Anxiety

Improve Body Size, Endocrine Function, and Anxiety in Anxious Obese Children with Mindfulness

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Improve Body Size, Endocrine Function, and Anxiety in Anxious Obese Children with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is a promising tool to be used as an adjunctive therapy for childhood obesity, either because of its potential to decrease stress or because it could counter act the stressful condition imposed by a restrictive dietary regimen,” – Mardia López-Alarcón

 

Obesity has become an epidemic in the industrialized world. In the U.S. the incidence of obesity, defined as a Body Mass Index (BMI) of 30 or above has more than doubled over the last 35 years to currently around 35% of the population, while two thirds of the population are considered overweight or obese (BMI > 25). Sadly, children and adolescents have not been spared with 1 in 5 school age children and young people (6 to 19 years) classified as obese.

 

Although the incidence rates have appeared to stabilize, the fact that over a third of the population is considered obese is very troubling. This is because of the health consequences of obesity. Obesity has been found to shorten life expectancy by eight years and extreme obesity by 14 years. This occurs because obesity is associated with cardiovascular problems such as coronary heart disease and hypertension, stroke, metabolic syndrome, diabetes, cancer, arthritis, and others.

 

Obviously, there is a need for effective treatments to prevent or treat obesity. But, despite copious research and a myriad of dietary and exercise programs, there still is no safe and effective treatment. Mindfulness is known to be associated with lower risk for obesity, alter eating behavior and improve health in obesity. This suggests that mindfulness training may be an effective treatment for overeating and obesity in children alone or in combination with other therapies. It would seem reasonable to attack the problem early in life with the children and adolescents. Hence, the benefits of mindfulness practice for obese children should be investigated.

 

In today’s Research News article “Mindfulness affects stress, ghrelin, and BMI of obese children: a clinical trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7040861/), López-Alarcón and colleagues recruited obese children and adolescents aged 10-17 years who scored high in anxiety levels and provided them with an 8-week, once a week for a half hour conventional nutritional intervention including recommendations for a 700 Kcal reduction in intake. They were then randomly assigned to receive either no further treatment or to receive an 8-week, once a week for 2 hours Mindfulness-Based Stress Reduction-Eat Mindful program based upon the Mindfulness-Based Stress Reduction (MBSR) program consisting on training in meditation, body scan, breathing exercises, mindful eating, and discussions of using mindfulness in everyday life. They were measured before and after the program and 8 weeks later for body size, perceived stress, and anxiety. Blood was drawn and assayed for insulin, cortisol, ghrelin, and leptin and a salivary sample was assayed for cortisol levels.

 

They found that in comparison to the baseline and the nutritional intervention only, the children and adolescents who received mindfulness training had significant reduction in anxiety levels of all forms, including phobias, generalized anxiety, obsessive-compulsive disorder, and separation anxiety. Also, there were significant reductions in body fat, cortisol, and ghrelin levels. In addition, at the 8- and 16-week follow-ups there were significant reductions in body size.

 

These are exciting results. Childhood obesity is major problem and the results of this study suggests that a mindfulness training program combined with a conventional nutritional intervention is safe and effective in improving the physical and psychological effects of obesity and in reducing body size. Mindfulness interventions have been shown to be effective in reducing anxiety in adults. But these programs have been found to have only small or mixed effectiveness in the treatment of adult obesity. But the present results suggest that mindfulness interventions may be particularly effective when applied to obese children and adolescents. A long-term follow up of these children is needed to determine the long-term effectiveness of mindfulness training.

 

So, improve body size, endocrine function, and anxiety in anxious obese children with mindfulness.

 

“We think mindfulness could recalibrate the imbalance in the brain connections associated with childhood obesity,” – Ronald Cowan

 

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

 

López-Alarcón, M., Zurita-Cruz, J. N., Torres-Rodríguez, A., Bedia-Mejía, K., Pérez-Güemez, M., Jaramillo-Villanueva, L., Rendón-Macías, M. E., Fernández, J. R., & Martínez-Maroñas, P. (2020). Mindfulness affects stress, ghrelin, and BMI of obese children: a clinical trial. Endocrine connections, 9(2), 163–172. https://doi.org/10.1530/EC-19-0461

 

Abstract

Childhood obesity is associated with stress. However, most treatment strategies include only dietary and physical activity approaches. Mindfulness may assist in weight reduction, but its effectiveness is unclear. We assessed the effect of mindfulness on stress, appetite regulators, and weight of children with obesity and anxiety. A clinical study was conducted in a pediatric hospital. Eligible children were 10–14 years old, BMI ≥95th percentile, Spence anxiety score ≥55, and who were not taking any medication or supplementation. Participants were assigned to receive an 8-week conventional nutritional intervention (CNI) or an 8-week mindfulness-based intervention plus CNI (MND-CNI). Anthropometry, body composition, leptin, insulin, ghrelin, cortisol, and Spence scores were measured at baseline and at the end of the intervention. Anthropometry was analyzed again 8 weeks after concluding interventions. Log-transformed and delta values were calculated for analysis. Thirty-three MND-CNI and 12 CNI children finished interventions; 17 MND-CNI children accomplished 16 weeks. At the end of the intervention, significant reductions in anxiety score (−6.21 ± 1.10), BMI (−0.45 ± 1.2 kg/m2), body fat (−1.28 ± 0.25%), ghrelin (−0.71 ± 0.37 pg/mL), and serum cortisol (−1.42 ± 0.94 µg/dL) were observed in MND-CNI children. Changes in anxiety score, ghrelin, and cortisol were different between groups (P < 0.05). Children who completed 16 weeks decreased BMI after intervention (−0.944 ± 0.20 kg/m2, P < 0.001) and remained lower 8 weeks later (−0.706 ± 0.19 kg/m2, P = 0.001). We concluded that mindfulness is a promising tool as an adjunctive therapy for childhood obesity. However, our findings need confirmation in a larger sample population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7040861/

 

Relieve Generalized Anxiety Disorder with Mindfulness

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Relieve Generalized Anxiety Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“a way to reduce the symptoms of anxiety is to be fully, mindfully, anxious. As anxiety reveals itself to be a misperception, symptoms will dissipate.” – George Hofmann

 

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. One way that this training might affect anxiety disorders is by reducing negative interpretation bias. This involves a tendency to interpret relatively ambiguous situations as threatening. Indeed, such bias is characteristic of patients with anxiety disorders.

