Depression

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/

 

Mindfulness-Based Therapies Effectively Treat Cardiovascular Disease

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Mindfulness-Based Therapies Effectively Treat Cardiovascular Disease

 

By John M. de Castro, Ph.D.

 

“What’s good for the mind also tends to be good for the heart. The mind-calming practice of meditation may play a role in reducing your risk of heart disease.” – Harvard Health

 

Cardiovascular disease is the number one killer. A myriad of treatments has been developed including a variety of surgical procedures and medications. In addition, lifestyle changes have proved to be effective including quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Unfortunately, for a variety of reasons, 60% of cardiovascular disease patients decline engaging in these lifestyle changes, making these patients at high risk for another attack.

 

Contemplative practices have been shown to be safe and effective alternative treatments for cardiovascular disease. Practices such as meditation, tai chi, and yoga, have been shown to be helpful for heart health and to reduce the physiological and psychological responses to stress. They have also been shown to be effective in maintaining cardiovascular health and the treatment of cardiovascular disease. The research has been accumulating. So, it makes sense to pause and take a look at what has been learned.

 

In today’s Research News article “Mindfulness-Based Interventions for Physical and Psychological Wellbeing in Cardiovascular Diseases: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8227381/ ) Marino and colleagues review, summarize and perform a meta-analysis of the published research studies of the effectiveness of mindfulness-based therapies for the treatment of cardiovascular diseases. They identified 17 published research studies.

 

They report that the published research studies found that mindfulness-based therapies produced significant decreases in systolic blood pressure, heart palpitations, heart rate, depression, and perceived stress, and significant increases in the quality of life of patients with cardiovascular disease. Hence, mindfulness-based therapies are effective in improving the physiological and psychological state of patients with cardiovascular disease and should be recommended for the treatment of these patients.

 

So, mindfulness-based therapies effectively treat cardiovascular disease.

 

“people who meditated had lower rates of high cholesterol, high blood pressure, diabetes, stroke, and coronary artery disease.” – Science Daily

 

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

 

Marino, F., Failla, C., Carrozza, C., Ciminata, M., Chilà, P., Minutoli, R., Genovese, S., Puglisi, A., Arnao, A. A., Tartarisco, G., Corpina, F., Gangemi, S., Ruta, L., Cerasa, A., Vagni, D., & Pioggia, G. (2021). Mindfulness-Based Interventions for Physical and Psychological Wellbeing in Cardiovascular Diseases: A Systematic Review and Meta-Analysis. Brain sciences, 11(6), 727. https://doi.org/10.3390/brainsci11060727

 

Abstract

Background: Recently, there has been an increased interest in the efficacy of mindfulness-based interventions (MBI) for people with cardiovascular diseases (CVD), although the exact beneficial effects remain unclear. Methods: This review aims to establish the role of MBI in the management of wellbeing for patients with CVD. Seventeen articles have been included in this systematic synthesis of the literature and eleven in the meta-analysis. Results: Considering physical (i.e., heart rate, blood pressure) and psychological outcomes (i.e., depression, anxiety, stress, styles of coping), the vast majority of studies confirmed that MBI has a positive influence on coping with psychological risk factors, also improving physiological fitness. Random-effects meta-analysis models suggested a moderate-to-large effect size in reducing anxiety, depression, stress, and systolic blood pressure. Conclusions: Although a high heterogeneity was observed in the methodological approaches, scientific literature confirmed that MBI can now be translated into a first-line intervention tool for improving physical and psychological wellbeing in CVD patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8227381/

 

Improve Cognitive Ability in Elementary School Children with Mindfulness

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Improve Cognitive Ability in Elementary School Children with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness [has been linked] to two core social-emotional skills: self-regulation and self-awareness. Skills in these areas teach students not only how to recognize their thoughts, emotions, and actions, but also how to react to them in positive ways.” – Waterford.org

 

Childhood is a miraculous period during which the child is dynamically absorbing information from every aspect of its environment. This is particularly evident during the elementary school years. Mindfulness training in school has been shown to have very positive effects. These include improvements in the academic, cognitive, psychological, emotional and social domains. Importantly, mindfulness training in school appears to improve attentional ability which is fundamental to success in all aspects of academic performance. But there have been few studies comparing the effects of mindfulness training to other types of training for elementary schoolchildren.

