Depression

Improve the Psychological Well-Being of Police with Mindfulness

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Improve the Psychological Well-Being of Police with Mindfulness

 

By John M. de Castro, Ph.D.

 

“self-reported mindfulness to be associated with increased resilience and emotional intelligence and decreased negative health outcomes among police officers.” – John H. Kim

 

Policing is a very stressful occupation. Stress in police can result from role conflicts between serving the public, enforcing the law, and upholding ethical standards and personal responsibilities as spouse, parent, and friend. Stress also results from, threats to health and safety, boredom, responsibility for protecting the lives of others, continual exposure to people in pain or distress, the need to control emotions even when provoked, the presence of a gun, even during off-duty hours, and the fragmented nature of police work, with only rare opportunities to follow cases to conclusion or even to obtain feedback or follow-up information.

 

This stress can have serious consequences for the individual and in turn for society. Police officers have one of the highest suicide rates in the nation, possibly the highest. They have a high divorce rate, about second in the nation. They are problem drinkers about twice as often as the general population. This is a major problem as stress and the resultant complications can impact job performance, which sometimes involve life or death situations.

 

Mindfulness training has been shown to improve the physiological and psychological responses to stress and it has been found to reduce burnout in first responders. So, it is likely that mindfulness training with police can help them cope with the stress and thereby improve their quality of life and psychological well-being.

 

In today’s Research News article “Mindfulness Training Improves Quality of Life and Reduces Depression and Anxiety Symptoms Among Police Officers: Results From the POLICE Study-A Multicenter Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7952984/ ) Trombka and colleagues recruited active police officers and randomly assigned them to a wait list control condition or to receive 8 weekly sessions of Mindfulness-Based Health Promotion (MBHP) which is based on Mindfulness-Based Stress Reduction (MBSR) program. It includes mindful movements, meditation, body scan, and breathing practices along with teachings on mindfulness and self-compassion and discussion. They were measured 2 weeks before and 2 weeks after training and 6 months later for quality of life, anxiety, depression, religiosity, mindfulness, self-compassion, and quality of life domains of spirituality, religiosity, and personal beliefs.

 

They found that in comparison to baseline and the wait-list control group, the group that received Mindfulness-Based Health Promotion (MBHP) had significantly greater quality of life, including physical health, psychological, social relationships, and environment, overall quality of life and general health facets. These improvements remained significant 6 months after the conclusion of treatment. In addition, the MBHP group had significant reductions in anxiety and depression and significant increases in self-compassion which were also still present at the 6-month follow-up. A mediation analysis revealed that MBHP improved all facets of quality of life directly and also indirectly by improving self-compassion which in turn improved the various facets of quality of life.

 

These are clear and important results. Mindfulness-Based Health Promotion (MBHP) produced significant improvements in the psychological well-being of the police. Mindfulness training has been previously shown to improve quality of life and self-compassion. The present study replicates these finding but also demonstrates that the improvement in self-compassion is in part responsible for the improvements in quality of life. Self-compassion involves kindness toward oneself in the face of one’s personal failings. This is important for psychological well-being especially for police who are often dealing with difficult and stressful situations. Recognizing their own imperfect humanness with kindness greatly reduce self-criticism and blame allowing them to being OK with doing the best they can,

 

So, improve the psychological well-being of police with mindfulness.

 

“The science is validating that mindfulness has the potential to increase fair and impartial policing, because we are open to recognizing our responses to a stimulus, to an event, to a person,” – Sylvia Moir

 

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

 

Trombka, M., Demarzo, M., Campos, D., Antonio, S. B., Cicuto, K., Walcher, A. L., García-Campayo, J., Schuman-Olivier, Z., & Rocha, N. S. (2021). Mindfulness Training Improves Quality of Life and Reduces Depression and Anxiety Symptoms Among Police Officers: Results From the POLICE Study-A Multicenter Randomized Controlled Trial. Frontiers in psychiatry, 12, 624876. https://doi.org/10.3389/fpsyt.2021.624876

 

Abstract

Background: Police officers’ high-stress levels and its deleterious consequences are raising awareness to an epidemic of mental health problems and quality of life (QoL) impairment. There is a growing evidence that mindfulness-based interventions are efficacious to promote mental health and well-being among high-stress occupations.

Methods: The POLICE study is a multicenter randomized controlled trial (RCT) with three assessment points (baseline, post-intervention, and 6-month follow-up) where police officers were randomized to mindfulness-based health promotion (MBHP) (n = 88) or a waiting list (n = 82). This article focuses on QoL, depression and anxiety symptoms, and religiosity outcomes. Mechanisms of change and MBHP feasibility were evaluated.

Results: Significant group × time interaction was found for QoL, depression and anxiety symptoms, and non-organizational religiosity. Between-group analysis showed that MBHP group exhibited greater improvements in QoL, and depression and anxiety symptoms at both post-intervention (QoL d = 0.69 to 1.01; depression d = 0.97; anxiety d = 0.73) and 6-month follow-up (QoL d = 0.41 to 0.74; depression d = 0.60; anxiety d = 0.51), in addition to increasing non-organizational religiosity at post-intervention (d = 0.31). Changes on self-compassion mediated the relationship between group and pre-to-post changes for all QoL domains and facets. Group effect on QoL overall health facet at post-intervention was moderated by mindfulness trait and spirituality changes.

