Anxiety

Mindfulness is Associated with Improved Symptoms of Schizophrenia

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Mindfulness is Associated with Improved Symptoms of Schizophrenia

 

By John M. de Castro, Ph.D.

 

“schizophrenia patients may benefit from mindfulness-based interventions because they . . . demonstrate strong relationships between mindfulness and psychological constructs related to adaptive functioning.” – Naomi T. Tabak

 

Schizophrenia is the most common form of psychosis. Its effects about 1% of the population worldwide. It appears to be highly heritable and involves changes in the brain. It is characterized by both positive and negative symptoms. Positive symptoms include hallucinations; seeing and, in some cases, feeling, smelling or tasting things that aren’t there, or delusions; unshakable beliefs that, when examined rationally, are obviously untrue. Negative symptoms include a reduced ability to function normally, neglect of personal hygiene, lack of emotion, blank facial expressions, speaking in a monotone, loss of interest in everyday activities, social withdrawal, an inability to experience pleasure, and a lack of insight into their symptoms. The symptoms of schizophrenia usually do not appear until late adolescence or early adulthood.

 

Schizophrenia is very difficult to treat with psychotherapy and is usually treated with antipsychotic drugs. These drugs, however, are not always effective, sometimes lose effectiveness, and can have some difficult side effects. Mindfulness training has been shown to be beneficial for a variety of mental health problems, including psychosis. Mindfulness has also been shown to associated with lower symptom severity of schizophrenia. So, it makes sense to study the relationships of mindfulness with the symptoms of schizophrenia.

 

In today’s Research News article “The Relationship Between Mindfulness, Depression, Anxiety, and Quality of Life in Individuals With Schizophrenia Spectrum Disorders.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.708808/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1721400_a0P58000000G0YfEAK_Psycho_20210909_arts_A ) Bergmann and colleagues recruited patients who were diagnosed with schizophrenia and measured them for mindfulness, anxiety, depression, perceived stress, and quality of life.

 

They found that the higher the levels of mindfulness, the lower the levels of anxiety, depression, and perceived stress and the higher the levels of quality of life. In addition, they found that the higher the levels of anxiety, depression, and perceived stress the lower the levels of quality of life. A mediation analysis found that mindfulness was positively related to quality of life directly and also indirectly by being associated with lower levels of anxiety and depression that were in turn associated with higher quality of life.

 

This study is correlational and as such causation cannot be determined. But, previous controlled research has demonstrated the mindfulness training produces lower levels of anxiety and depression and higher levels of quality of life. So the present results are likely due to causal effects of mindfulness. Hence, being mindful improves quality of life and decreases anxiety and depression which then also improve quality of life. These are similar findings to those seen in healthy individuals. So, the present findings suggest that mindfulness affects people with schizophrenia in a similar fashion. They further suggest that mindfulness training might improve the psychological health and well-being of patients with schizophrenia.

 

So, mindfulness is associated with improved symptoms of schizophrenia.

 

“mindfulness-based interventions for psychotic symptoms can afford people a greater acceptance and insight into their experiences. They can also reduce the symptoms of anxiety and depression which often accompany, and may exacerbate, psychotic disorders.” – Adrianna Mendrek

 

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

 

Bergmann N, Hahn E, Hahne I, Zierhut M, Ta TMT, Bajbouj M, Pijnenborg GHM and Böge K (2021) The Relationship Between Mindfulness, Depression, Anxiety, and Quality of Life in Individuals With Schizophrenia Spectrum Disorders. Front. Psychol. 12:708808. doi: 10.3389/fpsyg.2021.708808

 

Background: Schizophrenia spectrum disorders (SSD) are frequently accompanied by comorbid depressive and anxiety symptoms, as well as impaired quality of life (QoL). A growing body of evidence has demonstrated the relevance of mindfulness for SSD in recent years. The study examined the association between mindfulness, depression, anxiety, and QoL.

Materials and Methods: A total of 83 participants with SSD were recruited at the in- and outpatient psychiatric hospital care. Participants completed the Southampton Mindfulness Questionnaire, Comprehensive Inventory for Mindful Experiences, and Freiburger Mindfulness Inventory, the Depression, Anxiety, Stress Scale to assess depression and anxiety, and the WHO-QoL Questionnaire. Multiple regression analyses examined the relationship between mindfulness and QoL and the mediating role of depression and anxiety.

Results: Mindfulness had a significant statistical positive effect on QoL domains physical health, psychological, and environmental QoL in patients with SSD. Depression was identified as a significant mediator of this relationship.

Conclusion: This study provides novel insight into mindfulness’ mechanisms and paves the way for a process-oriented approach to treat SSD. The results provide first evidence for the process-based value of mindfulness for SSD; future studies can focus on the role of mindfulness for central therapeutic processes of change by employing longitudinal designs.

https://www.frontiersin.org/articles/10.3389/fpsyg.2021.708808/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1721400_a0P58000000G0YfEAK_Psycho_20210909_arts_A

 

Reduce Anxiety Around Cardiac Surgery with Yogic Breathing

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Reduce Anxiety Around Cardiac Surgery with Yogic Breathing

 

By John M. de Castro, Ph.D.

 

“Anxiety is the physical, mental and emotional reaction to stress. Both can be calmed through the practice of yoga breathing, also called pranayama.” – M. Patino

 

Patients scheduled for major surgeries usually experience anxiety. This is thoroughly understandable, but this anxiety can contribute to cardiac mortality. Yoga training has been shown to improve health and well-being. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. There are a wide variety of different yoga training techniques. But most contain breathing exercises. It is not known if these yogic breathing techniques can help relieve anxiety associated with major surgery.

