Anxiety

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

 

Mindfulness is Associated with Better Perinatal Mental Health Among Uncertainty Produced by Covid-19

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Mindfulness is Associated with Better Perinatal Mental Health Among Uncertainty Produced by Covid-19

 

By John M. de Castro, Ph.D.

 

“use of a mindfulness-based meditation app may benefit patients who are navigating the stressors of being pregnant during the COVID-19 pandemic.” –  Orli K. Florsheim, MD

 

The period of pregnancy is a time of intense physiological and psychological change. 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. 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.

 

In addition, immediately after birth it is common for the mother to experience mood swings including what has been termed “baby blues,” a sadness that may last for as much as a couple of weeks. But some women experience a more intense and long-lasting negative mood called postpartum depression. This occurs usually 4-6 weeks after birth in about 15% of births; about 600,000 women in the U.S. every year. For 50% of the women the depression lasts for about a year while about 30% are still depressed 3 years later.

 

Hence, it is clear that there is a need for methods to treat depression, and anxiety during the perinatal period. 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 and to relieve postpartum depression.

 

The COVID-19 pandemic has challenged the mental and physical health of the population. It has created intense stress for everyone including women during the perinatal period. Mindfulness is known to decrease the psychological and physical responses to stress and to improve well-being during the perinatal period. So, mindfulness training may be helpful in coping with the mental and physical challenges during the perinatal period resulting from the COVID-19 pandemic.

 

In today’s Research News article “The Indirect Effect of Parental Intolerance of Uncertainty on Perinatal Mental Health via Mindfulness During COVID-19.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8171361/ ) Sbrilli and colleagues recruited pregnant women or women who had given birth in the last 6 months during the Covid-19 pandemic. They were measured for Intolerance of uncertainty, mindfulness, and psychological symptoms, including anxiety, depression, and somatization.

 

They performed a path analysis and found that in these perinatal women intolerance of uncertainty was associated with psychological symptoms, especially anxiety and depression, directly and also indirectly by being associated with lower mindfulness which was, in turn, associated with greater psychological symptoms. The mindfulness facets that were significant in the indirect path were acting with awareness, non-reactivity, and describing.

 

The present study is correlational and as such caution must be exercised in reaching causal conclusions. But mindfulness has been shown in prior research to produce reductions in anxiety and depression. So, reduced mindfulness in the present study was probably the cause of the increased psychological symptoms. What’s new here is the finding that intolerance of uncertainty is directly and through mindfulness indirectly associated with increased psychological symptoms in perinatal women.

 

Intolerance of uncertainty is a fear of the unknown. During Covid-19 this fear is greatly amplified and the present results suggest that this results in greater anxiety and depression in these women. But since mindfulness is an intermediary it is possible that improvements in mindfulness, perhaps through training, could intervene to block the effects of intolerance of uncertainty on psychological symptoms. This is supported by the findings that mindfulness during Covid-19 improves psychological well-being.

 

Anxiety and depression during pregnancy can affect the birth and condition of the newborn. In addition, after birth they can affect post-partum depression. So, improving mindfulness is important during the perinatal period to improve the health and well-being of the infant and the mother. This becomes more important during the pandemic where uncertainty can exacerbate anxiety and depression.

 

So, mindfulness is associated with better perinatal mental health among uncertainty produced by Covid-19.

 

“The strength of mediation habits may play a role in pregnant women’s mental health during COVID-19. Stronger meditation habits may prevent increases in stress despite increased worry related to getting infected by COVID-19 and may reduce symptoms of depression and PTSD.” – Jennifer Huberty

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Sbrilli, M. D., Haigler, K., & Laurent, H. K. (2021). The Indirect Effect of Parental Intolerance of Uncertainty on Perinatal Mental Health via Mindfulness During COVID-19. Mindfulness, 1–10. Advance online publication. https://doi.org/10.1007/s12671-021-01657-x

 

Abstract

Objectives

The COVID-19 pandemic is associated with mental health difficulties, especially during pregnancy and early postpartum. Intolerance of uncertainty (IU) and reduced capacity for mindfulness—a protective factor for child-bearers—may be particularly relevant factors driving mental health problems given the unpredictable nature of the pandemic. The current study aims to shed light on modifiable paths to perinatal psychological distress by testing whether there is an indirect effect of IU on psychological symptoms through a perceived reduction in mindfulness during the pandemic.