 

In today’s Research News article “Mindfulness-Based Versus Story Reading Intervention in Public Elementary Schools: Effects on Executive Functions and Emotional Health.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.576311/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1679696_a0P58000000G0YfEAK_Psycho_20210713_arts_A ) Milaré and colleagues recruited 2 classrooms of children 8-9 years of age. One class received an 8-week mindfulness training that met twice a week for 30 minutes. The instructions were on awareness, generosity, and heartfulness. The other class received 8 weeks of story reading that met twice a week for 15 minutes. The stories were targeted to moral and emotional issues appropriate for children. They were measured before and after training for stress, anxiety, depression, positive and negative emotions, and executive functions including attention.

 

They found that in comparison to baseline both groups had significant improvements in executive functions including attention, processing speed, and controlled attention. On the other hand, the story reading but not mindfulness group had decreases in depression and negative emotions.

 

It should be noted that there wasn’t a control condition, so improvements from baseline might have been due to a number of confounding factors including practice effects, expectancy effects, experimenter bias etc. In addition, there wasn’t random assignment of the children to condition. But in adults it is well established that mindfulness training produces improvements in executive functions including attention. This is not surprising as mindfulness training involves focusing attention which is important for cognitive performance. The present study suggests that these benefits also accrue to 8-9 year-old children. Improving cognitive skills particularly attention in children is important and may well lead to improved academic performance.

 

It is interesting that targeted story reading produced similar cognitive benefits and also some emotional improvements. This may be due to the fact that the stories included emotional issues pertinent to children while the mindfulness training did not include mindfulness of emotions. This suggests that the mindfulness program could be improved by including paying attention to emotions.

 

So, improve cognitive ability in elementary school children with mindfulness.

 

”Students . . . have been spending anywhere from 10 to 12 minutes per day on mindfulness exercises. But classes appear to be gaining more instruction time as a result because there are fewer outbursts and disruptions.” – Emily DeRuy

 

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

 

Milaré CAR, Kozasa EH, Lacerda S, Barrichello C, Tobo PR and Horta ALD (2021) Mindfulness-Based Versus Story Reading Intervention in Public Elementary Schools: Effects on Executive Functions and Emotional Health. Front. Psychol. 12:576311. doi: 10.3389/fpsyg.2021.576311

 

Introduction: In this study we compared the effects of a mindfulness-based intervention (MBI) with a story reading intervention (SI) on the executive functions and psychological profile of children in two different public schools in São Paulo, Brazil.

Methods: In this controlled clinical trial, 207 children aged 8 to 9 years old responded to the Five-Digit Test (FDT), stress levels, depression, anxiety, positive and negative affect, at baseline (T0) and 8 weeks later (T1). From T0 to T1, school 1 participated in MBI classes and school 2 in IS classes.

Results: In school 1 (MBI), children improved their scores on all tests except reading (errors) and counting (errors) compared with school 2. No differences were observed between groups in terms of emotional health.

Conclusion: It is feasible to implement MBI or SI in Brazilian public schools. Students in the MBI group presented broader effects in executive functions, while students in the SI group showed a trend toward reduced negative affect and depression symptoms.

Highlights

This study contributes to the scientific evidence of the positive effects of Mindfulness and Story reading on executive functions and emotional well-being in children. Neither intervention had significant effects on depression, anxiety, stress, positive, and negative affect (although Story reading showed a trend in reducing negative affect and depression), while the Mindfulness-Based Intervention had relatively broader effects on executive functions.

https://www.frontiersin.org/articles/10.3389/fpsyg.2021.576311/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1679696_a0P58000000G0YfEAK_Psycho_20210713_arts_A

 

Improve the Mental, Physical, and Emotional Well-Being of Older Adults During Covid-19 Pandemic with Tai Chi

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Improve the Mental, Physical, and Emotional Well-Being of Older Adults During Covid-19 Pandemic with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Tai Chi Chuan has a potential effect on the prevention, treatment and rehabilitation of COVID-19. Its potential mechanisms include reducing anxiety, relieving depression and stress, enhancing pulmonary and cardiovascular function, enhancing immunity and improving quality of life.” – Chen Xianjian

 

The COVID-19 pandemic has challenged the mental and physical health of the population. It has created intense stress on everyone but particularly the elderly isolating at home. Mindfulness is known to decrease the psychological and physical responses to stress. So, mindfulness training may be helpful in coping with the mental and physical challenges resulting from the COVID-19 pandemic. Tai Chi and Qigong are both mindfulness practices and gentle exercises. They have been shown to be beneficial for the health and well-being of individuals of a variety of ages, but particularly the elderly. So, it would seem reasonable to examine the ability of Tai Chi practice to improve the well-being of older adults during the Covid-19 pandemic.

