Anxiety

Improve the Regulation of Emotions in Social Anxiety Disorder with Mindfulness

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Improve the Regulation of Emotions in Social Anxiety Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“One way to do this . . . is mindfulness meditation, in which you observe your thoughts and feelings with the objectivity of a disinterested, nonjudgmental witness. This form of mental training gives you the wherewithal to pause, observe how easily the mind can exaggerate the severity of a setback, note that it as an interesting mental process, and resist getting drawn into the abyss,” – Ritchie Davidson

 

Mindfulness practices have been shown to have a large number of beneficial effects on the psychological, emotional, and physical health of the individual and is helpful in the treatment of mental and physical illness. They have also been shown to effect a large number of physiological and psychological processes, including emotion regulation, attention, sensory awareness, decentering, and reappraisal. It is not known how mindfulness practices produce the myriad effects on the individual’s health and well-being, whether mindfulness has a direct effect or works through intermediary effects to produce the improved well-being.

 

There has been some research on this question, for instance mindfulness has been found to improve some symptoms of mental illness by increasing reappraisal which then affects the symptoms. In today’s Research News article “Testing the mindfulness-to-meaning theory: Evidence for mindful positive emotion regulation from a reanalysis of longitudinal data.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718463/ ), Garland and colleagues examine the hypothesis that mindfulness practices influence social anxiety disorder (SAD) through a series of intermediaries. They postulate that mindfulness training increases attention which, in turn increases decentering, which, in turn, broadens sensory awareness, which, in turn increases reappraisal, which increases emotion regulation and reductions in social anxiety disorder (SAD).

 

To examine this idea they reanalyzed the data from a longitudinal study of the effects of Mindfulness-Based Stress Reduction (MBSR) and Cognitive Behavioral Therapy (CBT) on social anxiety disorder (SAD) to determine the temporal sequence of mindfulness effects. Participants with SAD were randomly assigned to receive either 12 weeks of MBSR or CBT group therapy or on a wait-list control condition. MBSR consists of a combination of meditation, body scanning, and yoga practices. The participants were measured pretreatment, post-treatment, and 3, 6, 9, and 12 months later for attentional control, decentering, reappraisal, sensory awareness, dispositional mindfulness, emotion regulation and positive emotions. The data were analyzed with a sophisticated multivariate path analysis.

 

The best fit path revealed by the analysis had excellent model fit. It revealed that both MBSR and CBT produced significant improvements in attentional control at the end of the 12-week treatment. These attentional improvements were significantly associated with increases in decentering 3 months later. Similarly, change in decentering was significantly associated with broadened sensory awareness at the 6-month follow-up measurement. In turn, the broadened sensory awareness was significantly associated with increases in reappraisal at the 9-month follow-up measurement. Finally, increases in reappraisal were significantly associated with increases in positive emotions at the 12-month follow-up measurement. In comparing Mindfulness-Based Stress Reduction (MBSR) with Cognitive Behavioral Therapy (CBT) in this model, it was found that MBSR produced significantly greater decentering and broadened sensory awareness. So, both MBSR and CBT would appear effective for social anxiety disorder (SAD) but MBSR would appear to be the superior treatment.

 

These are interesting and important findings suggest the mechanism by which mindfulness training improves emotion regulation in patients with social anxiety disorder (SAD). They suggest that mindfulness training sets off a chain of events consisting of improved attention followed by increased decentering followed by broadened sensory awareness, followed by increased reappraisal, followed by increased emotion regulation and reduced social anxiety disorder (SAD). It remains for future research to determine if this sequence events accounts for any other of the mental or physical health benefits of mindfulness training.

 

So, improve the regulation of emotions in social anxiety disorder with mindfulness.

 

“Through your mindful acceptance, you can embrace or hold the feeling in your awareness– this alone can calm and soothe you. This is an act of self-compassion and responsiveness to your own distress, and it is so much more effective than punishing yourself for having this feeling.” – Melli O’Brien

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Garland, E. L., Hanley, A. W., Goldin, P. R., & Gross, J. J. (2017). Testing the mindfulness-to-meaning theory: Evidence for mindful positive emotion regulation from a reanalysis of longitudinal data. PLoS ONE, 12(12), e0187727. http://doi.org/10.1371/journal.pone.0187727

 

Abstract

Background and objective

The Mindfulness to Meaning Theory (MMT) provides a detailed process model of mindful positive emotion regulation.

Design

We conducted a post-hoc reanalysis of longitudinal data (N = 107) derived from a RCT of mindfulness-based stress reduction (MBSR) versus cognitive-behavioral therapy (CBT) for social anxiety disorder to model the core constructs of the MMT (attentional control, decentering, broadened awareness, reappraisal, and positive affect) in a multivariate path analysis.

Results

Findings indicated that increases in attentional control from baseline to post-training predicted increases in decentering by 3 months post-treatment (p<.01) that in turn predicted increases in broadened awareness of interoceptive and exteroceptive data by 6 months post-treatment (p<.001). In turn, broadened awareness predicted increases in the use of reappraisal by 9 months post-treatment (p<.01), which culminated in greater positive affect at 12 months post-treatment (p<.001). MBSR led to significantly greater increases in decentering (p<.05) and broadened awareness than CBT (p<.05). Significant indirect effects indicated that increases in decentering mediated the effect of mindfulness training on broadening awareness, which in turn mediated enhanced reappraisal efficacy.

Conclusion

Results suggest that the mechanisms of change identified by the MMT form an iterative chain that promotes long-term increases in positive affectivity. Though these mechanisms may reflect common therapeutic factors that cut across mindfulness-based and cognitive-behavioral interventions, MBSR specifically boosts the MMT cycle by producing significantly greater increases in decentering and broadened awareness than CBT, providing support for the foundational assumption in the MMT that mindfulness training may be a key means of stimulating downstream positive psychological processes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718463/

Improve Emotions of Ethnically Diverse At-Risk Students with Mindfulness

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Improve Emotions of Ethnically Diverse At-Risk Students with Mindfulness

 

By John M. de Castro, Ph.D.

