Anxiety

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/

Relieve Anxiety following Surgery with Meditation

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Relieve Anxiety following Surgery with Meditation

 

By John M. de Castro, Ph.D.

 

“Mindfulness trains you to view your thoughts differently. You learn to recognize and stop “mental time travel” — worrying about the future and ruminating about the past. Instead of following a worrying thought down the path of all possible negative outcomes, you learn to recognize it for what it is — one thought — and then let it go. This trains your brain to be less anxious.” – Deane Alban

 

It’s a normal human response to become anxious when confronted with highly stressful or frightening situations, such as undergoing heart surgery. Being overly anxious, however, can interfere with coping and recovery after surgery. It has been demonstrated repeatedly that mindfulness counteracts anxiety and mindfulness training is an effective treatment for a variety of forms of anxiety. Mindfulness training has been shown to be effective for anxiety disorders in general and in relieving test anxiety and social anxiety. It has yet to be demonstrated that mindfulness training can relieve the anxiety preceding and following major surgery.

 

In today’s Research News article “.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408519/, Kiran and colleagues examine the ability of meditation training to relieve anxiety before and after coronary artery bypass grafting. They recruited patients (average age of 55 years) who were scheduled to undergo coronary artery bypass grafting for coronary artery disease and randomly assigned them to either receive meditation training or counseling about the surgical procedure. The mindfulness training occurred upon admission to the hospital and consisted of three instructional sessions on Rajyoga meditation and 3 10-minute meditations per day, once before breakfast, lunch, and dinner. Meditation continued daily prior to and following surgery. Prior to training anxiety was measured with a self-report and on the day of surgery and 2 and 5 days later anxiety and plasma cortisol levels (to measure stress responding) were measured.

 

They found that before training and right before surgery the groups did not differ in anxiety levels. But, on the 2nd day after surgery the meditation group was significantly less anxious than the control group and on the 5th postoperative day the difference was even greater. Before surgery plasma cortisol levels did not differ between groups but the meditation group had a significantly smaller increase in cortisol immediately after surgery and a return to the normal range on the 5th postoperative day. Hence, meditation appears to lower postsurgical anxiety and stress levels. This may promote faster recovery from the procedure. It is interesting that such a simple and short-term mindfulness intervention can have such a large effect on anxiety and stress responding.

 

Anxiety is a fear of potential future negative events. It is dependent upon future oriented thought processes. Mindfulness training may counteract this by focusing the individual on the present moment. Since, there are no negative events there in the present moment, anxiety dissipates. In addition, mindfulness training improves the individual’s ability to see the negative future projections as they arise in the mind and recognize that they are not based in present reality. This can lead to reduced anxiety.

 

So, relieve anxiety following surgery with meditation.

 

“We have a bad habit of gathering up dramatic feelings and situations, clutching them to us as if they were prized possessions. We feel we are entitled to our ownership of this anxiety, and we believe we must hold onto it in order to keep ourselves emotionally safe. It takes a little courage, but meditation can help us see and nurture our internal strength, so we can separate ourselves from drama and achieve anxiety relief.” – Ram Das

 

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

 

Kiran, U., Ladha, S., Makhija, N., Kapoor, P. M., Choudhury, M., Das, S., … Airan, B. (2017). The Role of Rajyoga Meditation for Modulation of Anxiety and Serum Cortisol in Patients Undergoing Coronary Artery Bypass Surgery: A Prospective Randomized Control Study. Annals of Cardiac Anaesthesia, 20(2), 158–162. http://doi.org/10.4103/aca.ACA_32_17

 

Abstract

Introduction:

Rajyoga meditation is a form of mind body intervention that is promoted by the Brahma Kumaris World Spiritual University. This form of meditation can be easily performed without rituals or mantras and can be practiced anywhere at any time. The practice of Rajyoga meditation can have beneficial effects on modulating anxiety and cortisol level in patients undergoing major cardiac surgery.