Conclusion: MBHP is feasible and efficacious to improve QoL, and depression and anxiety symptoms among Brazilian officers. Results were maintained after 6 months. MBHP increased non-organizational religiosity, although the effect was not sustained 6 months later. To our knowledge, this is the first mindfulness-based intervention RCT to empirically demonstrate these effects among police officers. Self-compassion, mindfulness trait, and spirituality mechanisms of change are examined.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7952984/

 

Reduce Self-Harm in Patients with Borderline Personality Disorder with Mindfulness

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Reduce Self-Harm in Patients with Borderline Personality Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Dialectical Behavior Therapy group skills training was associated with a reduction in non-suicidal self-injury in patients with Borderline Personality Disorder.” – Gary Rothbard

 

Self-injury is a disturbing phenomenon occurring worldwide, especially in developed countries, such as the U.S. and those in western Europe. Approximately two million cases are reported annually in the U.S. Each year, 1 in 5 females and 1 in 7 males engage in self-injury usually starting in the teen years. Frequently, untreated depression and other mental health challenges create an environment of despair that leads people to cope with these challenges in unhealthy ways. Nearly 50 percent of those who engage in self-injury have been sexually abused.

 

Borderline Personality Disorder (BPD) is a very serious mental illness that is estimated to affect 1.6% of the U.S. population. It involves unstable moods, behavior, and relationships, problems with regulating emotions and thoughts, impulsive and reckless behavior, and unstable relationships. About ¾ of BPD patients engage in self-injurious behaviors.

 

One of the few treatments that appears to be effective for Borderline Personality Disorder (BPD) is Dialectical Behavior Therapy (DBT). It is targeted at changing the problem behaviors characteristic of BPD including self-injury. Behavior change is accomplished through focusing on changing the thoughts and emotions that precede problem behaviors, as well as by solving the problems faced by individuals that contribute to problematic thoughts, feelings and behaviors. In DBT five core skills are practiced; mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness. DBT reduces self-injurious behaviors in BPD patients.

 

In today’s Research News article “Cessation of Deliberate Self-Harm Behavior in Patients With Borderline Personality Traits Treated With Outpatient Dialectical Behavior Therapy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7952764/ ) Westad and colleagues recruited adults with subthreshold Borderline Personality Disorder (BPD) and provided them with 1 hour individual therapy and 2.5 hours of group skills training per week for 8 weeks of Dialectical Behavior Therapy (DBT). Prior to treatment they were assessed for personality and clinical symptoms. Before and after treatment they were measured for self-harm and suicidal behaviors, depression, hopelessness, personality disorders, quality of life, general health, and psychological, social, and occupational functioning.

 

They found that over the first year following therapy 94% of the patients ceased self-harm behaviors in an average of 16 weeks. Compared to baseline, following treatment the patients had significant increases in quality of life and functioning and significant decreases in depression, hopelessness, and personality disorders. A comparison of patients who reduced self-harm behaviors quickly to those who took longer for the reduction did not reveal any significant differences.

 

In the present study there wasn’t a control condition. So, alternative confounding interpretations are present. But the findings replicate previous controlled work that Dialectical Behavior Therapy (DBT) produces significant improvement in Borderline Personality Disorder and reductions in self-harm behaviors. So, the results of the present study are likely to due to DBT alone. The findings expand knowledge in that they demonstrate the effectiveness of DBT for patients who are subthreshold for BPD.

 

Dialectical Behavior Therapy (DBT) is one of very few treatments that are effective for Borderline Personality Disorder (BPD). But DBT is a complex therapy that includes mindfulness and other significant components. So, it is unclear which components or combination of components are necessary and sufficient for the clinical benefits.

 

So, reduce self-harm in patients with borderline personality disorder with mindfulness.

 

“DBT might provide an effective treatment for severe self-harm in institutional settings.” – Gail Skillington

 

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

 

Yngvill Ane Stokke Westad, Kristen Hagen, Egil Jonsbu, Stian Solem. Cessation of Deliberate Self-Harm Behavior in Patients With Borderline Personality Traits Treated With Outpatient Dialectical Behavior Therapy, Front Psychol. 2021; 12: 578230. Published online 2021 Feb 26. doi: 0.3389/fpsyg.2021.578230

 

Abstract

The first aim of the study was to identify when deliberate self-harm (DSH) behavior ceased in patients with borderline symptoms undergoing dialectical behavioral treatment (DBT). The second aim was to compare patients who ceased their self-harm behavior early or late in the course of treatment, with regard to demographics, comorbidity, and symptom severity. The study used a naturalistic design and included 75 treatment completers at an outpatient DBT clinic. Of these 75 patients, 46 presented with self-harming behavior at pre-treatment. These 46 participants where split into two groups, based on median amount of time before ceasing self-harm behavior, termed early (up to 8 weeks) and late (8+ weeks) responders. Treatment duration varied from 16 to 160 weeks. Patients were assessed pre- and post-treatment using measures of depression, hopelessness, personality traits, quality of life, and global assessment of symptoms and functioning. The majority (93.5%) ceased their self-harming within the first year, and the average number of weeks was 15.5 (SD = 17.8). Twenty-five percent of patients ceased their DSH behavior during the first week of treatment. For the remaining patients, the cessation of DSH continued gradually across a 1 year period. We found no differences between early and late responders with respect to demographics, comorbidity, symptom severity, or treatment outcome. None of the patients committed suicide. The findings indicate that self-harming behavior decreases gradually across the first year after starting DBT.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7952764/