 

“There is plenty of evidence available now that demonstrates the value of teaching mindfulness to young people, and many of the benefits of mindfulness are skills and dispositions that are especially helpful in the context of education. Mindfulness practices help children improve their ability to pay attention, by learning to focus on one thing (e.g., breath, sound) while filtering out other stimuli. Mindfulness also provides kids with skills for understanding their emotions and how to work with them.” – Sarah Beach

 

Adolescence should be a time of mental, physical, social, and emotional growth. It is during this time that higher levels of thinking, sometimes called executive function, develops. These executive functions are an important foundation for success in the complex modern world. 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. These difficulties can be markedly amplified by negative life events during childhood.

 

At-risk youth confront unique pressures that have been linked to poor psychosocial outcomes, impaired academic performance, and maladaptive behaviors such as substance use and delinquency. These risk factors may include language barriers, low SES, parents’ own involvement in high risk or illegal behavior, restrictive or neglectful parenting, and home environments that expose children to alcohol and substance abuse. Mindfulness training has been found to be helpful for adolescents and also to improve performance in school. So, it is possible that mindfulness training would be helpful for at-risk adolescents.

 

In today’s Research News article “A School-Based Mindfulness Pilot Study for Ethnically Diverse At-Risk Adolescents.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4809539/pdf/nihms652885.pdf, Bluth and colleagues recruited adolescents who were attending an alternative high school for troublesome and at-risk students. They were randomly assigned to receive either and 11-week class of mindfulness training or substance abuse training. The mindfulness training included body scan, sitting meditation, lovingkindness practice, walking meditation and mindful movement. The substance abuse training consisted of lectures designed to help adolescents address drug use and co-occurring life problems. The students were measured before and after the trainings for class attendance, retention, program acceptability, mindfulness, self-compassion, social connectedness, anxiety, depression, and perceived stress.

 

At the beginning of the mindfulness training there was considerable resistance and acting out. But, by the end of training the students responded that the class was helpful and wanted it to continue. They also found that the mindfulness training produced significant improvements in the students’ depression and anxiety levels. Mindfulness training has in the past been repeatedly shown to help relieve depression and anxiety. But, it is an important finding that it can do so in these difficult to treat at-risk adolescents. So, the study showed that mindfulness training was feasible and acceptable to these at-risk adolescents and produced improvements in their negative emotions.

 

The results are encouraging. These troubled youths are extremely difficult to work with and treat and that was reflected in the negative behaviors at the beginning of the class. But, by the end of the class the students found the mindfulness training useful and there were fairly large improvements in anxiety and depression. There were trends for other improvements and a larger future trial may be able to demonstrate other benefits of the mindfulness training. Although it was clear that mindfulness training is not a panacea for troubled youths, it can be helpful and provide space for them to destress and explore their inner lives.

 

So, improve emotions of ethnically diverse at-risk students with mindfulness.

 

“But a growing body of evidence suggests that mindfulness practice could be beneficial to teens, helping them cultivate empathy, as well as skills for concentration and impulse control. In short, mindfulness can help adolescents navigate the challenges of adolescence.” Sarah Beach

 

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

 

Bluth, K., Campo, R. A., Pruteanu-Malinici, S., Reams, A., Mullarkey, M., & Broderick, P. C. (2016). A School-Based Mindfulness Pilot Study for Ethnically Diverse At-Risk Adolescents. Mindfulness, 7(1), 90–104. http://doi.org/10.1007/s12671-014-0376-1

 

Adolescence is a transitional period marked by rapid physical, behavioral, emotional, and cognitive developmental changes. In addition to these normative development changes, adolescents also face a multitude of contextual stressors such as academic pressures at school, changing relationships with peers, and all too often, unstable family life characterized by divorce, frequent moves, income and occupational changes, and disruptions in family routines. Up to a quarter of adolescents suffer from depression or anxiety disorders, and an even larger proportion struggle with subclinical symptoms. Anxiety and depression during this stage can lead to impaired academic, social, and family functioning, and have long-term adverse outcomes.

Given the need to better understand both the implementation and potential benefit of mindfulness programs for at-risk youth, we conducted a randomized pilot study to investigate the feasibility and acceptability of such an intervention with ethnically diverse, primarily Hispanic youth enrolled in an alternative high school. We specifically examine intervention effects on psychosocial wellbeing and school performance relative to the control group, a class which focused on substance abuse prevention.

this study contributes to the literature by confirming the feasibility and acceptability of a mindfulness intervention with this population, and expands our knowledge on what works.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4809539/pdf/nihms652885.pdf

Decrease Stress and Improve Academic Performance with Mindfulness

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Decrease Stress and Improve Academic Performance with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Those higher in mindfulness experienced less anxiety associated with high-pressure math tests, and this in turn was linked with improved performance.” – Matthew Brensilver

 

In the modern world education is a key for success. Where a high school education was sufficient in previous generations, a college degree is now required to succeed in the new knowledge based economies. There is a lot of pressure on students to excel so that they can be admitted to the best universities and there is a lot of pressure on university students to excel so that they can get the best jobs after graduation. As a result, parents and students are constantly looking for ways to improve student performance in school.

 

The primary tactic has been to pressure the student and clear away routine tasks and chores so that the student can focus on their studies. But, this might in fact be counterproductive as the increased pressure can actually lead to stress and anxiety which can impede performance. A better tactic may be the development of mindfulness skills with contemplative practices. These practices and high levels of mindfulness have been shown to be helpful in coping with the school environment and for the performance of both students and teachers. So, perhaps, mindfulness training may provide the needed edge in college academic performance.

 

In today’s Research News article “A Randomized Controlled Pilot Intervention Study of a Mindfulness-Based Self-Leadership Training (MBSLT) on Stress and Performance.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605596/, Sampl and colleagues recruited college students and randomly assigned them to either receive a 10-week Mindfulness-Based Self-Leadership Training (MBSLT) program or a wait-list control condition.  MBSLT was administered once a week for 2 hours. In addition to mindfulness training MBSLT trained students in self-goal setting, self-reward, self-observation, self-cueing and reminding, visualizing successful performances, self-talk, and evaluating beliefs and assumption. The participants were also given exercises to be practiced at home. All participants were measured before and after training for mindfulness, self-leadership, perceived stress, test anxiety, self-efficacy, semester grades, and Grade Point Average (GPA).

 

They found that at the conclusion of training the Mindfulness-Based Self-Leadership Training (MBSLT) group had significantly greater mindfulness, self-efficacy, and self-leadership and significantly lower levels of perceived stress and test anxiety. Importantly, the MBSLT group had significantly 24% higher grades at the end of the semester than the control group. Hence, mindfulness training improved the student’s mental health and academic performance.

