Anxiety

Relieve Generalized Anxiety and Depression with a 2-Session Acceptance and Commitment Therapy (ACT)

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Relieve Generalized Anxiety and Depression with a 2-Session Acceptance and Commitment Therapy (ACT)

 

By John M. de Castro, Ph.D.

 

“ACT is about acceptance and it is about change at the same time. Applied to anxiety disorders, patients learn to end the struggle with their anxiety-related discomfort and take charge by engaging in actions that move them related to their chosen life aims.” – Mohsen Hasheminasab 

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. A characterizing feature of anxiety disorders is that the suffer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Anxiety disorders have generally been treated with drugs. But there are considerable side effects and these drugs are often abused.

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. Depression can be difficult to treat and is usually treated with anti-depressive medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression.

 

There are a number of psychological therapies for anxiety and depression. But, les than half the patients treated respond to the therapy and do not relapse. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders. A therapeutic technique that contains mindfulness training is Acceptance and Commitment Therapy (ACT). It is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT) and has also been shown to relieve anxiety. ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

In prior research Ruiz and associates have demonstrated that a 3 session Acceptance and Commitment Therapy (ACT) is effective Generalized Anxiety Disorder (GAD) and for depression. In today’s Research News article “Efficacy of a two-session repetitive negative thinking-focused acceptance and commitment therapy (ACT) protocol for depression and generalized anxiety disorder: A randomized waitlist control trial.” (See summary below or at: https://pubmed.ncbi.nlm.nih.gov/31944806/), Ruiz and colleagues examine the efficacy of a 2-session ACT for Generalized Anxiety Disorder (GAD) and for depression.

 

They recruited via social media patients diagnosed with either Generalized Anxiety Disorder (GAD) or depression and randomly assigned them to either a wait-list control condition or to receive 2 60-minute individual sessions of Acceptance and Commitment Therapy (ACT). They were measured before and after treatment and 1- and 3-months month later for anxiety, depression, perceived stress, perseverative thinking, experiential avoidance, cognitive fusion, valued living, and generalized pliance (rule governed behavior).

 

They found that in comparison to baseline and the wait-list control group, the patients who received Acceptance and Commitment Therapy (ACT) had significantly improved levels of all outcome measures including anxiety, depression, perceived stress, perseverative thinking, experiential avoidance, cognitive fusion, valued living, and generalized pliance that persisted at the 1- and 3-month follow-ups. Fully 91% of the patients receiving ACT had clinically significant changes in their Generalized Anxiety Disorder (GAD) or depression compared to 9% of the wait-list controls.

 

The findings are remarkable in that 2 1-hour sessions of Acceptance and Commitment Therapy (ACT) produced such large, significant and lasting improvements in patients with Generalized Anxiety Disorder (GAD) or depression. These disorders are widespread affecting a large number of people and are frequently debilitating or at least interfere with their ability to conduct their lives. It is exciting that a brief treatment that can be implemented cost-effectively is capable of relieving their suffering.

 

The study, however, lacked an active control condition, e.g. exercise, and so is open to a variety of confounding variables. Future research should include such an active control. The effects of confounding variables, however, generally fade fairly quickly over time. So, the fact that the current results were still large and significant 3-months later argues that the benefits were produced by ACT.

 

So, relieve generalized anxiety and depression with a 2-session Acceptance and Commitment Therapy (ACT).

 

“ACT has been used effectively to help treat workplace stress, test anxiety, social anxiety disorder, depression, obsessive-compulsive disorder, and psychosis.” – Psychology Today

 

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

 

Ruiz FJ, Peña-Vargas A, Ramírez ES, et al. Efficacy of a two-session repetitive negative thinking-focused acceptance and commitment therapy (ACT) protocol for depression and generalized anxiety disorder: A randomized waitlist control trial [published online ahead of print, 2020 Jan 16]. Psychotherapy (Chic). 2020;10.1037/pst0000273. doi:10.1037/pst0000273

 

Abstract

This parallel randomized controlled trial aimed to evaluate the effect of acceptance and commitment therapy (ACT) focused on disrupting repetitive negative thinking (RNT) versus a waitlist control (WLC) in the treatment of depression and generalized anxiety disorder (GAD). Forty-eight participants with a main diagnosis of depression and/or GAD were allocated by means of simple randomization to a 2-session RNT-focused ACT intervention or to the WLC. The primary outcomes were emotional symptoms as measured by the Depression, Anxiety, and Stress Scales-21. Process outcomes included ACT- and RNT-related measures: general RNT, experiential avoidance, cognitive fusion, values, and generalized pliance. At the 1-month follow-up, linear mixed effects models showed that the intervention was efficacious in reducing emotional symptoms (d = 2.42, 95% confidence interval [1.64, 3.19]), with 94.12% of participants in the RNT-focused ACT condition showing clinically significant change in the Depression, Anxiety, and Stress Scales-21 total scores versus 9.09% in the WLC condition (70% vs. 8% in intention-to-treat analysis). The intervention effects were maintained at the 3-month follow-up. No adverse events were found. A very brief RNT-focused ACT intervention was highly effective in the treatment of depression and GAD.

Clinical Impact Statement Question: What is the applied clinical practice question this paper is hoping to address?

To analyze whether a 2-session acceptance and commitment therapy (ACT) intervention focused on disrupting repetitive negative thinking (RNT) is effective in treating depression and GAD. Findings: How would clinicians meaningfully use the primary findings of this paper in their applied practice? Clinicians might use the RNT-focused ACT protocol to treat depression and GAD. Meaning: What are the key conclusions and implications for future clinical practice and research? The RNT-focused ACT protocol was highly effective in treating depression and GAD. Next Steps: Based on the primary findings and limitations of this paper, what are future directions to be explored in clinical practice and research? To analyze the long-term effects of the RNT-focused ACT protocol.

https://pubmed.ncbi.nlm.nih.gov/31944806/

 

Reduce Anxiety and Improve Self-Efficacy in Pregnancy with Mindfulness

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Reduce Anxiety and Improve Self-Efficacy in Pregnancy with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness practices during pregnancy has several benefits: better manage chronic pain, depression, and anxiety, reduce fears about childbirth, reduce fears surrounding your pregnancy and parenting, increase confidence for birth and parenting, reduce perception of pain in birth.” – Cara Terreri

 

The period of pregnancy is a time of intense physiological and psychological change. Anxiety, depression, and fear are quite common during pregnancy. More than 20 percent of pregnant women have an anxiety disorder, depressive symptoms, or both during pregnancy. A debilitating childbirth fear has been estimated to affect about 6% or pregnant women and 13% are sufficiently afraid to postpone pregnancy. It is difficult to deal with these emotions under the best of conditions but in combinations with the stresses of pregnancy can turn what could be a joyous experience of creating a human life into a horrible worrisome, torment.