 

In today’s Research News article “Investigating the Role of Interpretation Bias in Mindfulness-Based Treatment of Adults With Generalized Anxiety Disorder.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2020.00082/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1254058_69_Psycho_20200225_arts_A), Hoge and colleagues recruited adult patients with Generalized Anxiety Disorder (GAD) and provided them with an 8-week program in Mindfulness-Based Stress Reduction (MBSR). The program involves weekly 2-hour sessions consisting of meditation, body scan, yoga, and discussion with daily home practice. The patients were measured before and after training for mindfulness, anxiety, and interpretation bias.

 

They found that in comparison to baseline, after Mindfulness-Based Stress Reduction (MBSR) training there were significant increases in mindfulness and significant decreases in anxiety and interpretation bias. They then performed mediation analysis and found that the higher the levels of mindfulness after training the lower the levels of anxiety but negative interpretation bias did not significantly mediate the association. They also found that the greater the change in mindfulness from baseline, the greater the change in anxiety. But the change in negative interpretation bias did not significantly mediate the association.

 

These findings corroborate previous findings that mindfulness training produces decreases in anxiety. But, contrary to the experimental hypothesis, there was no evidence that mindfulness’ effectiveness for Generalized Anxiety Disorder (GAD) results from a change in negative interpretation bias. This is contrary to previous findings that interpretation bias mediates the effects of mindfulness on anxiety. The current study used patients with GAD while prior research used healthy undergraduate students. This suggests that interpretation bias may mediate the effect of mindfulness on normal, typical, levels of anxiety but not pathological levels.

 

Other research has suggested that changes in emotion regulation, rumination and worry, or  self-compassion might partially mediate  the effects of mindfulness training on anxiety. The present results, taken together with prior findings suggests that mindfulness induced reductions in negative interpretation bias may help to lower anxiety levels when the levels are relatively low but not when the levels are extreme as in Generalized Anxiety Disorder (GAD). At extreme levels it is known that anxiety begets anxiety. That is, that the high levels of anxiety tend to produce more anxiety. It may be this amplifying effect is not addressed by changes in interpretation bias while the initial levels are.

 

So, relieve generalized anxiety disorder with mindfulness.

 

“Breathing in, I calm my body. Breathing out, I smile. Dwelling in the present moment, I know this is a wonderful moment.” – Thich Nhat Hahn

 

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

 

Hoge EA, Reese HE, Oliva IA, Gabriel CD, Guidos BM, Bui E, Simon NM and Dutton MA (2020) Investigating the Role of Interpretation Bias in Mindfulness-Based Treatment of Adults With Generalized Anxiety Disorder. Front. Psychol. 11:82. doi: 10.3389/fpsyg.2020.00082

 

Although mindfulness-based interventions (MBIs) have garnered empirical support for a wide range of psychological conditions, the psychological processes that mediate the relationship between MBIs and subsequent symptomatic improvement are less well-understood. In the present study we sought to examine, for the first time, the relationship between mindfulness, negative interpretation bias as measured by the homophone task, and anxiety among adults with Generalized Anxiety Disorder (GAD). Forty-two individuals with GAD completed measures of mindfulness, interpretation bias, and anxiety before and after treatment with Mindfulness-based Stress Reduction (MBSR). Contrary to prior research, we did not find evidence of an indirect relationship between baseline levels of mindfulness and anxiety via negative interpretation bias. MBSR did result in significant reductions in negative interpretation bias from baseline to post-treatment; however, we did not find evidence of an indirect relationship between changes in mindfulness and changes in anxiety via changes in interpretation bias. Taken together, these results provide minimal support for the hypothesized relationship between mindfulness, negative interpretation bias, and anxiety among adults with GAD. Limitations and specific suggestions for further inquiry are discussed.

Highlights

– We examined the role of interpretation bias in the mindfulness-based treatment of adults with GAD.

– Participants experienced significant reductions in mindfulness, negative interpretation bias, and anxiety.

– We did not find evidence for an indirect relationship between mindfulness and anxiety via interpretation bias.

https://www.frontiersin.org/articles/10.3389/fpsyg.2020.00082/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1254058_69_Psycho_20200225_arts_A

 

Reduce Anxiety and Depression in Patients with Spinal Cord Injury with Mindfulness

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Reduce Anxiety and Depression in Patients with Spinal Cord Injury with Mindfulness

 

By John M. de Castro, Ph.D.

 

“For people with spinal cord injury, the Mindfulness for Health course was effective in reducing symptoms of depression, anxiety, pain unpleasantness, and pain catastrophizing.” – Breathworks

 

“Spinal cord injury (SCI) occurs when the spinal cord is damaged (such as through traumatic injury), and often leads to partial or complete loss of motor and/or sensory function below the level of injury.” Spinal cord injury is devastating to the individual. It results in a permanent cutting off the central nervous system from control of the muscles of the body and as a result paralysis. The severity of the paralysis depends on the location of the injury of the spine with the higher up the injury is on the spine the more widespread the paralysis. In the U.S. there are approximately 17,000 new cases of spinal cord injury each year. The World Health Organization summarizes the problem: “Every year, around the world, between 250 000 and 500 000 people suffer a spinal cord injury (SCI)”.