 

Yoga Practitioners Have Better Psychological Health During the Covid-19 Lockdown

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Yoga Practitioners Have Better Psychological Health During the Covid-19 Lockdown

 

By John M. de Castro, Ph.D.

 

“the well understood underlying mechanisms for the use of yoga for stress reduction and immune modulation shall be considered as the basis for its complimentary role in the management of an infectious condition like COVID-19.“ – H. R. Nagendra

 

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

 

In today’s Research News article “Yoga an effective strategy for self-management of stress-related problems and wellbeing during COVID19 lockdown: A cross-sectional study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7875402/ ) Sahni and colleagues recruited adults online during the Covid-19 lockdown. They separated the participants into three groups; those who practice yoga, other spiritual practices, and non-practitioners. The participants completed online measures of Covid-19 perceptions, depression, anxiety, perceived stress, general well-being, resilience, peace of mind, and emotion regulation.

 

They found that in comparison to the spiritual practices and non-practitioners, the yoga practitioners had a significantly higher level of Covid-19 perception of personal control, and significantly lower levels of illness concern and emotional impact of COVID19. In addition, the yoga practitioners had significantly lower levels of depression, anxiety, and perceived stress and significantly higher levels of peace of mind. well-being, and cognitive reappraisal strategies of emotion regulation. In general, they found that the longer that the yoga practitioners had practiced, the greater the benefits.

 

This study examined existing groups and there wasn’t random assignment. Hence, the findings could be due to systematic differences between people who choose to engage in yoga, other spiritual practices, or no practice. But previous controlled research has demonstrated that yoga practice causes decreased depression, anxiety, and perceived stress, and increased well-being. So, the difference seen here between groups probably represent the causal effects of yoga practice.

 

These results suggest that practicing yoga makes an individual more resistant to the deleterious psychological effects of the pandemic and the associated lockdown. It appears to improve the practitioners’ psychological well-being, peace of mind, attitude toward the pandemic, and ability to regulate emotions. In addition, the greater the amount of yoga practice, the greater the benefits. These yoga-produced abilities may well underlie yoga practice’s positive impact on various diseases.

 

So, yoga practitioners have better psychological health during the Covid-19 lockdown.

 

“COVID-19 has caused levels of stress and anxiety to skyrocket and it’s (understandably) taking a toll on people’s mental health. One thing that can help? Yoga.”- CorePower Yoga

 

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

 

Sahni, P. S., Singh, K., Sharma, N., & Garg, R. (2021). Yoga an effective strategy for self-management of stress-related problems and wellbeing during COVID19 lockdown: A cross-sectional study. PloS one, 16(2), e0245214. https://doi.org/10.1371/journal.pone.0245214

 

Abstract

This cross-sectional research aims to study the effect of yoga practice on the illness perception, and wellbeing of healthy adults during 4–10 weeks of lockdown due to COVID19 outbreak. A total of 668 adults (64.7% males, M = 28.12 years, SD = 9.09 years) participated in the online survey. The participants were grouped as; yoga practitioners, other spiritual practitioners, and non-practitioners based on their responses to daily practices that they follow. Yoga practitioners were further examined based on the duration of practice as; long-term, mid-term and beginners. Multivariate analysis indicates that yoga practitioners had significantly lower depression, anxiety, & stress (DASS), and higher general wellbeing (SWGB) as well as higher peace of mind (POMS) than the other two groups. The results further revealed that the yoga practitioners significantly differed in the perception of personal control, illness concern and emotional impact of COVID19. However, there was no significant difference found for the measure of resilience (BRS) in this study. Yoga practitioners also significantly differed in the cognitive reappraisal strategy for regulating their emotions than the other two groups. Interestingly, it was found that beginners -those who had started practicing yoga only during the lockdown period reported no significant difference for general wellbeing and peace of mind when compared to the mid- term practitioner. Evidence supports that yoga was found as an effective self- management strategy to cope with stress, anxiety and depression, and maintain wellbeing during COVID19 lockdown.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7875402/

 

Relieve Maternal Perinatal Depression with Smartphone-Based Mindfulness Training

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Relieve Maternal Perinatal Depression with Smartphone-Based Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“the ideal treatment plan for perinatal depression and anxiety often includes mindfulness techniques.” – Edith Gettes

 

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 vast majority of the mindfulness training techniques, however, require a trained teacher. The participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with busy employee schedules and at locations that may not be convenient. As an alternative, apps for smartphones 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. But the question arises as to the effectiveness of these apps and their ability to relieve depression during the perinatal period.