Methods

Pregnant individuals (67%, n = 133) and new mothers within 6 months postpartum (33%, n = 66) participated in a cross-sectional online survey assessing IU, current and retrospective pre-pandemic mindfulness (FFMQ), and psychological symptoms (anxiety, depression, somatization; BSI). Perceived change in mindfulness was captured by including retrospective mindfulness as a covariate in the PROCESS macro used for analyses.

Results

Tests of the direct association between mindfulness, IU, and psychological symptoms showed significant effects of IU (b = 0.46, SE = 0.064; p < .001) and perceived decrease in mindfulness during the pandemic (b =  − 0.72, SE = 0.08, p < .001) on psychological symptoms (R2 = .21–.34; F[2, 197] = 51.13–52.81, p < .001). The indirect effect of IU on symptoms via perceived decrease in mindfulness during the pandemic (b = 0.13, SE = 0.043, 95%CI [.060, .226]) was significant (R2 = .41, F[3, 195] = 45.08, p < .001).

Conclusions

Results suggest that mothers who are less able to tolerate uncertainty experience more psychological symptoms, in part due to perceived reduction in mindfulness during the pandemic. Future research should examine whether IU is a screening risk marker and target for mindfulness-based interventions to improve maternal well-being and family outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8171361/

 

Improve Somatic Symptom Disorder with Mindfulness

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Improve Somatic Symptom Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Somatic symptom disorder . . . symptoms cannot be explained by general medical conditions and significantly affect one’s functioning.” – S. Actas

 

According to the American Psychological Association “Somatic symptom disorder involves a person having a significant focus on physical symptoms, such as pain, weakness or shortness of breath, that results in major distress and/or problems functioning. The individual has excessive thoughts, feelings and behaviors relating to the physical symptoms.” Somatic Symptom Disorder occurs in about 5% to 7% of the population, effect people of all ages and is more common in women. It is associated with poor health, problems functioning in daily life, including physical disability, problems with relationships, problems at work or unemployment, other mental health disorders, such as anxiety, depression and personality disorders, increased suicide risk related to depression, and financial problems due to excessive health care visits. Obviously, this produces major suffering in the patients. But little is known of the causes or treatment of Somatic Symptom Disorder.

 

Somatic Symptom Disorder is frequently treated with antipsychotic and antidepressant drugs with limited success. It often co-occurs with anxiety and depression. Since, mindfulness training has been shown to be effective in treating anxiety, depression, and somatization, it makes sense to investigate the effectiveness of mindfulness-based therapies for the treatment of Somatic Symptom Disorder.

 

In today’s Research News article “Effect of Mindfulness-Based Stress Reduction Program on Psychological Symptoms, Quality of Life, and Symptom Severity in Patients with Somatic Symptom Disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8095256/ ) Zargar and colleagues recruited patients with Somatic Symptom Disorder who were on continuing treatment with the antidepressant drug, venlafaxine, and randomly assigned them to either 8 weeks of once a week treatment for 2 hours of Mindfulness-Based Stress Reduction (MBSR) or no further treatment. They were measured before and after treatment for Somatic Symptom Disorder symptom severity, including anxiety, depression, and stress, health-related quality of life, and patient health.

 

They found that in comparison to baseline and the control group, the group that received Mindfulness-Based Stress Reduction (MBSR) had significantly lower levels of Somatic Symptom Disorder symptom severity, including significantly lower levels of anxiety, depression, and stress and significant reductions in physical symptoms and increases in physical health. Hence, MBSR treatment significantly improved not only the psychological symptoms but also the physical symptoms of Somatic Symptom Disorder.

 

Mindfulness-Based Stress Reduction (MBSR) is a mindfulness training program that includes training and practice in meditation, body scan, and yoga and includes group discussion. The results demonstrate that MBSR is an effective treatment in addition to antidepressant drugs for Somatic Symptom Disorder. But since there wasn’t any follow-up data obtained it is not known how lasting is the symptom relief. It will be interesting in the future to examine if MBSR is effective as a stand-alone treatment and if its effects persist after the cessation of treatment.

