Improve the Quality of Life of Patients Living with HIV with Yoga

Improve the Quality of Life of Patients Living with HIV with Yoga

 

By John M. de Castro, Ph.D.

 

yoga can have positive impact on mental health for people living with HIV,” – Eugene Dunne

 

More than 35 million people worldwide and 1.2 million people in the United States are living with HIV infection. These include a significant number of children and adolescents. In 1996, the advent of the protease inhibitor and the so-called cocktail changed the prognosis for HIV. Since this development a 20-year-old infected with HIV can now expect to live on average to age 69. Hence, living with HIV is a long-term reality for a very large group of people.

 

People living with HIV infection experience a wide array of physical and psychological symptoms which decrease their perceived quality of life. The symptoms include chronic pain, muscle aches, anxiety, depression, weakness, fear/worries, difficulty with concentration, concerns regarding the need to interact with a complex healthcare system, stigma, and the challenge to come to terms with a new identity as someone living with HIV. Mindfulness training has been shown to improve psychological well-being, lower depression and strengthen the immune system of patients with HIV infection. Yoga practice has also been found to be effective in treating HIV.

 

In today’s Research News article “Feasibility and Impact of a Yoga Intervention on Cognition, Physical Function, Physical Activity, and Affective Outcomes among People Living with HIV: A Randomized Controlled Pilot Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318828/) Quigley and colleagues recruited patients living with HIV infection who were over the age of 35 years and randomly assigned them to receive 12 weeks of 3 times per week 1-hour Hatha yoga practice or to a no treatment control condition. They were measured before and after the practice period for cognitive ability, HIV-specific cognitive difficulties, balance, physical activity, medication adherence, HIV medical outcomes, quality of life, anxiety, depression, and mental health.

 

They found that the yoga classes were well attended, 82% of all classes and all participants reported satisfaction with the intervention. They also found that the yoga group had a significant improvement in health-related quality of life for cognitive function, and trends toward significance for depression and health -related quality of life for health transitions.

 

This was a small pilot study that did not have an active control condition and was not powered to detect small differences. As such, conclusions must be limited. But the study was successful in establishing that yoga practice for patients living with HIV is feasible and acceptable and appreciated by the participants, and that improvement in quality of life occurred with the yoga practice. These results are promising and thus strongly suggest that a large randomized controlled clinical trial with an active control condition be conducted in the future.

 

So, improve the quality of life of patients living with HIV with yoga

 

“Yoga quiets the mind, improves breathing and circulation, and reduces stress. Daily practice can help support the immune system in conjunction with a comprehensive HIV treatment program.” – Jon Kaiser

 

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

 

Quigley, A., Brouillette, M. J., Gahagan, J., O’Brien, K. K., & MacKay-Lyons, M. (2020). Feasibility and Impact of a Yoga Intervention on Cognition, Physical Function, Physical Activity, and Affective Outcomes among People Living with HIV: A Randomized Controlled Pilot Trial. Journal of the International Association of Providers of AIDS Care, 19, 2325958220935698. https://doi.org/10.1177/2325958220935698

 

Abstract

The purpose of this pilot randomized controlled trial is to assess the feasibility and impact of a triweekly 12-week yoga intervention among people living with HIV (PLWH). Additional objectives included evaluating cognition, physical function, medication adherence, health-related quality of life (HRQoL), and mental health among yoga participants versus controls using blinded assessors. We recruited 22 medically stable PLWH aged ≥35 years. A priori feasibility criteria were ≥70% yoga session attendance and ≥70% of participants satisfied with the intervention using a postparticipation questionnaire. Two participants withdrew from the yoga group. Mean yoga class attendance was 82%, with 100% satisfaction. Intention-to-treat analyses (yoga n = 11, control n = 11) showed no within- or between-group differences in cognitive and physical function. The yoga group improved over time in HRQoL cognition (P = .047) with trends toward improvements in HRQoL health transition (P =.063) and depression (P = .055). This pilot study provides preliminary evidence of feasibility and benefits of yoga for PLWH.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318828/

 

Reduce Depression After Stillbirth with Yoga

Reduce Depression After Stillbirth with Yoga

 

By John M. de Castro, Ph.D.

 

“Bereaved mothers with stillbirth (death at >20 weeks of gestation) have more than a 6-fold higher risk for Post Traumatic Stress Disorder (PTSD) compared to mothers after live birth. . . . Non-pharmacological approaches, such as yoga, may be an alternative option for bereaved women with stillbirth.” – Jennifer Huberty

 

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime with 7%-8% of the population developing Post-Traumatic Stress Disorder (PTSD). It involves a number of troubling symptoms including reliving the event with the same fear and horror in nightmares or with a flashback.

 

Having a stillbirth is a traumatic event for young women. It inevitably produces profound depression, grief, and symptoms of PTSD. Obviously, this is a troubling problem that needs to be addressed. There are a number of therapies that have been developed to treat depression, grief and  PTSD. One of which, mindfulness training has been found to be particularly effective for depression, PTSD symptoms, and grief.  Yoga practice has also been found to reduce depression and PTSD symptoms. There is, however, no studies to date on the effectiveness of yoga practice to help alleviate the trauma produced by stillbirth.

 

In today’s Research News article “Online yoga to reduce post traumatic stress in women who have experienced stillbirth: a randomized control feasibility trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275350/) Huberty and colleagues recruited women who had experienced stillbirth within the last 2 years and randomly assigned them to receive 12 weeks of either low dose Hatha yoga (60 minutes per week), moderate dose Hatha yoga (150 minutes per week), or stretching and toning practice (60 minutes per week). All practice was led by online videos. They were measured before and after training and 8 weeks later for acceptability and demand for the program, PTSD symptoms, anxiety, depression, grief, self-compassion, emotion regulation, mindfulness, and sleep quality.