These results are interesting and important and replicate prior research findings that mindfulness reduces stress and anxiety, including test anxiety and improves self-efficacy and academic performance. The present study supplemented mindfulness training with self-leadership training. Since there was not a mindfulness only or a self-leadership training only condition, it cannot be determined whether each component alone or in combination produced the benefits. In addition, they did not perform a mediation analysis to determine if the improvements in the students’ psychological condition was responsible for the improved academic performance.

 

Regardless, it is clear that the Mindfulness-Based Self-Leadership Training (MBSLT) training produced significant improvements in the students’ mental condition and academic performance. The magnitude of the increase in grades was striking and suggests that the mindfulness training may be important for college students to allow them to improve their psychological outlook and in turn reach their full academic potential.

 

So, decrease stress and improve academic performance with mindfulness.

 

“cultivating mindfulness is an effective and efficient technique for improving cognitive function, with widereaching consequences.” – Michael Mrazek

 

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

 

Sampl, J., Maran, T., & Furtner, M. R. (2017). A Randomized Controlled Pilot Intervention Study of a Mindfulness-Based Self-Leadership Training (MBSLT) on Stress and Performance. Mindfulness, 8(5), 1393–1407. http://doi.org/10.1007/s12671-017-0715-0

 

Abstract

The present randomized pilot intervention study examines the effects of a mindfulness-based self-leadership training (MBSLT) specifically developed for academic achievement situations. Both mindfulness and self-leadership have a strong self-regulatory focus and are helpful in terms of stress resilience and performance enhancements. Based on several theoretical points of contact and a specific interplay between mindfulness and self-leadership, the authors developed an innovative intervention program that improves mood as well as performance in a real academic setting. The intervention was conducted as a randomized controlled study over 10 weeks. The purpose was to analyze the effects on perceived stress, test anxiety, academic self-efficacy, and the performance of students by comparing an intervention and control group (n = 109). Findings demonstrated significant effects on mindfulness, self-leadership, academic self-efficacy, and academic performance improvements in the intervention group. Results showed that the intervention group reached significantly better grade point averages than the control group. Moreover, the MBSLT over time led to a reduction of test anxiety in the intervention group compared to the control group. Furthermore, while participants of the control group showed an increase in stress over time, participants of the intervention group maintained constant stress levels over time. The combination of mindfulness and self-leadership addressed both positive effects on moods and on objective academic performance. The effects demonstrate the great potential of combining mindfulness with self-leadership to develop a healthy self-regulatory way of attaining achievement-related goals and succeeding in high-stress academic environments.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605596/

8-Week Mindfulness Training Produces Greater Benefits than a 4-Week Training

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8-Week Mindfulness Training Produces Greater Benefits than a 4-Week Training

 

By John M. de Castro, Ph.D.

 

“adaptations of MBSR that include less class time than the traditional format may be worthwhile for populations for whom reduction of psychological distress is an important goal and for whom a lesser time commitment may be an important determinant of their ability or willingness to participate” – James Carmody

 

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

 

Mindfulness is defined as the “awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally” (John Kabat-Zinn). This is the goal of mindfulness training. There are, however, a vast array of techniques for the development of mindfulness. They include a variety of forms of meditation, yoga, mindful movements, contemplative prayer, and combinations of practices. Some are recommended to be practiced for years while others are employed for only a few weeks. Regardless of the technique, they all appear to develop and increase mindfulness. It is unclear exactly how much training is essential to producing maximum benefits.

 

In today’s Research News article “Efficacy of 8- and 4-Session Mindfulness-Based Interventions in a Non-clinical Population: A Controlled Study.” See summary below or view the full text of the study at: http://journal.frontiersin.org/article/10.3389/fpsyg.2017.01343/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_368025_69_Psycho_20170822_arts_A, Demarzo and colleagues recruited college students and randomly assigned them to a no-treatment control condition or to receive either a 4-week or 8-week Mindfulness-Based Stress Reduction (MBSR) programs that met once a week for 2 hours. MBSR consists of body scan, meditation, and mindful movement practice. Participants were also request to practice at home each day. Participants were measured before and after training and 6 months later for mindfulness, self-compassion, anxiety, depression, positive and negative emotions, and resilience.

 

They found that both the 4-week and 8-week mindfulness training groups in comparison to the control condition had, after training and at the 6-month follow-up, significantly improved mindfulness overall and in the mindfulness facets of describing, observing, acting with awareness, non-judging, and non-reacting, and in positive and negative emotions. On the other hand, only the 8-week mindfulness training produced a significant increase in self-compassion and decreases in anxiety and depression.

 

Mindfulness training has been shown in prior studies to improve mindfulness, emotions, anxiety, depression, self-compassion, and resilience. So, the benefits found in this study are not surprising. But the results on the amount of practice are interesting and suggest that considerable benefits accrue to participants in a short, 4-week, mindfulness training but for the full benefits an 8-week program is needed. Hence, unless an abbreviated program is needed for pragmatic reasons, training should be conducted for the full 8-week training period.

 

“people who have been mindfulness meditators for several decades have structural features in their brains that are proportional to their number of hours of practice.” – Daniel Segal

 

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

 

Demarzo M, Montero-Marin J, Puebla-Guedea M, Navarro-Gil M, Herrera-Mercadal P, Moreno-González S, Calvo-Carrión S, Bafaluy-Franch L and Garcia-Campayo J (2017) Efficacy of 8- and 4-Session Mindfulness-Based Interventions in a Non-clinical Population: A Controlled Study. Front. Psychol. 8:1343. doi: 10.3389/fpsyg.2017.01343

 

Background: Many attempts have been made to abbreviate mindfulness programmes in order to make them more accessible for general and clinical populations while maintaining their therapeutic components and efficacy. The aim of this study was to assess the efficacy of an 8-week mindfulness-based intervention (MBI) programme and a 4-week abbreviated version for the improvement of well-being in a non-clinical population.

Method: A quasi-experimental, controlled, pilot study was conducted with pre-post and 6-month follow-up measurements and three study conditions (8- and 4-session MBI programmes and a matched no-treatment control group, with a sample of 48, 46, and 47 participants in each condition, respectively). Undergraduate students were recruited, and mindfulness, positive and negative affect, self-compassion, resilience, anxiety, and depression were assessed. Mixed-effects multi-level analyses for repeated measures were performed.

