Anxiety

Interpretation Bias Mediates the Effect of Mindfulness and Acceptance on Anxiety and Depression

psyjdc 1 Comment

Interpretation Bias Mediates the Effect of Mindfulness and Acceptance on Anxiety and Depression

 

By John M. de Castro, Ph.D.

 

“Anxiety softens when we can create a space between ourselves and what we’re experiencing. When you react in ways that aren’t mindful, they can gradually grow into habits that are detrimental to your health and well-being.” – Mindful

 

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 sufferer 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. This may indicate that treating the cognitive processes that underlie the anxiety may be an effective treatment. Indeed, Mindfulness practices have been shown to be quite effective in altering cognitive processes and  relieving anxiety.

 

Depression is the most common mental illness, affecting over 6% of the population. Depression can be difficult to treat and is usually treated with anti-depressive medication. 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. Fortunately, Mindfulness training is also effective for treating depression.

 

A cognitive tendency that can exacerbate anxiety and depression is interpretation bias. This is a tendency to interpret situations in a negative way even when the situation is ambiguous. This can lead to interpreting even neutral situations as threatening. An alternative explanation for the effectiveness of mindfulness training for anxiety and depression is that it may reduce interpretation bias, making it less likely that situations would be interpreted as threatening and thereby lowering anxiety and depression.

 

In today’s Research News article “Mindfulness, Interpretation Bias, and Levels of Anxiety and Depression: Two Mediation Studies.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320741/ ), Mayer and colleagues performed 2 studies to examine the relationships of mindfulness, anxiety, depression, and interpretation bias.

 

In the first study they recruited college students and had them complete online questionnaires and psychometric tests measuring mindfulness, anxiety, depression, and interpretation bias. The variables were then subjected to regression analysis. They found that the higher the level of mindfulness the lower the levels of depression, anxiety, and interpretation bias. They further found that the mindfulness association with reduced anxiety and depression was in part the result of mindfulness’ association with reduced interpretation bias. Mindfulness was both directly associated with lower anxiety and depression and indirectly by being associated with lower levels of interpretation bias which, in turn, was associated with lower anxiety and depression.

 

In the second study they recruited a community sample of adults with mixed ages and had them complete online questionnaires measuring mindfulness, anxiety, depression, interpretation bias, and acceptance of internal sensations. They found similar results for acceptance as they found in study 1 for mindfulness, with the higher the level of acceptance the lower the levels of depression, anxiety, and interpretation bias. Also similar to study 1 they found that the association of acceptance with reduced anxiety and depression was in part the result of acceptance’ association with reduced interpretation bias. Acceptance was both directly associated with lower anxiety and depression and indirectly by being associated with lower levels of interpretation bias which, in turn, was associated with lower anxiety and depression.

 

These are interesting findings but they are correlational. So, no clear conclusions regarding causation can be reached. Previous research, however, has clearly shown a causal connection between mindfulness and acceptance and anxiety and depression. This suggests that the relationships observed in the current study as due to mindfulness and acceptance causing the relief of anxiety and depression.

 

The results suggest that the associations of both mindfulness and acceptance of internal states are associated with lower levels of both anxiety and depression and that these associations are in part due to direct associations with anxiety and depression and also indirect associations involving both mindfulness and acceptance being associated with lower levels of interpretation bias that, in turn, is associated with lower levels of anxiety and depression. This suggests that mindfulness and acceptance, in part, affect anxiety and depression by altering the cognitive interpretation of situations, lowering the tendency to interpret situations as threatening and thereby lowering the anxiety and depression that results from threatening interpretations.

 

So, interpretation bias mediates the effect of mindfulness and acceptance on anxiety and depression.

 

“Mindfulness keeps us focused on the present, and helps us meet challenges head on while we appreciate all our senses absorb. On the contrary, focus on the future contributes to anxiety, while perseveration on the past feeds depression.” – Vincent Fitzgerald

 

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

 

Mayer, B., Polak, M. G., & Remmerswaal, D. (2018). Mindfulness, Interpretation Bias, and Levels of Anxiety and Depression: Two Mediation Studies. Mindfulness, 10(1), 55-65.

 

Abstract

In two studies, a possible mediation effect was tested of cognitive interpretation bias in the relation between respectively dispositional mindfulness and acceptance, on the one hand, and symptoms of depression and anxiety, on the other hand. An undergraduate student sample (N = 133; 86% female, Mage = 19.8) and a convenience community sample (N = 186; 66% female, Mage = 36.5) were examined by means of an online questionnaire measuring dispositional mindfulness (FFMQ-SF; Study 1) and acceptance (AAQ-II; Study 2), anxiety (STAI-trait) and depressive (BDI-II) symptoms, and interpretation bias (with the interpretation bias task, IBT). Considering both studies, results showed consistently the expected relations of larger mindfulness skills going together with a smaller cognitive interpretation bias and lower levels of depression and anxiety symptoms. More interestingly, it was found that interpretation bias served as a mediator in the relations between respectively dispositional mindfulness and acceptance, and symptoms of depression and anxiety. With these findings, some more insight in the working mechanisms of mindfulness-based treatments on internalizing psychopathology has been obtained.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320741/

 

Reduce Anxiety and Depression with Mindfulness

psyjdc Leave a comment

Reduce Anxiety and Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Being unwilling to experience negative thoughts, feelings, or sensations is often the first link in a mental chain that can lead to automatic, habitual, and critical patterns of mind becoming re-established. By accepting unpleasant experiences, we can shift our attention to opening up to them. Thus, “I should be strong enough” shifts to “Ah, fear is here,” or “Judgment is present.”—Zindel Segal,

 

Meditation training has been shown to improve health and well-being. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. Meditation practice has been found to improve the regulation of emotions and reduce difficult emotional states such as anxiety and depression.

 

A characterizing feature of anxiety disorders is recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Indeed, Mindfulness practices have been shown to be quite effective in relieving anxiety. Anxiety often co-occurs with depression and mindfulness training is also effective for treating depression. Anxiety disorders and depression have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. So, there is a need to develop alternative treatments. Since mindfulness- based treatments are relatively new, it makes sense to step back and summarize what is known regarding the effectiveness of mindfulness training for anxiety disorders and for depression.