 

They found that PTSD symptoms decreased significantly over the measurement period with a 43% and 56% decrease for the low and moderate yoga groups and a 22% decrease for the stretching and toning group. But there were no significant differences between groups. On the other hand, in comparison to the stretching and toning group, both of the yoga groups had significant decreases in depression and grief. Unfortunately, the low dose yoga group only practiced on the average for 44 minutes per week and the high dose yoga only practiced for 77 minutes per week. This was well below the desired amount of practice.

 

The lack of a significant difference between the yoga and control groups was disappointing. Previous research has demonstrated that yoga practice reduces PTSD symptoms. It is possible that attempting to teach yoga remotely, online, to participants who are depressed simply may not be an effective way to encourage practice. Depressed patients lack motivation and it is possible that they need the encouragement of a group and an instructor to motivate their participation. Future research should employ traditional in person yoga classes for the treatment of women who had stillbirths.

 

Nevertheless, the yoga practice, even though it was below the dose desired, did significantly reduce depression. This corroborates previous findings that yoga practice is effective in treating a variety of forms of depression and suggests that it is also effective in treating depression emanating from stillbirth. Perhaps in person yoga classes may potentiate the effects on PTSD and other symptoms in women who had stillbirths.

 

So, reduce depression after stillbirth with yoga.

 

“a trauma-focused hatha yoga program may be a helpful adjunctive treatment for chronic PTSD.” – Sarah Krill Williston

 

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

 

Huberty, J., Sullivan, M., Green, J., Kurka, J., Leiferman, J., Gold, K., & Cacciatore, J. (2020). Online yoga to reduce post traumatic stress in women who have experienced stillbirth: a randomized control feasibility trial. BMC complementary medicine and therapies, 20(1), 173. https://doi.org/10.1186/s12906-020-02926-3

 

Abstract

Background

About 1 in every 150 pregnancies end in stillbirth. Consequences include symptoms of post traumatic stress disorder (PTSD), depression, and anxiety. Yoga has been used to treat PTSD in other populations and may improve health outcomes for stillbirth mothers. The purpose of this study was to determine: (a) feasibility of a 12-week home-based, online yoga intervention with varying doses; (b) acceptability of a “stretch and tone” control group; and (c) preliminary efficacy of the intervention on reducing symptoms of PTSD, anxiety, depression, perinatal grief, self-compassion, emotional regulation, mindfulness, sleep quality, and subjective health.

Methods

Participants (N = 90) were recruited nationally and randomized into one of three groups for yoga or exercise (low dose (LD), 60 min per week; moderate dose (MD), 150 min per week; and stretch-and-tone control group (STC)). Baseline and post-intervention surveys measured main outcomes (listed above). Frequency analyses were used to determine feasibility. Repeated measures ANCOVA were used to determine preliminary efficacy. Multiple regression analyses were used to determine a dose-response relationship between minutes of yoga and each outcome variable.

Results

Over half of participants completed the intervention (n = 48/90). Benchmarks (≥70% reported > 75% satisfaction) were met in each group for satisfaction and enjoyment. Participants meeting benchmarks (completing > 90% of prescribed minutes 9/12 weeks) for LD and MD groups were 44% (n = 8/18) and 6% (n = 1/16), respectively. LD and MD groups averaged 44.0 and 77.3 min per week of yoga, respectively. The MD group reported that 150 prescribed minutes per week of yoga was too much. There were significant decreases in PTSD and depression, and improvements in self-rated health at post-intervention for both intervention groups. There was a significant difference in depression scores (p = .036) and grief intensity (p = .009) between the MD and STC groups. PTSD showed non-significant decreases of 43% and 56% at post-intervention in LD and MD groups, respectively (22% decrease in control).

Conclusions

This was the first study to determine the feasibility and preliminary efficacy of an online yoga intervention for women after stillbirth. Future research warrants a randomized controlled trial.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275350/

 

Mindfulness Improves Flexibility Which Improves Residual Symptoms of Depression

Mindfulness Improves Flexibility Which Improves Residual Symptoms of Depression

 

By John M. de Castro, Ph.D.

 

Living resiliently represents a whole new way of being and doing. It isn’t just for the hard times — it’s for all times. Empowering us to live, love, and work adventurously in the face of change, it builds a well from which we can draw for the rest of our lives.” – Lynda Klau

 

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 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 failAcceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT). ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

It is not known how Acceptance and Commitment Therapy (ACT) might affect the residual symptoms in individuals in remission from depression. In today’s Research News article “Psychological Flexibility in Depression Relapse Prevention: Processes of Change and Positive Mental Health in Group-Based ACT for Residual Symptoms.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7119364/), Østergaard and colleagues recruited patients in remission from major depressive disorder and provided them with 8 weekly sessions of group based Acceptance and Commitment Therapy (ACT). They were measured before and after ACT and 6 months and 1 year later for psychiatric symptoms, mental health depression, cognitive defusion, flexibility, values, engaged living and mindfulness.

 

They found that after treatment and for the year following there were significant reductions in depression and increases in positive mental health. Mediation analysis revealed that Acceptance and Commitment Therapy (ACT) decreased depression and increased positive mental health directly and indirectly by increasing psychological flexibility. That is ACT not only directly decreased depression and increased positive mental health but also increased psychological flexibility which in turn decreased depression and increased positive mental health. They also showed that ACT had these effects by changing acceptance, cognitive defusion, values, and committed action, all of which increased psychological flexibility.