Results: The intervention groups showed significant improvements compared to controls in mindfulness and positive affect at the 2- and 6-month follow-ups, with no differences between 8- vs. 4-session programmes. The only difference between the abbreviated MBI vs. the standard MBI was found in self-kindness at 6 months, favoring the standard MBI. There were marginal differences in anxiety between the controls vs. the abbreviated MBI, but there were differences between the controls vs. the standard MBI at 2- and 6-months, with higher levels in the controls. There were no differences in depression between the controls vs. the abbreviated MBI, but differences were found between the controls vs. the standard MBI at 2- and 6-months, favoring the standard MBI. There were no differences with regard to negative affect and resilience.

Conclusion: To our knowledge, this is the first study to directly investigate the efficacy of a standard 8-week MBI and a 4-week abbreviated protocol in the same population. Based on our findings, both programmes performed better than controls, with similar effect size (ES). The efficacy of abbreviated mindfulness programmes may be similar to that of a standard MBI programme, making them potentially more accessible for a larger number of populations. Nevertheless, further studies with more powerful designs to compare the non-inferiority of the abbreviated protocol and addressing clinical populations are warranted.

http://journal.frontiersin.org/article/10.3389/fpsyg.2017.01343/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_368025_69_Psycho_20170822_arts_A

Improve Psychological Health in Pregnancy with Mindfulness

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Improve Psychological Health in Pregnancy with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Not only does cultivating moment-to-moment awareness of thoughts and surroundings seem to help pregnant women keep their stress down and their spirits up—benefits that are well-documented among other groups of people—it may also lead to healthier newborns with fewer developmental problems down the line.” – Kira Newman

 

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

 

The psychological health of pregnant women has consequences for fetal development, birthing, and consequently, child outcomes. Depression during pregnancy is associated with premature delivery and low birth weight. Childbirth fear is associated with “low childbirth self-efficacy, greater use of pain medication during labor, more unwanted obstetric interventions in labor, as well as increased risk of postpartum depression.” Hence, it is clear that there is a need for methods to treat childbirth fear, depression, and anxiety during pregnancy. Since the fetus can be negatively impacted by drugs, it would be preferable to find a treatment that did not require drugs. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy. So, it would make sense to further study the effects of mindfulness training during the perinatal period.

 

In today’s Research News article “A Comparative Study of Mindfulness Efficiency Based on Islamic-Spiritual Schemes and Group Cognitive Behavioral Therapy on Reduction of Anxiety and Depression in Pregnant Women.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5385237/, Aslami and colleagues recruited Islamic women in their 16th to 32nd week of pregnancy and based upon pretesting of anxiety and depression selected two groups; a high anxiety and a high depression group. The groups were then randomly divided into a no-treatment control condition, a 12-week Cognitive Behavioral Therapy (CBT) condition or an 8-week Mindfulness-Based Stress Reduction (MBSR) condition. Traditional MBSR consists of training and practice in meditation, yoga, and body scan. The researchers modified the training protocol to include Islamic spiritual teachings. The CBT and MBSR conditions were assigned home practice for 45 minutes per day for 6 days per week. The participants were measured for anxiety and depression before and after treatment.

 

They found that both the Cognitive Behavioral Therapy (CBT) and Mindfulness-Based Stress Reduction (MBSR) conditions produced significant decreases in both anxiety and depression while the no-treatment control group did not. In addition, the MBSR condition produced significantly greater reductions than the CBT condition. In fact, MBSR produced a very large reduction, on average, of 79% in anxiety and 81% in depression while CBT produced, on average, only a 45% reduction in anxiety and a 43% reduction in depression. Hence, although CBT was effective, MBSR produced far greater improvements in the pregnant women’s psychological states.

 

These are excellent results. It has been well established that mindfulness training produces significant reductions in anxiety and depression in a wide variety of people with a variety of conditions. But, this trial compared its effectiveness to another known effective treatment, Cognitive Behavioral Therapy (CBT) and found MBSR to be far superior. I am not aware of any other direct comparisons of the two forms of therapy. It is not known, however, if the inclusion of Islamic spiritual teachings added to MBSR’s effectiveness in this group of Islamic women. Regardless, it is clear the MBSR training is highly effective in reducing anxiety and depression in pregnant women. This should be of great assistance in making for a smooth remainder of the pregnancy and delivery and may well produce better outcomes with the infant.

 

So, improve psychological health in pregnancy with mindfulness.

 

“There could not be a better time to learn mindfulness than during pregnancy and early motherhood. For one thing, this is a time when most people have a strong motivation to become the best person they can be in a relatively short period of time. When you realize the full enormity of the responsibility you have taken on by becoming a mom, the primary source of care for another whole human being, not to mention one that you love more than you thought you could ever love, there is a really high level of motivation to try your best to get yourself into the best mental and emotional shape possible.” – Cassandra Vieten

 

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

 

Aslami, E., Alipour, A., Najib, F. S., & Aghayosefi, A. (2017). A Comparative Study of Mindfulness Efficiency Based on Islamic-Spiritual Schemes and Group Cognitive Behavioral Therapy on Reduction of Anxiety and Depression in Pregnant Women . International Journal of Community Based Nursing and Midwifery, 5(2), 144–152.

 

Abstract

Background:

Anxiety and depression during the pregnancy period are among the factors affecting the pregnancy undesirable outcomes and delivery. One way of controlling anxiety and depression is mindfulness and cognitive behavioral therapy. The purpose of this study was to compare the efficiency of mindfulness based on the Islamic-spiritual schemas and group cognitive behavioral therapy on reduction of anxiety and depression in pregnant women.

Methods:

The research design was semi-experimental in the form of pretest-posttest using a control group. Among the pregnant women in the 16th to 32nd weeks of pregnancy who referred to the health center, 30 pregnant women with high anxiety level and 30 pregnant women with high depression participated in the research. Randomly 15 participants with high depression and 15 participants with high anxiety were considered in the intervention group under the treatment of mindfulness based on Islamic-spiritual schemes. In addition, 15 participants with high scores regarding depression and 15 with high scores in anxiety were considered in the other group. The control group consisted of 15 pregnant women with high anxiety and depression. Beck anxiety-depression questionnaire was used in two steps of pre-test and post-test. Data were analyzed using SPSS, version 20, and P≤0.05 was considered as significant.