 

In today’s Research News article “Mindfulness-Based Interventions for Anxiety and Depression. The Psychiatric clinics of North America.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5679245/ ), Hofmann and Gomez review and summarize the published research literature on the effectiveness of mindfulness training for the relief of anxiety and depression.

 

They report that randomized controlled trials found that Mindfulness-Based interventions including the Mindfulness-Based Stress Reduction (MBSR), the Mindfulness-Based Cognitive Therapy (MBCT), Dialectical Behavior Therapy, and Acceptance and Commitment Therapy treatment programs were “moderately-to-largely effective at reducing anxiety and depression symptom severity among individuals with a broad range of medical and psychiatric conditions.” They also report that these programs are effective whether provided in person or over the internet. They are consistently more effective than health education, relaxation training, and supportive psychotherapy, but equivalently effective as Cognitive Behavioral Therapy (CBT).

 

Hence, accumulating controlled research has built a strong case for the use of Mindfulness-Based Interventions for the treatment of anxiety and depression. Since, these treatments are generally safe and effective with little if any side effects, they would appear to be preferable to pharmacological treatments.

 

So, reduce anxiety and depression with mindfulness.

 

“Mindfulness keeps us focused on the present, and helps us meet challenges head on while we appreciate all our senses absorb. On the contrary, focus on the future contributes to anxiety, while perseveration on the past feeds depression. Far too often when we look to the future, we ask ourselves, “What if,” and the answer we give ourselves is often a prediction of a negative result.” – Vincent Fitzgerald

 

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

 

Hofmann, S. G., & Gómez, A. F. (2017). Mindfulness-Based Interventions for Anxiety and Depression. The Psychiatric clinics of North America, 40(4), 739-749.

 

Key Points

  • Research on mindfulness-based interventions (MBIs) for anxiety and depression has increased exponentially in the past decade. The most common include Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT).
  • MBIs have demonstrated efficacy in reducing anxiety and depression symptom severity in a broad range of treatment-seeking individuals.
  • MBIs consistently outperform non-evidence-based treatments and active control conditions, such as health education, relaxation training, and supportive psychotherapy.
  • MBIs also perform comparably to cognitive-behavioral therapy (CBT). The treatment principles of MBIs for anxiety and depression are compatible with those of standard CBT.

Synopsis

This article reviews the ways in which cognitive and behavioral treatments for depression and anxiety have been advanced by the application of mindfulness practices. Research on mindfulness-based interventions (MBIs) has increased exponentially in the past decade. The most common include Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT). MBIs have demonstrated efficacy in reducing anxiety and depression symptom severity in a broad range of treatment-seeking individuals. MBIs consistently outperform non-evidence-based treatments and active control conditions, such as health education, relaxation training, and supportive psychotherapy. MBIs also perform comparably to cognitive-behavioral therapy (CBT). The treatment principles of MBIs for anxiety and depression are compatible with those of standard CBT.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5679245/

 

Change the Brain to Reduce Anxiety with Meditation

psyjdc Leave a comment

Change the Brain to Reduce Anxiety with Meditation

 

By John M. de Castro, Ph.D.

 

“In mindfulness practice you have an opportunity—the mental time and space, if you will—to see more elements of the story, a richer picture. “You may see more clearly as you anticipate a difficult encounter what the underlying emotion is that’s triggered and how it’s showing up in your body.” In this way, you become aware of the full context of the story, like seeing a flower opening in slow-motion photography. With this awareness, over time “your solid belief in a storyline may begin to erode.” – Zindel Segal

 

Meditation training has been shown to improve health and well-being. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. Meditation practice has been found to improve the regulation of emotions and reduce difficult emotional states such as anxiety and depression.

 

The nervous system is a dynamic entity, constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. These changes in the brain are called neuroplasticity. Over the last decade neuroscience has been studying the effects of contemplative practices on the brain and has identified neuroplastic changes in widespread areas. In other words, mindfulness practice appears to mold and change the brain, producing psychological, physical, and spiritual benefits. Meditation practice has been shown to change the brain and the brain’s reaction to emotions. The activity of the amygdala in the brain is highly associated with emotions. Hence, it would appear likely that meditation practice may alter the amygdala’s activity in response to emotions.

 

In today’s Research News article “Atypical Anxiety-Related Amygdala Reactivity and Functional Connectivity in Sant Mat Meditation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6288484/ ), Chen and colleagues recruited healthy highly experienced meditators and healthy meditation naive participants. The meditators practiced Sant Mat meditation for 4 hours per day and had been practicing for at least 4 years. They also had a vegetarian diet and abstained from alcohol. The meditation practice incorporated loving kindness meditation.

 

All participants were measured for their state anxiety and their trait anxiety. The participants viewed colorized pictures of faces while their brain activity was monitored with functional Magnetic Resonance Imaging (fMRI). They were asked to ignore everything about the faces except their color which they responded to with a button press. The faces were both male and female expressing either happy, fearful, or neutral emotions.

 

They found that the meditators were significantly less anxious than the controls in both state and trait anxiety and the greater the number of years of meditation experience the lower the levels of anxiety. The meditators were also significantly slower in responding to the faces color. Slower responding has been associated with lower anxiety. It is well documented that meditation practice lowers anxiety. So, the lower levels in the meditators and slower responding were expected.

 

In terms of the brain amygdala responses to the face stimuli, the meditators had significantly lower responses regardless of the emotion portrayed. In addition, the meditators had a stronger amygdala response to happy faces than fearful faces while the controls had the opposite pattern with higher amygdala responses to fearful faces than happy faces. Mediation analysis indicated that the years of meditation experience was directly related to lower anxiety but the amygdala response partly meditated the effect such that the more years of meditation experience the lower the response of the amygdala and the lower the levels of anxiety.

 

These are interesting and entirely consistent results. The amygdala is known to be involved in emotionality. The results suggest that meditation experience alters the amygdala to respond less to emotional stimuli and to respond more to positive emotional stimuli than negative emotional stimuli. These lower responses may be the source of the effect of meditation practice of improved regulation of emotions. The greater responses of the amygdala in meditators to positive emotional stimuli may be the source of the effect of meditation practice of increased happiness.

 

It needs to be recognized that the meditators also had vegetarian diets and abstained from alcohol while the meditation naïve participants did not. It is possible that the differences observed stemmed from these differences rather than the meditation. It should also be noted that the meditators practiced 4 hours per day which is much more than most meditators, placing these meditators as outliers of amounts of meditation practice. Whether similar results may be observed with lower levels of meditation practice should be an important question for future research.