 

Psychological flexibility is the ability to make changes in behavior in order to produce positive effects. It’s the individual’s ability to avoid rumination and brooding over negative emotions that contribute to depression. In this way psychological flexibility contributes to maintaining positive mental health. The study shows that ACT directly reduces residual symptoms and also increases psychological flexibility which in turn reduces residual symptoms in patients in remission from major depressive disorder. It is important to note that these benefits produced by ACT were enduring lasting over the year of testing. Hence, treatment with ACT  should reduce the likelihood of future depressive episodes.

 

So, mindfulness improves flexibility which improves residual symptoms of depression.

 

Mindfulness is a shallow description of a much larger process that makes us resilient when bad things happen.” – Michael Unger

 

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

 

Østergaard, T., Lundgren, T., Zettle, R. D., Landrø, N. I., & Haaland, V. Ø. (2020). Psychological Flexibility in Depression Relapse Prevention: Processes of Change and Positive Mental Health in Group-Based ACT for Residual Symptoms. Frontiers in psychology, 11, 528. https://doi.org/10.3389/fpsyg.2020.00528

 

Abstract

Relapse rates following a depressive episode are high, with limited treatments available aimed at reducing such risk. Acceptance and commitment therapy (ACT) is a cognitive-behavioral approach that has gained increased empirical support in treatment of depression, and thus represents an alternative in relapse prevention. Psychological flexibility (PF) plays an important role in mental health according to the model on which ACT is based. This study aimed to investigate the role of PF and its subprocesses in reducing residual symptoms of depression and in improving positive mental health following an 8-week group-based ACT treatment. Adult participants (75.7% female) with a history of depression, but currently exhibiting residual symptoms (N = 106) completed measures before and after intervention, and at 6 and 12-month follow-up. A growth curve model showed that positive mental health increased over 12-months. Multilevel mediation modeling revealed that PF significantly mediated these changes as well as the reduction of depressive symptoms, and that processes of acceptance, cognitive defusion, values and committed action, in turn, mediated increased PF.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7119364/

 

Improve Fertility with Mindfulness

 

Improve Fertility with Mindfulness

 

By John M. de Castro, Ph.D.

 

those who participate in a mind-body wellness program are 32% more likely to become pregnant!” – Michelle Anne

 

Infertility is primarily a medical condition due to physiological problems. It is quite common. It is estimated that in the U.S. 6.7 million women, about 10% of the population of women are infertile. Infertility can be more than just a medical issue. It can be an emotional crisis for many couples, especially for the women. Couples attending a fertility clinic reported that infertility was the most upsetting experience of their lives. Women with infertility reported feeling as anxious or depressed as those diagnosed with cancer, hypertension, or recovering from a heart attack.

 

Mindfulness training been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail. This is especially true for Mindfulness-Based Cognitive Therapy (MBCT) which was specifically developed to treat depression. MBCT has been shown to be effective in treating infertility. At this point it’s useful to step back and summarize what has been learned about mindfulness training and infertility.

 

In today’s Research News article “Application of Mindfulness-Based Psychological Interventions in Infertility.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7295259/), Patel and colleagues review and summarize the published scientific research of the effectiveness of mindfulness training in treating infertility. They identified 9 published research studies.

 

They report that the research found that mindfulness training decreases anxiety, depression, stress, and anger, and increases well-being and quality of life of infertile women. These enhance the self-efficacy of women coping with infertility. Mindfulness training also has been found to reduce emotional stress and stress hormones and improve sleep and immune function all of which are known to play an important role in infertility. These all lead to increased conception rates.

 

The psychological and emotional issues that result from infertility produce a negative spiral, where infertility increases emotional dysfunction, which in turn lessens the likelihood of conception, which increases emotionality and so on. Mindfulness training appears to interrupt this cycle by improving the psychological and physical well-being of infertile women. This allows the women to relax and better cope with the issues surrounding infertility. This in turn improves their likelihood of conception. Hence, mindfulness training should be recommended for infertile women.

 

So, improve fertility with mindfulness.

 

mindfulness becomes the perfect antidote for the paradoxical land mines infertility presents. Mindfulness starts from the perspective that you are whole and complete already, regardless of flaws or imperfections. It is based on the concept of original goodness: your essential nature is good and pure. Proceeding from this vantage point gives you freedom from the bondage of inadequacy and insecurity.” – Janetti Marotta

 

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

 

Patel, A., Sharma, P., & Kumar, P. (2020). Application of Mindfulness-Based Psychological Interventions in Infertility. Journal of Human Reproductive Sciences, 13(1), 3–21. https://doi.org/10.4103/jhrs.JHRS_51_19

 

Abstract

Living mindfully helps one gain a deeper understanding into realities of life. It enables people to witness suffering, desire, attachments, and impermanence without any fear, anxiety, anger, or despair. This is considered the hallmark of true psychological insight. As a skill, mindfulness can be inculcated by anyone. Mindfulness helps in attending, getting aware and understanding experiences in a compassion and open-minded way. Research suggests that applying mindfulness in daily life has been known to tame our emotional mind and enabled people to perceive things “as they are” without ascribing expectations, judgments, cynicism, or apprehensions to them. This review unravels the therapeutic power of mindfulness meditation in the context of infertility distress. It serves to integrate the evidence on the effectiveness of mindfulness-based psychological interventions to improve the emotional well-being and biological outcomes in Infertility.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7295259/

 

Generalized Anxiety Disorder with Co-occurring Major Depression is Associated with Lower Mindfulness

Generalized Anxiety Disorder with Co-occurring Major Depression is Associated with Lower Mindfulness

 

By John M. de Castro, Ph.D.