 

In today’s Research News article “Effectiveness of Smartphone-Based Mindfulness Training on Maternal Perinatal Depression: Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7875700/ ) Sun and colleagues recruited pregnant women who were diagnosed with depression and randomly assigned them to receive 8-weeks of either health consultation or mindfulness training. Mindfulness training occurred in 8 weekly sessions delivered on a smartphone app. The training was Mindfulness-Based Cognitive Therapy (MBCT) modified for pregnant women. Health consultation also occurred via smartphone app. They were measured before during, and after training, 10 weeks later, and 6-months after delivery for depression, anxiety symptoms, perceived stress, positive and negative emotions, sleep-related problems, fatigue, memory, and fear of childbirth. There was a 52% completion rate for the trainings.

 

They found that after training the mindfulness group had significantly lower levels of depression and anxiety and significantly higher levels of positive emotions but these were not maintained 6 months after delivery. The mindfulness group also had a significantly higher rate of depression symptom remission. Hence the smartphone-based mindfulness training improved the psychological health of the pregnant women.

 

These findings replicate previous findings that mindfulness training reduces anxiety and depression in non-pregnant individuals and relieves maternal anxiety and depression during pregnancy. The strength of the current study was that these effects were produced by mindfulness training with a smartphone app. This is important as this training is highly scalable at minimal cost and so can be made available to virtually all pregnant women who want it. Hence, it may be able to reduce the psychological misery that occurs in many women during the perinatal period, making pregnancy a happier time for the women and produce better outcoms for the infant.

 

So, relieve maternal perinatal depression with smartphone-based mindfulness training.

 

“the risk of having moderate depressive symptoms was reduced by nearly 90% in participants receiving the MMT [Mindfulness] intervention.” – Ruta Nonacs

 

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

 

Sun, Y., Li, Y., Wang, J., Chen, Q., Bazzano, A. N., & Cao, F. (2021). Effectiveness of Smartphone-Based Mindfulness Training on Maternal Perinatal Depression: Randomized Controlled Trial. Journal of medical Internet research, 23(1), e23410. https://doi.org/10.2196/23410

 

Abstract

Background

Despite potential for benefit, mindfulness remains an emergent area in perinatal mental health care, and evidence of smartphone-based mindfulness training for perinatal depression is especially limited.

Objective

The objective of this study was to evaluate the effectiveness of a smartphone-based mindfulness training intervention during pregnancy on perinatal depression and other mental health problems with a randomized controlled design.

Methods

Pregnant adult women who were potentially at risk of perinatal depression were recruited from an obstetrics clinic and randomized to a self-guided 8-week smartphone-based mindfulness training during pregnancy group or attention control group. Mental health indicators were surveyed over five time points through the postpartum period by online self-assessment. The assessor who collected the follow-up data was blind to the assignment. The primary outcome was depression as measured by symptoms, and secondary outcomes were anxiety, stress, affect, sleep, fatigue, memory, and fear.

Results

A total of 168 participants were randomly allocated to the mindfulness training (n=84) or attention control (n=84) group. The overall dropout rate was 34.5%, and 52.4% of the participants completed the intervention. Mindfulness training participants reported significant improvement of depression (group × time interaction χ24=16.2, P=.003) and secondary outcomes (χ24=13.1, P=.01 for anxiety; χ24=8.4, P=.04 for positive affect) compared to attention control group participants. Medium between-group effect sizes were found on depression and positive affect at postintervention, and on anxiety in late pregnancy (Cohen d=0.47, –0.49, and 0.46, respectively). Mindfulness training participants reported a decreased risk of positive depressive symptom (Edinburgh Postnatal Depression Scale [EPDS] score>9) compared to attention control participants postintervention (odds ratio [OR] 0.391, 95% CI 0.164-0.930) and significantly higher depression symptom remission with different EPDS reduction scores from preintervention to postintervention (OR 3.471-27.986). Parity did not show a significant moderating effect; however, for nulliparous women, mindfulness training participants had significantly improved depression symptoms compared to nulliparous attention control group participants (group × time interaction χ24=18.1, P=.001).

Conclusions

Smartphone-based mindfulness training is an effective intervention in improving maternal perinatal depression for those who are potentially at risk of perinatal depression in early pregnancy. Nulliparous women are a promising subgroup who may benefit more from mindfulness training.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7875700/

Improve Treatment Resistant Obsessive-Compulsive Disorder with Compassion-Focused Therapy

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Improve Treatment Resistant Obsessive-Compulsive Disorder with Compassion-Focused Therapy

 

By John M. de Castro, Ph.D.

 

“A big part of learning to live with OCD is to incorporate self-compassion. Instead of avoiding your anxiety, self-compassion invites you to look at it with understanding and gentle curiosity. This approach allows you to see your pain exactly how it is without self-judgment or self-criticism.” – Nancy Larsen

 

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

 

Fortunately, Obsessive-Compulsive Disorder (OCD) can be treated and many respond to Cognitive Behavioral Therapy (CBT). But some do not. Mindfulness training has been shown to be effective in treating OCD. One understudied meditation technique is Compassion -Focused Therapy. It is designed to develop kindness and compassion to oneself and others. On the face of it learning self-compassion would seem to be useful in dealing with OCD. But there is little empirical evidence.