 

In today’s Research News article “Effect of Short-Term Yoga-Based-Breathing on Peri-Operative Anxiety in Patients Undergoing Cardiac Surgery.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191222/ ) Azeez and colleagues recruited adult patients who were scheduled for cardiac surgery and randomly assigned them to either a no-treatment control condition or to receive 5 daily 60-minute sessions of yogic breathing including alternate nostril breathing, bee breathing, Udgith breathing, Sheetali breathing, and yoga nidra. They completed measures of anxiety before training, pre-surgery and post-surgery.

 

They found that in comparison to baseline and the control condition, the group that performed yogic breathing had significantly lower levels of both state and trait anxiety before surgery and another significant decrease after surgery. These findings need to be tempered with the understanding that the comparison, control, condition was passive leaving open the possibility of expectancy (placebo) effects, bias, and attentional effects. Future research should incorporate an active control condition, e.g. cardiac education.

 

Previous controlled research has demonstrated that yogic breathing reduces stress levels and improves psychological well-being. So, it I likely that the present results were due to yogic breathing exercises relieving anxiety. Although not measured, it would be expected that the lower anxiety levels in these cardiac surgery patients would lead to better surgical outcomes. It remains for future research to follow the patients after surgery to examine recovery and cardiac outcomes.

 

So, reduce anxiety around cardiac surgery with yogic breathing.

 

“There are many ways to combat anxiety, but perhaps none as quickly – and naturally – effective as certain forms of Pranayama. Pranayama is conscious breathwork and is often used in yoga, mindfulness practices and meditation.” – YogiApproved

 

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

 

Azeez, A. M., Puri, G. D., Samra, T., & Singh, M. (2021). Effect of Short-Term Yoga-Based-Breathing on Peri-Operative Anxiety in Patients Undergoing Cardiac Surgery. International journal of yoga, 14(2), 163–167. https://doi.org/10.4103/ijoy.IJOY_120_20

 

Abstract

Background:

Peri-operative anxiety in patients scheduled for cardiac surgery is detrimental. This study evaluated the effect of short-term yoga based-breathing with different variations on peri-operative anxiety.

Materials and Methods:

A prospective randomized controlled study was conducted in patients aged 20–60 years scheduled for major cardiac surgery. Patients in Yoga group were trained for yoga based-breathing with different variations for 5 days; no intervention was done in controls.

Results:

We analyzed twenty patients in each group. Anxiety scores measured at baseline, presurgery, and postsurgery were entered as the within-subjects factor; group status was entered as the between-subjects factor in the RMANOVA. Baseline demographics and anxiety scores were comparable. The short-term yoga-based breathing exercise-training program had a statistically significant effect on state (F = 13.45, P < 0.0001), Trait (F = 13.29, P < 0.0001) and total anxiety scores (F = 29.44, P < 0.0001) at different time points for yoga over control group.

Conclusion:

Short-term yoga-based breathing for 5 days lowers presurgery and postsurgery anxiety in patients undergoing cardiac surgery.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191222/

 

Improve Psychological Health with Online Mindfulness Training

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Improve Psychological Health with Online Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“Virtual mindfulness is an increasingly accessible intervention available world-wide that may reduce psychological distress.” – Suzan Farris

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health. But the vast majority of the mindfulness training techniques, however, require a trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. As an alternative, mindfulness training online has been developed. This has tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. In addition, research has indicated that mindfulness training online can be effective for improving the health and well-being of the participants. The research has been accumulating. So, it makes sense to step back and summarize what has been learned.

 

In today’s Research News article “New Evidence in the Booming Field of Online Mindfulness: An Updated Meta-analysis of Randomized Controlled Trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8329762/ ) Sommers-Spijkerman and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials of the effectiveness on online mindfulness training to improve psychological health. They identified 97 randomized controlled trials, including a total of 17,464 participants.

 

They report that the published randomized controlled trials found that online mindfulness training produced significant moderate reductions of perceived stress anxiety and depression and increases in mindfulness and well-being. One to 3 months after training there were still significant reductions in anxiety and depression remaining. Although the effects were larger when comparing online mindfulness training to passive control conditions, they were still present in significant when compared to active control conditions.

 

A very large amount of research has accumulated on the effectiveness of online mindfulness training for psychological health. This meta-analysis revealed that this research clearly demonstrates that online mindfulness training has similar effectiveness as face-to-face mindfulness training in improving psychological health. Hence, online training is safe, effective convenient, scalable, and inexpensive, and doesn’t require a trained therapist making it an excellent option for improving psychological health.

 

So, improve psychological health with online mindfulness training.

 

“The fear, anxiety and stress associated with the COVID-19 pandemic has taken a toll on mental health. But . . . these symptoms may be alleviated through safe and convenient online mindfulness practices.” – Wake Forest Baptist Health

 

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

 

Sommers-Spijkerman, M., Austin, J., Bohlmeijer, E., & Pots, W. (2021). New Evidence in the Booming Field of Online Mindfulness: An Updated Meta-analysis of Randomized Controlled Trials. JMIR mental health, 8(7), e28168. https://doi.org/10.2196/28168

 

Abstract

Background

There is a need to regularly update the evidence base on the effectiveness of online mindfulness-based interventions (MBIs), especially considering how fast this field is growing and developing.

Objective

This study presents an updated meta-analysis of randomized controlled trials assessing the effects of online MBIs on mental health and the potential moderators of these effects.

Methods

We conducted a systematic literature search in PsycINFO, PubMed, and Web of Science up to December 4, 2020, and included 97 trials, totaling 125 comparisons. Pre-to-post and pre-to-follow-up between-group effect sizes (Hedges g) were calculated for depression, anxiety, stress, well-being, and mindfulness using a random effects model.