 

So, change the brain to reduce anxiety with meditation.

 

“To me, this amazing brain science and the very real rewards gained from meditation combine to form a compelling argument for developing and/or maintaining a daily practice. It definitely motivates me on those days I don’t “feel” like sitting. So, try to remind yourself that meditating every day, even if it’s only 15 minutes, will keep those newly formed connections strong and those unhelpful ones of the past at bay.” – Rebecca Gladding

 

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

 

Chen, C., Chen, Y. C., Chen, K. L., & Cheng, Y. (2018). Atypical Anxiety-Related Amygdala Reactivity and Functional Connectivity in Sant Mat Meditation. Frontiers in behavioral neuroscience, 12, 298. doi:10.3389/fnbeh.2018.00298

 

Abstract

While meditation has drawn much attention in cognitive neuroscience, the neural mechanisms underlying its emotional processing remains elusive. Sant Mat meditators were recruited, who adopt a loving-kindness mode of meditation along with a vegetarian diet and an alcohol-restricted lifestyle and novices. We assessed their State-Trait Anxiety Inventory (STAI) and scanned their amygdala reactivity in response to an explicit and implicit (backward masked) perception of fearful and happy faces. In contrast with novices, meditators reported lower STAI scores. Meditators showed stronger amygdala reactivity to explicit happiness than to fear, whereas novices exhibited the opposite pattern. The amygdala reactivity was reduced in meditators regardless of implicit fear or happiness. Those who had more lifetime practice in meditation reported lower STAI and showed a weaker amygdala response to fear. Furthermore, the amygdala in meditators, relative to novices, had a stronger positive functional connectivity with the ventrolateral prefrontal cortex (PFC) to explicit happiness, but a more negative connectivity with the insula and medial orbitofrontal cortex (OFC) to explicit fear. Mediation analysis indicated the amygdala reactivity as the mediator for the linkage between meditation experience and trait anxiety. The findings demonstrate the neural correlates that underpin the beneficial effects of meditation in Sant Mat. Long-term meditation could be functionally coupled with the amygdala reactivity to explicit and implicit emotional processing, which would help reduce anxiety and potentially enhance well-being.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6288484/

 

Mindfulness Improves Depression by Affecting Trait Anxiety

psyjdc Leave a comment

Mindfulness Improves Depression by Affecting Trait Anxiety

 

By John M. de Castro, Ph.D.

 

“When you become aware of the present moment, you gain access to resources you may not have had before. You may not be able to change a situation, but you can mindfully change your response to it. You can choose a more constructive and productive way of dealing with stress rather than a counterproductive or even destructive way of dealing with it.” – Mindful

 

A characterizing feature of anxiety disorders is recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Indeed, Mindfulness practices have been shown to be quite effective in relieving anxiety. Anxiety often co-occurs with depression. Mindfulness training is also effective for treating depression. Anxiety disorders and depression have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders and for depression either alone or in combination with other therapies. The fact that anxiety and depression occur together so often suggests that they may be linked and mindfulness training may affect that linkage.

 

In today’s Research News article “The Factorial Structure of Trait Anxiety and Its Mediating Effect Between Mindfulness and Depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6212471/ ), Wang and colleagues recruited college students with depression and measured before and after training for trait anxiety, depression and mindfulness. A second set of students were provided with an 8-week program of Mindfulness-Based Cognitive Therapy (MBCT). It met once a week for 2.5 hours.  MBCT was developed specifically to treat depression. It involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. These students were measured before and after training for trait anxiety, depression and mindfulness.

 

They then performed a factor analysis of the trait anxiety scale from the untreated group of students and identified two distinct factors; Trait Anxiety Present and Trait Anxiety Absent. They found that the higher the level of mindfulness the lower the levels of depression and both of the trait anxiety factors. In addition, the higher the levels of both of the trait anxiety factors, the higher the levels of depression. So, trait anxiety and depression covaried and mindfulness was associated with lower levels of these psychological issues. In a mediation analysis they discovered that the association of mindfulness with lower depression was mediated by the two trait anxiety factors. In other words, mindfulness was associated with lower trait anxiety and this was in turn associated with lower levels of depression.

 

In the second group of students they found that MBCT training resulted in significantly lower levels of depression and both trait anxiety factors. Importantly, after MBCT training the mediational relationship of mindfulness to trait anxiety to depression was still present. So, the training lowered levels of anxiety and depression but did not change their relationships with mindfulness, with trait anxiety changes associated with the changes in depression.

 

These results are interesting and suggest a high degree of relationship between trait anxiety and depression. This could represent a conceptual overlap in that both involve rumination regarding past events. On the other hand, it could indicate that anxiety and depression are separate but linked. Perhaps, feeling chronic anxiety may lead to depression. This would explain the mediation analysis wherein high mindfulness is associate with low anxiety and this tends to relieve depression.

 

So, mindfulness improves depression by affecting trait anxiety.

 

“mindfulness-based practices have proved to be helpful in promoting mental well-being, especially by reducing the symptoms of depression and anxiety in various populations. For people with medicine noncompliance issues or people unwilling to start formal psychotherapy, mindfulness-based therapies could be a beneficial alternative to consider.” Han Ding

 

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

 

Wang, T., Li, M., Xu, S., Jiang, C., Gao, D., Wu, T., Lu, F., Liu, B., … Wang, J. (2018). The Factorial Structure of Trait Anxiety and Its Mediating Effect Between Mindfulness and Depression. Frontiers in psychiatry, 9, 514. doi:10.3389/fpsyt.2018.00514

 

Abstract

Background: Increasing studies have found that high trait anxiety is a key susceptibility phenotype that causes depression. Mindfulness-based interventions can target on dealing with depressogenic vulnerability effectively. Evidence indicates that trait anxiety could affect the trajectory of anti-depressive psychotherapy, and play an important role in the relationship between mindfulness and depression. Furthermore, related studies have found that trait anxiety could involve factors beyond anxiety and be a two-factor construct instead of one-dimensional concept. This viewpoint provides a new prospective for exploring the pathways of the two factors of trait anxiety in the complex relationship and further understand the potential mechanism of vulnerable personality mediated the link of mindfulness and depression.