 

Beyond, the devastating physical consequences of spinal cord injury are difficult psychological, behavioral, emotional, and social issues. The vast majority of patients experience chronic pain and a decreased quality of life. In addition, depression and anxiety disorders are common. Since, spinal cord injury is permanent, it is important to address the pain and psychosocial consequences of the injury that may be present throughout the lifetime. Mindfulness training may help. It has shown to be effective in reducing chronic pain, treat depression and anxiety disorders, and improve quality of life following a variety of diseases.  Hence, it would seem reasonable to examine the ability of mindfulness training in treating the psychological consequences of spinal cord injury.

 

In today’s Research News article “Mindfulness for pain, depression, anxiety, and quality of life in people with spinal cord injury: a systematic review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971852/), Hearn and Cross review and summarize the published research studies of the effectiveness of mindfulness training for the pain and psychological issues resulting from spinal cord injury. They identified 5 published research studies employing a variety of mindfulness -based intervention techniques including yoga practice.

 

They report that the published studies found that mindfulness training produced significant decreases in depression and anxiety in the patients. Overall, however, the studies did not report significant improvements in pain or quality of life. A limiting factor is that the quality of the study methodologies and analyses were low with only one randomized controlled study.

 

Hence, the results suggest that mindfulness-based intervention improve the mental health of spinal cord patients. This is important as depression, in particular, is a serious problem with patients with spinal cord injuries. There is a need for more, larger, and better controlled trials in the future.

 

So, reduce anxiety and depression in patients with spinal cord injury with mindfulness.

 

“mindfulness training intervention for people with reduced sensory and motor function arising from SCI. . . offered greater improvements in symptoms of depression and anxiety, pain catastrophizing.” – Jasmine Heath Hearn

 

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

 

Hearn, J. H., & Cross, A. (2020). Mindfulness for pain, depression, anxiety, and quality of life in people with spinal cord injury: a systematic review. BMC neurology, 20(1), 32. https://doi.org/10.1186/s12883-020-1619-5

 

Abstract

Background

Populations with reduced sensory and motor function, such as spinal cord injury (SCI) are at increased risk of depression, anxiety, pain, and poorer quality of life (QoL). Mindfulness-Based Interventions (MBIs) have been developed with the aim of improving outcomes for people with SCI. To understand the value of MBIs, a systematic review was conducted pertaining to the use of MBIs, and interventions including elements of mindfulness, with people with SCI.

Methods

Databases were reviewed from 1996 to October 2018 (updated January 2020). Eligibility criteria included the assessment of at least one of the common secondary consequences of SCI (i.e. risk of depression, anxiety, pain, and QoL), describe the use of mindfulness training as a component part of an intervention, or as the whole intervention. The Cochrane Collaboration Risk of Bias and The Effective Public Health Practice Project Quality Assessment Tools were utilised for quality appraisals. Two assessors appraised the studies and demonstrated good agreement (Cohen’s k = .848, p < .001).

Results

Five papers met the inclusion criteria, and demonstrated a range of results of interventions delivered individually, in a group format, in person, and online. Only one study reported significant reductions in pain-related outcomes (with moderate effect sizes), with the remaining studies (n = 4) demonstrating no change. Four studies described reductions in depressive symptoms and three reported reductions in anxiety. Despite the importance of good QoL as a goal for people with SCI, few studies (n = 2) assessed this as an outcome with no improvements reported. Study quality ranged from high to low/weak.

Conclusions

The findings in this review provide mixed support for the use of mindfulness to improve outcomes after SCI. In particular, findings indicate that mindfulness may be particularly effective for improving symptoms of depression and anxiety. This review highlights the requirement for more rigorous, high-quality research, particularly larger randomised-controlled trials with long-term follow-up, in this area. The small number of studies included in the present review mean that conclusions drawn are preliminary and thus reflects the paucity of the research in the area to date.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971852/

 

Improve the Long-Term Mental Health of Breast Cancer Survivors with Mindfulness

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Improve the Long-Term Mental Health of Breast Cancer Survivors with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness-based meditation can help ease the stress, anxiety, fear, and depression that often come along with a breast cancer diagnosis and treatment.” – Breast Cancer.org

 

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 alleviate many of the residual physical and psychological symptoms, including fatigue, stress,  sleep disturbance, and anxiety and depression. Although there is considerable research on the topic, there is very little on the long-term effectiveness of mindfulness training on Hispanic breast cancer survivors.

 

In today’s Research News article “Long-Term Effect of a Nonrandomized Psychosocial Mindfulness-Based Intervention in Hispanic/Latina Breast Cancer Survivors.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971966/), Elimimian and colleagues recruited patients who had received a breast cancer diagnosis within the last 5 years. They provided them with a once a week for 2 hours, 8 week program of Mindfulness-Based Stress Reduction (MBSR). The program included meditation, body scan, yoga practices, and discussion along with daily home practice. They were measured before the program and every 3 months thereafter for 2 years for anxiety, depression, mental, emotional, and physical health, and physical and mental quality of life.