Results

The findings revealed statistically significant moderate pre-to-post effects on depression (g=0.34, 95% CI 0.18-0.50; P<.001), stress (g=0.44, 95% CI 0.32-0.55; P<.001), and mindfulness (g=0.40, 95% CI 0.30-0.50; P<.001) and small effects on anxiety (g=0.26, 95% CI 0.18-0.33; P<.001). For well-being, a significant small effect was found only when omitting outliers (g=0.22, 95% CI 0.15-0.29; P<.001) or low-quality studies (g=0.26, 95% CI 0.12-0.41; P<.001). Significant but small follow-up effects were found for depression (g=0.25, 95% CI 0.12-0.38) and anxiety (g=0.23, 95% CI 0.13-0.32). Subgroup analyses revealed that online MBIs resulted in higher effect sizes for stress when offered with guidance. In terms of stress and mindfulness, studies that used inactive control conditions yielded larger effects. For anxiety, populations with psychological symptoms had higher effect sizes. Adherence rates for the interventions ranged from 35% to 92%, but most studies lacked clear definitions or cut-offs.

Conclusions

Our findings not only demonstrate that online MBIs are booming but also corroborate previous findings that online MBIs are beneficial for improving mental health outcomes in a broad range of populations. To advance the field of online MBIs, future trials should pay specific attention to methodological quality, adherence, and long-term follow-up measurements.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8329762/

 

Hallucinogenic Drugs may Effectively Treat Mental Illness

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Hallucinogenic Drugs may Effectively Treat Mental Illness

 

By John M. de Castro, Ph.D.

 

“Combined with psychotherapy, some psychedelic drugs like MDMA, psilocybin and ayahuasca may improve symptoms of anxiety, depression and post-traumatic stress disorder,” – Cristina L. Magalhaes

 

Psychedelic substances such as peyote, mescaline, LSD, Bufotoxin, ayahuasca and psilocybin 

have been used almost since the beginning of recorded history to alter consciousness and produce spiritually meaningful experiences. More recently hallucinogenic drugs such as MDMA (Ecstasy) and Ketamine have been similarly used. People find the experiences produced by these substances extremely pleasant. eye opening, and even transformative. They often report that the experiences changed them forever. Psychedelics and hallucinogens have also been found to be clinically useful as they markedly improve mood, increase energy and enthusiasm and greatly improve clinical depression. The research on the effectiveness of these drugs on mood and mental illness is accumulating. So, it makes sense to step back and summarize what has been learned.

 

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/PMC7880300/ ) De Gregorio and colleagues review and summarize the published research on the brain mechanisms of hallucinogenic drug actions and their effectiveness as treatments for mental illness.

 

They report that the different drugs have very different effects on the nervous system although most interact with serotonin receptors. The nervous systems effects appear to alter sensory integration and associations with these sensations resulting in altered experiences.

 

They also report that the published research suggests that psilocybin may be useful in treating anxiety, depression, alcohol abuse, and obsessive-compulsive disorder (OCD), LSD may relieve anxiety and depression, that Ketamine may improve major depressive disorder, and MDMA (Ecstasy) may help in the treatment of post-traumatic stress disorder. Hence, psychedelic and hallucinogenic drugs may be effective in treating mental illness. It needs to be kept in mind that these drugs have powerful effects so they must be administered in controlled environments by trained practitioners.

 

So, hallucinogenic drugs may effectively treat mental illness.

 

“Most powerful substances that we know of, that have powerful effects on the central nervous system, are like any powerful tool, They can have dangerous effects, or beneficial effects, if judiciously used in a context where the dangers are known and mechanisms are in place to address them.” – Matthew Johnson

 

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

 

De Gregorio, D., Aguilar-Valles, A., Preller, K. H., Heifets, B. D., Hibicke, M., Mitchell, J., & Gobbi, G. (2021). Hallucinogens in Mental Health: Preclinical and Clinical Studies on LSD, Psilocybin, MDMA, and Ketamine. The Journal of neuroscience : the official journal of the Society for Neuroscience, 41(5), 891–900. https://doi.org/10.1523/JNEUROSCI.1659-20.2020

 

Abstract

A revamped interest in the study of hallucinogens has recently emerged, especially with regard to their potential application in the treatment of psychiatric disorders. In the last decade, a plethora of preclinical and clinical studies have confirmed the efficacy of ketamine in the treatment of depression. More recently, emerging evidence has pointed out the potential therapeutic properties of psilocybin and LSD, as well as their ability to modulate functional brain connectivity. Moreover, MDMA, a compound belonging to the family of entactogens, has been demonstrated to be useful to treat post-traumatic stress disorders. In this review, the pharmacology of hallucinogenic compounds is summarized by underscoring the differences between psychedelic and nonpsychedelic hallucinogens as well as entactogens, and their behavioral effects in both animals and humans are described. Together, these data substantiate the potentials of these compounds in treating mental diseases.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7880300/

 

Improve Unmedicated Obsessive-Compulsive Disorder with Mindfulness

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Improve Unmedicated Obsessive-Compulsive Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“a growing pool of research coming out over the last few years suggests that those who are adding mindfulness into treatment for OCD are on the right track.” – John Hershfield

 

Obsessive-Compulsive Disorder (OCD) sufferers have repetitive anxiety producing intrusive thoughts (obsessions) that result in repetitive behaviors to reduce the anxiety (compulsions). In a typical example of OCD, the individual is concerned about germs and is unable to control the anxiety that these thoughts produce. Their solution is to engage in ritualized behaviors, such as repetitive cleaning or hand washing that for a short time relieves the anxiety. The obsessions and compulsions can become so frequent that they become a dominant theme in their lives. Hence OCD drastically reduces the quality of life and happiness of the sufferer and those around them. About 2% of the population, 3.3 million people in the U.S., are affected at some time in their life.

 

Fortunately, Obsessive-Compulsive Disorder (OCD) can be treated, and many respond to Cognitive Behavioral Therapy (CBT). But some do not. Mindfulness training has been shown to be effective in treating OCD. Mindfulness-Based Cognitive Therapy (MBCT) involves the combination of mindfulness training and cognitive behavioral therapy. It contains sitting, walking and body scan meditations, and cognitive therapy that is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. MBCT has been shown to reduce anxiety. So, it makes sense to examine the effectiveness of MBCT for Obsessive-Compulsive Disorder (OCD).