Methods: A cross-sectional survey and a preliminary intervention study were conducted. Thousand two hundred and sixty-two subjects completed a set of self-reported questionnaires that evaluated trait anxiety, mindfulness, and depressive symptoms. Twenty-Three eligible participants with depression were recruited to attend mindfulness-based cognitive training for eight weeks. The same questionnaires were completed 1 week before the training and 6 months after the training. Factor analysis was performed on the 1262-subject sample to explore and confirm the factorial structure of trait anxiety. In addition, mediating effect analysis was conducted in the two studies to test whether two factors of trait anxiety were mediators of the relationship between mindfulness and depression.

Results: The exploratory factor analysis extracted two dimensions of trait anxiety, namely, trait anxiety-present factor (TA-P) and trait anxiety-absent factor (TA-A). And confirmatory factor analysis showed that the fit of the two-factor model was acceptable. Both TA-P and TA-A were significantly negatively correlated with mindfulness and positively correlated with depression, and they played a mediating role between mindfulness and depression. The two factors of trait anxiety had multiple mediating effects on the relationship between mindfulness and depression, and the mediating effect of the TA-P factor was stronger than that of the TA-A factor.

Conclusion: Our results demonstrated a two-factor model of trait anxiety in the Chinese population. TA-P and TA-A played a multiple mediating role in the relationship between mindfulness and depression. The findings provide new perspectives for psychological interventions to treat depression for people with susceptible personalities. Aiming to reduce negative emotional tendencies (TA-P factor) and enhance positive cognition (TA-A factor) may achieve the early prevention and efficient treatment of depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6212471/

 

Improve Physical and Mental Health with Musculoskeletal Disorders with Mindfulness Practices

psyjdc Leave a comment

Improve Physical and Mental Health with Musculoskeletal Disorders with Mindfulness Practices

 

By John M. de Castro, Ph.D.

 

“Musculoskeletal disorders (MSDs) is the term given to a variety of painful conditions that affect the muscles, bones, and joints, which are a leading cause of long term sickness absence. . .MSDs are also at risk of developing symptoms of depression . . . Being off work for a significant period of time, whether due to an musculoskeletal disorder or other condition, can cause many other repercussions – including mental health issues.” – Fit for Work

 

Orthopedic Disorders consist of a wide range of problems that are concerned with muscles, ligaments and joints. Disorders are ailments, injuries or diseases that cause knee problems, whiplash, dislocated shoulder, torn cartilages, foot pain and fibromyalgia. The most common forms of orthopedic disorders are arthritis, and back and neck pain.

 

Arthritis is a chronic disease that most commonly affects the joints. Depending on the type of arthritis symptoms may include pain, stiffness, swelling, redness, and decreased range of motion. It affects an estimated 52.5 million adults in the United States. The pain, stiffness, and lack of mobility associate with arthritis produce fatigue and markedly reduce the quality of life of the sufferers.

 

The most common forms of chronic pain are back and neck pain. Low Back Pain is the leading cause of disability worldwide and affects between 6% to 15% of the population. Back and neck pain interferes with daily living and with work, decreasing productivity and creating absences. Arthritis and back pain can have very negative psychological effects and may lead to depression, isolation, and withdrawal from friends and social activities.

 

There are many different treatments for pain, but few are both safe and effective for chronic musculoskeletal pain conditions. So, alternative treatments are needed. Mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of arthritis, low back pain and neck pain. In addition, mindfulness practices have been shown to improve mental health. So, it is likely that mindfulness practices will be effective for both the physical and mental health issues that accompany musculoskeletal disorders.

 

In today’s Research News article “Scoping review of systematic reviews of complementary medicine for musculoskeletal and mental health conditions.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196876/ ), Lorenc and colleagues review and summarize the published research studies on the effectiveness of mindfulness practices for the treatment of the psychological problems that accompany musculoskeletal disorders.

 

They summarize the evidence from 111 published research studies and report that these studies support the effectiveness of yoga for low back pain, and anxiety; Tai Chi for osteoarthritis, depression, anxiety, and sleep disorders; meditation for depression, anxiety, and sleep disorders; and mindfulness for stress and distress. There were no safety problems found with any of these mindfulness techniques.

 

This review indicates that there has accumulated a large body of evidence for the safety and effectiveness of mindfulness practices for the physical and mental health issues that accompany musculoskeletal disorders. Hence the published research to date supports the use of mindfulness practices in the package of treatments for musculoskeletal disorders.

 

So, improve physical and mental health with musculoskeletal disorders with mindfulness practices.

 

“Yoga has been used to alleviate musculoskeletal pain and has been associated with significant improvement in range of motion and function, decreased tenderness, lower levels of depressive symptoms, and decreased pain during activity in patients with musculoskeletal disorders.” – Ruth McCaffrey

 

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

 

Lorenc, A., Feder, G., MacPherson, H., Little, P., Mercer, S. W., & Sharp, D. (2018). Scoping review of systematic reviews of complementary medicine for musculoskeletal and mental health conditions. BMJ open, 8(10), e020222. doi:10.1136/bmjopen-2017-020222

 

Abstract

Objective

To identify potentially effective complementary approaches for musculoskeletal (MSK)–mental health (MH) comorbidity, by synthesising evidence on effectiveness, cost-effectiveness and safety from systematic reviews (SRs).

Design

Scoping review of SRs.

Methods

We searched literature databases, registries and reference lists, and contacted key authors and professional organisations to identify SRs of randomised controlled trials for complementary medicine for MSK or MH. Inclusion criteria were: published after 2004, studying adults, in English and scoring >50% on Assessing the Methodological Quality of Systematic Reviews (AMSTAR); quality appraisal checklist). SRs were synthesised to identify research priorities, based on moderate/good quality evidence, sample size and indication of cost-effectiveness and safety.

Results

We included 84 MSK SRs and 27 MH SRs. Only one focused on MSK–MH comorbidity. Meditative approaches and yoga may improve MH outcomes in MSK populations. Yoga and tai chi had moderate/good evidence for MSK and MH conditions. SRs reported moderate/good quality evidence (any comparator) in a moderate/large population for: low back pain (LBP) (yoga, acupuncture, spinal manipulation/mobilisation, osteopathy), osteoarthritis (OA) (acupuncture, tai chi), neck pain (acupuncture, manipulation/manual therapy), myofascial trigger point pain (acupuncture), depression (mindfulness-based stress reduction (MBSR), meditation, tai chi, relaxation), anxiety (meditation/MBSR, moving meditation, yoga), sleep disorders (meditative/mind–body movement) and stress/distress (mindfulness). The majority of these complementary approaches had some evidence of safety—only three had evidence of harm. There was some evidence of cost-effectiveness for spinal manipulation/mobilisation and acupuncture for LBP, and manual therapy/manipulation for neck pain, but few SRs reviewed cost-effectiveness and many found no data.