 

In today’s Research News article “Tai chi improves psychoemotional state, cognition, and motor learning in older adults during the COVID-19 pandemic.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8054611/ ) Solianik and colleagues recruited healthy sedentary older adults (over 60 years of age) during the Covid-19 pandemic and randomly assigned them to 10 weeks of twice a week for 60 minute Tai Chi practice or to a no treatment control condition. They were measured before and after training for heart rate, perceived stress, anxiety, depression cognitive performance, and motor performance. In addition, blood was drawn and assayed for brain-derived neurotrophic factor.

 

They found that in comparison to baseline and the control group, the older adults who practiced Tai Chi had significantly higher levels of brain-derived neurotrophic factor, high frequency power in the heart rate, visuospatial performance, response inhibition, and shifting mental set, and significantly lower reaction times, heart rate, perceived stress, and depression.

 

The results must be interpreted with the understanding that the control condition was no treatment in a sedentary group of older adults. So, it cannot be determined if the effects were due to Tai Chi itself or exercise in general. Nevertheless, Tai Chi practice resulted in significant improvements in cardiovascular fitness, brain development, cognitive performance, and psychological health.

 

Tai Chi practice is not strenuous, involves slow gentle movements, and is safe, having no appreciable side effects, it is appropriate the elderly. It can also be practiced without professional supervision and in groups making it inexpensive to deliver and fun to engage in. This suggests that during stressful times Tai Chi should be recommended for older adults for their mental, physical, and emotional well-being.

 

So, improve the mental, physical, and emotional well-being of older adults during Covid-19 pandemic with Tai Chi.

 

“Older people should exercise for the entire duration of self-isolation. One large systematic review of falls prevention exercises emphasised the importance of maintaining exercise over time – benefits from Tai Chi were found after 20 weeks.” –  Jamie Hartmann-Boyce

 

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

 

Solianik, R., Mickevičienė, D., Žlibinaitė, L., & Čekanauskaitė, A. (2021). Tai chi improves psychoemotional state, cognition, and motor learning in older adults during the COVID-19 pandemic. Experimental gerontology, 150, 111363. https://doi.org/10.1016/j.exger.2021.111363

 

Abstract

The aim of this study was to determine the effect of a 10-week tai chi intervention on psychoemotional state, cognition, and motor learning in older adults during the COVID-19 pandemic. Participants aged 60–78 years were randomized to either a control group (n = 15) or a tai chi group (n = 15) for a 10-week period. The tai chi group received two, 8-form tai chi classes of 60 min duration per week. Changes in psychoemotional state, cognition, and the learning of fast and accurate reaching movements were assessed. In addition, the potential roles of the autonomic nervous system and brain-derived neurotrophic factor (BDNF) were investigated. Tai chi practice decreased (P < 0.05) perceived stress, whereas no change in autonomic nervous system activity was observed. Improvements in mental switching correlated with decreased depressive symptoms and increased BDNF levels (P < 0.05), whereas improvements in inhibitory control tended to correlate with BDNF levels (P = 0.08). Improvements in visuospatial processing tended to correlate with decreased depressive symptoms (P = 0.07) while improved visuospatial processing correlated with improved motor planning during learning tasks (P < 0.05). This study suggests that tai chi is an effective intervention that can be delivered under pandemic conditions to improve mental and physical function in older adults.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8054611/

 

Spirituality and Religion are Associated with Better Well-Being in Medical Residents

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Spirituality and Religion are Associated with Better Well-Being in Medical Residents

 

By John M. de Castro, Ph.D.

 

“Most internal medicine residents have positive attitudes toward spirituality, religion, and medicine. They do not have adequate knowledge or skill to care for patients in this area.” – Gina M. Piscitello

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. Religion and spirituality have been promulgated as solutions to the challenges of life. There have been a number of studies of the influence of religiosity and spirituality on the physical and psychological well-being of practitioners and patients mostly showing positive benefits, with spirituality encouraging personal growth and mental health. But there is still a need to investigate the relationships of spirituality with psychological well-being in patients and medical residents.

 

In today’s Research News article “Spirituality and religion in residents and inter-relationships with clinical practice and residency training: a scoping review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8166631/ ) Chow and colleagues review and summarize the published research on the relationship of spirituality and religion to the psychological well-being of patients and medical residents. They identified 44 published studies.