 

So, improve Somatic Symptom Disorder with mindfulness.

 

“mindfulness-based cognitive therapy that can be useful in the treatment of somatic disorders.” – Recovery Village

 

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

 

Zargar, F., Rahafrouz, L., & Tarrahi, M. J. (2021). Effect of Mindfulness-Based Stress Reduction Program on Psychological Symptoms, Quality of Life, and Symptom Severity in Patients with Somatic Symptom Disorder. Advanced biomedical research, 10, 9. https://doi.org/10.4103/abr.abr_111_19

 

Abstract

Background:

Patients with somatic symptom disorder (SSD) had a poor quality of life and suffered from depression, anxiety, and stress. Mindfulness-based stress reduction (MBSR) is a psychological treatment with remarkable effects on several psychological disorders. This study aimed to evaluate the effect of the MBSR program on psychological symptoms, quality of life, and symptom severity in patients with SSD.

Materials and Methods:

The patients with SSD were randomly divided into two groups of receiving venlafaxine alone and venlafaxine with an 8-week MBSR program. Depression, anxiety, and stress with their severities were assessed along with the quality of life, the number of physical symptoms and their severities, as well as SSD severity before and after the intervention. Subsequently, the results were compared between the two groups.

Results:

This study included 37 patients with SSD who referred to Shariati Psychosomatic Clinic, Isfahan, Iran, with a mean age of 37.08 ± 8.26 years. It should be noted that 37.8% of the participants were male. The intervention group obtained significantly lower scores in depression, anxiety, stress, and their severities, compared to the control group. Moreover, the number of physical symptoms, their severity, and the severity of SSD were significantly decreased more in the intervention group rather than the controls.

Conclusion:

The MBSR accompanied by prescribing venlafaxine can significantly reduce the severity of SSD, as well as the number and severity of physical symptoms. Moreover, it can reduce depression, anxiety, stress, and their severity. The MBSR can be used as complementary medicine for the treatment of patients with SSD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8095256/

 

The Setting of Psychedelic Administration Affects the Obtained Psychological Benefits

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The Setting of Psychedelic Administration Affects the Obtained Psychological Benefits

 

By John M. de Castro, Ph.D.

 

“If you choose to take psychedelics, it is strongly recommended to have a sitter,” Gael said. “Ideally, this person is familiar with the psychedelic state and is someone you can trust to be a responsible, calm grounded presence.” – Sara Gael

 

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. Psychedelics produce effects that are similar to those that are reported in spiritual awakenings, a positive mood, with renewed energy and enthusiasm. It is easy to see why people find these experiences so pleasant and eye opening. They often report that the experiences changed them forever. Even though the effects of psychedelic substances have been experienced and reported on for centuries, only very recently have these effects come under rigorous scientific scrutiny. The setting in which psychedelic drugs are taken in the real world varies widely and there is little research on the effects of these settings on the experiences and their effects.

 

In today’s Research News article “Psychedelic Communitas: Intersubjective Experience During Psychedelic Group Sessions Predicts Enduring Changes in Psychological Wellbeing and Social Connectedness.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8114773/ Kettner and colleagues recruited online adults who intended to attend a retreat where psychedelic drugs were used. They had them complete questionnaires at 5 time points; 2 weeks before and 3 hours before the retreat, the day after the psychedelic experience, after the retreat, and 4 weeks later. They were measured for experience details, preparedness, mental well-being, social connectedness, depression, anxiety, openness toward people, trait absorption, subjective psychedelic experiences, and retreat experiences. They used factor analysis to identify a combination of 8 questionnaire items that comprised a measure of communitas (experience of intense togetherness and shared humanity),

 

Psilocybin (80%) and ayahuasca (16%) were the drugs most frequently used at the retreats. They found that 4-weeks after the retreat social connectedness, well-being, and interpersonal tolerance, were significantly higher and anxiety and depression were significantly lower than at baseline. They also found that the higher the level of communitas the higher the levels of social connectedness and well-being. Using path analysis they found that overall communitas was associated with psychological well-being and social connectedness at follow-up and the overall communitas was associated with the communitas during the experience, trait absorption, rapport with the therapist, social support during the experience, and the level of self-disclosure.