 

attempts to avoid uncomfortable thoughts and feelings may worsen anxiety. The paradox here is that mindfulness helps us turn toward those and learn to change our relationship to the actual thoughts and the physical sensations, rather than try to change them in any way. By changing [that] relationship, we actually stop feeding those cyclical processes and they start to die off on their own.” – Judson Brewer

 

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. There are a number of psychological therapies for anxiety. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments.

 

One of the premiere measurement tools for mindfulness is the Five Factors of Mindfulness Questionnaire. It measures overall mindfulness and also five facets; observing, describing, acting with awareness, non-judgement, and non-reactivity. People differ and an individual can be high or low on any of these facets and any combination of facets. It is not known what pattern of mindfulness facets are most predictive of the ability of mindfulness to improve anxiety disorders.

 

Depression often co-occurs with anxiety disorders. Recently, it has been found that mindfulness training can be effective for anxiety disorders. Mindfulness has also been shown to be effective for depression. So, patients with generalized anxiety with co-occurring depression may have lower ability to be mindful.

 

In today’s Research News article “Facets of Mindfulness in Adults with Generalized Anxiety Disorder and Impact of Co-occurring Depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6662732/), Baker and colleagues recruited adult patients with Generalized Anxiety Disorder (GAD) and measured them for mindfulness, including observing, describing, acting with awareness, nonjudging, and nonreactivity facets, worry, depression, and severity of psychopathology.

 

The participants were separated into GAD with and without Major Depressive Disorder. They found that the GAD participants who also had co-occurring Major Depressive Disorder were lower in mindfulness, especially the acting with awareness facet of mindfulness. They also found that over the entire sample that higher levels of depression and worry were associated with lover levels of mindfulness. Looking at the facets of mindfulness they found that depression was negatively associated with acting with awareness and worry was negatively associated with the nonjudging and nonreactivity facets.

 

These are correlative findings and causation cannot be determined. But previous research has demonstrated that mindfulness training reduces anxiety and depression.  So, a causal connection is likely. The results, then, suggest that patients with Generalized Anxiety Disorder (GAD) are less likely to act with awareness if they also have Major Depressive Disorder. In addition, With GAD patients in general higher levels of depression were associated with lower levels of acting with awareness. Depression is associated with very low energy levels. So, it makes sense that the presence of depression would interfere with taking mindful action.

 

They also found that the higher the levels of worry the lower the levels of the nonjudging and nonreactivity mindfulness facets. This suggests that worry in patients with Generalized Anxiety Disorder (GAD) interferes with the ability to not judge and not react to inner experience. Conversely, worry promotes judging and reacting to inner experience. Patients who have high anxiety are worried about potential future negative occurrences and as such may judge inner experience as indicative of a problematic future and so react to it more.

 

So, the results indicate that Generalized Anxiety Disorder with co-occurring Major Depression is associated with lower mindfulness.

 

a way to reduce the symptoms of anxiety is to be fully, mindfully, anxious. As anxiety reveals itself to be a misperception, symptoms will dissipate.” – George Hofmann

 

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

 

Baker AW, Frumkin MR, Hoeppner SS, et al. Facets of Mindfulness in Adults with Generalized Anxiety Disorder and Impact of Co-occurring Depression. Mindfulness (N Y). 2019;10(5):903‐912. doi:10.1007/s12671-018-1059-0

 

Abstract

Anxiety and depressive symptoms are associated with lower levels of mindfulness, yet few studies to date have examined facets of mindfulness in adults with Generalized Anxiety Disorder (GAD). In this study, we examined differences in mindfulness between individuals with GAD with and without concurrent Major Depressive Disorder (MDD) and/or Dysthymic Disorder (DD). We also examined the associations of anxiety and depressive symptoms with facets (subscales) of mindfulness. We hypothesized that individuals with primary GAD and co-occurring MDD/DD would exhibit lower mindfulness than those without a concurrent depressive disorder. We also hypothesized that mindfulness would be negatively correlated with worry and depressive symptom severity. Subjects were 140 adults (M (SD) age = 33.4 (12.9); 73% female) with a primary diagnosis of GAD; 30.8% (n = 43) also met criteria for current MDD/DD as determined by a structured clinical interview for DSM-IV. Current worry and depressive symptoms were assessed using self-report measures at baseline of a 12-week treatment study. Individuals with GAD and co-occurring MDD/DD exhibited significantly lower mindfulness than those without a depressive disorder diagnosis and specifically lower scores on the Awareness sub-scale compared to individuals with primary GAD and no comorbid depression. In terms of the dimensional impact of worry and depression ratings, depression symptoms independently predicted lower Awareness scores and worry independently predicted lower levels of Nonreacting and Nonjudging sub-scales. This may have direct treatment implications. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6662732/

 

Reduce the Risk of Major Depression Relapse with Mindfulness

Reduce the Risk of Major Depression Relapse with Mindfulness

 

By John M. de Castro, Ph.D.

 

a growing body of research is pointing to an intervention that appears to help prevent relapse by altering thought patterns without side effects: mindfulness-based cognitive therapy, or MBCT.” – Stacy Lu

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. Depression can be difficult to treat and is usually treated with anti-depressive medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression.