Conclusions

Only one SR studied MSK–MH comorbidity. Research priorities for complementary medicine for both MSK and MH (LBP, OA, depression, anxiety and sleep problems) are yoga, mindfulness and tai chi. Despite the large number of SRs and the prevalence of comorbidity, more high-quality, large randomised controlled trials in comorbid populations are needed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196876/

 

Mindfulness is Associated with Lower Anxiety and Depression in Adolescents Partly by Higher Emotional Intelligence

psyjdc 1 Comment

Mindfulness is Associated with Lower Anxiety and Depression in Adolescents Partly by Higher Emotional Intelligence

 

By John M. de Castro, Ph.D.

 

“It is well-documented that mindfulness helps to relieve depression and anxiety in adults. A small but growing body of research shows that it may also improve adolescent resilience to stress through improved cognitive performance and emotional regulation. This is encouraging news for anyone concerned about the increasing rates of depressive symptoms and suicide rates among adolescents in the United States” – Malka Main

 

Adolescence is a time of mental, physical, social, and emotional growth. It is during this time that higher levels of thinking, sometimes called executive function, develops. But adolescence can be a difficult time, fraught with challenges. During this time the child transitions to young adulthood; including the development of intellectual, psychological, physical, and social abilities and characteristics. There are so many changes occurring during this time that the child can feel overwhelmed and unable to cope with all that is required. 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 and depression 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. In today’s Research News article “Does Emotional Intelligence Mediate the Relation Between Mindfulness and Anxiety and Depression in Adolescents?” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2018.02463/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_856297_69_Psycho_20181220_arts_A ), Foster and colleagues recruited 8th Grade students and had them complete an online questionnaire measuring mindfulness, anxiety, depression, and emotional intelligence, including subscales for emotional recognition and expression, understanding emotions, motions direct cognition, and emotional management and control. The data were then subjected to regression analysis.

 

They found that the higher the levels of mindfulness the higher the levels of emotional intelligence, overall and all subscales, and the lower the levels of anxiety and depression. They also found that the higher the levels of emotional intelligence, overall and all subscales, the higher the levels of mindfulness and the lower the levels of anxiety and depression. Performing a mediation analysis, they found that mindfulness was associated with lower levels of anxiety and depression directly and also indirectly by its association with emotional intelligence which in turn was associated with lower levels of anxiety and depression.

 

The study was correlational. So, no conclusions about causation can be reached. The results, however, suggest that adolescents are similar to adults in having clear relationships between mindfulness, emotional intelligence, and psychological health. Like adults, the adolescents’ levels of mindfulness and emotional intelligence are associated with lower levels of anxiety and depression. The results, though, also suggest that mindfulness’ association with anxiety and depression is partly by a direct association and partly indirectly through an association with emotional intelligence. This further highlights the fact that mindfulness is an important contributor to the development of an understanding of and ability to regulate emotions. It can’t be overemphasized how important this is for the adolescent in navigating the turbulent years of adolescence.

 

So, mindfulness is associated with lower anxiety and depression in adolescents partly by higher emotional intelligence.

 

“Anything that increases awareness helps with the struggle with depression, anxiety, and substance use. In terms of adolescents increasing awareness actually increases maturation—particularly if the practice is done in an environment leading to increased connection with others who understand your challenges.” – Michel Mennesson

 

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

 

Foster B, Lomas J, Downey L and Stough C (2018) Does Emotional Intelligence Mediate the Relation Between Mindfulness and Anxiety and Depression in Adolescents? Front. Psychol. 9:2463. doi: 10.3389/fpsyg.2018.02463

 

High anxiety and depression are often observed in the Australian adolescent population, and if left untreated, can have long-term negative consequences impacting educational attainment and a range of important life outcomes. The utilization of mindfulness techniques has been associated with decreased anxiety and depression, but the underlying mechanisms for this is only beginning to be understood. Previous research with adult samples has suggested that the development of emotional intelligence (EI) may be one mechanism by which mindfulness confers its benefits on wellbeing. This study is the first to examine the relation between mindfulness, EI, anxiety, and depression in an adolescent population. It was hypothesized that EI would mediate the relationships between mindfulness and anxiety, as well as mindfulness and depression. The sample consisted of 108 adolescents from a public secondary school, aged between 13 and 15 years (Mage = 13.68, SDage = 0.56, 51 males and 57 females). Participants completed an online self-report questionnaire which measured dispositional mindfulness, EI, anxiety, and depression. The results indicated that one subscale of EI – Emotional Recognition and Expression (ERE) mediated the relation between mindfulness and anxiety, while two subscales of EI – ERE and Emotional Management and Control (EMC) mediated the relation between mindfulness and depression. Future research utilizing a mindfulness intervention should be conducted to examine whether the use of mindfulness increases EI and decreases anxiety and depression in adolescents.

https://www.frontiersin.org/articles/10.3389/fpsyg.2018.02463/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_856297_69_Psycho_20181220_arts_A

 

Improve the Psychological Health of Mothers of Children With Fragile X Syndrome with Mindfulness

psyjdc Leave a comment

Improve the Psychological Health of Mothers of Children With Fragile X Syndrome with Mindfulness

 

By John M. de Castro, Ph.D.

 

“the key to reducing caregiver burnout and compassion fatigue lies in what can be construed to some as the seemingly counter intuitive wisdom of mindfulness. Being mindful and engaging in radical self-care is proving to be one of the most effective ways to take care of your loved one while fortifying yourself.” – Audrey Meinertzhagen

 

Fragile X Syndrome is an incurable genetic disorder that involves the FMR1 gene on the X Chromosome. This gene is involved in promotion communications between neurons in the nervous system. This disorder affects about 200,000 children a year in the US and is characterized by trouble learning skills like sitting, crawling, or walking, problems with language and speech, hand-flapping and not making eye contact, temper tantrums, poor impulse control, anxiety, extreme sensitivity to light or sound, and hyperactivity and trouble paying attention. Some children with fragile X also have changes to their face and body that can include a large head, long, narrow face, large ears, a large forehead and chin, loose joints, and flat feet.