Results:

The results of multivariate analysis of variance test and tracking Tukey test showed that there was a significant difference between the mean scores of anxiety and depression in the two groups of mindfulness based on spiritual- Islamic scheme (P<0.001) and the group of cognitive behavioral therapy with each other (P<0.001) and with the control group(P<0.001). The mean of anxiety and depression scores decreased in the intervention group, but it increased in the control group.

Conclusion:

Both therapy methods were effective in reduction of anxiety and depression of pregnant women, but the effect of mindfulness based on spiritual- Islamic schemes was more.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5385237/

Reduce Depression and Anxiety Around Pregnancy with Mindfulness

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Reduce Depression and Anxiety Around Pregnancy with Mindfulness

 

By John M. de Castro, Ph.D.

 

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

 

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

 

The psychological health of pregnant women has consequences for fetal development, birthing, and consequently, child outcomes. Depression during pregnancy is associated with premature delivery and low birth weight. Childbirth fear is associated with “low childbirth self-efficacy, greater use of pain medication during labor, more unwanted obstetric interventions in labor, as well as increased risk of postpartum depression.” Hence, it is clear that there is a need for methods to treat childbirth fear, depression, and anxiety during pregnancy. Since the fetus can be negatively impacted by drugs, it would be preferable to find a treatment that did not require drugs. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy. So, it would make sense to study the effects of mindfulness training during the perinatal period.

 

In today’s Research News article “The Effectiveness of Mindfulness-Based Interventions on Maternal Perinatal Mental Health Outcomes: a Systematic Review.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506176/, Shi & MacBeth reviewed the published research literature on the effectiveness of mindfulness training on the emotional states of women in the perinatal period. They found 18 published studies that employed Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), or mindful yoga as the treatment for anxiety and depression during the perinatal period.

 

They found that the research indicated that mindfulness-based treatments were particularly effective for anxiety and to a lesser extent for depression and its recurrence. The treatments were reported to be safe, with no appreciable negative side effects, and acceptable, with low drop out rates. They note that there is a need for more highly controlled randomized controlled trials that include active control conditions in the future.

 

The results from the summarized 18 studies suggest that mindfulness based interventions are safe and effective treatment for perinatal anxiety and depression. Mindfulness practices have been shown to increase the focus on the present moment. Anxiety tends to revolve around the future while depression appears to revolve around the past. By focusing the individual on what is occurring in the present moment mindfulness training appears to decrease thinking about the past or the future and may thereby reduce anxiety and depression. Mindfulness training has also been shown to reduce the physiological and psychological responses to stress. The reduction in stress responses during the high stress perinatal period may also contribute to the women’s improved mood.

 

So, reduce depression and anxiety around pregnancy with mindfulness.

 

“Since mindfulness has a lot to do with being in touch with the sensations in your body, and being aware, new moms are in a prime state to learn it! In fact, pregnancy and early motherhood, nursing and sleep disturbance, weight gain and weight loss-these all in some way force you to be in your body. For those of us who live most of our lives above our necks, this can actually be a great blessing.” – Cassandra Vieten

 

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

 

Shi, Z., & MacBeth, A. (2017). The Effectiveness of Mindfulness-Based Interventions on Maternal Perinatal Mental Health Outcomes: a Systematic Review. Mindfulness, 8(4), 823–847. http://doi.org/10.1007/s12671-016-0673-y

 

Presenting with common mental health difficulties, particularly depression and anxiety, there is also preliminary evidence that mindfulness-based interventions (MBIs) including mindfulness-based cognitive therapy (MBCT), mindfulness-based stress reduction (MBSR) and integrated mindfulness yoga practices may also be effective in reducing common mental health difficulties during pregnancy. We systematically reviewed and synthesized the current literature on the effectiveness of MBIs in reducing severity of perinatal anxiety and depression. Databases including PubMed, Cochrane Library, IndMED and PsychoInfo were searched for relevant studies. Manual searches were conducted in relevant articles and Google Scholar. Seventeen cohorts representing 18 studies were included. Pre-post effect sizes were reported for both treatment and control groups. Seven randomized controlled trials (RCTs), two non-randomized controlled trials and nine treatment evaluations were included. Maternal participation in an MBI was associated with reductions in perinatal anxiety of moderate to large magnitude. Results for the effect of MBIs on depression were less consistent, with pre-post treatment reductions of moderate magnitude, but no significant differences in depression scores when MBI was compared with a control group. There was some evidence that MBIs were associated with increased mindfulness. Risk of bias in studies was variable. Our review offers preliminary evidence for the effectiveness of MBIs in reducing perinatal anxiety, with more equivocal findings with regard to perinatal depressive symptoms. Further methodologically rigorous evaluation using RCTs and longer follow-up periods are recommended.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506176/

Mindfulness Training Benefits Neurotic Individuals the Most

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Mindfulness Training Benefits Neurotic Individuals the Most

 

By John M. de Castro, Ph.D.

 

“Do you have neurotic tendencies? You might give mindfulness a try. The practice has been shown to help quell the voice of the “obnoxious roommate” in your head. One of the “Big Five” personality traits, neuroticism is characterized by negative affect, rumination on the past and worry about the future, moodiness and loneliness. Practicing mindfulness may be a powerful way for people to detach from common characteristics of neuroticism, including obsessive negative thoughts and worries, and challenges regulating one’s emotions and behavior.” – Carolyn Gregoire

 

We know that people differ in how they interact with the environment and other people. We call these differences personality. Personality characteristics are thought to be relatively permanent traits that form an individual’s distinctive character. Different personalities predict different behaviors and different responses to the environment. This suggests that different personality types might respond differently to mindfulness training.

 

Current psychological research and theorization on personality has suggested that there are five basic personality characteristics. The so called “Big 5” are Extraversion, Agreeableness, Openness to Experience, Conscientiousness, and Neuroticism. Extraversion involves engagement with the external world, particularly other people. Agreeableness involves trust and helpfulness and a positive temperament. Openness to Experience is intellectual curiosity and is associated with creativity and a preference for novelty and variety. Conscientiousness involves planning, organization, dependability and self-discipline. Finally, Neuroticism involves moodiness, negative emotions, and a tendency to perceive even minor things as threatening or impossible. It is thought that most individual personalities can be captured by these five characteristics.