 

Relapsing into depression is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering. Mindfulness training is 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 failMindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior.

 

There has been considerable research demonstrating that Mindfulness-Based Cognitive Therapy (MBCT) is effective in treating depression.  In today’s Research News article “The effects of mindfulness-based cognitive therapy on risk and protective factors of depressive relapse – a randomized wait-list controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275325/), Schanche and colleagues investigate the ability of  MBCT to reduce risk factors associated with relapse in patients with major depressive disorder.

 

They recruited adult patients diagnosed with major depressive disorder who had at least 3 depressive episodes and who were currently in remission. They were randomly assigned to be on a wait list or to receive 8 weekly 2-hour sessions of Mindfulness-Based Cognitive Therapy (MBCT). They were measured before and after training for rumination, emotion regulation, anxiety, self-compassion, mindfulness, and depression.

 

They found that in comparison to baseline and the wait-list group after Mindfulness-Based Cognitive Therapy (MBCT) there were significant reductions in rumination, anxiety, emotional reactivity to stress and depression and significant increases in emotion regulation, self-compassion and mindfulness. Hence, MBCT significantly improved the psychological well-being of these patients.

 

These are interesting results that suggest that Mindfulness-Based Cognitive Therapy (MBCT) produces a reduction in the types of negative emotional symptoms that could promote a depressive relapse and an increase in factors that could promote resistance to relapse especially the ability to effectively cope with their emotions and compassion for themselves. Mindfulness training has been repeatedly shown in the past to reduce rumination, anxiety, emotional reactivity to stress and depression and increase emotion regulation and self-compassion. The present study demonstrates that these benefits occur in patients in remission from major depressive disorder. This suggests that MBCT is effective in improving the major depressive disorder patients psychological state in a way that suggests that they would be resistant to relapse in the future.

 

So, reduce the risk of major depression relapse with mindfulness.

 

MBCT and CT attempt to reduce the risk of relapse by promoting different skill sets. CT promotes challenging dysfunctional thinking and increasing physical activity level. MBCT promotes nonjudgmental monitoring of moment-by-moment experience, and decentering from thoughts or seeing thoughts as transient mental phenomena and not necessarily valid.” – American Mindfulness Research Association

 

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

 

Elisabeth Schanche, Jon Vøllestad, Endre Visted, Julie Lillebostad Svendsen, Berge Osnes, Per Einar Binder, Petter Franer, Lin Sørensen. The effects of mindfulness-based cognitive therapy on risk and protective factors of depressive relapse – a randomized wait-list controlled trial. BMC Psychol. 2020; 8: 57. Published online 2020 Jun 5. doi: 10.1186/s40359-020-00417-1

 

Abstract

Background

The aim of this randomized wait-list controlled trial was to explore the effects of Mindfulness–Based Cognitive Therapy (MBCT) on risk and protective factors for depressive relapse within the domains of cognition, emotion and self-relatedness.

Methods

Sixty-eight individuals with recurrent depressive disorder were randomized to MBCT or a wait-list control condition (WLC).

Results

Completers of MBCT (N = 26) improved significantly on measures assessing risk and protective factors of recurrent depression compared to WLC (N = 30) on measures of rumination (d = 0.59, p = .015), emotion regulation (d = 0.50, p = .028), emotional reactivity to stress (d = 0.32, p = .048), self-compassion (d = 1.02, p < .001), mindfulness (d = 0.59, p = .010), and depression (d = 0.40, p = .018). In the Intention To Treat sample, findings were attenuated, but there were still significant results on measures of rumination, self-compassion and depression.

Conclusions

Findings from the present trial contribute to evidence that MBCT can lead to reduction in risk factors of depressive relapse, and strengthening of factors known to be protective of depressive relapse. The largest changes were found in the domain of self-relatedness, in the form of large effects on the participants’ ability to be less self-judgmental and more self-compassionate.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275325/

 

Mindfulness is Associated with Lower Functional Impairment and Avoidance in Major Depressive Disorder

Mindfulness is Associated with Lower Functional Impairment and Avoidance in Major Depressive Disorder

 

By John M. de Castro, Ph.D.

 

People at risk for depression are dealing with a lot of negative thoughts, feelings and beliefs about themselves and this can easily slide into a depressive relapse. MBCT helps them to recognize that’s happening, engage with it in a different way and respond to it with equanimity and compassion.” – Willem Kuyken

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating, impairing the ability of the patients to effectively conduct their lives. Depression can be difficult to treat and is usually treated with anti-depressive medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression. Even after remission some symptoms of depression may still be present (residual symptoms).

 

Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering. Mindfulness training is 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. Behavioral activation involves engaging with what is going on in the present moment and is thought to help with depression while avoiding symptoms and ruminating tend to exacerbate the depression. There is little data, however, of the interplay of activation and mindfulness in patients with major depression.

 

In today’s Research News article “Roles of Trait Mindfulness in Behavioral Activation Mechanism for Patients With Major Depressive Disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202344/), Takagaki and colleagues had adult patients with major depressive disorder complete questionnaires designed to measure behavioral activation for depression including subscales measuring activation, avoidance/rumination, work/school impairment, and social impairment; mindfulness including subscales measuring describe, observe, act with awareness, nonreactivity, and non-judging; depression; and disability.