 

They found that after MBSR treatment and over the 2-year follow-up period that there were significant reductions in anxiety and depression, and significant improvements in mental quality of life. It should be noted that there wasn’t a control comparison condition present so the results must be interpreted with caution. But prior better controlled research studies have demonstrated that MBSR treatment is effective in improving symptoms in cancer survivors. So, it is likely that the present results were due to the effectiveness of the MBSR program and not to a confounding factor. The contribution of the present study is that it demonstrates that these mental health improvements also occur in Hispanic women.

 

So, improve the long-term mental health of breast cancer survivors with mindfulness.

 

“Results show promise for mindfulness-based interventions to treat common psychological problems such as anxiety, stress, and depression in cancer survivors and to improve overall quality of life.” – Linda E. Carlson

 

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

 

Elimimian, E., Elson, L., Bilani, N., Farrag, S. E., Dwivedi, A. K., Pasillas, R., & Nahleh, Z. A. (2020). Long-Term Effect of a Nonrandomized Psychosocial Mindfulness-Based Intervention in Hispanic/Latina Breast Cancer Survivors. Integrative cancer therapies, 19, 1534735419890682. https://doi.org/10.1177/1534735419890682

 

Abstract

Background: There is a paucity of research on the long-term impact of stress-reduction in Hispanic/Latina breast cancer (BC) survivors, a growing minority. In this article, we assess the long-term efficacy of an 8-week training program in mindfulness-based stress reduction (MBSR) on quality of life (QoL) in Hispanic BC survivors. Methods: Hispanic BC survivors, within the first 5 years of diagnosis, stages I to III BC, were recruited. Participants were enrolled in bilingual, 8-week intensive group training in MBSR and were asked to practice a- home, daily. They were also provided with audio recordings and a book on mindfulness practices. Patient-reported outcomes for QoL and distress were evaluated at baseline, and every 3 months, for 24 months. Results: Thirty-three self-identified Hispanic women with BC completed the MBSR program and were followed at 24 months. Statistically significant reduction was noted for the Generalized Anxiety Disorder measure (mean change −2.39, P=0.04); and Patient Health Questionnaire (mean change −2.27, P=0.04), at 24 months, compared with baseline. Improvement was noted in the Short-Form 36 Health-related QoL Mental Component Summary with an increase of 4.07 (95% confidence interval = 0.48-7.66, P=0.03). However, there was no significant change in the Physical Component Summary. Conclusions: Hispanic BC survivors who participated in an 8-week MBSR–based survivorship program reported persistent benefits with reduced anxiety, depression, and improved mental health QoL over 24 months of follow-up. Stress reduction programs are beneficial and can be implemented as part of a comprehensive survivorship care in BC patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971966/

 

Improve the Psychological Well-Being of Patients Living with HIV/AIDS with Mindfulness

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Improve the Psychological Well-Being of Patients Living with HIV/AIDS with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Given the stress-reduction benefits of mindfulness meditation training, these findings indicate there can be health protective effects not just in people with HIV but in folks who suffer from daily stress,” – – David Creswell

 

More than 35 million people worldwide and 1.2 million people in the United States are living with HIV infection. These include a significant number of children and adolescents. In 1996, the advent of the protease inhibitor and the so-called cocktail changed the prognosis for HIV. Since this development a 20-year-old infected with HIV can now expect to live on average to age 69. Hence, living with HIV is a long-term reality for a very large group of people.

 

People living with HIV infection experience a wide array of physical and psychological symptoms which decrease their perceived quality of life. The symptoms include chronic pain, muscle aches, anxiety, depression, weakness, fear/worries, difficulty with concentration, concerns regarding the need to interact with a complex healthcare system, stigma, and the challenge to come to terms with a new identity as someone living with HIV. Mindfulness training has been shown to improve psychological well-being, lower depression and strengthen the immune system of patients with HIV infection. Yoga practice has also been found to be effective in treating HIV.

 

The research is accumulating. So, it makes sense to step back and review what has been learned about the effectiveness of mindfulness training for the treatment of the symptoms of living with HIV/AIDS. In today’s Research News article “Mindfulness-Based Interventions for Adults Living with HIV/AIDS: 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/PMC6344266/), Scott-Sheldon and colleagues review, summarize, and perform a meta-analysis of the effectiveness of Mindfulness-Based Interventions (MBIs) for the treatment of the symptoms experienced by people living with HIV/AIDS.

 

They identified 16 published research studies containing a total of 1059 participants. Of these studies 11 employed Mindfulness-Based Stress Reduction (MBSR) while 5 studies employed Mindfulness-Based Cognitive Therapy (MBCT). All studies compared pre- to post-treatment measures while 9 of these studies also had a control comparison group.

 

They report that the published research found that in comparison to baseline after treatment with Mindfulness-Based Interventions (MBIs) there were significant improvements in quality of life and positive emotions and significant reductions in anxiety and depression. The reductions in depression were significantly greater for those participants who received Mindfulness-Based Cognitive Therapy (MBCT). No significant effects were reported for improvements in immune system function (CD4 counts).

 

This analysis of the available research suggests that Mindfulness-Based Interventions (MBIs) are a safe and effective treatment to improve the psychological health of patients diagnosed with HIV/AIDS. The fact that Mindfulness-Based Cognitive Therapy (MBCT) was more effective for depression was not surprising as MBCT was specifically developed to treat depression. It has been well established the Mindfulness-Based Interventions (MBIs) are effective in reducing anxiety and depression and improving positive emotions and quality of life in a wide variety of patients. The present analysis simply extends types of patients for which Mindfulness-Based Interventions (MBIs)are beneficial to patients diagnosed with HIV/AIDS.

 

So, improve the psychological well-being of patients living with HIV/AIDS with mindfulness.