Materials and Methods:

A prospective randomized control study was carried out in a single tertiary care center. One hundred and fifty patients undergoing elective coronary artery bypass surgery were enrolled in the study. The patients were randomized in two groups namely, Group 1 (Rajyoga group) and Group 2 (Control Group). Anxiety was measured on a visual analog scale 1–10 before the start of Rajyoga training or patient counseling (T1), on the morning of the day of surgery (T2), on the 2nd postoperative day (T3), and on the 5th postoperative day (T4). The serum cortisol level was measured in the morning of the day of surgery (T1), on the 2nd postoperative day (T2) and on the 5th postoperative day (T3), respectively.

Results:

In the study, it was seen that the anxiety level of the patients before the surgery (T1) and on the day of surgery (T2) were comparable between the two groups. However on the 2nd postoperative day (T3), the patients who underwent Rajyoga training had lower anxiety level in comparison to the control group (3.12 ± 1.45 vs. 6.12 ± 0.14, P < 0.05) and on the 5th postoperative day (T4) it was seen that Rajyoga practice had resulted in significant decline in anxiety level (0.69 ± 1.1 vs. 5.6 ± 1.38, P < 0.05). The serum cortisol level was also favorably modulated by the practice of Rajyoga meditation.

Conclusion:

Mindbody intervention is found to effective in reducing the anxiety of the patients and modulating the cortisol level in patients undergoing wellknown stressful surgery like coronary artery bypass surgery.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408519/

Improve Social Anxiety Disorder with Mindfulness

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Improve Social Anxiety Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“regular and consistent mindfulness meditation will help to strengthen your ability to overcome the initial problems that you experience. If you are suffering with the symptoms of social anxiety disorder (SAD), regular practice will eventually improve your self-concept and ability to handle negative emotions. You will also learn how to better respond to troubling thoughts and treat yourself with more compassion.” – Arlin Cuncic

 

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. It has a typical onset in late childhood or young adulthood, prior to the age of 25. Hence, it is particularly widespread among young adults. Anxiety disorders 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. There are a number of psychological therapies for SAD. Although, these therapies can be effective they are costly and only available to a small numbers of sufferers. In addition, 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 “An open trial of mindfulness-based stress reduction for young adults with social anxiety disorder.” (See summary below), Hjeltnes and colleagues perform a pilot study of the effectiveness of a Mindfulness-Based Stress Reduction (MBSR) program for the treatment of Social Anxiety Disorder (SAD) in young adults. They recruited university students, aged 19 to 25 years, who suffered from SAD. The students participated in a standard 8-week MBSR program. They were assessed at the beginning, midway, and at the end of the program for social anxiety, global psychological distress, mindfulness, self-compassion, and self-esteem.

 

They found that the MBSR program produced a large clinically significant reduction in social anxiety and global psychological distress. They also found significant increases in mindfulness, particularly in the non-judging and non-reacting facets of mindfulness, self-esteem, self-compassion, self-kindness, and common humanity. These results are impressive, but, it needs to be recognized that this was an uncontrolled pilot trial and as such the results could have been due to a number of contaminating factors including placebo effects, experimenter bias, attention effects etc. It remains for a randomized controlled clinical trial to verify these findings. But the magnitudes of the effects are impressive and the fact that MBSR has been demonstrated in controlled trials to reduce anxiety, makes it more likely that the MBSR program was responsible.

 

Anxiety is a fear of potential future negative events. It is dependent upon future oriented thought processes. Mindfulness training may counteract this by focusing the individual on the present moment. Since, there are no negative events there in the present moment, anxiety dissipates. In addition, mindfulness training improves the individual’s ability to see the negative future projections as they arise in the mind and recognize that they are not based in present reality. This can lead to reduced anxiety and better performance at school, work and other activities and improve the person’s ability to form relationships.

 

So, improve social anxiety disorder with mindfulness.