 

It is clear that there is a need for methods to treat depression, and anxiety during pregnancy. Since the fetus can be negatively impacted by drugs, it would be preferable to find a treatment that did not require drugs. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy.

 

In today’s Research News article “The effect of mindfulness-based stress reduction on maternal anxiety and self-efficacy: A randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177577/), Zarenejad and colleagues recruited women pregnant with their first child between 24 and 36 weeks of pregnancy. They were randomly assigned to either usual care or to receive 6 weeks of twice a week for 1-hour group mindfulness training based upon the Mindfulness-Based Stress Reduction (MBSR) program. The training employs meditation, body scan, yoga, discussions, and home practice. They were measured before and after training and 1 month later for mindfulness, pregnancy related anxiety, and self-efficacy.

 

They found that in comparison to baseline and the usual care group, the women who received mindfulness training had significant increases in mindfulness and significant decreases in pregnancy related anxiety immediately after training and one month after training where there was also a significant increase in self-eficacy..

 

Mindfulness training has been repeatedly demonstrated in prior research to decrease anxiety and increase self-efficacy in a wide range of healthy and ill populations. The present study demonstrates that this training has similar effects with late-term pregnant women in Iran. The increase in self-efficacy suggests that mindfulness training improves the women’s beliefs that they can deal with their situation and the reduction in anxiety suggests that they can approach delivery with greater levels of confidence and relaxation. This should reduce the stress of delivery and increase the likelihood of a satisfactory and health outcome.

 

So, reduce anxiety and improve self-efficacy in pregnancy with mindfulness.

 

“By learning mindfulness skills as part of their childbirth education, expectant mothers can reappraise the impending birth as something they can handle instead of viewing it as something they fear,”- Larissa Duncan

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

 

Zarenejad, M., Yazdkhasti, M., Rahimzadeh, M., Mehdizadeh Tourzani, Z., & Esmaelzadeh-Saeieh, S. (2020). The effect of mindfulness-based stress reduction on maternal anxiety and self-efficacy: A randomized controlled trial. Brain and behavior, 10(4), e01561. https://doi.org/10.1002/brb3.1561

 

Abstract

Objective

The aim of the study was to assess the effect of mindfulness‐based stress reduction (MBSR) on anxiety and self‐efficacy in coping with childbirth.

Material and Methods

This randomized controlled trial was conducted on 70 pregnant women in Abyek city of Qazvin province in Iran. The convenient sampling method was recruited. Samples were assigned to control and intervention groups using random blocks. In addition to routine care, individuals in the intervention group received 6 MBSR training sessions. The data gathering questionnaire in this study included mindfulness, Pregnancy‐Related Anxiety Questionnaire, and self‐efficacy in coping with childbirth questionnaire.

Results

There was no statistically significant difference between the demographic characteristics in the control and intervention groups. The results of the analysis of variance (ANOVA) with repeated measures indicated the effect of time on the change in the total score of anxiety in the intervention group (p = .001). There was a significant difference between the two groups (p = .001). Also, the results of ANOVA with repeated measures showed that time had no impact on the score of self‐efficacy in delivery coping (p = 0/1) and that there was no significant difference between the two groups in this respect (p = .6).

Conclusion

The result of this study showed that mindfulness reduces anxiety of pregnant mothers, and it is suggested that mindfulness programs be educated for healthcare providers and pregnant mothers to reduce maternal anxiety and improve pregnancy outcomes and delivery.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177577/

 

Reduce Distress and Increase Pregnancy in Women with Fertility Problems with Mind-Body Practices

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Reduce Distress and Increase Pregnancy in Women with Fertility Problems with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

“mindfulness becomes the perfect antidote for the paradoxical land mines infertility presents. Mindfulness starts from the perspective that you are whole and complete already, regardless of flaws or imperfections. It is based on the concept of original goodness: your essential nature is good and pure. Proceeding from this vantage point gives you freedom from the bondage of inadequacy and insecurity.” – Janetti Marrota

 

Infertility is primarily a medical condition due to physiological problems. It is quite common. It is estimated that in the U.S. 6.7 million women, about 10% of the population of women 15-44, have an impaired ability to get pregnant or carry a baby to term and about 6% are infertile. Infertility can be more than just a medical issue. It can be an emotional crisis for many couples, especially for the women. Couples attending a fertility clinic reported that infertility was the most upsetting experience of their lives.

 

Women with infertility reported feeling as anxious or depressed as those diagnosed with cancer, hypertension, or recovering from a heart attack. In addition, infertility can markedly impact the couple’s relationship, straining their emotional connection and interactions and the prescribed treatments can take the spontaneity and joy from lovemaking making it strained and mechanical. The stress of infertility and engaging in infertility treatments may exacerbate the problem. Since mindfulness training has been shown to reduce depression, anxiety, and stress it is reasonable to believe that mind-body training may be helpful in reducing the distress in women with fertility issues.

 

In today’s Research News article “An internet-based mind/body intervention to mitigate distress in women experiencing infertility: A randomized pilot trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7080396/), Clifton and colleagues recruited childless adult women who were seeking care for infertility. They were randomly assigned to either a wait-list control condition or to receive a 10-week online program of mind/body for fertility including weekly online modules and homework assignments. “The skills and strategies taught included: (a) knowledge regarding the relationship between stress, lifestyle, and fertility; (b) relaxation techniques including diaphragmatic breathing and Hatha Yoga; (c) mindfulness; (d) cognitive restructuring; (e) stress reduction strategies; (f) listening and communication skills; (g) strategies for emotional expression and effective coping with anger; and (h) assertiveness training and goal-setting skills.” They were measured before and after training for anxiety, depression, perceived stress, and fertility problems.