 

“mindfulness-based therapies . . . had a long-term effect on stress and both a short- and long-term effect on depression in people living with an HIV infection.” – Xu Tian

 

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

 

Scott-Sheldon, L., Balletto, B. L., Donahue, M. L., Feulner, M. M., Cruess, D. G., Salmoirago-Blotcher, E., … Carey, M. P. (2019). Mindfulness-Based Interventions for Adults Living with HIV/AIDS: A Systematic Review and Meta-analysis. AIDS and behavior, 23(1), 60–75. doi:10.1007/s10461-018-2236-9

 

Abstract

This meta-analysis examined the effects of mindfulness-based interventions (MBIs) on stress, psychological symptoms, and biomarkers of disease among people living with HIV/AIDS (PLWHA). Comprehensive searches identified 16 studies that met the inclusion criteria (N = 1,059; M age = 42 years; 20% women). Participants had been living with HIV for an average of 8 years (range = <1 to 20 years); 65% were currently on antiretroviral therapy. Between-group analyses indicated that depressive symptoms were reduced among participants receiving the MBIs compared to controls (d+ = 0.37, 95% CI = 0.03, 0.71). Within-group analyses showed reductions in psychological symptoms (i.e., less anxiety, fewer depressive symptoms) and improved quality of life over time among MBI participants (d+s = 0.40–0.85). No significant changes were observed for immunological outcomes (i.e., CD4 counts) between- or within- groups. MBIs may be a promising approach for reducing psychological symptoms and improving quality of life among PLWHA. Studies using stronger designs (i.e., randomized controlled trials) with larger sample sizes and longer follow-ups are needed to clarify the potential benefits of MBIs for PLWHA.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6344266/

 

Less Negative Emotions Occur in Mindful Children and Adolescents

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Less Negative Emotions Occur in Mindful Children and Adolescents

 

By John M. de Castro, Ph.D.

 

“We ultimately want to give children (and teens, and adults!) the ability to notice however they feel in the moment, and the tools to manage and respond appropriately to their inner and outer experience.” – Oren Jay Sofer

 

Childhood and adolescence are times of mental, physical, social, and emotional growth. But they can be difficult times, fraught with challenges. During these times the individual transitions from childhood to young adulthood; including the development of intellectual, psychological, physical, and social abilities and characteristics. There are so many changes occurring during these times that the child can feel overwhelmed and unable to cope with all that is required. This can heighten negative emotions and anxiety. Indeed, up to a quarter of adolescents suffer from depression or anxiety disorders, and an even larger proportion struggle with subclinical symptoms.

 

Mindfulness training in adults has been shown to reduce anxiety, depression, and perceived stress levels and improve emotional regulation. In addition, in adolescents it has been shown to improve emotion regulation and to benefit the psychological and emotional health. On the other hand, getting lost in thought (mind wandering) has been shown to be associated with negative emotions. Hence, there is a need to explore the relationship between mindfulness, getting lost in thought, and emotions in children and adolescents.

 

In today’s Research News article “Cognitive Fusion Mediates the Relationship between Dispositional Mindfulness and Negative Affects: A Study in a Sample of Spanish Children and Adolescent School Students.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6926870/), García-Gómez and colleagues recruited children and adolescents between the ages of 8 to 16 years. They were measured for cognitive fusion, experiential avoidance, mindfulness, positive and negative emotions, and anxiety.

 

They found that the higher the levels of mindfulness the lower the levels of cognitive fusion, experiential avoidance, negative emotions, and anxiety. A mediation analysis revealed that mindfulness had both direct and indirect associations such that mindfulness was negatively associated directly with both negative emotions and anxiety and also indirectly by way of its negative association with cognitive fusion which was in turn negatively associated with negative emotions and anxiety. Higher levels of mindfulness were associated with lower levels of cognitive fusion which, in turn, were associated with lower levels of negative emotions and anxiety.

 

These results are correlational and thus causation cannot be determined. Also, this study employed only children and adolescents, So, it is not established if similar findings would occur in adults. But there are a large number of studies that demonstrate a causal effect of mindfulness on negative emotions and anxiety with adults. Indeed, in the present study, age did not moderate the results. Hence the present results probably are due to the effects of mindfulness on cognitive fusion and on these negative emotions and occur regardless of age.

 

“Cognitive fusion is a process by which the individual becomes entangled with memories, thoughts, judgments, and evaluations and adjust behavior to the internal experiences.” Hence cognitive fusion is the antithesis of mindfulness. One cannot be mindful and at the same time be lost in thoughts. This suggests that being lost in thought (cognitive fusion) tends to produce negative emotions, while being mindful tends to reduce these negative emotions. This suggests that mindfulness by focusing the individual on the present moment improves the individual’s emotional state and also tends to prevent getting lost in thought which also improves the individual’s emotional state.

 

So, reduce getting lost in thought and negative emotions with mindfulness.

 

“When I look at childhood anxiety I see an enormous problem and a precursor to other problems in adolescents and adults,” – Randye Semple

 

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

 

García-Gómez, M., Guerra, J., López-Ramos, V. M., & Mestre, J. M. (2019). Cognitive Fusion Mediates the Relationship between Dispositional Mindfulness and Negative Affects: A Study in a Sample of Spanish Children and Adolescent School Students. International journal of environmental research and public health, 16(23), 4687. doi:10.3390/ijerph16234687

 