 

“When you develop a mindfulness-based relationship with your inner emotions, your anxiety and fear, you set up a completely different inner environment that greatly facilitates transformation, resolution and healing of the emotional constructs of anxiety and fear. The simple fact is that reactivity inhibits change, while mindfulness promotes change and healing.” – Peter Strong

 

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

Aslak Hjeltnes, Helge Molde, Elisabeth Schanche, Jon Vøllestad, Julie Lillebostad Svendsen, Christian Moltu and Per-Einar Binder. An open trial of mindfulness-based stress reduction for young adults with social anxiety disorder. Scandinavian Journal of Psychology, Volume 58, Issue 1, February 2017, Pages: 80–90, DOI: 10.1111/sjop.12342.

 

Abstract

The present study investigated mindfulness-based stress reduction (MBSR) for young adults with a social anxiety disorder (SAD) in an open trial. Fifty-three young adults in a higher education setting underwent a standard eight-week MBSR program. Eight participants (15%) did not complete the program. Participants reported significant reductions in SAD symptoms and global psychological distress, as well as increases in mindfulness, self-compassion, and self-esteem. Using intention-to-treat (ITT) analyses, effect sizes ranged from large to moderate for SAD symptoms (Cohen’s d = 0.80) and global psychological distress (d = 0.61). Completer analyses yielded large effect sizes for SAD symptoms (d = 0.96) and global psychological distress (d = 0.81). The largest effect sizes were found for self-compassion (d = 1.49) and mindfulness (d = 1.35). Two thirds of the participants who were in the clinical range at pretreatment reported either clinically significant change (37%) or reliable improvement (31%) on SAD symptoms after completing the MBSR program, and almost two thirds reported either clinically significant change (37%) or reliable improvement (26%) on global psychological distress. MBSR may be a beneficial intervention for young adults in higher education with SAD, and there is a need for more research on mindfulness and acceptance-based interventions for SAD.

Mindfulness Training is Effective when Learned over the Internet.

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Mindfulness Training is Effective when Learned over the Internet.

 

By John M. de Castro, Ph.D.

 

“online mindfulness/stress management programs can be as effective as real-world programs, delivered at a fraction of the cost. . . . online programs could make mindfulness more accessible to underserved populations—as long as they have a computer and an Internet connection.” – Hooria Jazaieri

 

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. Techniques such as Mindfulness Training, Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) as well as Yoga practice and Tai Chi or Qigong practice have been demonstrated to be effective. This has led to an increasing adoption of these mindfulness techniques for the health and well-being of both healthy and ill individuals.

 

The vast majority of the mindfulness training techniques, however, require a certified trained therapist. This produces 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. As a result, there has been attempts to develop on-line mindfulness training programs. These have tremendous advantages in decreasing costs and making training schedules much more flexible. But, the question arises as to whether these programs are as effective as their traditional counterparts. Many believe that the presence of a therapist is a crucial component to the success of the programs and the lack of an active therapist in on-line programs may greatly reduce their effectiveness.

 

In today’s Research News article “Mindfulness Interventions Delivered by Technology Without Facilitator Involvement: What Research Exists and What Are the Clinical Outcomes?” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010616/

Fish and colleagues review and summarize the published research literature on the effectiveness of mindfulness therapies delivered online. They identified 9 randomized controlled trials of web-based mindfulness training. “All interventions introduced participants to some form of mindfulness practice including body scans, mindfulness of breathing, mindful movement and loving kindness” meditation.

 

They found that the studies reported that mindfulness training resulted in large improvements in mindfulness, reductions in stress, and clinically significant reductions in depression and anxiety. A large proportion of participants, 83%, continued practice after training ceased and the beneficial effects of the practice were still significant as much as 6-months later. These are impressive results which are comparable to the effects reported for therapist guided mindfulness training for stress, anxiety, and depression.  The studies, however, generally used weak control conditions and there is a need to continue the research with stronger research designs.

 

These are important findings in that mindfulness therapies were successfully implemented on-line. Web-based therapy allows for widespread, inexpensive, and convenient distribution of the treatment programs thereby opening up treatment to individuals who live in remote areas, cannot afford traditional therapist led treatment, or do not have the time to come repeatedly to a clinic during the workday. Hence, mindfulness training can be provided at low cost to widespread communities and individuals at their convenience. This greatly magnifies the potential societal benefits of mindfulness training; improving health and well-being.