 

They report that the research found that medical residents believed that spirituality and religion were important to patients and made a difference in the outcomes of treatment. Over half of the residents identified themselves as spiritual or religious. The higher the degree of spirituality but not church going of the residents’ the greater sense of accomplishment and overall health and the lower the levels of burnout and depression. They report that although the patients rarely brought up spirituality and religion and the residents rarely inquired, when the medical issue was very serious and life threatening, it was brought up 72% of the time. They also report that the curriculum for medical residents rarely included spirituality and religion topics.

 

The findings suggest that the majority of medical residents recognize the importance of spirituality and religion for their patients and that it positively relates to treatment adherence and clinical outcomes, but the issues were rarely addressed. Spirituality and religion were important personally to the majority of the residents and were related to better well-being and lower burnout. But there was little instruction in the curriculum about these issues and there was great reticence to bring it up with patients. This suggests that training curricula for medical residents should include greater incorporation of spiritual and religious issues and how to incorporate them into patient care.

 

So, spirituality and religion are associated with better well-being in medical residents.

 

“Although religion and spirituality continue to be contested and controversial topics in our society, the existing evidence highlights patients’ desires to have some level of spiritual interaction with their healthcare providers.” – James Behan

 

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

 

Chow, H., Chew, Q. H., & Sim, K. (2021). Spirituality and religion in residents and inter-relationships with clinical practice and residency training: a scoping review. BMJ open, 11(5), e044321. https://doi.org/10.1136/bmjopen-2020-044321

 

Abstract

Objectives

With the increased emphasis on personalised, patient-centred care, there is now greater acceptance and expectation for the physician to address issues related to spirituality and religion (SR) during clinical consultations with patients. In light of the clinical need to improve SR-related training in residency, this review sought to examine the extant literature on the attitudes of residents regarding SR during residency training, impact on clinical care and psychological well-being of residents and SR-related curriculum implemented within various residency programmes.

Design

A scoping review was conducted on studies examining the topic of SR within residency training up until July 2020 on PubMed/Medline and Web of Science databases. Keywords for the literature search included: (Spirituality OR Religion) AND (Residen* OR “Postgraduate Medicine” OR “Post-graduate Medicine” OR “Graduate Medical Education”).

Results

Overall, 44 studies were included. The majority were conducted in North America (95.5%) predominantly within family medicine (29.5%), psychiatry (29.5%) and internal medicine (25%) residency programmes. While residents held positive attitudes about the role of SR and impact on patient care (such as better therapeutic relationship, treatment adherence and coping with illness), they often lacked the knowledge and skills to address these issues. Better spiritual well-being of residents was associated with greater sense of work accomplishment, overall self-rated health, decreased burnout and depressive symptoms. SR-related curricula varied from standalone workshops to continuous modules across the training years.

Conclusions

These findings suggest a need to better integrate appropriate SR-related education within residency training. Better engagement of the residents through different pedagogical strategies with supervision, feedback, reflective practice and ongoing faculty and peer support can enhance learning about SR in clinical care. Future studies should identify barriers to SR-related training and evaluate the outcomes of these SR-related curriculum including how they impact the well-being of patients and residents over time.

Keywords: medical education & training, Education & training (see medical education & training), mental

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8166631/

 

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/

 

Forest Walking and Forest Qigong Improve Cognitive Function in the Elderly

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Forest Walking and Forest Qigong Improve Cognitive Function in the Elderly

 

By John M. de Castro, Ph.D.

 

“forest bathing has received increasing attention due to its health-promoting effects, including enhancing immune functions and decreasing blood pressure in hypertension patients, as well as stress relief effects.” – Genxiang Mao,

 

Modern living is stressful, perhaps, in part because it has divorced us from the natural world that our species was immersed in throughout its evolutionary history. Modern environments may be damaging to our health and well-being simply because the species did not evolve to cope with them. This suggests that returning to nature, at least occasionally, may be beneficial. Indeed, researchers are beginning to study nature walks or what the Japanese call “Forest Bathing” and their effects on our mental and physical health.

 

Mindfulness practices have been found routinely to reduce the psychological and physiological responses to stress and improve mood. People have long reported that walking in nature elevates their mood. It appears intuitively obvious that if mindfulness training occurred in a beautiful natural place, it would greatly improve the effectiveness of mindfulness practice. In fact, being in nature has been shown to improve psychological health.

 

Qigong has been practiced for thousands of years with benefits for health and longevity. Qigong training is designed to enhance function and regulate the activities of the body through regulated breathing, mindful concentration, and gentle movements. Qigong  practice has been found to be effective for an array of physical and psychological issues. Qigong has been shown to help the elderly improve attention, balance, reducing falls, arthritis, cognitive function, memory, and reduce age related deterioration of the brain. So, it makes sense to further study the ability of Qigong training particularly when practiced in nature to improve well-being in the elderly.