Abstract

Nowadays, mindfulness-based interventions (MBI) have experienced a remarkable development of studies among childhood and adolescent interventions. For this reason, dispositional mindfulness (DM) measures for children and adolescents have been developed to determine the effectiveness of MBI at this age stage. However, little is known about how key elements of DM (for example, cognitive de/fusion or experiential avoidance that both confirm psychological inflexibility) are involved in the mechanisms of the children and adolescents’ mental health outcomes. This research examined the mediating effect of cognitive fusion between DM and anxiety and other negative emotional states in a sample of 318 Spanish primary-school students (aged between 8 and 16 years, M = 11.24, SD = 2.19, 50.8% males). Participants completed the AFQ-Y (Avoidance and Fusion Questionnaire for youth), which is a measure of psychological inflexibility that encompasses cognitive defusion and experiential avoidance; CAMM (DM for children and adolescents), PANAS-N (positive and negative affect measure for children, Spanish version of PANASC), and STAIC (an anxiety measure for children). The study accomplished ethical standards. As MBI relevant literature has suggested, cognitive defusion was a significant mediator between DM and symptoms of both negative emotions and anxiety in children and adolescents. However, experiential avoidance did not show any significant mediating relationship. Probably, an improvement of the assessment of experiential avoidance is needed. MBI programs for children and adolescents may include more activities for reducing effects of the cognitive defusion on their emotional distress.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6926870/

 

Further Improve Depression Treated with Drugs and Counseling with Yoga

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Further Improve Depression Treated with Drugs and Counseling with Yoga

 

By John M. de Castro, Ph.D.

 

“I feel like the creator of my own reality, rather than the victim of my own circumstance. Yoga has also allowed me to form healthy boundaries and relationships without the highs and the lows.” – Kacey DeGuardia

 

Depression affects over 6% of the population. Depression can be difficult to treat. It is usually treated with antidepressant 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. Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering.

 

Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail.  Another effective alternative treatment is exercise. But it is difficult to get depressed people, who lack energy, to engage in regular exercise. Yoga is a contemplative practice that is both a mindfulness practice and an exercise. It has been shown to be effective in the treatment of depression. So, it makes sense to further study the effectiveness of yoga for depression.

 

In today’s Research News article “Effect of adjunct yoga therapy in depressive disorders: Findings from a randomized controlled study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6862972/), Kumar and colleagues recruited adult patients diagnosed with depression and randomly assigned them to either receive standard treatment or standard treatment plus yoga therapy. Standard treatment included antidepressant medication and counseling. Yoga therapy sessions included training in breath awareness, postures, and mindful relaxation and occurred 5 times per week for 45 minutes for 4 weeks. They were measured before, during, and after treatment for depression, anxiety, depression severity, and clinical improvement.

 

They found that in comparison to baseline and the treatment as usual control condition, the group who received yoga therapy had significantly decreased depression, anxiety, and depression severity, and a significant increase in clinical improvement. These results are encouraging and suggest that yoga therapy works to improve depression even in patients continuing to receive drugs and counseling.

 

Yoga therapy is a complex technique including training in breath awareness, various postures, and mindful relaxation. Future research needs to examine which of these components or combination of components of the yoga therapy program are necessary and sufficient for the improvement. In addition, there’s a need to study the long-term effectiveness of yoga therapy. The results, however, suggest that yoga therapy is safe and effective as an adjunctive treatment for depression producing further improvements.

 

So, further improve depression treated with drugs and counseling with yoga.

 

‘That yoga seems to be effective is good news for people struggling with depression. . . . the practice has far fewer side effects and potential drug interactions than mood-altering medications.” – Amanda MacMillan

 

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

 

Kumar, S., Subramaniam, E., Bhavanani, A. B., Sarkar, S., & Balasundaram, S. (2019). Effect of adjunct yoga therapy in depressive disorders: Findings from a randomized controlled study. Indian journal of psychiatry, 61(6), 592–597. doi:10.4103/psychiatry.IndianJPsychiatry_173_19

 

Abstract

Background:

Depression causes significant burden both to the individual and to society, and its treatment by antidepressants has various disadvantages. There is preliminary evidence that adds on yoga therapy improves depression by impacting the neurotransmitters involved in the regulation of mood, motivation, and pleasure. Our study aimed to find the effect of adjunctive yoga therapy on outcome of depression and comorbid anxiety.

Materials and Methods:

A randomized controlled study involving patients with major depressive disorder (n = 80) were allocated to two groups, one received standard therapy (antidepressants and counseling) and the other received adjunct yoga therapy along with standard therapy. Ratings of depression and anxiety were done using Montgomery–Asberg Depression Rating Scale and Hospital Anxiety and Depression Scale at baseline, 10th and 30th day. Clinical Global Impression (CGI) Scale was applied at baseline and 30th day to view the severity of illness and clinical improvement.

Results:

By the 30th day, individuals in the yoga group had significantly lower scores of depression, anxiety, and CGI scores, in comparison to the control group. The individuals in the yoga group had a significant fall in depression scores and significant clinical improvement, compared to the control group, from baseline to 30th day and 10th to 30th day. In addition, the individuals in the yoga group had a significant fall in anxiety scores from baseline to 10th day.

Conclusion:

Anxiety starts to improve with short-term yoga sessions, while long-term yoga therapy is likely to be beneficial in the treatment of depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6862972/

 

Moderate the Negative Psychological Effects of Racism with Mindfulness

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Moderate the Negative Psychological Effects of Racism with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness and related practices do assist in increasing focus and raising awareness, and have been shown to assist in minimizing bias.” – Rhonda Magee

 

Discrimination based upon race, religion, gender, national origin, sexual orientation, etc. has been going on since the beginning of recorded history. Even though quite common, it can have considerable negative impact for all who are involved but especially for the subject of the discrimination. General well-being, self-esteem, self-worth, and social relations can be severely impacted as a result of discrimination. This can, in turn, result in anxiety and depression.