 

They found that in comparison to baseline and the wait-list control group, the women who received the training had significantly lower levels of anxiety, depression, perceived stress, and infertility related stress specific to sexual and social concerns. At the end of the study the women who received the training had significantly higher self-reported pregnancy rates. 53% of the trained women reported successful pregnancy while only 20% of the wait-list control women did.

 

The study was a randomized controlled trial but the control condition, wait-list, was passive. It would be important for future research to include an active control condition, such as online health education. In addition, the program included a complex set of practices and it is impossible to tease apart what components or combination of components were necessary for the effects observed. It would be interesting in future research to examine the effectiveness of the individual components.

 

Nevertheless, these are interesting and potentially important findings. The online mind/body for fertility program produced significant reductions in the distress levels of the women and increased the likelihood of becoming pregnant. By reducing the psychological distress produced by infertility the program appeared to markedly improve the likelihood of becoming pregnant. This is very helpful in reducing the suffering produced by infertility and thereby improving pregnancy success..

 

In addition, the fact that the program was implemented online makes it scalable at low cost to large groups of women over wide geographic areas and the women can engage in the program at times and places that were most comfortable and convenient for them. This greatly expands the usefulness of the program.

 

So, reduce distress and increase pregnancy in women with fertility problems with mind-body practices.

 

“Many women fear that becoming mindful and starting to meditate will make them passive in their quest for a child.  This simply isn’t so.  The wish for a child remains vibrant and active – it’s simply that happiness doesn’t depend on the fulfillment of this wish.” – Beth Heller

 

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

 

Clifton, J., Parent, J., Seehuus, M., Worrall, G., Forehand, R., & Domar, A. (2020). An internet-based mind/body intervention to mitigate distress in women experiencing infertility: A randomized pilot trial. PloS one, 15(3), e0229379. https://doi.org/10.1371/journal.pone.0229379

 

Abstract

Objective

To determine if an internet-based mind/body program would lead to participants experiencing infertility (1) being willing to be recruited and randomized and (2) accepting and being ready to engage in a fertility-specific intervention. Secondary exploratory goals were to examine reduced distress over the course of the intervention and increased likelihood to conceive.

Methods

This was a pilot randomized controlled feasibility trial with a between-groups, repeated measure design. Seventy-one women self-identified as nulliparous and meeting criteria for infertility. Participants were randomized to the internet-based version of the Mind/Body Program for Fertility or wait-list control group and asked to complete pre-, mid- and post-assessments. Primary outcomes include retention rates, number of modules completed, and satisfaction with intervention. Secondary exploratory outcomes sought to provide preliminary data on the impact of the program on distress (anxiety and depression) and self-reported pregnancy rates relative to a quasi-control group.

Results

The retention, adherence, and satisfaction rates were comparable to those reported in other internet-based RCTs. Although time between pre- and post-assessment differed between groups, using intent-to-treat analyses, women in the intervention group (relative to the wait-list group) had significant reduction in distress (anxiety, p = .003; depression, p = .007; stress, p = .041 fertility-social, p = .018; fertility-sexual, p = .006), estimated as medium-to-large effect sizes (ds = 0.45 to 0.86). The odds of becoming pregnant was 4.47 times higher for the intervention group participants as compared to the wait-list group, OR 95% CI [1.56, 12.85], p = .005 and occurred earlier. The findings suggest that the research design and program specific to this population are feasible and acceptable. Replication efforts with an active control group are needed to verify distress reduction and conception promotion findings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7080396/

 

Reduce Anxiety and Depression with COPD with Mind-Body practices

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Reduce Anxiety and Depression with COPD with Mind-Body practices

 

By John M. de Castro, Ph.D.

 

“We found that yoga can be a simple, cost-effective method that can help improve quality of life in patients with COPD.” – Randeep Guleria

 

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

 

There is no cure for COPD. Treatments include lifestyle changes, medicine, bronchodilators, steroids, pulmonary rehabilitation, oxygen therapy, and surgery. They all attempt to relieve symptoms, slow the progress of the disease, improve exercise tolerance, prevent and treat complications, and improve overall health. Gentle mind-body exercise such as Yoga, Tai Chi and Qigong practices could improve COPD symptoms. Yoga has been shown to improve exercise tolerance and overall health and includes breathing exercises. Indeed, it has been shown that yoga practice improves the mental and physical health of patients with COPD. Mindful movement practices such Tai Chi and Qigong are ancient Chinese practices involving mindfulness and gentle movements. They are easy to learn, safe, and gentle. So, it may be appropriate for patients with COPD who lack the ability to engage in strenuous exercises to engage in these gentle mind-body practices.

 

In today’s Research News article “Mind-Body Exercise for Anxiety and Depression in COPD Patients: 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/PMC6981896/), Li and colleagues review, summarize, and perform a meta-analysis of the published research studies of the effectiveness of mind-body practices on the symptoms of Chronic Obstructive Pulmonary Diseases (COPD).

 

They found 13 peer-reviewed randomized controlled trials; 7 employing Qigong, 3 Tai Chi, and 3 yoga. They report that the published research found that mind-body practices produced significant reductions in anxiety and depression in patients with Chronic Obstructive Pulmonary Diseases (COPD).

 

Mindfulness practices, in general have been found to reduce anxiety and depression. The present review extends this effectiveness to mind-body mindfulness practices with patients with COPD. The mechanisms by which these practices produce these effects are not known. But all these practices involve focusing on the present moment. Anxiety is produced by fear of the future while depression is produced by rumination about the past. While focusing on the present, anxiety and depression are eliminated. Obviously, training does not eliminate thinking about the past and future. But, it may reduce the amount of time spent outside the present moment and thereby reduce the overall levels of anxiety and depression.

 

So, Reduce Anxiety and Depression with COPD with Mind-Body practices.