 

In today’s Research News article “Mindfulness-Based Cognitive Therapy for Unmedicated Obsessive-Compulsive Disorder: A Randomized Controlled Trial With 6-Month Follow-Up.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8369060/ ) Zhang and colleagues recruited adults diagnosed with Obsessive-Compulsive Disorder (OCD) and randomly assigned them to receive either drugs (SSRIs), or 10 weekly 150-minute sessions of Mindfulness-Based Cognitive Therapy (MBCT) or an active placebo control treatment, containing education about OCD, group support, and relapse prevention. They were measured before and after treatment and 6 months later for mindfulness, anxiety, depression, social function, and Obsessive-Compulsion severity.

 

They found that in comparison to baseline and the active placebo control group, both the drugs (SSRIs) and Mindfulness-Based Cognitive Therapy (MBCT) groups had significant improvements in Obsessive-Compulsion severity. But the differences were no longer significant at the 6-month follow-up where all groups were significantly improved. All groups had significant improvements in anxiety and depression that were maintained at the 6-month follow up.

 

These are interesting results that show that drugs (SSRIs) and Mindfulness-Based Cognitive Therapy (MBCT)  improve OCD severity after treatment to a greater extent than the placebo group. But 6 months after treatment all groups had equivalent significant improvements on OCD and all groups had significant reductions in anxiety and depression at all post-treatment time points. In other words, drugs, MBCT, and placebo are all effective in improving the symptoms of OCD patients. But drugs and MBCT are slightly more effective immediately after treatment. This suggests that regardless of the actual treatment, OCD is improved if the patients believe that the treatment will improve their symptoms.

 

So, improve unmedicated obsessive-compulsive disorder with mindfulness

 

“Mindfulness requires you to be aware of intrusive thoughts or triggers, accept and possibly internally analyze any discomforts caused by such thoughts and resist the urge to respond with compulsions.” – NOCD

 

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

 

Zhang, T., Lu, L., Didonna, F., Wang, Z., Zhang, H., & Fan, Q. (2021). Mindfulness-Based Cognitive Therapy for Unmedicated Obsessive-Compulsive Disorder: A Randomized Controlled Trial With 6-Month Follow-Up. Frontiers in psychiatry, 12, 661807. https://doi.org/10.3389/fpsyt.2021.661807

 

Abstract

Background: This was the first randomized controlled trial (RCT) designed to compare the efficacy of mindfulness-based cognitive therapy (MBCT) on unmedicated obsessive-compulsive disorder with that of the first-line treatment for OCD (SSRIs) or a placebo, as well as to analyze the treatment acceptability and safety of MBCT.

Methods: A total of 123 unmedicated OCD patients with mild to moderate symptoms were randomly assigned into selective serotonin reuptake inhibitors group (SSRIs group), MBCT group or psycho-education group (PE group), respectively. They were intervened for 10 weeks. The Yale–Brown Obsessive-Compulsive Scale (Y-BOCS) grade was the primary outcome, and Hamilton Depression Scale-24 (HAMD-24) and Hamilton Anxiety Scale (HAMA) grades were secondary outcomes to be measured at baseline, mid-intervention, post-intervention and 14, 22, and 34 weeks of follow-up. The Five Facet Mindfulness Questionnaire (FFMQ) and Sheehan Disability Scale (SDS) were used to assess mindfulness and social functions, respectively. In addition, treatment acceptability (dropout rate and frequency of occurrence) and safety [adverse event (AE)] of MBCT were investigated.

Results: Significant differences were detected in the treatment responses among SSRIs group, MBCT group and PE group. Notably, treatment responses were significantly better in the former two groups than that of PE group (χ2 = 6.448, p = 0.04), although we did not identify significant differences between SSRIs group and MBCT group (χ2 = 1.220, p = 0.543). Observed until 6 months of follow-up, there were no significant differences in treatment response among three groups. No AE was recorded in MBCT group.

Conclusion: MBCT is effective in the treatment of unmedicated OCD with mild to moderate symptoms comparable to that of SSRIs, which contributes to maintain the treatment outcomes at follow-up. Besides, MBCT is safe with a good clinical compliance.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8369060/

 

Yoga Practitioners Cope Better with the Stress and Psychological Distress During Covid-19 Pandemic

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Yoga Practitioners Cope Better with the Stress and Psychological Distress During Covid-19 Pandemic

 

By John M. de Castro, Ph.D.

 

“As the lockdown cannot last forever and workplaces will have to be functional soon, there is an increased possibility of recurrent infection. Therefore, Yoga can provide the necessary tool for risk reduction, amelioration of stress and anxiety and strengthening of the immune function.” – Kanupriya Sharma 

 

Mindfulness training and yoga practices have been shown to improve health and well-being in healthy individuals. They have also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. The COVID-19 pandemic has challenged the mental and physical health of the population. It has created intense stress both for frontline workers but also for people simply isolating at home. Mindfulness is known to decrease the psychological and physical responses to stress and yoga practice also produces similar improvements. So, yoga practice may be helpful in coping with the mental and physical challenges resulting from the lockdown during the COVID-19 pandemic.

 

In today’s Research News article “Yoga Practice Is Beneficial for Maintaining Healthy Lifestyle and Endurance Under Restrictions and Stress Imposed by Lockdown During COVID-19 Pandemic.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8257944/ ) Nagarathna and colleagues recruited adult (>18 years of age) participants in India online during the Covid-19 lockdown and had them complete a questionnaire measuring demographics, Covid-19 exposure, physical health, mental health, coping strategies, lifestyle, and physical activities.