 

In today’s Research News article “Compassion-Focused Group Therapy for Treatment-Resistant OCD: Initial Evaluation Using a Multiple Baseline Design.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7835278/ ) Petrocchi and colleagues recruited patients with Obsessive-Compulsive Disorder (OCD) who had received 6-months of Cognitive Behavioral Therapy (CBT) and still have significant residual OCD symptoms. They received 8 weekly 2-hour sessions of Compassion-Focused Therapy after varying periods of baseline (Multiple Baseline Research Design). The treatment consisted of training in meditation and visualization practices during sessions and at home. It is designed to replace self-criticism with self-compassion. Before and after training and 1 month later they were measured for OCD symptom severity, OCD symptom presence and distress, depression, fear of guilt, self-criticizing, self-attacking, self-reassuring, and self-compassion.

 

They found that the patients all had large improvements in Obsessive-Compulsive Disorder (OCD) symptoms that were maintained at the 1-month follow-up. They also found significant improvements in fear of guilt, self-criticism, and self-reassurance. In additions, there were less reliable improvements in depression and common humanity. Hence, Compassion-Focused Therapy improved the symptom of OCD in patients who didn’t respond to Cognitive Behavioral Therapy (CBT).

 

These are important preliminary findings that must be followed up with a large randomized controlled trial. But these results suggest that Compassion-Focused Therapy may be effective in treating Obsessive-Compulsive Disorder (OCD) symptoms in patients who do not respond to the gold standard treatment of Cognitive Behavioral Therapy (CBT). The results may suggest that CBT should incorporate Compassion-Focused training when being employed to treat OCD. This should be explored in future studies.

 

So, improve treatment resistant obsessive-compulsive disorder with compassion-focused therapy.

 

“people with OCD may feel better if they remind themselves that it is normal to worry, and that it is not their fault if their OCD symptoms get worse.” –  Jessica Caporuscio

 

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

 

Petrocchi, N., Cosentino, T., Pellegrini, V., Femia, G., D’Innocenzo, A., & Mancini, F. (2021). Compassion-Focused Group Therapy for Treatment-Resistant OCD: Initial Evaluation Using a Multiple Baseline Design. Frontiers in psychology, 11, 594277. https://doi.org/10.3389/fpsyg.2020.594277

 

Abstract

Obsessive–compulsive disorder (OCD) is a debilitating mental health disorder that can easily become a treatment-resistant condition. Although effective therapies exist, only about half of the patients seem to benefit from them when we consider treatment refusal, dropout rates, and residual symptoms. Thus, providing effective augmentation to standard therapies could improve existing treatments. Group compassion-focused interventions have shown promise for reducing depression, anxiety, and avoidance related to various clinical problems, but this approach has never been evaluated for OCD individuals. However, cultivating compassion for self and others seems crucial for OCD patients, given the accumulating research suggesting that fear of guilt, along with isolation and self-criticism, can strongly contribute to the development and maintenance of OCD. The primary aim of this pilot study was to evaluate the acceptability, tolerability, and effectiveness of an 8-week group compassion-focused intervention for reducing OCD symptoms, depression, fear of guilt and self-criticism, and increasing common humanity and compassionate self-reassuring skills in treatment-resistant OCD patients. Using a multiple baseline experimental design, the intervention was evaluated in a sample of OCD patients (N = 8) who had completed at least 6 months of CBT treatment for OCD, but who continued to suffer from significant symptoms. Participants were randomized to different baseline assessment lengths; they then received 8 weekly, 120-min group sessions of compassion-focused therapy for OCD (CFT-OCD), and then were tested again at post-treatment and at 1 month follow up. Despite the adverse external circumstances (post-treatment and follow-up data collection were carried out, respectively, at the beginning and in the middle of the Italian lockdown due to the COVID-19 pandemic), by the end of treatment, all participants demonstrated reliable decreases in OCD symptoms, and these improvements were maintained at 4-week follow-up for seven of eight participants. The intervention was also associated with improvements in fear of guilt, self-criticism, and self-reassurance, but less consistent improvements in depression and common humanity. Participants reported high levels of acceptability of and satisfaction with the intervention. Results suggest that the intervention may be beneficial as either a stand-alone treatment or as an augmentation to other treatments.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7835278/

 

Improve Psychological Well-Being and Happiness with Mindfulness

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Improve Psychological Well-Being and Happiness with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness has been shown to help us be healthier, less affected by stress, more relaxed, more creative, more open to learning, sleep better, improve our relationships with others and feel happier and more satisfied with our lives.” – Action for Happiness

 

There has accumulated a large amount of research demonstrating that mindfulness practices have significant benefits for psychological, physical, and spiritual wellbeing. They have been shown to improve emotions and their regulation. They also increase happiness levels in practitioners. It is not known how mindfulness improves well-being and happiness, directly or through intermediaries. That is, does mindfulness produce these benefits directly or by altering a variable that in turn affects well-being and happiness.