 

This study was naturalistic in that it measured individuals who were engaged in naturally occurring psychedelic retreats. This provided varied retreat conditions in real world settings. This is distinct from laboratory research with psychedelics which provide for highly controlled circumstances. The results demonstrate very positive effects of psychedelic experiences even in varied environments like they have been shown to do in the laboratory.

 

The results suggest that the social conditions and setting surrounding psychedelic experiences affect the effects of the experiences on the mental and social well-being of the participants. In other words, the ability of psychedelics to produce positive effects on the participants does not happen in a vacuum. For optimum effectiveness there needs to be optimum social support conditions. Regardless, psychedelic experiences appear to promote social and psychological health.

 

So, the setting of psychedelic administration affects the obtained psychological benefits.

 

“The science of how to use drug responsibly and effectively should be made accessible by educating the public on the principles of set and setting, a shared body of knowledge on the do’s and don’ts of responsible and effective drug use in a world where drug harms cannot be nullified but can doubtlessly be minimized.” – Ido Hartogsohn

 

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

 

Kettner, H., Rosas, F. E., Timmermann, C., Kärtner, L., Carhart-Harris, R. L., & Roseman, L. (2021). Psychedelic Communitas: Intersubjective Experience During Psychedelic Group Sessions Predicts Enduring Changes in Psychological Wellbeing and Social Connectedness. Frontiers in pharmacology, 12, 623985. https://doi.org/10.3389/fphar.2021.623985

 

Abstract

Background: Recent years have seen a resurgence of research on the potential of psychedelic substances to treat addictive and mood disorders. Historically and contemporarily, psychedelic studies have emphasized the importance of contextual elements (‘set and setting’) in modulating acute drug effects, and ultimately, influencing long-term outcomes. Nevertheless, current small-scale clinical and laboratory studies have tended to bypass a ubiquitous contextual feature of naturalistic psychedelic use: its social dimension. This study introduces and psychometrically validates an adapted Communitas Scale, assessing acute relational experiences of perceived togetherness and shared humanity, in order to investigate psychosocial mechanisms pertinent to psychedelic ceremonies and retreats.

Methods: In this observational, web-based survey study, participants (N = 886) were measured across five successive time-points: 2 weeks before, hours before, and the day after a psychedelic ceremony; as well as the day after, and 4 weeks after leaving the ceremony location. Demographics, psychological traits and state variables were assessed pre-ceremony, in addition to changes in psychological wellbeing and social connectedness from before to after the retreat, as primary outcomes. Using correlational and multiple regression (path) analyses, predictive relationships between psychosocial ‘set and setting’ variables, communitas, and long-term outcomes were explored.

Results: The adapted Communitas Scale demonstrated substantial internal consistency (Cronbach’s alpha = 0.92) and construct validity in comparison with validated measures of intra-subjective (visual, mystical, challenging experiences questionnaires) and inter-subjective (perceived emotional synchrony, identity fusion) experiences. Furthermore, communitas during ceremony was significantly correlated with increases in psychological wellbeing (r = 0.22), social connectedness (r = 0.25), and other salient mental health outcomes. Path analyses revealed that the effect of ceremony-communitas on long-term outcomes was fully mediated by communitas experienced in reference to the retreat overall, and that the extent of personal sharing or ‘self-disclosure’ contributed to this process. A positive relationship between participants and facilitators, and the perceived impact of emotional support, facilitated the emergence of communitas.

Conclusion: Highlighting the importance of intersubjective experience, rapport, and emotional support for long-term outcomes of psychedelic use, this first quantitative examination of psychosocial factors in guided psychedelic settings is a significant step toward evidence-based benefit-maximization guidelines for collective psychedelic use.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8114773/

Spirituality is Associated with Fewer Suicide Attempts

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Spirituality is Associated with Fewer Suicide Attempts

 

By John M. de Castro, Ph.D.

 

“spirituality can engender the perspective that things happen for some reason and serve a greater purpose. This, in turn, deploys our attention toward the potential for a brighter future, which can create a sense of optimism even when one’s situation seems dire.” – David Rosmarin

 

Around 43,000 people take their own lives each year in the US. Someone dies from suicide every 12.3 minutes. Worldwide over 800,000 people die by suicide every year. The problem is far worse than these statistics suggest as it has been estimated that for every completed suicide there were 12 unsuccessful attempts. In other words, about a half a million people in the U.S. attempt suicide each year. Yet compared with other life-threatening conditions there has been scant research on how to identify potential suicide attempters, intervene, and reduce suicidality.