 

“The challenge for meditators with a history of asthma, COPD, or other breathing problems is that the seemingly simple process of breathing is entangled with fear, anxiety, and other difficult emotions.” – Susan Haejin Lee

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Li, Z., Liu, S., Wang, L., & Smith, L. (2019). Mind-Body Exercise for Anxiety and Depression in COPD Patients: A Systematic Review and Meta-Analysis. International journal of environmental research and public health, 17(1), 22. https://doi.org/10.3390/ijerph17010022

 

Abstract

Objectives: Mind–body exercise has been generally recognized as a beneficial strategy to improve mental health in those with Chronic Obstructive Pulmonary Disease (COPD). However, to date, no attempt has been made to collate this literature. The aim of the present study was to systematically analyze the effects of mind–body exercise for COPD patients with anxiety and depression and provide scientific evidence-based exercise prescription. Methods: both Chinese and English databases (PubMed, the Cochrane Library, EMBASE, Web of Science, Google Scholar, Chinese National Knowledge Infrastructure, Wanfang, Baidu Scholar) were used as sources of data to search randomized controlled trials (RCT) relating to mind–body exercise in COPD patients with anxiety and depression that were published between January 1982 to June 2019. 13 eligible RCT studies were finally used for meta-analysis. Results: Mind–body exercise (tai chi, health qigong, yoga) had significant benefits on COPD patients with anxiety (SMD = −0.76, 95% CI −0.91 to −0.60, p = 0.04, I2 = 47.4%) and depression (SMD = −0.86, 95% CI −1.14 to −0.58, p = 0.000, I2 = 71.4%). Sub-group analysis indicated that, for anxiety, 30–60 min exercise session for 24 weeks of health qigong or yoga had a significant effect on patients with COPD who are more than 70 years and have more than a 10-year disease course. For depression, 2–3 times a week, 30–60 min each time of health qigong had a significant effect on patients with COPD patients who are more than 70 years old and have less than a 10-year disease course. Conclusions: Mind–body exercise could reduce levels of anxiety and depression in those with COPD. More robust RCT are required on this topic.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6981896/

 

Improve Self-Compassion with Psychophysiological Flexibility and Mindfulness

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Improve Self-Compassion with Psychophysiological Flexibility and Mindfulness

By John M. de Castro, Ph.D.

 

“self-compassion is strongly associated with emotional wellbeing, coping with life challenges, lower levels of anxiety and depression, healthy habits such as diet and exercise, and more satisfying personal relationships. It is an inner strength that enables us to be more fully human—to acknowledge our shortcomings, learn from them, and make necessary changes with an attitude of kindness and self-respect.” – Greater Good Science Center

 

One of the more remarkable aspects of Western culture is that in general people do not like themselves. We are constantly comparing ourselves to others and since there can only one best, virtually everyone falls short. So, we constantly criticize ourselves for not being the smartest, the swiftest, the strongest, the most liked, the most handsome or beautiful. If there wasn’t something wrong with us, then we would be the best. As a result, we become focused and obsessed with our flaws. This can lead to anxiety and worry.

 

Mindfulness promotes experiencing and accepting ourselves as we are, which is a direct antidote to seeing ourselves in comparison to others and as we wish to be. In other words, mindfulness promotes self-compassion. Self-compassion involves being warm and understanding about ourselves rather than self-criticism. If we have that attitude, we will like ourselves more and suffer less. So, it is important to study the mindfulness and self-compassion and their relationships with the ability to regulate emotional arousal.

 

In today’s Research News article “Is Dispositional Self-Compassion Associated With Psychophysiological Flexibility Beyond Mindfulness? An Exploratory Pilot Study.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2020.00614/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1302118_69_Psycho_20200416_arts_A), Svendsen and colleagues recruited college students and had them complete scales measuring self-compassion, mindfulness, anxiety, and rumination. They also had their cardiac function measured at rest with an electrocardiogram (ECG). This was used to calculate the vagally mediated heart rate variability as a measure of psychophysiological flexibility. It measures the interplay between the parasympathetic and sympathetic branches of the autonomic nervous system, with higher heart rate variability signaling parasympathetic predominance, usually indicating relaxation.

 

Employing regression analysis, they found that the higher the levels of self-compassion the higher the levels of mindfulness and psychophysiological flexibility. They also found that both higher levels of mindfulness and also self-compassion the lower the levels of anxiety and rumination (worry). So, mindfulness is related to self-compassion and lower anxiety and rumination and self-compassion is related to mindfulness and psychophysiological flexibility and lower anxiety and rumination.

 

The findings are correlative and as such causation cannot be determined. But they show that mindfulness is significantly related to self-compassion and both are related to better mental health. In prior manipulative studies, it has been demonstrated that mindfulness causes increased self-compassion and decreased anxiety and rumination. So, the present results likely reflect causal connections.

 

The results also demonstrated that self-compassion has the strongest relationship with psychophysiological flexibility suggesting that self-compassion is related to the ability to regulate emotional arousal. It is this ability that may underlie the lower levels of anxiety and rumination found with high levels of self-compassion. Hence, mindfulness and self-compassion are important components of the mental health of young adults.

 

So, improve self-compassion with psychophysiological flexibility and mindfulness.

 

“mindfulness increases empathy and compassion for others and for oneself, and that such attitudes are good for you. To me, that affirms that when we practice mindfulness, we are simultaneously strengthening our skills of compassion.” – Shauna Shapiro

 

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

 

Svendsen JL, Schanche E, Osnes B, Vøllestad J, Visted E, Dundas I, Nordby H, Binder P-E and Sørensen L (2020) Is Dispositional Self-Compassion Associated With Psychophysiological Flexibility Beyond Mindfulness? An Exploratory Pilot Study. Front. Psychol. 11:614. doi: 10.3389/fpsyg.2020.00614

 

Abstract

Background: Dispositional mindfulness and self-compassion are shown to associate with less self-reported emotional distress. However, previous studies have indicated that dispositional self-compassion may be an even more important buffer against such distress than dispositional mindfulness. To our knowledge, no study has yet disentangled the relationship between dispositional self-compassion and mindfulness and level of psychophysiological flexibility as measured with vagally mediated heart rate variability (vmHRV). The aim was thus to provide a first exploratory effort to expand previous research relying on self-report measures by including a psychophysiological measure indicative of emotional stress reactivity.