 

In today’s Research News article “Relationships between Mindfulness, Purpose in Life, Happiness, Anxiety, and Depression: Testing a Mediation Model in a Sample of Women.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908241/ ) Crego and colleagues recruited online a transnational sample of adult women and had them complete online measures of mindfulness, purpose in life, behavioral activation, happiness, anxiety, and depression. These data were analyzed with regression analysis and structural equation modelling.

 

They found that the higher the levels of mindfulness, the higher the levels of purpose in life, behavioral activation, and happiness and the lower the levels of anxiety and depression. Similarly, the higher the levels of purpose in life, the higher the levels of mindfulness, behavioral activation, and happiness and the lower the levels of anxiety and depression. Finally, the higher the levels of behavioral activation, the higher the levels of mindfulness, purpose in life, and happiness and the lower the levels of anxiety and depression.

 

To untangle these similar associations, structural equation modelling was performed. It revealed that mindfulness was directly associated with higher levels of happiness and lower levels of anxiety and depression. But mindfulness was also indirectly associated with these variables through positive associations with purpose in life and behavioral activation which in turn were associated with higher levels of happiness and lower levels of anxiety and depression.

 

The findings are correlative, so caution must be exercised in making causal inferences. But previous research has shown that mindfulness training results in significant increases in purpose in life, behavioral activation, and happiness and significant decreases in anxiety and depression. So, the current findings likely represent causal connections between the variables. Hence, mindfulness improves psychological well-being directly and also indirectly by increasing purpose in live and behavioral activation which also improve psychological well-being. Clearly, being mindful leads to happiness.

 

So, improve psychological well-being and happiness with mindfulness.

 

“Happiness isn’t about being upbeat all the time. Instead, think of it as a trait—one that helps you to recognize even the tiniest moments of joy, to fully embrace the good stuff in life without pause, and to know that even when things aren’t going well, this hard time, too, shall pass.” Kelle Walsh

 

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

 

Crego, A., Yela, J. R., Gómez-Martínez, M. Á., Riesco-Matías, P., & Petisco-Rodríguez, C. (2021). Relationships between Mindfulness, Purpose in Life, Happiness, Anxiety, and Depression: Testing a Mediation Model in a Sample of Women. International journal of environmental research and public health, 18(3), 925. https://doi.org/10.3390/ijerph18030925

 

Abstract

Mindfulness is connected to positive outcomes related to mental health and well-being. However, the psychological mechanisms that account for these relationships are largely unknown. A multiple-step multiple mediator structural equation modeling (SEM) model was tested with mindfulness as the independent variable; purpose in life and behavioral activation as serial mediators; and happiness, anxiety, and depression as outcome measures. Data were obtained from 1267 women. Higher mindfulness was associated with higher levels of happiness and lower anxiety and depression symptoms. The association of mindfulness with the outcome variables could be partially accounted for by purpose in life and behavioral activation. The SEM model explained large proportions of variance in happiness (50%), anxiety (34%), and depression (44%) symptoms. Mindfulness is associated with both a sense of purpose in life and engagement in activities, which are also connected with positive outcomes. Moreover, having purposes in life is linked to higher levels of behavioral activation.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908241/

 

Improve Brain Function and Mental Health in Chronic Pain Patients with Mindfulness

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Improve Brain Function and Mental Health in Chronic Pain Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“With the ACT approach, learning to let go of behaviors, memories, thoughts, and emotions creates space to explore new experiences, including acceptance of chronic pain sensations.” – Rosemary Black

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.

 

Hence, it is important to find an effective method to treat Chronic pain. There is an accumulating volume of research findings to demonstrate that mindfulness practices, in general, are effective in treating pain. Acceptance 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.

 

Pain experiences are processed in the nervous system. So, it’s likely that mindfulness practices somehow alter the brain’s processing of pain. So, it makes sense to study the how Acceptance and Commitment Therapy (ACT) may affect the brain to improve the mental health of chronic pain patients.

 

In today’s Research News article “Neural Mechanisms of Acceptance and Commitment Therapy for Chronic Pain: A Network-Based fMRI Approach.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7892587/ ) Aytur and colleagues recruited with musculoskeletal pain who did not abuse opioids. They completed 2 sessions per week for 4 weeks of Acceptance and Commitment Therapy (ACT). Before and after therapy they were measured for acceptance, chronic pain acceptance, quality of life, pain interference, and depression. Brain systems were measured before and after therapy with functional Magnetic Resonance Imaging (fMRI).

 

They found that in comparison to baseline after Acceptance and Commitment Therapy (ACT) the participants had significant increases in acceptance, chronic pain acceptance, quality of life and significant decreases in pain interference, and depression. In the fMRIs they also observed significant decreases in activation and connectivity in the Default Mode Network (DMN), Salience Network (SN), and Frontal-Parietal Network (FPN) networks of the brain. In addition, they observed that changes in the connectivity between these networks were correlated with decreases in depression and pain interference, and increases in quality of life.

 

These are interesting results that need to be interpreted with caution as there wasn’t a control, comparison condition present opening the findings up to alternative confounded interpretations. But the results replicate previous findings with controlled designs that Acceptance and Commitment Therapy (ACT) produces improvements in depression, pain, and quality of life. So, the improvements observed in the present study are likely due to causal effects of ACT.