 

They defined a yoga group as those participants who practiced yoga before and during the Covid-19 lockdown and the non-yoga group as those who did not. They report that the yoga group had a significantly greater proportion of females and students, were younger, were less likely to use alcohol, tobacco, or other substances and eat junk food, more likely to be vegetarian, were disciplined in their diet, and had greater sleep quality, physical strength and endurance, and energy, have lower levels of anxiety and fear, but did not differ in Covid-19 exposure. In addition, the yoga group indicated more adaptive coping strategies.

 

This study was a comparison between groups defined by whether they were yoga practitioners or not. Any observed differences could well be due to the types of people attracted to yoga practice versus those who are not. It cannot be concluded that the practice of yoga was responsible for the differences. But prior research has demonstrated in controlled trials that the practice of yoga produces many physical and psychological benefits. So, the differences observed here may well be due to causal effects of yoga practice. Regardless of causation, the results clearly show that during the Covid-19 lockdown, yoga practitioners have greater physical and mental well-being and have healthier lifestyles.

 

So, yoga practitioners cope better with the stress and psychological distress during Covid-19 pandemic.

 

“Yoga can be a powerful tool to deal with the lockdown’s uncertainty and isolation, as well as to maintain physical well-being.” – United Nations

 

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

Nagarathna, R., Anand, A., Rain, M., Srivastava, V., Sivapuram, M. S., Kulkarni, R., Ilavarasu, J., Sharma, M., Singh, A., & Nagendra, H. R. (2021). Yoga Practice Is Beneficial for Maintaining Healthy Lifestyle and Endurance Under Restrictions and Stress Imposed by Lockdown During COVID-19 Pandemic. Frontiers in psychiatry, 12, 613762. https://doi.org/10.3389/fpsyt.2021.613762

 

Abstract

Uncertainty about Coronavirus disease 2019 (COVID-19) and resulting lockdown caused widespread panic, stress, and anxiety. Yoga is a known practice that reduces stress and anxiety and may enhance immunity. This study aimed to (1) investigate that including Yoga in daily routine is beneficial for physical and mental health, and (2) to evaluate lifestyle of Yoga practitioners that may be instrumental in coping with stress associated with lockdown. This is a pan-India cross-sectional survey study, which was conducted during the lockdown. A self-rated scale, COVID Health Assessment Scale (CHAS), was designed by 11 experts in 3 Delphi rounds (Content valid ratio = 0.85) to evaluate the physical health, mental health, lifestyle, and coping skills of the individuals. The survey was made available digitally using Google forms and collected 23,760 CHAS responses. There were 23,290 valid responses (98%). After the study’s inclusion and exclusion criteria of yogic practices, the respondents were categorized into the Yoga (n = 9,840) and Non-Yoga (n = 3,377) groups, who actively practiced Yoga during the lockdown in India. The statistical analyses were performed running logistic and multinomial regression and calculating odds ratio estimation using R software version 4.0.0. The non-Yoga group was more likely to use substances and unhealthy food and less likely to have good quality sleep. Yoga practitioners reported good physical ability and endurance. Yoga group also showed less anxiety, stress, fear, and having better coping strategies than the non-Yoga group. The Yoga group displayed striking and superior ability to cope with stress and anxiety associated with lockdown and COVID-19. In the Yoga group, participants performing meditation reportedly had relatively better mental health. Yoga may lead to risk reduction of COVID-19 by decreasing stress and improving immunity if specific yoga protocols are implemented through a global public health initiative.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8257944/

 

Better Mental Health During the Covid-19 Pandemic is Associated with Exercise and Meditation

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Better Mental Health During the Covid-19 Pandemic is Associated with Exercise and Meditation

 

By John M. de Castro, Ph.D.

 

“Introducing a mindfulness and meditation practice during this pandemic has the potential to complement treatment and is a low-cost beneficial method of providing support with anxiety for all.” C. Behan

 

Mindfulness training has been shown to improve health and well-being in healthy individuals. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. The COVID-19 pandemic has challenged the mental and physical health of the population. It has created intense stress both for frontline workers but also for people simply isolating at home. Mindfulness is known to decrease the psychological and physical responses to stress. So, meditation may be helpful in coping with the mental and physical challenges resulting from the COVID-19 pandemic.

 

In today’s Research News article “The Effect of Meditation and Physical Activity on the Mental Health Impact of COVID-19-Related Stress and Attention to News Among Mobile App Users in the United States: Cross-sectional Survey.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8045775/ ) Green and colleagues recruited adult participants online who used the meditation app “Calm” and had them complete a questionnaire measuring worry regarding Covid-19, meditation, exercise, and health related behaviors. They also had them complete measures of habits, perceived stress, anxiety, depression, and PTSD symptoms.

 

There were 8,392 responses. They reported a significant increase in meditation and exercise during Covid-19. But the greater the worry about Covid-19, the lower the levels of meditation and exercise and the greater the levels of perceived stress and PTSD symptoms.  They found that the Covid-19 worry was associated with lower the levels of meditation and exercise and these decreases were in turn associated with higher levels of perceived stress, PTSD symptoms, anxiety and depression. Hence, worry about Covid-19 appears to be detrimental to mental health as a result of decreases meditation and exercise.

 

These results are correlational, and caution must be exercised in concluding causation. In addition, the sample was composed of users of a meditation app and thus the results may not be predictive of the responses of non-meditators. But the associations are clear. Worry about the pandemic is associated with decreases in meditation and exercise which are in turn associated with poorer mental health.

 

This suggests that methods to support continued meditation practice and exercise during the pandemic may be helpful in improving mental health during the pandemic. They may mitigate the detrimental effects of worry about the pandemic. Indeed, previous research has found that mindfulness training improves mental health during the Covid-19 pandemic.

 

So, better mental health during the covid-19 pandemic is associated with exercise and meditation.