 

Needless to say, raising these children can be a challenge and place considerable stress on the caregivers. Caregiving exacts a tremendous toll on caregivers’ health and well-being. Caregiving has been associated with increased levels of depression and anxiety as well as higher use of psychoactive medications, poorer self-reported physical health, compromised immune function, and increased mortality. The challenges of caring for a child with Fragile X Syndrome requires that the individual be able to deal with stress, to regulate their own emotions, and to be sensitive and attentive. These skills are exactly those that are developed in mindfulness training. It improves the psychological and physiological responses to stress. It improves emotion regulation. And it improves the ability to maintain attention and focus in the face of high levels of distraction. So, it is not surprising that mindfulness improves caregiving and assists the caregiver in coping with the stress.

 

In today’s Research News article “Mindfulness and Acceptance as Potential Protective Factors for Mothers of Children With Fragile X Syndrome.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6232517/ ), Wheeler and colleagues administered an online survey to mothers of children with Fragile X Syndrome. They measured the severity of the child’s disability, perceived stress, mindfulness, mindful parenting, anxiety, depression, physical health, and psychological acceptance. They then performed a regression analysis to explore the relationships between these variables.

 

They found that overall the mothers were high in perceived stress and anxiety. The child’s symptoms took their toll as the greater the severity of the child’s disability the higher the levels of stress, anxiety, depression, and physical symptoms in the mothers. They also found that mindfulness and acceptance appeared to buffer these effects with high levels of mindfulness and acceptance associated with low levels of stress, anxiety, depression, and physical symptoms and high levels of mindful parenting associated with low levels of anxiety, depression, and physical symptoms. Importantly, acceptance attenuated the effect of the child’s disability the lower the levels of physical symptoms. Being mindful and accepting of the child’s condition and behavior were very highly associated with reduced maternal distress.

 

These results are interesting but they are correlational and causation cannot be determined. But they suggest that mindfulness, mindful parenting, and acceptance are important for dealing with the deleterious effects of caring for a child with Fragile X Syndrome. Previous research has shown that mindfulness can produce improvements in the caregiver’s psychological state. So, it is likely that there is a causal connection between mindfulness and the psychological state of caregivers for children with Fragile X Syndrome.

 

These results suggest that training in mindfulness, mindful parenting, and acceptance may be greatly beneficial for mothers caring for children with Fragile X Syndrome, reducing their distress and potentially improving their caregiving for the child. This is a difficult situation for the mothers and such help could be greatly beneficial.

 

So, improve the psychological health of mothers of children with Fragile X Syndrome with mindfulness.

 

“mindfulness practices could be helpful for these caregivers because they encourage a nonjudgmental interpretation of their child’s situation, and increased acceptance of their reality. Mindfulness practices also help people observe their thoughts and behaviors with less reactivity and judgment, which could enable caregivers to better respond to the emotional and physical difficulties they encounter.” – Emily Nauman

 

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

 

Wheeler, A. C., Miller, S., Wylie, A., & Edwards, A. (2018). Mindfulness and Acceptance as Potential Protective Factors for Mothers of Children With Fragile X Syndrome. Frontiers in public health, 6, 316. doi:10.3389/fpubh.2018.00316

 

Abstract

Women with an FMR1 premutation may be at increased genetic risk for stress vulnerability. This increased vulnerability, when combined with stressful parenting that can result from raising children with fragile X syndrome (FXS), may result in negative physical and emotional outcomes. Mindfulness and acceptance have been found to be protective factors for parents of children with similar behavioral challenges, but these traits have not previously been explored among mothers with a child with FXS. This study explored the associations of child disability severity with maternal stress, anxiety, depression, and physical health symptoms in 155 biological mothers of children with FXS. Women completed an online survey using standardized measures of stress, mindfulness, and acceptance. General mindfulness, mindfulness in the parenting role, and general acceptance were explored as potential protective factors between the child disability severity and maternal outcomes. Trait mindfulness and acceptance were significant predictors of lower stress, anxiety, depression, and daily health symptoms, while mindful parenting was associated with lower stress, anxiety, and depression. Acceptance was found to attenuate the effects of child severity on maternal stress and depression. These findings suggest that interventions focused on improving mindfulness and acceptance may promote health and well-being for mothers of children with FXS and have important health implications for all individuals with an FMR1 premutation.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6232517/

 

Improve Mental Health with Mindfulness Learned Over the Internet

psyjdc Leave a comment

Improve Mental Health with Mindfulness Learned Over the Internet

 

By John M. de Castro, Ph.D.

 

“With the rise of mental illness and the increasingly pressing need for effective treatments, there’s never been a more important moment for mindfulness — the ability to cultivate a focused, non-judgmental awareness on the present moment. Research has shown mindfulness and meditation-based programs to hold promise for treating a number of psychiatric conditions, including depression, anxiety, post-traumatic stress disorder, bipolar disorder and obsessive-compulsive disorder.” Carolyn Gregoire

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress. The vast majority of the mindfulness training techniques, however, require a certified trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. As an alternative, online mindfulness training programs have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. There is evidence that mindfulness programs delivered online can be quite effective. But there is a need to further investigate the effectiveness of these programs as an alternative to face-to-face trainings for the treatment of clinical mental health problems.

 

In today’s Research News article “Web-Based Mindfulness Interventions for Mental Health Treatment: 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/PMC6231788/ ), Sevilla-Llewellyn-Jones and colleagues review, summarize, and perform a meta-analysis of the effectiveness on mindfulness training delivered online for the improvement of clinical mental health. They found 12 published studies employing patients with diagnosed mental health issues who received online mindfulness training.

 

They found that the published research literature reported that online mindfulness training produced significant improvements in depression and anxiety, especially in patients diagnosed with anxiety disorders. In addition, they found that online mindfulness training produced significant improvements in quality of life and mindfulness skills in these clinical patients. The effects were strongest when the control condition was a wait-list and less so, and often non-significant when compared to other active treatments. This suggests the online mindfulness training is not more but equivalently effective as other treatments.