 

These results also show that the psychological improvements produced by Acceptance and Commitment Therapy (ACT) are related to changes in the activity and connectivity within and between significant brain networks. This suggests that these neural alterations may underly the improvements in mental health of chronic pain patients produced by ACT. It remains for future studies to unravel the cause effect relationships.

 

So, improve brain function and mental health in chronic pain patients with mindfulness.

 

“ACT can help us to break out of that box that we have created for ourselves. To understand that the key to living with our condition is not to limit our lives and miss out on experiences, but instead to face things head on and be dedicated to working with our pain and doing things that bring us joy. ACT’s goal is not necessarily to reduce the pain but to help you to live your life with it, to feel more confident in engaging in activities that you might have otherwise swayed away from.” – Ann-Marie D’arcy-Sharpe

 

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

 

Aytur, S. A., Ray, K. L., Meier, S. K., Campbell, J., Gendron, B., Waller, N., & Robin, D. A. (2021). Neural Mechanisms of Acceptance and Commitment Therapy for Chronic Pain: A Network-Based fMRI Approach. Frontiers in human neuroscience, 15, 587018. https://doi.org/10.3389/fnhum.2021.587018

 

Abstract

Over 100 million Americans suffer from chronic pain (CP), which causes more disability than any other medical condition in the United States at a cost of $560–$635 billion per year (Institute of Medicine, 2011). Opioid analgesics are frequently used to treat CP. However, long term use of opioids can cause brain changes such as opioid-induced hyperalgesia that, over time, increase pain sensation. Also, opioids fail to treat complex psychological factors that worsen pain-related disability, including beliefs about and emotional responses to pain. Cognitive behavioral therapy (CBT) can be efficacious for CP. However, CBT generally does not focus on important factors needed for long-term functional improvement, including attainment of personal goals and the psychological flexibility to choose responses to pain. Acceptance and Commitment Therapy (ACT) has been recognized as an effective, non-pharmacologic treatment for a variety of CP conditions (Gutierrez et al., 2004). However, little is known about the neurologic mechanisms underlying ACT. We conducted an ACT intervention in women (n = 9) with chronic musculoskeletal pain. Functional magnetic resonance imaging (fMRI) data were collected pre- and post-ACT, and changes in functional connectivity (FC) were measured using Network-Based Statistics (NBS). Behavioral outcomes were measured using validated assessments such as the Acceptance and Action Questionnaire (AAQ-II), the Chronic Pain Acceptance Questionnaire (CPAQ), the Center for Epidemiologic Studies Depression Scale (CES-D), and the NIH Toolbox Neuro-QoLTM (Quality of Life in Neurological Disorders) scales. Results suggest that, following the 4-week ACT intervention, participants exhibited reductions in brain activation within and between key networks including self-reflection (default mode, DMN), emotion (salience, SN), and cognitive control (frontal parietal, FPN). These changes in connectivity strength were correlated with changes in behavioral outcomes including decreased depression and pain interference, and increased participation in social roles. This study is one of the first to demonstrate that improved function across the DMN, SN, and FPN may drive the positive outcomes associated with ACT. This study contributes to the emerging evidence supporting the use of neurophysiological indices to characterize treatment effects of alternative and complementary mind-body therapies.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7892587/

 

Improve Psychological Well-Being in Cancer Survivors with Online Mindfulness-Based Cognitive Therapy (MBCT)

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Improve Psychological Well-Being in Cancer Survivors with Online Mindfulness-Based Cognitive Therapy (MBCT)

 

By John M. de Castro, Ph.D.

 

“both MBCT and eMBCT interventions reduced fear of cancer recurrence and rumination, and increased mental health–related quality of life, mindfulness skills, and positive mental health.” – Félix Compen

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatigue, stress,  sleep disturbance, fear, and anxiety and depression. Mindfulness-Based Cognitive Therapy (MBCT) is a well-established therapy that involves mindfulness training and cognitive therapy to change maladaptive thought processes. MBCT has been found to be effective in reducing the residual psychological issues that are common in cancer survivors.

 

But the vast majority of the mindfulness training techniques require a trained therapist. This results in costs that many parents 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 parents’ busy schedules and at locations that may not be convenient. As an alternative, mindfulness trainings over the internet have been developed. These have tremendous advantages in making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. So, it makes sense to explore the effectiveness of internet-based Mindfulness-Based Cognitive Therapy (iMBCT) in treating the psychological symptoms of cancer survivors.

 

In today’s Research News article “Internet-delivered Mindfulness-Based Cognitive Therapy for anxiety and depression in cancer survivors: Predictors of treatment response.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7843453/ )  Nissen and colleagues recruited adult breast and prostrate cancer survivors and randomly assigned them to a wait-list control condition or to receive internet-based Mindfulness-Based Cognitive Therapy (iMBCT); consisting of 8 1-week modules. They were measured before and after training and 6 months later for mindfulness, self-compassion, anxiety, depression, and therapy related working reliance.