 

So, mindfulness training is effective when learned over the internet.

 

“One of the benefits of living in a digital age is that we can pretty much access whatever we want. That is certainly true of meditation. Every major meditation center or university has an online component, offering you virtual courses, guided meditations, information on retreats and workshops. “ – Mindful

 

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

Fish, J., Brimson, J., & Lynch, S. (2016). Mindfulness Interventions Delivered by Technology Without Facilitator Involvement: What Research Exists and What Are the Clinical Outcomes? Mindfulness, 7(5), 1011–1023. http://doi.org/10.1007/s12671-016-0548-2

 

Abstract

New cost-effective psychological interventions are needed to contribute to treatment options for psychiatric and physical health conditions. This systematic review aims to investigate the current literature on one potentially cost-effective form of mindfulness-based therapy, those delivered through technological platforms without any mindfulness facilitator input beyond the initial design of the programme. Three electronic databases (Ovid Medline, PsychINFO and Embase) were searched for relevant keywords, titles, medical subject headings (MeSH) and abstracts using search terms derived from a combination of two subjects: ‘mindfulness’ and ‘technology’. Overall, ten studies were identified. The majority of studies were web-based and similar in structure and content to face-to-face mindfulness-based stress reduction courses. Clinical outcomes of stress (n = 5), depression (n = 6) and anxiety (n = 4) were reported along with mindfulness (n = 4), the supposed mediator of effects. All eight studies that measured significance found at least some significant effects (p < .05). The highest reported effect sizes were large (stress d = 1.57, depression d = .95, both ps > .005). However, methodological issues (e.g. selection bias, lack of control group and follow-up) which reflect the early nature of the work mean these largest effects are likely to be representative of maximal rather than average effects. Whilst there are important differences in the construction, length and delivery of interventions, it is difficult to draw firm conclusions about the most effective models. Suggestions of key characteristics are made though, needing further investigation preferably in standardised interventions. Given the existing research and the speed at which technology is making new platforms and tools available, it seems important that further research explores two parallel lines: first, refinement and thorough evaluation of already established technology-based mindfulness programmes and second, exploration of novel approaches to mindfulness training that combine the latest technological advances with the knowledge and skills of experienced meditation teachers.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010616/

 

Reduce Grief with Mindfulness

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Reduce Grief with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Releasing the grief we carry is a long, tear-filled process. Yet it follows the natural intelligence of the body and heart. Trust it, trust the unfolding. Along with meditation, some of your grief will want to be written, to be cried out, to be sung, to be danced. Let the timeless wisdom within you carry you through grief to an open heart.” – Jack Kornfield

 

Grief is a normal, albeit complex, process that follows a loss of a significant person or situation in one’s life. This can involve the death of a loved one, a traumatic experience, termination of a relationship, loss of employment etc. Exactly what transpires depends upon the individual and the nature of the loss. It involves physical, emotional, psychological and cognitive processes. Not everyone grieves in the same way but there have been identified four general stages of grief, shock and denial, intense concern, despair and depression, and recovery. These are normal and healthy. But, in about 15% of people grief can be overly intense or long and therapeutic intervention may become necessary.

 

A stillbirth can be a devastating loss as the joyous anticipation of a new baby is replaced by a death. This can produce intense mental challenges. Mindfulness training is known to help with coping with emotions and stress, and is very effective for depression. Hence, mindfulness training may be helpful in coping with the grief following a stillbirth. In today’s Research News article “Mindfulness-based Intervention for Perinatal Grief Education and Reduction among Poor Women in Chhattisgarh, India: a Pilot Study.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367631/

Roberts and Montgomery recruited women, aged 18 to 35 years, in rural India who had a history of stillbirth. They provided them with a one session per week for 5-weeks of mindfulness training based upon Mindfulness-Based Stress Reduction (MBSR). This included meditation, body scanning, and yoga practices and had additional education materials on risk factors for stillbirth and prevention strategies. The women were measured before and after the intervention and 6-weeks later for grief, anxiety and depression symptoms, satisfaction with life, religious coping, social support, and mindfulness. During the 6-week follow up period the women practiced daily at home.