 

“certain meditation, yoga asana (postures), and pranayama (breathing) practices may possibly be effective adjunctive means of treating and/or preventing SARS-CoV-2 infection” – William Bushell

 

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

 

Green, J., Huberty, J., Puzia, M., & Stecher, C. (2021). The Effect of Meditation and Physical Activity on the Mental Health Impact of COVID-19-Related Stress and Attention to News Among Mobile App Users in the United States: Cross-sectional Survey. JMIR mental health, 8(4), e28479. https://doi.org/10.2196/28479

 

Abstract

Background

The COVID-19 pandemic has been declared an international public health emergency, and it may have long-lasting effects on people’s mental health. There is a need to identify effective health behaviors to mitigate the negative mental health impact of COVID-19.

Objective

The objectives of this study were to (1) examine the regional differences in mental health and COVID-19–related worry, attention to news, and stress, in light of the state-level prevalence of COVID-19 cases; (2) estimate the associations between mental health and COVID-19–related worry, attention to news, and stress and health behavior engagement (ie, physical activity, mindfulness meditation); and (3) explore the mediating effect of health behavior engagement on the associations between mental health and COVID-19–related worry, attention to news, and stress.

Methods

A cross-sectional survey was distributed to a sample of US adult paying subscribers to the Calm app (data were collected from April 22 to June 3, 2020). The survey assessed COVID-19–related worry, attention to news, and stress; health behavior engagement; and mental health (ie, perceived stress, posttraumatic stress disorder, and anxiety and depression). Statistical analyses were performed using R software. Differences in COVID-19–related worry, attention to news, and stress and mental health by location were assessed using t tests and chi-square tests. Logistic and ordinary least squares models were used to regress mental health and health behavior on COVID-19–related worry, attention to news, and stress; moreover, causal mediation analysis was used to estimate the significance of the mediation effects.

Results

The median age of the respondents (N=8392) was 47 years (SD 13.8). Participants in the Mid-Atlantic region (New Jersey, New York, and Pennsylvania) reported higher levels of stress, more severe depression symptoms, greater worry about COVID-19, paying more attention to COVID-19–related news, and more stress related to social distancing recommendations than participants living in other regions. The association between worry about COVID-19 and perceived stress was significantly mediated by changes in physical activity (P<.001), strength of meditation habit (P<.001), and stopping meditation (P=.046). The association between worry about COVID-19 and posttraumatic stress disorder symptoms was significantly mediated by changes in physical activity (P<.001) and strength of meditation habit (P<.001).

Conclusions

Our findings describe the mental health impact of COVID-19 and outline how continued participation in health behaviors such as physical activity and mindfulness meditation reduce worsening of mental health due to the COVID-19 pandemic. These data have important implications for public health agencies and health organizations to promote the maintenance of health habits to reduce the residual mental health burden of the COVID-19 pandemic.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8045775/

 

Mindfulness is Associated with Better Dementia Patient and Caregiver Outcomes

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Mindfulness is Associated with Better Dementia Patient and Caregiver Outcomes

 

By John M. de Castro, Ph.D.

 

“Research has shown preliminary but promising results for mindfulness-based interventions to benefit people with dementia and caregivers.” – Lotte Berk

 

Dementia is a progressive loss of mental function produced by degenerative diseases of the brain. Dementia patients require caregiving particularly in the later stages of the disease. Caregiving for dementia patients is a daunting intense experience that can go on for four to eight years with increasing responsibilities as the loved one deteriorates. This places tremendous psychological and financial stress on the caregiver. Hence, there is a need to both care for the dementia patients and also for the caregivers. Mindfulness practice for caregivers has been shown to help them cope with the physical and psychological demands of caregiving. In addition, mindfulness training has been found to help protect aging individuals from physical and cognitive declines.

 

In today’s Research News article “The Effect of Baseline Patient and Caregiver Mindfulness on Dementia Outcomes.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8324319/ ) Innis and colleagues recruited patients with dementia and their caregivers and both were measured for cognitive function, functional activities, health related quality of life, verbal learning, memory, executive function, visual ability, mindfulness, resilience, vulnerability, and Apolipoprotein E. In addition, “caregivers completed ratings of care confidence, care preparedness, burden, mood, and appraisals of caregiving”.  Finally, a subset of participants underwent brain scanning with Magnetic Resonance Imaging (MRI).

 

They found that participants without dementia had significantly higher levels of mindfulness than those with even mild dementia. They also found that the higher the level of patient mindfulness the lower the caregiver ratings of patient dementia, the higher the ratings of health-related quality of life, and the lower the rated patient impairment, cognitive complaints, anxiety, and depression. In addition, the higher the patient’s level of mindfulness the higher the levels of cognition, verbal learning, memory, visuospatial ability, and resilience and the lower the levels of vulnerability. Finally, the found that the association of patient mindfulness on cognitive ability was mediated by resilience and vulnerability.

 

These results are based upon correlations and thus causation cannot be determined. Nevertheless, the associations are clear. The degree of mindfulness of dementia patients is associated with better cognitive ability, emotional health, and resilience and lower levels of vulnerability. These latter relationships appear to be the intermediaries between the patient’s mindfulness and their cognitive ability. It has been shown that mindfulness training in normal individuals produces improvements in resilience. This suggests that mindfulness may help protect against cognitive decline by improving the patient’s resilience and lessening their vulnerability to the effects of aging. This further suggests the possibility that mindfulness training might help to ameliorate the cognitive decline associated with dementia. It remains for future research to explore these possibilities.

 

So, mindfulness is associated with better dementia patient and caregiver outcomes.

 

“Alzheimer’s disease patients who practice mindfulness may have better outcomes than those who do not.” – Josh Baxt

 

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

 

Innis, A. D., Tolea, M. I., & Galvin, J. E. (2021). The Effect of Baseline Patient and Caregiver Mindfulness on Dementia Outcomes. Journal of Alzheimer’s disease : JAD, 79(3), 1345–1367. https://doi.org/10.3233/JAD-201292

 

Abstract

Background:

Mindfulness is the practice of awareness and living in the present moment without judgment. Mindfulness-based interventions may improve dementia-related outcomes. Before initiating interventions, it would be beneficial to measure baseline mindfulness to understand targets for therapy and its influence on dementia outcomes.