 

It has been shown that people high in mindfulness are also high in the “Big 5” traits of Conscientiousness, and Neuroticism.  It is possible that people high in these traits are more susceptible to the effects of mindfulness training. In today’s Research News article “For Whom Does Mindfulness-Based Stress Reduction Work? Moderating Effects of Personality.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506177/, Nyklíček, I., & Irrmischer examine whether the effectiveness of mindfulness training is affected by the individual’s personality. They recruited adults and provided them with Mindfulness-Based Stress Reduction (MBSR) program. MBSR consists of meditation, yoga and body scan and training occurs over 8 weeks in 2.5-hour weekly sessions with daily homework assignments. Before training their personality was measured and before and after training and 3-months later, they were measured for anxiety and depression.

 

They found that as has been previously demonstrated MBSR resulted in substantial significant reductions in anxiety and depression after training and these mood states continued to improve and were even lower 3 months later. They then tested for mediation effects to determine if personality characteristics affected the MBSR reductions in anxiety and depression. They found that the personality characteristic of neuroticism accentuated the effect such that the higher the levels of neuroticism the greater the reductions in anxiety and depression produced by MBSR. This mediation effect, however, was in part due to the fact that high neuroticism was related to higher depression and anxiety. When they controlled for the levels of depression and anxiety present when the study began, the mediation effect for depression was no longer significant while neuroticism continued to mediate the effect of MBSR on anxiety.

 

So, they found that MBSR training produces a long-lasting reduction in anxiety and depression. The effect of MBSR on depression occurs equally regardless of personality characteristics. On the other hand, MBSR training reduces anxiety to a greater extent in people high in neuroticism. By focusing attention more on the present moment, MBSR training reduces the past orientation that energizes depression and the future orientation that fuels anxiety. It appears to have its effect on anxiety magnified in highly neurotic people. Neuroticism involves a tendency to perceive even minor things as threatening. Focusing on the present moment interrupts seeing future threat and thereby may make the neuroticism less impactful.

 

So, mindfulness training benefits neurotic individuals the most.

 

“By the posture, by the action,
By eating, seeing, and so on,
By the kind of states occurring,
May temperament be recognized.” – Path of Purification

 

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

 

Nyklíček, I., & Irrmischer, M. (2017). For Whom Does Mindfulness-Based Stress Reduction Work? Moderating Effects of Personality. Mindfulness, 8(4), 1106–1116. http://doi.org/10.1007/s12671-017-0687-0

 

Abstract

The aim of the present study was to examine potentially moderating effects of personality characteristics regarding changes in anxious and depressed mood associated with Mindfulness-Based Stress Reduction (MBSR), controlling for socio-demographic factors. Meditation-naïve participants from the general population self-presenting with psychological stress complaints (n = 167 participants, 70% women, mean age 45.8 ± 9.3 years) were assessed in a longitudinal investigation of change in mood before and after the intervention and at a 3-month follow-up. Participants initially scoring high on neuroticism showed stronger decreases in both anxious and depressed mood (both p < 0.001). However, when controlled for baseline mood, only the time by neuroticism interaction effect on anxiety remained significant (p = 0.001), reflecting a smaller decrease in anxiety between pre- and post-intervention but a larger decrease in anxiety between post-intervention and follow-up in those with higher baseline neuroticism scores. Most personality factors did not show moderating effects, when controlled for baseline mood. Only neuroticism showed to be associated with delayed benefit. Results are discussed in the context of findings from similar research using more traditional cognitive-behavioral interventions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506177/

Change Your Brain’s Activity with Mindfulness

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Change Your Brain’s Activity with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The impact that mindfulness exerts on our brain is borne from routine: a slow, steady, and consistent reckoning of our realities, and the ability to take a step back, become more aware, more accepting, less judgmental, and less reactive. Just as playing the piano over and over again over time strengthens and supports brain networks involved with playing music, mindfulness over time can make the brain, and thus, us, more efficient regulators, with a penchant for pausing to respond to our worlds instead of mindlessly reacting.” – Jennifer Wolkin

 

There has accumulated a large amount of research demonstrating that mindfulness practices have significant benefits for psychological, physical, and spiritual wellbeing. Its positive effects are so widespread that it is difficult to find any other treatment of any kind with such broad beneficial effects on everything from mood and happiness to severe mental and physical illnesses. This raises the question of how meditation could do this. 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 practices appears to mold and change the brain, producing psychological, physical, and spiritual benefits.

 

If mindfulness training can alter the nervous system then perhaps simply being a mindful individual will be associated with differences in the same brain regions. This idea was examined in today’s Research News article “Resting Brain Activity Related to Dispositional Mindfulness: a PET Study.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506209/, Gartenschläger and colleagues recruited normal and psychologically disturbed individuals and measured their levels of mindfulness, depression, and anxiety. The participants then underwent a brain scan for neural activity (Positron Emission Tomography, PET Scan).

 

They found that the higher the participant’s level of mindfulness, the lower the levels of both depression and anxiety. This is not surprising as mindfulness training has been shown repeatedly to produce lower levels of anxiety and depression. They also found that the higher the levels of mindfulness the higher the resting brain activity in the superior parietal lobule and in precuneus and superior parietal lobule and the lower the activity in the inferior frontal orbital gyrus and anterior thalamus.

 

These results are complex but the lower activity in the Thalamus may represent lower levels of general activation of the brain in mindful individuals. Also, the lower activity in the inferior frontal orbital gyrus may represent lower levels of language processing in mindful individuals, possibly indicating less internal language, thinking, with individuals high in mindfulness. In addition, the higher activity in the parietal lobe and precuneus may represent greater activity in the Default Mode Network (DMN) of which these structures are a part. The DMN is associated with a sense of self, self-referential thinking, and mind wandering. This suggests that mindful individuals while at rest, with their eyes closed, may be less activated (more at rest), have less internal language (thought), and have their minds wandering.

 

It may seem counterintuitive that mindful individuals’ minds may be wandering more as mindfulness has been shown to be associated with less mind wandering. But, the situation of lying in a scanner with eyes closed may be one in which discursive thought is perfectly appropriate. In any case, these are interesting results that add to our understanding of the brain systems involved in mindfulness. It will require considerable future research to paint a complete picture of the neural systems underlying mindfulness and being altered by mindfulness training.

 

So, change your brain’s activity with mindfulness.