 

It is important that we identify methods to deal with the consequences of discrimination. Mindfulness practices have been shown to reduce prejudice. It has also been shown to reduce depression and enhance positive emotions and reduce the negative effects of discrimination. So perhaps mindfulness can modulate the impact of discrimination on the individual.

 

In today’s Research News article “The Experience of Racism on Behavioral Health Outcomes: The Moderating Impact of Mindfulness.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402779/?report=classic), Zapolski and colleagues recruited African American college students aged 18 to 24 years. They completed an on-line questionnaire measuring demographics, frequency of experiencing racial discrimination, anxiety, depression, alcohol use, and mindfulness.

 

They found that 57% of the African American students had experienced racial discrimination over the last year. A correlational analysis revealed that the greater the frequency of racial discrimination reported, the greater the levels of anxiety, depression, and alcohol use. They also found that the higher the levels of mindfulness the lower the levels of anxiety, depression, and alcohol use. A mediation analysis of these data revealed that mindfulness moderated the effects of racial discrimination on anxiety, depression, and alcohol use such that the higher the levels of mindfulness the smaller the impact of racial discrimination on anxiety, depression, and alcohol use.

 

The study was correlational and as such causation cannot be concluded. Nevertheless, the results suggest that racial discrimination is associated with the individuals’ levels of psychological health and alcohol use but that these associations are weaker when mindfulness levels are high. This suggests that mindfulness may be helpful in mitigating the negative consequences of experience racism. It remains to be established if mindfulness training can immunize the individual from the impact of racism on their psychological health.

 

So, moderate the negative psychological effects of racism with mindfulness.

 

“Mindfulness can help us with a lot of the really subtle difficulties of doing the work that must be done to dismantle these patterns and habits that draw us to reinvest in segregation.” – Rhonda Magee

 

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

 

Zapolski, T., Faidley, M. T., & Beutlich, M. (2019). The Experience of Racism on Behavioral Health Outcomes: The Moderating Impact of Mindfulness. Mindfulness, 10(1), 168–178. doi:10.1007/s12671-018-0963-7

 

Abstract

Research shows that racial discrimination results in adverse behavioral health outcomes for African American young adults, including risk for depression, anxiety, and substance use. Although high levels of mindfulness have been shown to reduce risk for such health outcomes, it is unknown whether mindfulness can reduce risk as a consequence of racial discrimination, particularly among African Americans. Three-hundred and eighty-eight African American young adults between the ages of 18–24 (M=20.6, 62% female) completed measures assessing past year experiences of racial discrimination, depressive symptoms, anxiety symptoms, alcohol use, and trait mindfulness. A positive correlation was found between racial discrimination and the behavioral health outcomes, as well as a negative correlation between mindfulness and the behavioral health outcomes. Moreover, mindfulness was found to significantly moderate the effect of racial discrimination on mood symptoms. Although mindfulness was found to lessen the effect of racial discrimination on alcohol use, this difference was not statistically significant. In line with previous literature, racial discrimination was shown to have a negative impact on behavioral health outcomes among African Americans. Moreover, our findings provide support for the buffering effect of mindfulness on mood symptoms as a consequence discrimination. This suggests that increasing mindfulness may be an effective strategy to include in interventions targeting improvement in mood symptoms for African American young adults. However, alternative strategies may be more appropriate to address outcomes, such as alcohol use, as a consequence of racial discrimination.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402779/?report=classic

 

Improve Gulf War Illness in Veterans with Tai Chi

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Improve Gulf War Illness in Veterans with Tai Chi

 

By John M. de Castro, Ph.D.

 

“A prominent condition affecting Gulf War Veterans is a cluster of medically unexplained chronic symptoms that can include fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, and memory problems.” – US Department of Veterans Affairs

 

Engaging in warfare has many consequences to society and individuals, including the warriors themselves. Post-Traumatic Stress Disorder (PTSD) is a common problem among military veterans with between 11% to 20% of veterans who were involved in combat developing PTSD. There is a specific syndrome that has been identified in about 36% of veterans of the Persian Gulf war of 1991. The cluster of symptoms include fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, and memory problems.

 

It has been demonstrated that mindfulness training is effective for PTSD symptoms . In addition, Yoga practice is a mindfulness practice that has been shown to be helpful for PTSD. Mindful movement practices such as Tai Chi and Qigong have been found to be beneficial for individuals with a myriad of physical and psychological problems. This raises the possibility that Tai Chi practice may be beneficial for veterans suffering from Gulf War Illness.

 

In today’s Research News article “The Effects of Tai Chi Mind-Body Approach on the Mechanisms of Gulf War Illness: an Umbrella Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6600798/), Reid and colleagues review and summarize the published research studies of the effectiveness of Tai Chi practice in relieving the symptoms of participants whose symptoms were similar to Gulf War Illness. They identified multiple randomized controlled trials and meta-analyses of Tai Chi practice for these symptoms.

 

They report that the published research indicates that Tai Chi practice significantly improves mood, sleep, global cognitive function, and respiratory function and significantly decreases insomnia, anxiety, depression, stress, and chronic pain. Hence Tai Chi practice has been shown to be effective in relieving symptoms that commonly occur in Gulf War Illness. This suggests that Tai Chi practice should be tried directly to treat veterans with Gulf War Syndrome. It remains for future research to test this hypothesis.

 

So, improve Gulf War Illness in veterans with Tai Chi.