Objective:

This cross-sectional study examined patient and caregiver mindfulness with patient and caregiver rating scales and patient cognitive performance and determined whether dyadic pairing of mindfulness influences patient outcomes.

Methods:

Individuals (N = 291) underwent comprehensive evaluations, with baseline mindfulness assessed using the 15-item Applied Mindfulness Process Scale (AMPS). Correlation, regression, and mediation models tested relationships between patient and caregiver mindfulness and outcomes.

Results:

Patients had a mean AMPS score of 38.0 ± 11.9 and caregivers had a mean AMPS score of 38.9 ± 11.5. Patient mindfulness correlated with activities of daily living, behavior and mood, health-related quality of life, subjective cognitive complaints, and performance on episodic memory and attention tasks. Caregiver mindfulness correlated with preparedness, care confidence, depression, and better patient cognitive performance. Patients in dyads with higher mindfulness had better cognitive performance, less subjective complaints, and higher health-related quality of life (all p-values<0.001). Mindfulness effects on cognition were mediated by physical activity, social engagement, frailty, and vascular risk factors.

Conclusion:

Higher baseline mindfulness was associated with better patient and caregiver outcomes, particularly when both patients and caregivers had high baseline mindfulness. Understanding the baseline influence of mindfulness on the completion of rating scales and neuropsychological test performance can help develop targeted interventions to improve well-being in patients and their caregivers.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8324319/

 

Improve Health Outcomes in Women on Long-Term Sick Leave with Mindfulness

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Improve Health Outcomes in Women on Long-Term Sick Leave with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Since stress compromises our immune system, becoming caught up in this way can slow down our recovery. Instead, aim to approach your illness with care, seeing things as they are, with acceptance and compassion.” — Mark Bertin

 

Chronic Pain and mental health issues are the most common causes of long-term sick leave. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain. There is an accumulating volume of research findings that demonstrate that mindfulness practices, in general, are effective in treating pain.

 

Depression affects over 6% of the population. Depression can be difficult to treat. It is usually treated with antidepressant medication. But, of patients treated initially with drugs only about a third attained remission of the depression. Even after remission there are a number of symptoms that remain. These include lingering dysphoria, impaired psychosocial functioning, fatigue, and decreased ability to work. These residual symptoms can lead to relapse. Mindfulness training is also an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail.

 

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

 

A therapeutic technique that contains mindfulness training and Cognitive Behavioral Therapy (CBT) is Acceptance and Commitment Therapy (ACT). It focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. This suggests that ACT may be an effective treatment for women who are on long-term sick leave.

 

In today’s Research News article “Comparing the Efficacy of Multidisciplinary Assessment and Treatment, or Acceptance and Commitment Therapy, with Treatment as Usual on Health Outcomes in Women on Long-Term Sick Leave-A Randomised Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916944/ ) Finnes and colleagues recruited working age women who were on long-term sick leave and randomly assigned them to receive either treatment as usual, Acceptance and Commitment Therapy (ACT), or ACT in combination with a multidisciplinary team consisting of a physician, a psychologist, an occupational therapist and a social worker. They were measured before and after treatment and at 6 and 12 months after treatment for sick leave, satisfaction with treatment, pain, anxiety, depression, satisfaction with life, and general health well-being.

 

They found that there were no significant differences between Acceptance and Commitment Therapy (ACT), or ACT plus team with the women’s satisfaction with treatment. But in comparison to baseline and the treatment as usual group, both treatments produced significant reductions in anxiety, depression, pain intensity and significant increases in satisfaction with life, and general health well-being. At one year after treatment the ACT plus team group had significantly more patients classified as recovered than the ACT alone group.

 

These results demonstrate that Acceptance and Commitment Therapy (ACT) is effective in treating the physical and psychological symptoms of women who were on long-term sick leave. Women on long-term sick leave are very difficult to treat as their issues have resisted improvement for a substantial period of time. So, the ability of ACT to improve these symptoms is impressive. Adding the team produced slightly better outcomes at 12 months but the additional cost of the team is quite significant. So, from a cost effectiveness standpoint, ACT alone is superior.

 

So, improve health outcomes in women on long-term sick leave with mindfulness.

 

“Musculoskeletal pain, depression, and anxiety cause the majority of all sick leave. . . Interestingly enough, mindfulness has become an important construct in return-to-work rehabilitation.” – Emily Lipinski

 

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

 

Finnes, A., Anderzén, I., Pingel, R., Dahl, J., Molin, L., & Lytsy, P. (2021). Comparing the Efficacy of Multidisciplinary Assessment and Treatment, or Acceptance and Commitment Therapy, with Treatment as Usual on Health Outcomes in Women on Long-Term Sick Leave-A Randomised Controlled Trial. International journal of environmental research and public health, 18(4), 1754. https://doi.org/10.3390/ijerph18041754

 

Abstract

Background: Chronic pain and mental disorders are common reasons for long term sick leave. The study objective was to evaluate the efficacy of a multidisciplinary assessment and treatment program including acceptance and commitment therapy (TEAM) and stand-alone acceptance and commitment therapy (ACT), compared with treatment as usual (Control) on health outcomes in women on long-term sick leave. Method: Participants (n = 308), women of working age on long term sick leave due to musculoskeletal pain and/or common mental disorders, were randomized to TEAM (n = 102), ACT (n = 102) or Control (n = 104). Participants in the multidisciplinary assessment treatment program received ACT, but also medical assessment, occupational therapy and social counselling. The second intervention included ACT only. Health outcomes were assessed over 12 months using adjusted linear mixed models. The results showed significant interaction effects for both ACT and TEAM compared with Control in anxiety (ACT [p < 0.05]; TEAM [p < 0.001]), depression (ACT [p < 0.001]; TEAM [p < 0.001]) and general well-being (ACT [p < 0.05]; TEAM [p < 0.001]). For self-rated pain, there was a significant interaction effect in favour of ACT (p < 0.05), and for satisfaction with life in favour of TEAM (p < 0.001). Conclusion: Both ACT alone and multidisciplinary assessment and treatment including ACT were superior to treatment as usual in clinical outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916944/