 

“The practice of mindfulness can train our brains to have a new default. Instead of automatically falling into the stream of past or future rumination that ignites the depression loop, mindfulness draws our attention to the present moment. As we practice mindfulness, we actually start wiring neurons that balance the brain in a way that is naturally an antidepressant.” – Alex Korb

 

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

 

Gartenschläger, M., Schreckenberger, M., Buchholz, H.-G., Reiner, I., Beutel, M. E., Adler, J., & Michal, M. (2017). Resting Brain Activity Related to Dispositional Mindfulness: a PET Study. Mindfulness, 8(4), 1009–1017. http://doi.org/10.1007/s12671-017-0677-2

 

Abstract

Mindfulness denotes a state of consciousness characterized by receptive attention to and awareness of present events and experiences. As a personality trait, it constitutes the ability to become aware of mental activities such as sensations, images, feelings, and thoughts, and to disengage from judgment, conditioned emotions, and their cognitive processing or automatic inhibition. Default brain activity reflects the stream of consciousness and sense of self at rest. Analysis of brain activity at rest in persons with mindfulness propensity may help to elucidate the neurophysiological basis of this important mental trait. The sample consisted of 32 persons—23 with mental disorders and 9 healthy controls. Dispositional mindfulness (DM) was operationalized by Mindful Attention Awareness Scale (MAAS). Brain activity at rest with eyes closed was assessed by fluorodeoxyglucose positron emission tomography (F-18-FDG PET). After adjustment for depression, anxiety, age and years of education, resting glucose metabolism in superior parietal lobule and left precuneus/Brodmann area (BA) 7 was positively associated with DM. Activity of the left inferior frontal orbital gyrus (BA 47) and bilateral anterior thalamus were inversely associated with DM. DM appears to be associated with increased metabolic activity in some core area of the default mode network (DMN) and areas connected to the DMN, such as BA 7, hosting sense of self functions. Hypometabolism on the other hand was found in some nodes connected to the DMN, such as left inferior frontal orbital gyrus and bilateral thalamus, commonly related to functions of memory retrieval, decision making, or outward attention.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506209/

Improve Social Anxiety Disorder with Mindfulness

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Improve Social Anxiety Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Using mindfulness, we can begin to notice what happens in the body when anxiety is present and develop strategies to empower clients to “signal safety” to their nervous system. Over time, clients feel empowered to slow down their response to triggers, manage their body’s fear response (fight-or-flight) and increase their ability to tolerate discomfort. The client experiences this as feeling like they have a choice about how they will respond to a trigger.” – Jeena Cho 

 

It is a common human phenomenon that being in a social situation can be stressful and anxiety producing. This is particularly true when asked to perform in a social context such as giving a speech. Most people can deal with the anxiety and can become quite comfortable. But many do not cope well and the anxiety is overwhelming, causing the individual to withdraw. Social Anxiety Disorder (SAD) is characterized by a persistent, intense, and chronic fear of being watched and judged by others and feeling embarrassed or humiliated by their actions. This fear may be so severe that it interferes with work, school, and other activities and may negatively affect the person’s ability to form relationships.

 

SAD is the most common form of anxiety disorder and it is widespread, occurring in about 7% of the U.S. population and is particularly widespread among young adults. 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 SAD. Although, these therapies can be effective they are costly and because of availability, cost, and inconvenience, are only available to small numbers of sufferers. As a result, there is a growing trend to using group based therapy. 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 including Social Anxiety Disorder (SAD). Mindfulness-Based Stress Reduction (MBSR) contains three mindfulness trainings, meditation, body scan, and yoga, and has been shown to be effective in treating anxiety disorders. So, it would be reasonable to expect that MBSR training would improve the symptoms of Social Anxiety Disorder (SAD) in young adults.

 

In today’s Research News article “Group CBT versus MBSR for Social Anxiety Disorder: A Randomized Controlled Trial.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837056/, Goldin and colleagues compared the efficacy of Group Cognitive Behavioral Therapy (Group-CBT) to Mindfulness-Based Stress Reduction (MBSR) program for the relief of Social Anxiety Disorder (SAD). They recruited through clinician referrals and community listings, patients who were diagnosed with SAD but had not been treated with drugs, CBT or MBSR in the recent past. In Group-CBT 6 patients met once a week for 2.5 hours over 12 weeks while the standard MBSR program was modified to include meetings of 6 patients once a week for 2.5 hours over 12 weeks. They were assigned in consecutive blocks of 6 patients to either Group-CBT, MBSR, or a wait-list control group. They were measured before and after treatment and every 3 months for the next year for social anxiety, emotion regulation, cognitive reappraisal self-efficacy, subtle avoidance, cognitive distortions, mindfulness, attention control, and rumination.

 

They found that compared to the wait-list control patients both Group-CBT and MBSR produced clinically significant improvements in social anxiety, increases in mindfulness, cognitive reappraisal, cognitive reappraisal self-efficacy, and attention control, and decreases in subtle avoidance, cognitive distortions, and rumination. There were no significant differences in the effectiveness of Group-CBT and MBSR and the effects appeared to last for a year afterward. Hence, both forms of therapy were highly effective and long-lasting for patients with Social Anxiety Disorder (SAD), improving emotions and thought processes.

 

It is interesting that the two therapies had such similar effects given that they target different processes. But, the results showed that both therapies equally improved the processes that are targeted by Group-CBT, thought processes, and the processes that are targeted by MBSR,  mindfulness and attention. So, although designed to effect different processes the two therapies produced the same outcomes. Regardless, they were both highly effective in oriducing long-lasting improvements in the conditions of these patients suffering from SAD.

 

So, improve social anxiety disorder with mindfulness.

 

“The power of a mindfulness practice, however, may come in the realization that one can live a meaningful life even with social anxiety. (Participant) says that he still feels nervous in social situations but now feels compassion — not judgment — for himself, and sees that “I can be more the person I want to be.”’ – Jason Drwal

 

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

 

Goldin, P. R., Morrison, A., Jazaieri, H., Brozovich, F., Heimberg, R., & Gross, J. J. (2016). Group CBT versus MBSR for Social Anxiety Disorder: A Randomized Controlled Trial. Journal of Consulting and Clinical Psychology, 84(5), 427–437. http://doi.org/10.1037/ccp0000092

 

Abstract

Objective

To investigate treatment outcome and mediators of Cognitive-Behavioral Group Therapy (CBGT) vs. Mindfulness-Based Stress Reduction (MBSR) vs. Waitlist (WL) in patients with generalized social anxiety disorder (SAD).