 

They found that the greater the level of depression the greater the level of disability, avoidance/rumination, and mindful observing and the lower the levels of mindful describing, acting with awareness, nonreacting and non-judging. Similarly, they also found that the higher the levels of avoidance/rumination the greater the levels of depression, disability, and mindful observing and the lower the levels of mindful describing, acting with awareness, nonreacting and non-judging. Structural equation modelling revealed that mindful acting with awareness, nonreacting and non-judging was directly negatively related to avoidance/rumination which was in turn positively related to disability. In addition, mindful acting with awareness and nonreacting were directly negatively related to disability.

 

These results are correlative and caution must be taken in making causal inferences. Nevertheless, the results suggest that the degree of disability/impairment in patients with major depressive disorder is directly and indirectly associated with mindfulness with avoidance/rumination as an intermediary. That is, avoidance of a negative aversive state and engagement in rumination rather than active problem-solving to some extent mediates the association of mindfulness with lower levels of impairment in life. Hence, mindfulness is related to the patient’s ability to better conduct their life and it does so directly and indirectly by being associated with less avoidance of psychological pain and less rumination.

 

So, mindfulness is associated with lower functional impairment and avoidance in major depressive disorder.

 

Mindfulness training can “generate positive emotions by cultivating self-compassion and self-confidence through an upward spiral process, although behavioral activation is action oriented while mindfulness emphasizes the acceptance and awareness of present moment emotions, thoughts, and bodily sensations, the two can be complementary.” _ Amanda MacMillan

 

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

 

Takagaki, K., Ito, M., Takebayashi, Y., Nakajima, S., & Horikoshi, M. (2020). Roles of Trait Mindfulness in Behavioral Activation Mechanism for Patients With Major Depressive Disorder. Frontiers in psychology, 11, 845. https://doi.org/10.3389/fpsyg.2020.00845

 

Abstract

Behavioral activation and mindfulness have both been shown to engender improvement of functional impairment in patients with major depressive disorder. In behavioral activation, the practice of engaging with the direct experience of the present moment is central, especially when targeting avoidance. Consequently, mindfulness affects changes of avoidance in behavioral activation. This study was designed to assess exploratory relations among trait mindfulness, avoidance, and functional impairment in behavioral activation mechanism for depression. For 1042 participants with depression only or for depression with anxiety disorders, we used structural equation modeling to examine relations among trait mindfulness, avoidance, and functional impairment. Trait mindfulness non-reactivity, non-judging, and acting with awareness had a direct negative effect on avoidance. Trait mindfulness non-reactivity, trait non-judging, and trait acting with awareness had indirect negative effects on functional impairment. Results show that each trait mindfulness facet exhibited a distinct pattern of relations with avoidance and impairment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202344/

 

Reduce Depression with Infertility with Mindfulness

Reduce Depression with Infertility with Mindfulness

 

By John M. de Castro, Ph.D.

 

Studies have shown that women dealing with infertility have anxiety and depression levels equals to women with cancer and HIV.” – Beth Heller

 

Infertility is primarily a medical condition due to physiological problems. It is quite common. It is estimated that in the U.S. 6.7 million women, about 10% of the population of women are infertile. Infertility can be more than just a medical issue. It can be an emotional crisis for many couples, especially for the women. Couples attending a fertility clinic reported that infertility was the most upsetting experience of their lives.

 

Women with infertility reported feeling as anxious or depressed as those diagnosed with cancer, hypertension, or recovering from a heart attack. In addition, infertility can markedly impact the couple’s relationship, straining their emotional connection and interactions and the prescribed treatments can take the spontaneity and joy from lovemaking making it strained and mechanical. The stress of infertility and engaging in infertility treatments may exacerbate the problem. Since mindfulness training has been shown to reduce depression, anxiety, and stress it is reasonable to believe that mindfulness training may be helpful in reducing the distress in women with fertility issues.

 

In today’s Research News article “Mindfulness-Based Group Counseling on Depression in Infertile Women: Randomized Clinical Trial Study.” (See summary below or view the full text of the study at:),   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7139233/  Kalhori and colleagues recruited women aged 25 to 40 years who were diagnosed with infertility and who were undergoing in vitro fertilization. They were randomly assigned to receive treatment as usual or to receive 4 weeks, twice a week for 90 minutes of group mindfulness counseling with home exercises. They were measured before and after the 4-week training period for depression and measures of infertility.

 

They found that in comparison to baseline and the treatment as usual group, the women who received group mindfulness counseling had significant decreases in depression. It has been well established that mindfulness training reduces depression levels in a wide range of healthy and ill individuals. The present study demonstrates that it can also relieve depression in infertile women undergoing in vitro fertilization. It would be interesting in the future to determine if the improved mood increased the likelihood of successful in vitro fertilization.

 

So, reduce depression with infertility with mindfulness.

 

Through sustained practice, mindfulness becomes a great ally, and combats the myopic thinking often caused by a diagnosis of infertility. Instead of seeing things in such bimodal terms of “all good, or “all bad,” we learn to appreciate the space in between by paying attention to whatever emerges moment to moment.” – Julie Fraga

 

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

 

Kalhori, F., Masoumi, S. Z., Shamsaei, F., Mohammadi, Y., & Yavangi, M. (2020). Effect of Mindfulness-Based Group Counseling on Depression in Infertile Women: Randomized Clinical Trial Study. International journal of fertility & sterility, 14(1), 10–16. https://doi.org/10.22074/ijfs.2020.5785

 

Abstract

Background

Assisted reproductive technologies (ARTs) such as in vitro fertilization (IVF) can lead to depressive symptoms in infertile women due to their low success and high costs. Mindfulness-based group counseling can decrease depressive symptoms by increasing mental concentration. The aim of the present study was to evaluate the effect of mindfulness-based group counseling on depression in infertile women undergoing IVF.