Methods: Fifty-three university students filled out the “Five Facet Mindfulness Questionnaire” (FFMQ) and the “Self-Compassion Scale” (SCS), and their heart rate was measured during a 5 min resting electrocardiogram. Linear hierarchical regression analyses were conducted to examine the common and unique variance explained by the total scores of the FFMQ and the SCS on level of resting vmHRV.

Results: Higher SCS total scores associated significantly with higher levels of vmHRV also when controlling for the FFMQ total scores. The SCS uniquely explained 7% of the vmHRV. The FFMQ total scores did not associate with level of vmHRV.

Conclusion: These results offer preliminary support that dispositional self-compassion associates with better psychophysiological regulation of emotional arousal above and beyond mindfulness

https://www.frontiersin.org/articles/10.3389/fpsyg.2020.00614/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1302118_69_Psycho_20200416_arts_A

 

Improve Psychological Health in the COVID-19 pandemic with Mindfulness

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Improve Psychological Health in the COVID-19 pandemic with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Amid ever-changing information around the COVID-19 pandemic, many people are experiencing heightened stress and anxiety. . . Another way to cope with anxiety is to practice mindfulness.” – Cynthia Weiss

 

Modern living is stressful under the best of conditions. But with the COVID-19 pandemic the levels of stress have been markedly increased. These conditions markedly increase anxiety. This is true for everyone but especially for healthcare workers and people caring for patients with COVID-19 and for people with pre-existing conditions that makes them particularly vulnerable. But it is also true for healthy individuals who worry about infection for themselves or loved ones.

 

The COVID-19 pandemic has also produced considerable economic stress, with loss of employment and steady income. For the poor this extends to high levels of food insecurity. This not only produces anxiety about the present but also for the future. It is important for people to engage in practices that can help them control their responses to the stress and their levels of anxiety. Mindfulness practices have been found routinely to reduce the psychological and physiological responses to stress, reduce anxiety levels, and improve mood.

 

In today’s Research News article “The benefits of meditation and mindfulness practices during times of crisis such as COVID-19.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7287297/), Behan discusses the uses of mindfulness practices for helping individuals cope with the stress and anxiety surrounding the COVID-19 pandemic. It is asserted that the pandemic produces psychological issues for individuals and also for those tasked with caring for them and that these issues can be ameliorated with mindfulness practice.

 

For the individual mindfulness practice can be helpful in coping with the anxiety about infection or the future, depression, loneliness, and reduction in quality of life resulting from isolation, physical and psychological manifestations of stress produced by financial and employment concerns or family or relationship difficulties, the strong emotions and general distress produced, the frustration resulting from feelings of helplessness, and the worry and rumination about the present situation and the future or the health of loved ones. Mindfulness practice can even strengthen the immune system to better fight off the infection.

 

For first responders and healthcare workers the pandemic produces a number of difficult issues that may be helped by mindfulness practice. Being mindful or engaging in mindfulness practices can be helpful in coping with the physical and psychological manifestations of stress produced by long hours of working with very sick people with a highly infectious disease, the depression resulting from separation from family and loved ones, the post-traumatic stress disorder that can be produced by repeated exposure to suffering and death, and burnout that can result from the overwhelming quantity and seriousness of the symptoms. In addition mindfulness can help build empathy, compassion, patience, and flexibility that are so important for the treatment of the patients, resilience to withstand the stresses, and the ability to effectively cope with the strong emotions produced.

 

Mindfulness practices have a wide variety of benefits that can be very helpful to the individual and those charged with caring for them in coping with the varied effects of the pandemic. So, improve psychological health in the COVID-19 pandemic by being mindful and engaging in mindfulness practices.

 

“There is so much uncertainty about what is to come, and we have less opportunity for social support than in other crises.  Some are already ill, others know someone who is, and many are caring for those who have COVID-19.  In these circumstances, it can be easy to feel frightened and overwhelmed.  Having a regular mindfulness practice can be helpful.” – John Schorling

 

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

 

Behan C. (2020). The benefits of meditation and mindfulness practices during times of crisis such as COVID-19. Irish journal of psychological medicine, 1–3. Advance online publication. https://doi.org/10.1017/ipm.2020.38

 

Abstract

Meditation and mindfulness are practices that can support healthcare professionals, patients, carers and the general public during times of crisis such as the current global pandemic caused by COVID-19. While there are many forms of meditation and mindfulness, of particular interest to healthcare professionals are those with an evidence base such as mindfulness-based stress reduction (MBSR). Systematic reviews of such practices have shown improvements in measures of anxiety, depression and pain scores. Structural and functional brain changes have been demonstrated in the brains of people with a long-term traditional meditation practice, and in people who have completed a MBSR programme. Mindfulness and meditation practices translate well to different populations across the lifespan and range of ability. Introducing a mindfulness and meditation practice during this pandemic has the potential to complement treatment and is a low-cost beneficial method of providing support with anxiety for all.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7287297/

 

Improve the Psychological Health in Breast Cancer Patients with Mindfulness

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Improve the Psychological Health in Breast Cancer Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is a state of mind which we can all acquire and use to support our wellbeing physically, emotionally and mentally.  . . Having cancer, or specifically breast cancer, is no exception. Our cancer experiences take up a lot of energies, mental focus and can drain us emotionally. It is important to have a few tools to help us create ‘down’ and ‘out’ times, and to replenish and reconnect with who we are. “ – Breast Cancer Now

 

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

 

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

 

In today’s Research News article “Mindfulness-based stress reduction for women diagnosed with breast cancer.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436161/), Schell and colleagues review, summarize, and perform a meta-analysis of the published research studies investigating the effectiveness of the Mindfulness-Based Stress Reduction (MBSR) program for the treatment of the psychological problems that occur in women who survive breast cancer. MBSR includes meditation, body scan, yoga practices, and discussion along with daily home practice. They identified 14 randomized controlled trials.