Method

108 unmedicated patients (55.6% female; mean age = 32.7, SD = 8.0; 43.5% Caucasian, 39% Asian, 9.3% Hispanic, 8.3% other) were randomized to CBGT vs. MBSR vs. WL and completed assessments at baseline, post-treatment/WL, and at 1-year follow-up, including the Liebowitz Social Anxiety Scale – Self-Report (primary outcome) as well as measures of treatment-related processes.

Results

Linear mixed model analysis showed that CBGT and MBSR both produced greater improvements on most measures compared to WL. Both treatments yielded similar improvements in social anxiety symptoms, cognitive reappraisal frequency and self-efficacy, cognitive distortions, mindfulness skills, attention focusing and rumination. There were greater decreases in subtle avoidance behaviors following CBGT than MBSR. Mediation analyses revealed that increases in reappraisal frequency, mindfulness skills, attention focusing and attention shifting, and decreases in subtle avoidance behaviors and cognitive distortions mediated the impact of both CBGT and MBSR on social anxiety symptoms. However, increases in reappraisal self-efficacy and decreases in avoidance behaviors mediated the impact of CBGT (vs. MBSR) on social anxiety symptoms.

Conclusions

CBGT and MBSR both appear to be efficacious for SAD. However, their effects may be a result of both shared and unique changes in underlying psychological processes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837056/

Improve Anxiety in Adolescents with Mindfulness

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Image result for teen anxiety

Improve Anxiety in Adolescents with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness also helps us to get to know our real self which is never a bad thing! People suffering from social anxiety are often marred by an exaggerated perception of their shortcomings which leads them to believe that they are inadequate and that everybody must be noticing. Practicing mindfulness based cognitive therapy will help them to reestablish a more realistic self-image.” – Kyle MacDonald

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. Anxiety Disorders affects about 3.1% of the U.S. population. Severe anxiety affects about 6% of adolescents. Physically, anxiety sufferers will often show excessive fatigue, irritability, muscle tension or muscle aches, trembling, feeling twitchy, being easily startled, trouble sleeping, sweating, nausea, diarrhea or irritable bowel syndrome, and headaches.

 

Anxiety disorders in adults have generally been treated with drugs. It has been estimated that 11% of women in the U.S. are taking anti-anxiety medications. But, there are considerable side effects and these drugs are often abused. The drugs are also not appropriate for children and adolescents with developing nervous systems. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders. Mindfulness-Based Cognitive Therapy (MBCT) has been shown to be effective in treating anxiety in adults. Mindfulness training has also been shown to produce changes in the nervous system. It is not known, however, what changes in the nervous system underlie the effect of MBCT on anxiety.

 

In today’s Research News article “Neural Function Before and After Mindfulness-Based Cognitive Therapy in Anxious Adolescents at Risk for Developing Bipolar Disorder.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4876535/, Strawn and colleagues examine the effects of Mindfulness-Based Cognitive Therapy (MBCT) on the nervous systems of youth with high levels of anxiety. They recruited children and adolescents, aged 9 to 16 years, who were diagnosed with an anxiety disorder and who were at risk for developing bipolar disorder. They were treated with a 12-week program of MBCT. Before and after the treatment they were measured for anxiety, clinical symptoms, and mindfulness and also underwent functional Magnetic Resonance (f-MRI) brain scans while performing a continuous processing task with emotional and neutral distractors.

 

They found that following MBCT there was a significant increase in activity of the insula, lentiform nucleus, and thalamus, and anterior cingulate cortex with the presentation of emotional pictures. So, MBCT produces changes in the brains of children and adolescents similar to those seen in adults. They also found that the greater the reduction in anxiety resulting from MBCT the greater the decrease in activity of the insula and anterior cingulate cortex.

 

The insula and the anterior cingulate cortex have been shown to be involved in emotional processing and MBCT is aimed at altering the thought processes revolving around the interpretations of emotions. So, the changes in the functional activity of these structures following MBCT are commensurate with the changes in emotionality. Hence, MBCT appears to change the brains of children and adolescents with anxiety disorders to improve emotional processing.

 

It should be noted that this was a pilot study with a very small number of participants and no control group. So, the findings must be interpreted with caution. But the findings are sufficiently interesting to justify conducting a larger randomized clinical trial in the future.

 

“If you have unproductive worries, you can train yourself to experience those thoughts completely differently. ‘You might think ‘I’m late, I might lose my job if I don’t get there on time, and it will be a disaster!’ Mindfulness teaches you to recognize, ‘Oh, there’s that thought again. I’ve been here before. But it’s just that—a thought, and not a part of my core self,‘” – Elizabeth Hoge

 

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

 

Strawn, J. R., Cotton, S., Luberto, C. M., Patino, L. R., Stahl, L. A., Weber, W. A., … DelBello, M. P. (2016). Neural Function Before and After Mindfulness-Based Cognitive Therapy in Anxious Adolescents at Risk for Developing Bipolar Disorder. Journal of Child and Adolescent Psychopharmacology, 26(4), 372–379. http://doi.org/10.1089/cap.2015.0054

 

Abstract

Objective: We sought to evaluate the neurophysiology of mindfulness-based cognitive therapy for children (MBCT-C) in youth with generalized, social, and/or separation anxiety disorder who were at risk for developing bipolar disorder.

Methods: Nine youth (mean age: 13 ± 2 years) with a generalized, social, and/or separation anxiety disorder and a parent with bipolar disorder completed functional magnetic resonance imaging (fMRI) while performing a continuous processing task with emotional and neutral distractors (CPT-END) prior to and following 12 weeks of MBCT-C.

Results: MBCT-C was associated with increases in activation of the bilateral insula, lentiform nucleus, and thalamus, as well as the left anterior cingulate while viewing emotional stimuli during the CPT-END, and decreases in anxiety were correlated with change in activation in the bilateral insula and anterior cingulate during the viewing of emotional stimuli (p < 0.05, uncorrected; p < 0.005 corrected; cluster size, 37 voxels).

Conclusions: MBCT-C treatment in anxious youth with a familial history of bipolar disorder is associated with increased activation of brain structures that subserve interoception and the processing of internal stimuli—functions that are ostensibly improved by this treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4876535/