 

Improve Pain, Sleep, and the Mental Health of Chronic Pain Patients with Internet Mindfulness Training

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Improve Pain, Sleep, and the Mental Health of Chronic Pain Patients with Internet Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“In the context of chronic pain . . . meditation can help you to stop your mind wandering back to your pain when you are trying to focus on something else, therefore improving your ability to give your entire attention to the task at hand and in turn, improve your level of functioning. It gives you the power to take your mind off your pain and refocus it, therefore aiding you in replacing unhelpful, behaviours with healthy ones which can reduce your pain and allow you to take better care of your health.” – Ann-Marie D’arcy-Sharpe

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain.

 

There is an accumulating volume of research findings that demonstrate that mindfulness practices, in general, are effective in treating pain. A therapeutic technique that contains mindfulness training and Cognitive Behavioral Therapy (CBT) is Acceptance and Commitment Therapy (ACT). It focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

Acceptance and Commitment Therapy (ACT) requires a scheduled program of sessions with a trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. As an alternative, mindfulness training over the internet have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. In addition, research has indicated that mindfulness training online can be effective for improving the health and well-being of the participants.

 

In today’s Research News article “Internet‐delivered acceptance and commitment therapy as microlearning for chronic pain: A randomized controlled trial with 1‐year follow‐up.” (See summary below or view the full text of the study at: https://onlinelibrary.wiley.com/doi/10.1002/ejp.1723 ) Rickardsson and colleagues recruited adult chronic pain patients and randomly assigned them to either a wait-list control condition or to receive an 8-week program of Acceptance and Commitment Therapy (ACT) delivered over the internet. ACT was delivered in daily microlearning short learning interactions. There was a 74% completion rate of the modules. The participants were measured before and after training and at 3-, 6-, and 12-month follow-ups for psychiatric problems, pain interference, pain intensity, anxiety, depression, psychological inflexibility, values, and health-related quality of life.

 

They found that compared to baseline and the wait-list control group, the group that received internet-delivered Acceptance and Commitment Therapy (ACT) had significant decreases in pain interference, pain intensity, anxiety, depression, psychological inflexibility, value obstruction, and insomnia. These improvements were long-lasting as they were maintained at the 12-month follow-up.

 

These are impressive improvements in the pain and psychological health of these diverse chronic pain patients. These results correspond with the frequent prior observations that mindfulness training produces reductions in pain, anxiety, depression, psychological inflexibility, and insomnia in a wide range of patient types and normal individuals. These results are particularly impressive as Acceptance and Commitment Therapy (ACT) was delivered over the internet. in daily microlearning short learning interactions. This was very convenient for the patients and required only 12.4 minutes per week of therapist time per week and was thus very inexpensive to deliver. Yet ACT was highly effective and lasting in relieving the suffering of these chronic pain patients.

 

So, improve pain, sleep, and the mental health of chronic pain patients with internet mindfulness training.

 

“What we want to do as best as we can is to engage with the pain just as it is. It’s not about achieving a certain goal – like minimizing pain – but learning to relate to your pain differently.” – 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

 

Jenny Rickardsson, Charlotte Gentili, Linda Holmström, Vendela Zetterqvist, Erik Andersson, Jan Persson, Mats Lekander, Brjánn Ljótsson, Rikard K. Wicksell. Internet‐delivered acceptance and commitment therapy as microlearning for chronic pain: A randomized controlled trial with 1‐year follow‐up, European Journal of Pain, 2021;00:1–19, https://doi.org/10.1002/ejp.1723

 

Abstract

Background

Studies of Internet‐delivered acceptance and commitment therapy (ACT) for chronic pain have shown small to moderate positive effects for pain interference and pain acceptance. Effects on pain intensity, depression, anxiety and quality of life (QoL) have been less favourable, and improvements for values and sleep are lacking. In this randomized controlled trial iACT – a novel format of Internet‐ACT using daily microlearning exercises – was examined for efficacy compared to a waitlist condition.

Methods

Adult participants (mean age 49.5 years, pain duration 18.1 years) with diverse chronic pain conditions were recruited via self‐referral, and randomized to iACT (n = 57) or waitlist (n = 56). The primary outcome was pain interference. The secondary outcomes were QoL, depression, anxiety, insomnia and pain intensity. The process variables included psychological inflexibility and values. Post‐assessments were completed by 88% (n = 100) of participants. Twelve‐month follow‐up assessments were completed by 65% (iACT only, n = 37). Treatment efficacy was analysed using linear mixed models and an intention‐to‐treat‐approach.

Results

Significant improvements in favour of iACT were seen for pain interference, depression, anxiety, pain intensity and insomnia, as well as process variables psychological inflexibility and values. Between‐group effect sizes were large for pain interference (d = 0.99) and pain intensity (d = 1.2), moderate for anxiety and depressive symptoms and small for QoL and insomnia. For the process variables, the between‐group effect size was large for psychological inflexibility (d = 1.0) and moderate for values. All improvements were maintained at 1‐year follow‐up.

Conclusions

Internet‐ACT as microlearning may improve a broad range of outcomes in chronic pain.

Significance

The study evaluates a novel behavioral treatment with positive results on pain interference, mood as well as pain intensity for longtime chronic pain sufferers. The innovative format of a digital ACT intervention delivered in short and experiential daily learnings may be a promising way forward.

https://onlinelibrary.wiley.com/doi/10.1002/ejp.1723