 

They report that the published research studies provide evidence that the Mindfulness-Based Stress Reduction (MBSR) program improves the quality of life and sleep and reduces anxiety, depression, and fatigue in breast cancer patients. The effect sizes are small and the effects were no longer present at long-term follow-up a year after the end of treatment. MBSR is a complex of practices and the research to date cannot differentiate which components or which combination of components are responsible for the benefits.

 

There is substantial evidence that mindfulness training improves quality of life and sleep and reduces anxiety, depression, and fatigue in a wide variety of healthy and ill individuals. The present results suggest that it also has these benefits for women suffering with breast cancer. Hence, MBSR may be recommended to improve the psychological health of breast cancer patients.

 

So, improve the psychological health in breast cancer patients with mindfulness.

 

“Studies have shown mindfulness-based stress reduction can be effective in alleviating anxiety and depression, decreasing long-term emotional and physical side effects of treatments and improving the quality of sleep in breast cancer patients.” – Breast Cancer Research Foundation

 

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

 

Schell, L. K., Monsef, I., Wöckel, A., & Skoetz, N. (2019). Mindfulness-based stress reduction for women diagnosed with breast cancer. The Cochrane database of systematic reviews, 3(3), CD011518. https://doi.org/10.1002/14651858.CD011518.pub2

 

Abstract

Background

Breast cancer is the most common cancer in women. Diagnosis and treatment may drastically affect quality of life, causing symptoms such as sleep disorders, depression and anxiety. Mindfulness‐based stress reduction (MBSR) is a programme that aims to reduce stress by developing mindfulness, meaning a non‐judgmental, accepting moment‐by‐moment awareness. MBSR seems to benefit patients with mood disorders and chronic pain, and it may also benefit women with breast cancer.

Objectives

To assess the effects of mindfulness‐based stress reduction (MBSR) in women diagnosed with breast cancer.

Search methods

In April 2018, we conducted a comprehensive electronic search for studies of MBSR in women with breast cancer, in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and two trial registries (World Health Organization’s International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov). We also handsearched relevant conference proceedings.

Selection criteria

Randomised clinical trials (RCTs) comparing MBSR versus no intervention in women with breast cancer.

Data collection and analysis

We used standard methodological procedures expected by Cochrane. Using a standardised data form, the review authors extracted data in duplicate on methodological quality, participants, interventions and outcomes of interest (quality of life, fatigue, depression, anxiety, quality of sleep, overall survival and adverse events). For outcomes assessed with the same instrument, we used the mean difference (MD) as a summary statistic for meta‐analysis; for those assessed with different instruments, we used the standardised mean difference (SMD). The effect of MBSR was assessed in the short term (end of intervention), medium term (up to 6 months after intervention) and long term (up to 24 months after intervention).

Main results

Fourteen RCTs fulfilled our inclusion criteria, with most studies reporting that they included women with early breast cancer. Ten RCTs involving 1571 participants were eligible for meta‐analysis, while four studies involving 185 participants did not report usable results. Queries to the authors of these four studies were unsuccessful. All studies were at high risk of performance and detection bias since participants could not be blinded, and only 3 of 14 studies were at low risk of selection bias. Eight of 10 studies included in the meta‐analysis recruited participants with early breast cancer (the remaining 2 trials did not restrict inclusion to a certain cancer type). Most trials considered only women who had completed cancer treatment.

MBSR may improve quality of life slightly at the end of the intervention (based on low‐certainty evidence from three studies with a total of 339 participants) but may result in little to no difference up to 6 months (based on low‐certainty evidence from three studies involving 428 participants). Long‐term data on quality of life (up to two years after completing MBSR) were available for one study in 97 participants (MD 0.00 on questionnaire FACT‐B, 95% CI −5.82 to 5.82; low‐certainty evidence).

In the short term, MBSR probably reduces fatigue (SMD −0.50, 95% CI −0.86 to −0.14; moderate‐certainty evidence; 5 studies; 693 participants). It also probably slightly reduces anxiety (SMD −0.29, 95% CI −0.50 to −0.08; moderate‐certainty evidence; 6 studies; 749 participants), and it reduces depression (SMD −0.54, 95% CI −0.86 to −0.22; high‐certainty evidence; 6 studies; 745 participants). It probably slightly improves quality of sleep (SMD −0.38, 95% CI −0.79 to 0.04; moderate‐certainty evidence; 4 studies; 475 participants). However, these confidence intervals (except for short‐term depression) are compatible with both an improvement and little to no difference.

In the medium term, MBSR probably results in little to no difference in medium‐term fatigue (SMD −0.31, 95% CI −0.84 to 0.23; moderate‐certainty evidence; 4 studies; 607 participants). The intervention probably slightly reduces anxiety (SMD −0.28, 95% CI −0.49 to −0.07; moderate‐certainty evidence; 7 studies; 1094 participants), depression (SMD −0.32, 95% CI −0.58 to −0.06; moderate‐certainty evidence; 7 studies; 1097 participants) and slightly improves quality of sleep (SMD −0.27, 95% CI −0.63 to 0.08; moderate‐certainty evidence; 4 studies; 654 participants). However, these confidence intervals are compatible with both an improvement and little to no difference.

In the long term, moderate‐certainty evidence shows that MBSR probably results in little to no difference in anxiety (SMD −0.09, 95% CI −0.35 to 0.16; 2 studies; 360 participants) or depression (SMD −0.17, 95% CI −0.40 to 0.05; 2 studies; 352 participants). No long‐term data were available for fatigue or quality of sleep.

No study reported data on survival or adverse events.

Authors’ conclusions

MBSR may improve quality of life slightly at the end of the intervention but may result in little to no difference later on. MBSR probably slightly reduces anxiety, depression and slightly improves quality of sleep at both the end of the intervention and up to six months later. A beneficial effect on fatigue was apparent at the end of the intervention but not up to six months later. Up to two years after the intervention, MBSR probably results in little to no difference in anxiety and depression; there were no data available for fatigue or quality of sleep.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436161/

 

Improve Mental Health with Yoga

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Improve Mental Health with Yoga

 

By John M. de Castro, Ph.D.

