. Participants were instructed to smoke as much or as little as they liked. Participants carried a PDA for 2 weeks and were instructed to initiate 20 minutes of meditation (or control) training on the PDA daily, completing an assessment of cognitive and affective processes immediately afterwards. Additionally, they completed assessments at random times up to four times per day. Primary outcome variables were negative affect, craving, and cigarettes smoked per day, all self-reported.

Results: Thirty-seven participants provided EMA data totaling 1874 assessments. Linear Mixed Model analyses on EMA data revealed that Brief-MP (vs. Control) reduced overall negative affect, F(1, 1798) = 13.8, P= .0002; reduced craving immediately post-meditation, (Group × Assessment Type interaction, F(2, 1796) = 12.3, P = .0001); and reduced cigarettes smoked per day over time (Group × Day interaction, F(1, 436) = 5.50, P = .01).

Conclusions: Brief-MP administered in the field reduced negative affect, craving, and cigarette use, suggesting it may be a useful treatment.