 

These are important results as anxiety disorders and depression are very common diagnoses. It has been well established that mindfulness training improves depression and anxiety. These results extend these prior findings by demonstrating that treatment can be delivered online and to patients with clinical mental health diagnoses. The fact that the treatment was found to be especially effective for patients with anxiety disorders is important as patients with anxiety disorders may be reticent to venture into a clinical environment to receive treatment. Being able to receive treatment without venturing out into the outside world with all of its anxiety evoking situations may be very helpful for these patients.

 

The fact that mindfulness training can be effective when delivered online is very important. Online delivery allows for the application of mindfulness training to a much wider audience at low cost and thus increases the availability of treatment for the relief of suffering,

 

So, improve mental health with mindfulness learned over the internet.

 

“Mindfulness helps to be awakening to the patterns of the mind rather than emptying the mind. It helps you to be in touch with your way of ‘being’ rather than ‘doing’. It is a concept that could be life changing and worth experiencing.” – Christos Papalekas

 

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

 

Sevilla-Llewellyn-Jones, J., Santesteban-Echarri, O., Pryor, I., McGorry, P., & Alvarez-Jimenez, M. (2018). Web-Based Mindfulness Interventions for Mental Health Treatment: Systematic Review and Meta-Analysis. JMIR mental health, 5(3), e10278. doi:10.2196/10278

 

Abstract

Background

Web-based mindfulness interventions are increasingly delivered through the internet to treat mental health conditions.

Objective

The objective of this study was to determine the effectiveness of web-based mindfulness interventions in clinical mental health populations. Secondary aims were to explore the impact of study variables on the effectiveness of web-based mindfulness interventions.

Methods

We performed a systematic review and meta-analysis of studies investigating the effects of web-based mindfulness interventions on clinical populations.

Results

The search strategy yielded 12 eligible studies. Web-based mindfulness interventions were effective in reducing depression in the total clinical sample (n=656 g=−0.609, P=.004) and in the anxiety disorder subgroup (n=313, g=−0.651, P<.001), but not in the depression disorder subgroup (n=251, P=.18). Similarly, web-based mindfulness interventions significantly reduced anxiety in the total clinical sample (n=756, g=−0.433, P=.004) and the anxiety disorder subgroup (n=413, g=−0.719, P<.001), but not in the depression disorder group (n=251, g=−0.213, P=.28). Finally, web-based mindfulness interventions improved quality of life and functioning in the total sample (n=591, g=0.362, P=.02) in the anxiety disorder subgroup (n=370, g=0.550, P=.02) and mindfulness skills in the total clinical sample (n=251, g=0.724, P<.001).

Conclusions

Results support the effectiveness of web-based mindfulness interventions in reducing depression and anxiety and in enhancing quality of life and mindfulness skills, particularly in those with clinical anxiety. Results should be interpreted with caution given the high heterogeneity of web-based mindfulness interventions and the low number of studies included.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231788/

 

Improve Psychological Health with Online Mindfulness Training

psyjdc Leave a comment

Improve Psychological Health with Online Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“The research is strong for mindfulness’ positive impact in certain areas of mental health, including stress reduction, emotion and attention regulation, reduced rumination, for reducing mild to moderate depression and anxiety, and preventing depressive relapse.” – Kelle Walsh

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress. The vast majority of the mindfulness training techniques, however, require a certified trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. As an alternative, online mindfulness training programs have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. There is evidence that mindfulness programs delivered online can be quite effective. But there is a need to further investigate the effectiveness of these programs as an alternative to face-to-face trainings.

 

In today’s Research News article “The Effects of an Online Mindfulness Intervention on Perceived Stress, Depression and Anxiety in a Non-clinical Sample: A Randomised Waitlist Control Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6244637/ ), Querstet and colleagues recruited adult participants online and randomly assigned them to either a wait-list control condition or to receive a 4-week online mindfulness course. The course was implemented with audio and video components and required about 2 hours each week and additional homework. The participants were measured before and after the training for mindfulness, perceived stress, anxiety, and depression. After the wait-list controls completed their mindfulness training they completed follow-up measures at 3 and 6 months after the training.

 

They found that in comparison to the wait-list controls, the participants who received mindfulness training had significant reductions in perceived stress, anxiety, and depression. There were also significant increases in mindfulness including the observing, describing, acting with awareness, and non-judging facets. These effects were sustained 3 and 6 months after the completion of training. They also found that the decreases in perceived stress, anxiety, and depression, produced by the intervention were mediated by the increases in the non-judging facet of mindfulness. The effect on depression was also meditated by the describing facet of mindfulness.

 

It is interesting that the facet of mindfulness that appeared to have the greatest impact on the psychological health of the participants was non-judging. Hence, being able to be aware of varied experiences simply as experiences and not judging them is a key to improved psychological well-being. This makes sense as most of the things that happen to an individual are not under their control. What can be controlled are the reactions to the experiences. These are best accomplished if they can be seen as not good or bad, important or trivial, or due to some personal characteristic, but simply as they are.

 

The results add to the accumulating evidence that mindfulness can be trained online and that it produces similar benefits as face-to-face training. This is very important as this makes mindfulness training inexpensive and available to a very large population regardless of schedule and location. This makes it possible to bring the benefits of mindfulness training, promoting psychological health and well-being, to a wide audience.

 

So, improve psychological health with online mindfulness training.

 

“Mindfulness helps to train individuals in bringing back the attention time and time again when it has wandered. And it is precisely through helping individuals to not get carried away by their thoughts that mindfulness has been shown to be so effective for conditions like anxiety and depression.” – Carolyn Gregoire

 

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

Querstret, D., Cropley, M., & Fife-Schaw, C. (2018). The Effects of an Online Mindfulness Intervention on Perceived Stress, Depression and Anxiety in a Non-clinical Sample: A Randomised Waitlist Control Trial. Mindfulness, 9(6), 1825–1836.