 

“for many patients dealing with depression, anxiety, or stress, yoga may be a very appealing way to better manage symptoms. . . The evidence is growing that yoga practice is a relatively low-risk, high-yield approach to improving overall health.” – Harvard Health

 

Mindfulness practice has been shown to improve emotions and their regulation. Practitioners demonstrate more positive and less negative emotions and the ability to fully sense and experience emotions, while responding to them in appropriate and adaptive ways. The ability of mindfulness training to improve emotion regulation is thought to be the basis for a wide variety of benefits that mindfulness provides to mental health and the treatment of mental illness especially depression and anxiety disorders.

 

Exercise has also been shown to improve mental health. Yoga is both a mindfulness practice and an exercise. It has been shown to have a myriad of benefits for psychological and physical health, social, and spiritual well-being. There has accumulated a wealth of research studies of the effects of yoga practice on mental health. It makes sense to take a look at what has been learned. In today’s Research News article “Applications of Yoga in Psychiatry: What We Know.” (See summary below or view the full text of the study at:), Nyer and colleagues review and summarize the published research studies of the effectiveness of yoga practice and exercise for the treatment of psychological problems.

 

They report that the published research studies found that there was a powerful effect of yoga practice on depression, including major depressive disorders, even in patients who did not respond to antidepressant drugs. They also report that yoga practice is a safe and effective treatment for anxiety disorders, including generalized anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder, PTSD.

 

They report that the research postulates a number of potential mechanisms for yoga’s ability to improve depressive and anxiety disorders. These disorders are associated with an imbalance in the autonomic nervous system such that sympathetic activity, activation, predominates over parasympathetic activity, relaxation. Yoga practice has been shown to rebalance these systems, strengthening parasympathetic activity. Also, high levels of perceived stress have also been found to be associated with depressive and anxiety disorders and yoga practice has been shown to reduce perceived stress levels. In addition, depressive and anxiety disorders are characterized by excessive emotions and yoga practice has been found to improve the individual’s ability to regulate their emotions. These are thought to be a potential explanations for yoga’s effectiveness.

 

So, improve mental health with yoga.

 

“In Sanskrit, yoga means to unite. As you grow in your ability to sense the relationship between your mind and body, you become more aware of dualities that exist in experience. The practice of yoga brings you to the awareness that there is a relationship between two ends of one phenomenon. You are body and mind.” – Deborah Khoshaba

 

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

 

Nyer, M., Nauphal, M., Roberg, R., & Streeter, C. (2018). Applications of Yoga in Psychiatry: What We Know. Focus (American Psychiatric Publishing), 16(1), 12–18. https://doi.org/10.1176/appi.focus.20170055

 

Abstract

Yoga has been in use for thousands of years in the East as a healing modality. Western practitioners are now starting to recognize the potential of yoga-based treatments. The purpose of this article is to explore the evidence-base of yoga-based treatments for depression and anxiety with the purpose of furthering the integration of yoga into conventional Western mental health treatment plans.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519580/

 

Improve Generalized Anxiety Disorder with Acceptance and Commitment Therapy (ACT)

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Improve Generalized Anxiety Disorder with Acceptance and Commitment Therapy (ACT)

 

By John M. de Castro, Ph.D.

 

“Acceptance and commitment therapy (ACT) is a type of psychotherapy gaining popularity in the treatment of anxiety disorders like generalized anxiety disorder (GAD). It is also used to treat other conditions including depression, eating disorders, chronic pain, and substance use disorders.” – Deborah Glasofer

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. A characterizing feature of anxiety disorders is that the suffer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Anxiety disorders have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for anxiety. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders.

 

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

 

In today’s Research News article “A Multiple-Baseline Evaluation of Acceptance and Commitment Therapy Focused on Repetitive Negative Thinking for Comorbid Generalized Anxiety Disorder and Depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082425/), Ruiz and colleagues recruited 6 adults with Generalized Anxiety Disorder (GAD) and also depression. They received a 3 session Acceptance and Commitment Therapy (ACT) protocol of 90, 60, and 60 minutes focused on repetitive negative thinking implemented at different times on a multiple baseline. They were measured weekly over the internet for emotional symptoms (a combination of anxiety, depression and perceived stress), worry, experiential avoidance, cognitive fusion, perseverative thinking, and valuing.

 

They found that all participants demonstrated no significant changes during the 5 or more weeks of the baseline period in emotional symptoms or worry. But once Acceptance and Commitment Therapy (ACT) was provided all participants immediately demonstrated a precipitous decline in emotional symptoms, worry, experiential avoidance, cognitive fusion, and perseverative thinking that was maintained for 3 months. Effect sizes were very large and 5 of the 6 participants had clinically significant changes in emotional symptoms and worry.

 

It is well established that mindfulness training reduces anxiety, depression, perceived, stress, and worry. Nevertheless, the results of the present study are striking. Administration of a brief Acceptance and Commitment Therapy (ACT)  focused on repetitive negative thinking produced dramatic clinically significant improvements in the core symptoms of Generalized Anxiety Disorder (GAD) and depression. The fact that this was accomplished in 3-sessions is important as it reduces the investment of therapists in treatment, reducing costs and improving the numbers of people being able to be treated. These findings suggest that this brief form of mindfulness-based therapy be implemented for anxiety and deprressive disorders.

 

So, improve Generalized Anxiety Disorder with Acceptance and Commitment Therapy (ACT).