Materials and Methods

The present clinical trial included 90 infertile women undergoing IVF treatment in an infertility center in 2016. Women were divided into two groups, intervention and control. Both groups completed a demographic questionnaire and the Beck depression inventory (BDI). Eight 90-minute sessions (two each week) of mindfulness-based group counseling were held with the intervention group, while the control group received treatment as normal. Following the intervention, the BDI was again completed by both groups. The data were analyzed and independent t tests and, paired t tests conducted at a significance level of P<0.05.

Results

No statistically significant demographic differences were observed between the two groups. Women in the control group had a somewhat lower depressive symptom score than the intervention group before the intervention. However, compared with before, the depressive symptom score among women in the intervention group decreased significantly (48%) (P<0.001) after the intervention. In contrast, the depressive symptom score in control women was higher after the intervention than before.

Conclusion

According to the findings of the present research, mindfulness-based group counseling is able to reduce depressive symptoms in infertile women under IVF treatment. Therefore, group counseling sessions are suggested for all depressed women undergoing infertility treatment (Registration number: IRCT2015082013405N14).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7139233/

 

Improve Major Depressive Disorder with Acceptance and Commitment Therapy

Improve Major Depressive Disorder with Acceptance and Commitment Therapy

 

By John M. de Castro, Ph.D.

 

Insecure attachment styles are more prevalent in individuals with mood disorders and has been associated with worse clinical outcomes, whereas a secure attachment is linked to more positive health behaviors, such as greater adherence to health plans and preventive health behaviors.” – Tamara Cassis

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating and 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. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time.

 

Attachment has been shown to affect the individual’s well-being. There are a variety of ways that individuals attach to others. They are secure, insecure, avoidant, ambivalent, fearful, preoccupied, and disorganized attachment styles. Secure attachment style is healthy and leads to positive development while all of the others are maladaptive and unhealthy. All of the  attachment styles, save secure attachment, are associated with depression.

 

Mindfulness training is 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 failAcceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that 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.

 

It is possible that Acceptance and Commitment Therapy (ACT) may improve depression by affecting attachment. In today’s Research News article “Explicit and implicit attachment and the outcomes of acceptance and commitment therapy and cognitive behavioral therapy for depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7137238/),  A-Tjak and colleagues explore this possibility. They recruited adult patients diagnosed with major depressive disorder and randomly assigned them to receive 18 weekly 50 minute sessions of Cognitive Behavioral Therapy (CBT) or Acceptance and Commitment Therapy (ACT). They were measured before and after treatment and 6 months later for depressive symptoms, quality of life, attachment anxiety, and attachment avoidance. Implicit attachment was measured with a card sorting task.

 

They found that the two treatments were equally effective producing 75% to 80% rates of remission from depression and significant reductions in depression, attachment anxiety, and attachment avoidance and increases in quality of life. The effects were still present at the 6-month follow-up. The decreases in attachment anxiety and attachment avoidance were associated with decreases in depression and increases in quality of life while no relationships were present for implicit attachment.

 

The fact that Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) were equally effective for major depression is not surprising as ACT incorporates CBT. It is interesting that the magnitude in the changes in attachment anxiety and attachment avoidance were related to the improvements in depression and quality of life. But these results do not demonstrate causation, changes in attachment might cause changes in depression, changes in depression might cause changes in attachment, or therapy might change both independently. What is clear is that both ACT and CBT are highly effective and lasting treatments for major depressive disorder.

 

So, improve major depressive disorder with Acceptance and Commitment Therapy.

 

Mindfulness training can “generate positive emotions by cultivating self-compassion and self-confidence through an upward spiral process.” – Amanda MacMillan

 

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

 

A-Tjak, J., Morina, N., Boendermaker, W. J., Topper, M., & Emmelkamp, P. (2020). Explicit and implicit attachment and the outcomes of acceptance and commitment therapy and cognitive behavioral therapy for depression. BMC psychiatry, 20(1), 155. https://doi.org/10.1186/s12888-020-02547-7

 

Abstract

Background

Attachment theory predicts that patients who are not securely attached may benefit less from psychological treatment. However, evidence on the predictive role of attachment in the effectiveness of treatment for depression is limited.

Methods

Explicit attachment styles, levels of attachment anxiety and attachment avoidance, as well as implicit relational self-esteem and implicit relational anxiety were assessed in 67 patients with major depressive disorder (MDD) receiving Acceptance and Commitment Therapy (ACT) or Cognitive Behavioral Therapy (CBT). ANOVA and hierarchical regression analyses were performed to investigate the predictive power of explicit and implicit attachment measures on treatment outcome.

Results

Explicit attachment avoidance at pre-treatment significantly predicted reduction of depressive symptoms following treatment. Reductions in attachment anxiety and avoidance from pre- to post-treatment predicted better treatment outcomes. Neither one of the implicit measures, nor change in these measures from pre- tot post-treatment significantly predicted treatment outcome.