 

“Mindfulness-based stress reduction may provide significant benefits to symptoms associated with Gulf War Illness in veterans.” – Laura Stiles

 

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

 

Reid, K. F., Bannuru, R. R., Wang, C., Mori, D. L., & Niles, B. L. (2019). The Effects of Tai Chi Mind-Body Approach on the Mechanisms of Gulf War Illness: an Umbrella Review. Integrative medicine research, 8(3), 167–172. doi:10.1016/j.imr.2019.05.003

 

Abstract

Gulf War illness (GWI) is a chronic and multisymptom disorder affecting military veterans deployed to the 1991 Persian Gulf War. It is characterized by a range of acute and chronic symptoms, including but not limited to, fatigue, sleep disturbances, psychological problems, cognitive deficits, widespread pain, and respiratory and gastrointestinal difficulties. The prevalence of many of these chronic symptoms affecting Gulf War veterans occur at markedly elevated rates compared to nondeployed contemporary veterans. To date, no effective treatments for GWI have been identified. The overarching goal of this umbrella review was to critically evaluate the evidence for the potential of Tai Chi mind-body exercise to benefit and alleviate GWI symptomology. Based on the most prevalent GWI chronic symptoms and case definitions established by the Centers for Disease Control and Prevention and the Kansas Gulf War Veterans Health Initiative Program, we reviewed and summarized the evidence from 7 published systematic reviews and meta-analyses. Our findings suggest that Tai Chi may have the potential for distinct therapeutic benefits on the major prevalent symptoms of GWI. Future clinical trials are warranted to examine the feasibility, efficacy, durability and potential mechanisms of Tai Chi for improving health outcomes and relieving symptomology in GWI.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6600798/

 

Mindfulness Training Improves the Psychological Health of Health Care Professionals

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Mindfulness Training Improves the Psychological Health of Health Care Professionals

 

By John M. de Castro, Ph.D.

 

“Levels of stress and burnout in the healthcare profession have been exacerbated in recent decades by significant changes in how health care is delivered and administered. Extensive research has shown that mindfulness training . . . can have significant positive impacts on participants’ job satisfaction; their relationships with patients, co-workers and administration; and their focus and creativity at work.” – WPHP

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It is estimated that over 45% of healthcare workers experience burnout. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion.

 

Improving the psychological health of health care professionals has to be a priority. Contemplative practices have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, and improving sleep. Hence, mindfulness may be a means to improve the psychological health of medical professionals.

 

In today’s Research News article “Mindfulness-Based IARA Model® Proves Effective to Reduce Stress and Anxiety in Health Care Professionals. A Six-Month Follow-Up Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6888054/), Barattucci and colleagues recruited doctors, nurses, and healthcare assistants and randomly assigned them to either a no-treatment control condition or to receive self-awareness/mindfulness training. The training occurred in 4 8-hour group sessions and emphasized mindfulness, emotion regulation, counseling techniques and skills to deal with stress. They were measured before and 6 months after training for anxiety, perceived stress, and emotion regulation.

 

They found that 6 months after training the self-awareness/mindfulness training group had significant reductions in perceived stress and anxiety and significant improvements in emotion regulation while the control group did not. They also found that the higher the levels of emotion regulation the lower the levels of anxiety and perceived stress.

 

The intervention of self-awareness/mindfulness training involves a complex set of trainings and it cannot be determined which component or combination of components are responsible for the effects. But it has been shown in previous research showing that mindfulness training produces lasting improvements in emotion regulation, reductions in anxiety and perceived stress, and improvements in the psychological health of healthcare workers. Hence, it can be concluded that at least the mindfulness training component of the self-awareness/mindfulness training is effective. It was not established but it is assumed that these psychological improvements will lead to greater resilience and decrease burnout in healthcare workers.

 

So, mindfulness training improves the psychological health of health care professionals.

 

“Mindfulness training has been shown to reduce depression, anxiety, rumination, and stress, and to improve self-compassion and positive mood states in health care professionals. Second, the practice of mindfulness improves qualities that are critical to effective treatment, such as attention, empathy, emotion regulation, and affect tolerance.” – 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

 

Barattucci, M., Padovan, A. M., Vitale, E., Rapisarda, V., Ramaci, T., & De Giorgio, A. (2019). Mindfulness-Based IARA Model® Proves Effective to Reduce Stress and Anxiety in Health Care Professionals. A Six-Month Follow-Up Study. International journal of environmental research and public health, 16(22), 4421. doi:10.3390/ijerph16224421

 

Abstract

Changes in the health care environment, together with specific work-related stressors and the consequences on workers’ health and performance, have led to the implementation of prevention strategies. Among the different approaches, those which are mindfulness-based have been institutionally recommended with an indication provided as to their effectiveness in the management of stress. The aim of the present study was to analyze the efficacy of the mindfulness-based IARA Model® (an Italian acronym translatable into meeting, compliance, responsibility, autonomy) in order to ameliorate perceived stress, anxiety and enhance emotional regulation among health care professionals (HCPs; i.e., doctors, nurses, and healthcare assistants). Four hundred and ninety-seven HCPs, 215 (57.2%) of which were women, were randomly assigned to a mindfulness-based training or control group and agreed to complete questionnaires on emotion regulation difficulties (DERS), anxiety, and perceived stress. Results showed that HCPs who attended the IARA training, compared to the control group, had better emotional regulation, anxiety and stress indices after 6 months from the end of the intervention. Furthermore, the results confirmed the positive relationship between emotional regulation, perceived stress and anxiety. The present study contributes to literature by extending the effectiveness of IARA in improving emotional regulation and well-being in non-clinical samples. Moreover, the study provides support for the idea that some specific emotional regulation processes can be implicated in perceived stress and anxiety. From the application point of view, companies should invest more in stress management intervention, monitoring and training, in order to develop worker skills, emotional self-awareness, and relational resources.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6888054/