 

“ACT helps you take action on your values, instead of letting your anxiety dictate your decisions and your days.” –  Margarita Tartakovsky

 

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

 

Ruiz, F. J., Luciano, C., Flórez, C. L., Suárez-Falcón, J. C., & Cardona-Betancourt, V. (2020). A Multiple-Baseline Evaluation of Acceptance and Commitment Therapy Focused on Repetitive Negative Thinking for Comorbid Generalized Anxiety Disorder and Depression. Frontiers in psychology, 11, 356. https://doi.org/10.3389/fpsyg.2020.00356

 

Abstract

Repetitive negative thinking (RNT) is a core feature of generalized anxiety disorder (GAD) and depression. Recently, some studies have shown promising results with brief protocols of acceptance and commitment therapy (ACT) focused on RNT in the treatment of emotional disorders in adults. The current study analyzes the effect of an individual, 3-session, RNT-focused ACT protocol in the treatment of severe and comorbid GAD and depression. Six adults meeting criteria for both disorders and showing severe symptoms of at least one of them participated in the study. A delayed multiple-baseline design was implemented. All participants completed a 5-week baseline without showing improvement trends in emotional symptoms (Depression Anxiety and Stress Scale – 21; DASS-21) and pathological worry (Penn State Worry Questionnaire; PSWQ). The ACT protocol was then implemented, and a 3-month follow-up was conducted. Five of the six participants showed clinically significant changes in the DASS-21 and the PSWQ. The standardized mean difference effect sizes for single-case experimental design were very large for emotional symptoms (d = 3.34), pathological worry (d = 4.52), experiential avoidance (d = 3.46), cognitive fusion (d = 3.90), repetitive thinking (d = 4.52), and valued living (d = 0.92 and d = 1.98). No adverse events were observed. Brief, RNT-focused ACT protocols for treating comorbid GAD and depression deserve further empirical tests.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082425/

 

Reduce Anxiety and Depression in Coronary Heart Disease Patients with Tai Chi

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Reduce Anxiety and Depression in Coronary Heart Disease Patients with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Tai chi is an interesting, promising exercise option. I think based on what we found, it’s a reasonable and safe step to offer tai chi within cardiac rehab.” – Elena Salmoriago-Blotcher

 

Cardiovascular disease is the number one killer, claiming more lives than all forms of cancer combined. There are myriads of treatments that have been developed to treat cardiovascular disease including a variety of surgical procedures and medications. Importantly, lifestyle changes have proved to be quite effective. These include quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Contemplative practices, such as meditation, tai chi, and yoga, have also been shown to be helpful for heart health. These practices have also been shown to be helpful for producing the kinds of other lifestyle changes needed such as smoking cessation, weight reduction and stress reduction.

 

Cardiac rehabilitation programs for patients recovering from implantation of a stent for coronary heart disease, emphasize lifestyle changes. Unfortunately, for a variety of reasons, 60% of coronary heart disease patients decline participation, making these patients at high risk for a heart attack.  Tai Chi and Qigong are ancient mindfulness practices involving slow prescribed movements. They are gentle and completely safe, can be used with the elderly and sickly, are inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, they can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Since Tai Chi is both a mindfulness practice and a gentle exercise, it may be an acceptable, safe, and effective treatment for coronary heart disease patients.

 

In today’s Research News article “The 24-Form Tai Chi Improves Anxiety and Depression and Upregulates miR-17-92 in Coronary Heart Disease Patients After Percutaneous Coronary Intervention.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078346/), Liu and colleagues recruited coronary heart disease patients who had a myocardial infarction and a stent implanted less than 4 days prior. The patients received usual care and were randomly assigned to receive either no further treatment or Tai Chi practice twice a day for 60 minutes for 10 months. They were measured before and after the 10-month practice period for anxiety, depression, perceived stress, and quality of life. In addition, blood was drawn and measured for miR-17-92.

 

They found that in comparison to baseline and the control group, the group that received Tai Chi training had significantly lower levels of anxiety, depression, and perceived stress and significantly higher levels of quality of life and miR-17-92. In addition, they found that the higher the levels of miR-17-92 the lower the levels of anxiety, depression, and perceived stress.

 

It should be noted that the control condition was not active. Future research should have an active control that performed some other activity of comparable duration, perhaps another type of exercise or health education. Nevertheless, the results show that Tai Chi practice can significantly improve the psychological well-being of coronary heart disease patients after surgery to insert a stent.

 

Prior research has demonstrated the RNA segments are associated with anxiety and depression. The current research also detected this relationship. But the study also demonstrated that the improvements in anxiety, depression, and perceived stress were associated with increased levels of miR-17-92. This may indicate a mechanism of action by which Tai Chi practice improves psychological well-being. It remains for future research to further explore this interesting possibility.

 

So, reduce anxiety and depression in coronary heart disease patients with Tai Chi.

 

“Tai chi shows promise for patients with existing heart disease. Participants in the intensive tai chi program were significantly more active, lost more weight and reported a higher quality of life.” – CardioSmart

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Liu, J., Yu, P., Lv, W., & Wang, X. (2020). The 24-Form Tai Chi Improves Anxiety and Depression and Upregulates miR-17-92 in Coronary Heart Disease Patients After Percutaneous Coronary Intervention. Frontiers in physiology, 11, 149. https://doi.org/10.3389/fphys.2020.00149

 

Abstract

Background

Anxiety and depression are common symptoms in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI). The 24-form Tai Chi may exert a protective function for CHD patients after PCI by improving anxiety and depression.

Methods

Patients who received PCI after 1–4 days were randomly assigned to the 24-form Tai Chi group (TG) and the control group (CG). The differences in anxiety and depression, using the Medical Outcomes Study 36−item Short−Form Health Survey (SF-36), before and after an average of 10 months of Tai Chi intervention were compared in both groups to analyze the effects of Tai Chi on the emotion and the life quality of CHD patients. Meanwhile, the relative levels of miR-17-92 were measured by using real-time qPCR. The association between the relative levels of miR-17-92 and the anxiety and the depression of CHD patients after PCI was analyzed. Adjusted Cox models were used to explore the effect of Tai Chi exercise in CHD patients.

Results

After 10 months of intervention, the changes in the anxiety subscale (P = 0.002), in the depression subscale (P = 0.008), and in the stress (P = 0.015) scores were higher in the TG group when compared to those of the CG group. The proportion of anxious (P = 0.045) and depressed subjects (P = 0.042) in the TG group was lower than that in the CG group. On the other hand, the increase in the SF-36 scores and in the relative levels of miR-17-92 was significantly higher in the TG group when compared with that of the CG group (P < 0.05). The serum level of miR-17-92 had a negative correlation with the anxiety, the depression, and the stress scores (P < 0.01).

Conclusion

The 24-form Tai Chi improved the anxiety and the depression symptoms and upregulated the miR-17-92 levels in CHD patients after PCI.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078346/