 

Depression and other mood disorders are the number-one risk factor for suicide. More than 90% of people who kill themselves have a mental disorder, whether depression, bipolar disorder or some other diagnosis. So, the best way to prevent suicide may be to treat the underlying cause. For many this means treating depression. Spirituality may help to provide meaning and prevent suicide. But there is scant research on the relationship of spirituality and religiosity and suicide.

 

In today’s Research News article “Factors Related to Suicide Attempts: The Roles of Childhood Abuse and Spirituality.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8044867/ ) Tae and Chae recruited patients with anxiety or depressive disorders and had them complete measures of suicide attempts, anxiety, depression, childhood trauma, spiritual well-being, and social support. 25% of the participants indicated that they had attempted suicide.

 

They found that in comparison to non-suicide attempters, the participants who had attempted suicide had significantly higher levels of anxiety, depression, emotional, physical, and sexual abuse, and emotional and physical neglect and significantly lower levels of spirituality and social support. A hierarchal regression revealed that a high level of emotional abuse and a high level of sexual abuse as well as low spirituality predicted suicide attempts. A mediation analysis revealed that childhood emotional, sexual abuse, and low spirituality were all significant direct predictors of suicide attempts and also significant indirect predictors such that abuse and low spirituality were associated with higher levels of depression which, in turn was associated with suicide attempts.

 

These results are correlational. So, no conclusions concerning causation can be reached. But the associations are clear. Depression, childhood emotional and sexual abuse, and low spirituality are all associated with suicide attempts. It is also clear that in addition to being directly associated with suicide attempts, childhood emotional and sexual abuse, and low spirituality also are associated with higher levels of depression which, in turn, is associated with suicide attempts.

 

Childhood emotional and sexual abuse are clearly risk factors for suicide and should be viewed as red flags in evaluating a patient. But these abuses occurred in the past and cannot be changed. Spirituality on the other hand can change. There are many religious and contemplative practices that can improve spirituality. The present results suggest that this may be helpful and lowering depression and preventing suicide. Future research is needed to investigate this idea, that increasing spirituality can decrease suicide risk.

 

So, spirituality is associated with fewer suicide attempts.

 

“I personally think spirituality is a part of each of our beings. It has been the difference in my life and has walked me back from the place where I thought suicide was my only option.” – Kelli Evans

 

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

 

Tae, H., & Chae, J. H. (2021). Factors Related to Suicide Attempts: The Roles of Childhood Abuse and Spirituality. Frontiers in psychiatry, 12, 565358. https://doi.org/10.3389/fpsyt.2021.565358

 

Abstract

Objectives: The purpose of this article was to identify independent factors associated with suicide attempts in patients with depression and/or anxiety.

Background and Aims: This study was conducted in order to examine whether risk and protective psychological factors influence the risk of suicide attempts among outpatients with anxiety and/or depressive disorders. In this regard, explanatory models have been reported to detect high-risk groups for suicide attempt. We also examined whether identified factors serve as mediators on suicide attempts.

Materials and Methods: Patients from 18 to 65 years old from an outpatient clinic at Seoul St. Mary’s Hospital were invited to join clinical studies. From September 2010 to November 2017, a total of 737 participants were included in the final sample. The Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Childhood Trauma Questionnaire (CTQ), Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale (FACIT-Sp-12), and Functional Social Support Questionnaire (FSSQ) were used to assess psychiatric symptoms. An independent samples t-test, a chi-square test, hierarchical multiple regression analyses, and the Baron and Kenny’s procedures were performed in order to analyze data.

Results: Young age, childhood history of emotional and sexual abuse, depression, and a low level of spirituality were significant independent factors for increased suicide attempts. Depression was reported to mediate the relationship between childhood emotional and sexual abuse, spirituality, and suicide attempts.

Conclusions: Identifying the factors that significantly affect suicidality may be important for establishing effective plans of suicide prevention. Strategic assessments and interventions aimed at decreasing depression and supporting spirituality may be valuable for suicide prevention.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8044867/