 

In today’s Research News article “Psycho-Electrophysiological Benefits of Forest Therapies Focused on Qigong and Walking with Elderly Individuals.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7999348/ ) Yi and colleagues recruited healthy elderly (65 years of age and older) participants and assigned them to one of 3 conditions; no-treatment control, forest walking, or forest Qigong. The forest programs were 2 hours per session twice per week for 6 weeks and included warm-up exercises, stretching, physio-cognitive play, and cool-down along with 50 minutes of either forest walking, or forest Qigong. They were measured before and after training for cognitive impairment, depression, and quality of life. They also had the electroencephalogram (EEG) and electrocardiogram (EKG) recorded. Bioimpedance was used to determine body composition and nutritional metabolism.

 

They found that in comparison to baseline and the no-treatment control condition, the forest qigong group had a significant decrease in depression while the forest walking group had a significant decrease in cognitive impairment and increase in quality of life. In the EEG, the forest walking group had significant increases in Alpha and Beta rhythm power and a significant decrease in low frequency heart rate variability after training while the control and forest qigong groups did not. In addition, the forest qigong group had a significant increase in the upper body bioimpedance phase angle while the forest walking group had a significant increase in the lower body bioimpedance phase angle.

 

Bioimpedance phase angle is an indicator of the metabolic nutrition of the muscles. So, the practice of qigong in the forest appears to increase the metabolic nutritional status of the upper body while walking in the forest appears to increase the metabolic nutritional status of the lower body. This is not surprising as qigong involves frequent arm movements while walking involves more leg movements. Low frequency heart rate variability is an indicator of sympathetic nervous system activity and its decrease in the forest walking group suggests that walking in the forest is physiologically relaxing, reducing activating sympathetic activity. Finally, EEG power is indicative of brain information processing and its increase with forest walking is indicative of an increase in information (cognitive) processing.

 

These findings are interesting and suggest that walking in the forest and qigong in the forest have different effects on elderly individuals. Where forest qigong appears to be superior for decreasing depression and upper body metabolism, forest walking appears to improve cognitive ability, lower body metabolism, and physiological relaxation. Hence qigong in the forest is superior for emotional health while walking in the forest is superior for cognitive health. This suggests that the combination of qigong and walking in the forest may produce better well-being for elderly individual.

 

So, forest walking and forest qigong improve cognitive function in the elderly.

 

“Forest bathing, also known as forest therapy or shinrin-yoku in Japanese, is an evidence-based practice of connecting to nature as a way to heal.” – Credible Mind

 

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

 

Yi, J., Kim, S. G., Khil, T., Shin, M., You, J. H., Jeon, S., Park, G. H., Jeong, A. Y., Lim, Y., Kim, K., Kim, J., Kang, B., Lee, J., Park, J. H., Ku, B., Choi, J., Cha, W., Lee, H. J., Shin, C., Shin, W., … Kim, J. U. (2021). Psycho-Electrophysiological Benefits of Forest Therapies Focused on Qigong and Walking with Elderly Individuals. International journal of environmental research and public health, 18(6), 3004. https://doi.org/10.3390/ijerph18063004

 

Abstract

We developed two distinct forest therapy programs (FTPs) and compared their effects on dementia prevention and related health problems for older adults. One was focused on Qigong practice in the forest (QP) and the other involved active walking in the forest (WP). Both FTPs consisted of twelve 2-h sessions over six weeks and were conducted in an urban forest. We obtained data from 25, 18, and 26 participants aged 65 years or above for the QP, WP, and control groups, respectively. Neuropsychological scores via cognition (MoCA), geriatric depression (GDS) and quality of life (EQ-5D), and electrophysiological variables (electroencephalography, bioimpedance, and heart rate variability) were measured. We analyzed the intervention effects with a generalized linear model. Compared to the control group, the WP group showed benefits in terms of neurocognition (increases in the MoCA score, and alpha and beta band power values in the electroencephalogram), sympathetic nervous activity, and bioimpedance in the lower body. On the other hand, the QP group showed alleviated depression and an increased bioimpedance phase angle in the upper body. In conclusion, both active walking and Qigong in the forest were shown to have distinctive neuropsychological and electrophysiological benefits, and both had beneficial effects in terms of preventing dementia and relieving related health problems for elderly individuals.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7999348/

 

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/