 

Abstract

Mindfulness interventions have been shown to be effective for health and wellbeing, and delivering mindfulness programmes online may increase accessibility and reduce waiting times and associated costs; however, research assessing the effectiveness of online interventions is lacking. We sought to: (1) assess the effects of an online mindfulness intervention on perceived stress, depression and anxiety; (2) assess different facets of mindfulness (i.e. acting with awareness, describing, non-judging and non-reacting) as mechanisms of change and (3) assess whether the effect of the intervention was maintained over time. The sample was comprised of 118 adults (female, n = 95) drawn from the general population. Using a randomised waitlist control design, participants were randomised to either an intervention (INT) or waitlist control (WLC) group. Participants completed the online intervention, with the WLC group starting after a 6-week waitlist period. Participants completed measures of depression (PHQ-9), anxiety (GAD-7) and perceived stress (PSS-10) at baseline, post-treatment, 3- and 6-month follow-up. Participants who completed the mindfulness intervention (n = 60) reported significantly lower levels of perceived stress (d = − 1.25 [− 1.64, − 0.85]), anxiety (d = − 1.09 [− 1.47, − 0.98]) and depression (d = − 1.06 [− 1.44, − 0.67]), when compared with waitlist control participants (n = 58), and these effects were maintained at follow-up. The effect of the intervention was primarily explained by increased levels of non-judging. This study provides support for online mindfulness interventions and furthers our understanding with regards to how mindfulness interventions exert their positive effects.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6244637/

 

Improve Health Anxiety with Online Acceptance and Commitment Therapy

psyjdc Leave a comment

Improve Health Anxiety with Online Acceptance and Commitment Therapy

 

By John M. de Castro, Ph.D.

 

“Most of us care about our health but for up to 5% of people, worrying about health has become a significant problem in itself. Severe health anxiety, or hypochondriasis, is said to exist when someone holds a strong fear of having a serious disease, despite all medical assurances to the contrary.” – Fabio Fuchelli

 

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. Health anxiety is a fear of a serious illness can interfere with their daily life. It often leads to seeking unnecessary testing and to spend days consumed by worry. Health anxiety is a relatively common condition, affecting 4% to 5% of both men and women equally.

 

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. Additionally, ACT helps people strengthen aspects of cognition such as in committing to valued living. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

Acceptance and Commitment Therapy (ACT), however, requires a certified trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. As an alternative, mindfulness-based treatments delivered over the internet have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. But the question arises as to the effectiveness of these internet applications in inducing mindfulness and improving psychological health.

 

In today’s Research News article “Development and Feasibility Testing of Internet-Delivered Acceptance and Commitment Therapy for Severe Health Anxiety: Pilot Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5938695/ ), Hoffman and colleagues examine the acceptability and effectiveness of an internet-based Acceptance and Commitment Therapy (ACT) module applied to the treatment of Health Anxiety Disorder. They recruited participants who expressed symptoms of Health Anxiety Disorder and delivered 7 once-a-week online modules of ACT including 10-15 pages of textual instructions, videos, and home exercises. The participants were measured before and after treatment and 3 months later for health anxiety, depression, anxiety, health related quality of life, life satisfaction, and psychological flexibility.

 

They found that 80% of the participants completed the program. The participants found the internet format acceptable and some commented that it produced less anxiety working on this at home instead of a hospital or clinic. They found that after treatment there were significant decreases in health anxiety, depression, and anxiety and significant increases in life satisfaction and psychological flexibility. These effects were maintained at the 3-month follow-up. Hence the internet-based Acceptance and Commitment Therapy (ACT) was acceptable to patients and produced lasting benefits in reducing health anxiety and improving psychological health.

 

This study did not have a comparable control condition and as such has to be seen as a pilot feasibility study. A randomized clinical trial is needed to verify the results. But the present findings are encouraging and suggest that a large controlled study is warranted. The development of an effective online version of ACT would be particularly significant as it would markedly open up accessibility of this therapy to a much wider patient population, reduce costs, and improve outcomes.

 

So, improve health anxiety with online Acceptance and Commitment Therapy.

 

“mindfulness allows us to interrupt automatic, reflexive fight, flight, or freeze reactions—reactions that can lead to anxiety, fear, foreboding, and worry.” – Bob Stahl

 

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

Hoffmann, D., Rask, C. U., Hedman-Lagerlöf, E., Ljótsson, B., & Frostholm, L. (2018). Development and Feasibility Testing of Internet-Delivered Acceptance and Commitment Therapy for Severe Health Anxiety: Pilot Study. JMIR mental health, 5(2), e28. doi:10.2196/mental.9198

 

Abstract

Background

Severe health anxiety (hypochondriasis), or illness anxiety disorder according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, is characterized by preoccupation with fear of suffering from a serious illness in spite of medical reassurance. It is a debilitating, prevalent disorder associated with increased health care utilization. Still, there is a lack of easily accessible specialized treatment for severe health anxiety.

Objective

The aims of this paper were to (1) describe the development and setup of a new internet-delivered acceptance and commitment therapy (iACT) program for patients with severe health anxiety using self-referral and a video-based assessment; and (2) examine the feasibility and potential clinical efficacy of iACT for severe health anxiety.

Methods

Self-referred patients (N=15) with severe health anxiety were diagnostically assessed by a video-based interview. They received 7 sessions of clinician-supported iACT comprising self-help texts, video clips, audio files, and worksheets over 12 weeks. Self-report questionnaires were obtained at baseline, post-treatment, and at 3-month follow-up. The primary outcome was Whiteley-7 Index (WI-7) measuring health anxiety severity. Depressive symptoms, health-related quality of life (HRQoL), life satisfaction, and psychological flexibility were also assessed. A within-group design was employed. Means, standard deviations, and effect sizes using the standardized response mean (SRM) were estimated. Post-treatment interviews were conducted to evaluate the patient experience of the usability and acceptability of the treatment setup and program.

Results

The self-referral and video-based assessments were well received. Most patients (12/15, 80%) completed the treatment, and only 1 (1/15, 7%) dropped out. Post-treatment (14/15, 93%) and 3-month follow-up (12/15, 80%) data were available for almost all patients. Paired t tests showed significant improvements on all outcome measures both at post-treatment and 3-month follow-up, except on one physical component subscale of HRQoL. Health anxiety symptoms decreased with 33.9 points at 3-month follow-up (95% CI 13.6-54.3, t11= 3.66, P=.004) with a large within-group effect size of 1.06 as measured by the SRM.

Conclusions

Treatment adherence and potential efficacy suggest that iACT may be a feasible treatment for health anxiety. The uncontrolled design and small sample size of the study limited the robustness of the findings. Therefore, the findings should be replicated in a randomized controlled trial. Potentially, iACT may increase availability and accessibility of specialized treatment for health anxiety.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5938695/