Conclusions

Our findings show that attachment avoidance as well as reductions in avoidant and anxious attachment predict symptom reduction after psychological treatment for depression. Future research should use larger sample sizes to further examine the role of attachment orientation as moderator and mediator of treatment outcome.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7137238/

 

Reduce Distress and Increase Pregnancy in Women with Fertility Problems with Mind-Body Practices

Reduce Distress and Increase Pregnancy in Women with Fertility Problems with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

mindfulness becomes the perfect antidote for the paradoxical land mines infertility presents. Mindfulness starts from the perspective that you are whole and complete already, regardless of flaws or imperfections. It is based on the concept of original goodness: your essential nature is good and pure. Proceeding from this vantage point gives you freedom from the bondage of inadequacy and insecurity.” – Janetti Marrota

 

Infertility is primarily a medical condition due to physiological problems. It is quite common. It is estimated that in the U.S. 6.7 million women, about 10% of the population of women 15-44, have an impaired ability to get pregnant or carry a baby to term and about 6% are infertile. Infertility can be more than just a medical issue. It can be an emotional crisis for many couples, especially for the women. Couples attending a fertility clinic reported that infertility was the most upsetting experience of their lives.

 

Women with infertility reported feeling as anxious or depressed as those diagnosed with cancer, hypertension, or recovering from a heart attack. In addition, infertility can markedly impact the couple’s relationship, straining their emotional connection and interactions and the prescribed treatments can take the spontaneity and joy from lovemaking making it strained and mechanical. The stress of infertility and engaging in infertility treatments may exacerbate the problem. Since mindfulness training has been shown to reduce depression, anxiety, and stress it is reasonable to believe that mind-body training may be helpful in reducing the distress in women with fertility issues.

 

In today’s Research News article “An internet-based mind/body intervention to mitigate distress in women experiencing infertility: A randomized pilot trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7080396/), Clifton and colleagues recruited childless adult women who were seeking care for infertility. They were randomly assigned to either a wait-list control condition or to receive a 10-week online program of mind/body for fertility including weekly online modules and homework assignments. “The skills and strategies taught included: (a) knowledge regarding the relationship between stress, lifestyle, and fertility; (b) relaxation techniques including diaphragmatic breathing and Hatha Yoga; (c) mindfulness; (d) cognitive restructuring; (e) stress reduction strategies; (f) listening and communication skills; (g) strategies for emotional expression and effective coping with anger; and (h) assertiveness training and goal-setting skills.” They were measured before and after training for anxiety, depression, perceived stress, and fertility problems.

 

They found that in comparison to baseline and the wait-list control group, the women who received the training had significantly lower levels of anxiety, depression, perceived stress, and infertility related stress specific to sexual and social concerns. At the end of the study the women who received the training had significantly higher self-reported pregnancy rates. 53% of the trained women reported successful pregnancy while only 20% of the wait-list control women did.

 

The study was a randomized controlled trial but the control condition, wait-list, was passive. It would be important for future research to include an active control condition, such as online health education. In addition, the program included a complex set of practices and it is impossible to tease apart what components or combination of components were necessary for the effects observed. It would be interesting in future research to examine the effectiveness of the individual components.

 

Nevertheless, these are interesting and potentially important findings. The online mind/body for fertility program produced significant reductions in the distress levels of the women and increased the likelihood of becoming pregnant. By reducing the psychological distress produced by infertility the program appeared to markedly improve the likelihood of becoming pregnant. This is very helpful in reducing the suffering produced by infertility and thereby improving pregnancy success..

 

In addition, the fact that the program was implemented online makes it scalable at low cost to large groups of women over wide geographic areas and the women can engage in the program at times and places that were most comfortable and convenient for them. This greatly expands the usefulness of the program.

 

So, reduce distress and increase pregnancy in women with fertility problems with mind-body practices.

 

“Many women fear that becoming mindful and starting to meditate will make them passive in their quest for a child.  This simply isn’t so.  The wish for a child remains vibrant and active – it’s simply that happiness doesn’t depend on the fulfillment of this wish.” – Beth Heller

 

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

 

Clifton, J., Parent, J., Seehuus, M., Worrall, G., Forehand, R., & Domar, A. (2020). An internet-based mind/body intervention to mitigate distress in women experiencing infertility: A randomized pilot trial. PloS one, 15(3), e0229379. https://doi.org/10.1371/journal.pone.0229379

 

Abstract

Objective

To determine if an internet-based mind/body program would lead to participants experiencing infertility (1) being willing to be recruited and randomized and (2) accepting and being ready to engage in a fertility-specific intervention. Secondary exploratory goals were to examine reduced distress over the course of the intervention and increased likelihood to conceive.

Methods

This was a pilot randomized controlled feasibility trial with a between-groups, repeated measure design. Seventy-one women self-identified as nulliparous and meeting criteria for infertility. Participants were randomized to the internet-based version of the Mind/Body Program for Fertility or wait-list control group and asked to complete pre-, mid- and post-assessments. Primary outcomes include retention rates, number of modules completed, and satisfaction with intervention. Secondary exploratory outcomes sought to provide preliminary data on the impact of the program on distress (anxiety and depression) and self-reported pregnancy rates relative to a quasi-control group.

Results

The retention, adherence, and satisfaction rates were comparable to those reported in other internet-based RCTs. Although time between pre- and post-assessment differed between groups, using intent-to-treat analyses, women in the intervention group (relative to the wait-list group) had significant reduction in distress (anxiety, p = .003; depression, p = .007; stress, p = .041 fertility-social, p = .018; fertility-sexual, p = .006), estimated as medium-to-large effect sizes (ds = 0.45 to 0.86). The odds of becoming pregnant was 4.47 times higher for the intervention group participants as compared to the wait-list group, OR 95% CI [1.56, 12.85], p = .005 and occurred earlier. The findings suggest that the research design and program specific to this population are feasible and acceptable. Replication efforts with an active control group are needed to verify distress reduction and conception promotion findings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7080396/