 

They found, not surprisingly, that at baseline the women had clinically significant levels of anxiety, depression, and grief. After the mindfulness training, there were significant improvements in grief, anxiety and depression, religious coping, and the mindfulness facets of describe and acting with awareness. Hence the mindfulness training appeared to increase mindfulness and help relieve some of the psychological consequences of having a stillbirth. This could be important as the grief and depression after stillbirth can be severe. Relieving these consequences may be very helpful to the women learning to cope with and move past their tragic loss.

 

These are encouraging results, but must be viewed as preliminary pilot data. There was no control condition so, there are a large number of possible other explanations for the results including placebo effects, attentional effects, experimenter bias, etc. The data do support, however, conducting a larger randomize controlled clinical trial. Such research could lead to mindfulness training being used to assist in coping with loss and grief.

 

So, reduce grief with mindfulness.

 

“Mindful grieving informs us to allow ourselves to feel what is there, without judgment. For me, there was sadness there and I needed to nonjudgmentally acknowledge it, feel it, and let it be. It was important in that moment that I didn’t resist it or strive to make it any different, but just feel it as it was. Ronald Pies, M.D. wrote to us, “Having problems means being alive”, and I’d add “Being alive, means grieving loved ones who pass.” Grief is a natural part of the human experience.” – Elisha Goldstein

 

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

Roberts, L., & Montgomery, S. (2016). Mindfulness-based Intervention for Perinatal Grief Education and Reduction among Poor Women in Chhattisgarh, India: a Pilot Study. Interdisciplinary Journal of Best Practices in Global Development, 2(1), 1.

 

Abstract

Introduction

Stillbirth is a significant public health problem in low-to-middle-income countries and results in perinatal grief, often with negative psychosocial impact. In low-resource settings, such as Chhattisgarh, India, where needs are high, it is imperative to utilize low-cost, effective interventions. Mindfulness-based stress reduction (MBSR) is an empirically sound intervention that has been utilized for a broad range of physical and mental health problems, and is adaptable to specific populations. The main objective of this pilot study was to explore the feasibility and effectiveness of a shortened, culturally adapted mindfulness-based intervention to address complex grief after stillbirth.

Methods

We used an observational, pre-post-6-week post study design. The study instrument was made up of descriptive demographic questions and validated scales and was administered as a structured interview due to low literacy rates. We used a community participatory approach to culturally adapt the five-week mindfulness-based intervention and delivered it through two trained local nurses. Quantitative and qualitative data analyses explored study outcomes as well as acceptability and feasibility of the intervention.

Results

29 women with a history of stillbirth enrolled, completed the pretest and began the intervention; 26 completed the five-week intervention and post-test (89.7%), and 23 completed the six-week follow-up assessment (88.5%). Pretest results included elevated psychological symptoms and high levels of perinatal grief, including the active grief, difficulty coping, and despair subscales. General linear modeling repeated measures was used to explore posttest and six-week follow up changes from baseline, controlling for significantly correlated demographic variables. These longitudinal results included significant reduction in psychological symptoms; four of the five facets of mindfulness changed in the desired direction, two significantly; as well as significant reduction in overall perinatal grief and on each of the three subscales.

Discussion

The shortened, culturally adapted, mindfulness-based intervention pilot study was well received and had very low attrition. We also found significant reductions of perinatal grief and mental health symptoms over time, as well as a high degree of practice of mindfulness skills by participants. This study not only sheds light on the tremendous mental health needs among rural women of various castes who have experienced stillbirth in Chhattisgarh, it also points to a promising effective intervention with potential to be taken to scale for wider delivery.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367631/