 

They found that at baseline the higher the levels of self-compassion and the mindfulness facets of describing, non-judging, and acting with awareness, the lower the levels of anxiety and depression. Mindfulness-Based Cognitive Therapy (iMBCT) resulted in significant decreases in anxiety and depression. The amount of decrease in anxiety was related to the baseline depression level with the most depressed participants having the greatest reductions, while the amount of decrease in depression was related to the baseline self-compassion level with the participants with the highest levels of self-compassion having the greatest reductions. Neither mindfulness, therapy related working reliance, nor were related to the improvements.

 

These are interesting results that replicate previous findings of mindfulness training producing improvements in depression and anxiety in cancer patients, and that mindfulness training over the internet is effective in improving cancer patients. The primary intent of the research, though, was to examine predictors of patient responsiveness to the therapy. The results here were disappointing as only baseline self-compassion was related to depression improvements and only baseline depression was related to improvements in anxiety. Regardless, it is clear that mindfulness training can be successfully implemented over the internet and it is effective in improving the levels of anxiety and depression in cancer survivors.

 

So, improve psychological well-being in cancer survivors with online Mindfulness-Based Cognitive Therapy (iMBCT).

 

“I love being more mindful. Instead of waiting for the flowers to come out, I go out in the garden and see what is happening now. I am happier. Things still get difficult at times and when they do, I do my practice.” – MBCT Patient

 

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

 

Nissen, E. R., Zachariae, R., O’Connor, M., Kaldo, V., Jørgensen, C. R., Højris, I., Borre, M., & Mehlsen, M. (2021). Internet-delivered Mindfulness-Based Cognitive Therapy for anxiety and depression in cancer survivors: Predictors of treatment response. Internet interventions, 23, 100365. https://doi.org/10.1016/j.invent.2021.100365

 

Abstract

Background

The present study investigates possible predictors of treatment response in an Internet-delivered Mindfulness-Based Cognitive Therapy (iMBCT) intervention with therapist support. This iMBCT program, a fully online delivered intervention with asynchronous therapist support, has previously been shown to be efficacious in reducing symptoms of anxiety and depression in women treated for breast cancer and men treated for prostate cancer.

Methods

Eighty-two breast- and prostate cancer survivors experiencing psychological distress received 8 weeks of therapist-guided iMBCT. Primary outcomes were improvement in anxiety and depression scores from baseline to post-treatment and from baseline to six-months follow-up. Clinical predictors included levels of depression and anxiety at the time of screening and at baseline, as well as time since diagnosis. Demographic predictors included age and educational level. Therapy-related predictors included working alliance, self-compassion, and five facets of mindfulness. Mixed Linear Models were employed to test the prediction effects over time.

Results

Higher levels of baseline depression were associated with increased treatment response in anxiety at post-treatment, and lower levels of self-compassion were associated with increased treatment response in depression at post-treatment. None of the proposed predictors significantly predicted treatment response at six-months follow-up.

Conclusion

The findings suggest that iMBCT can be provided for cancer survivors regardless of their age, educational level, and time since diagnosis (up to five years) and that therapeutic alliance is not crucial for treatment response. We did not identify characteristics predicting treatment response, although many factors were tested. Still, other characteristics may be predictors, and given the relatively small sample size and a large number of statistical tests, the results should be interpreted with caution.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7843453/

 

Mindfulness-Based Therapies Benefits are Greatly Affected by Social Factors in Therapy

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Mindfulness-Based Therapies Benefits are Greatly Affected by Social Factors in Therapy

 

By John M. de Castro, Ph.D.

 

“Designed to deliberately focus a person’s attention on the present experience in a way that is non-judgmental, mindfulness-based interventions, whether offered individually or in a group setting, may offer benefit to people seeking therapy for any number of concerns.” – Manuel A. Manotas

 

Psychotherapy is an interpersonal transaction. Its effectiveness in treating the ills of the client is to some extent dependent upon the chemistry between the therapist and the client, termed the therapeutic alliance. Research has demonstrated that there is a positive relationship with moderate effect sizes between treatment outcomes and the depth of the therapeutic alliance.

 

There are also other factors that may be important for successful therapy. The client’s engagement in the process as well as the therapists interpersonal skills may also be important ingredients in producing successful therapeutic outcomes. There are also important social factors present particularly when the therapy is provided in groups. In addition, formal and informal practice effects are involved. There is little known, however, of the role of these components of therapy on the effectiveness of treatment for mental health issues such as depression.

 

In today’s Research News article “The Contribution of Common and Specific Therapeutic Factors to Mindfulness-Based Intervention Outcomes.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874060/ )  Canby and colleagues recruited patients diagnosed with mild to severe depression and randomly assigned them to receive once a week for 8 weeks, 3 hour sessions of either focused meditation, open monitoring meditation or Mindfulness-Based Cognitive Therapy (MBCT) which contains both focused and open monitoring meditation practices. Before and after the 8-weeks of practice and 3 months later they were measured for empathy, therapeutic alliance, formal and informal mindfulness practices, depression, anxiety, stress, mindfulness, and group therapeutic factors in group therapy: instillation of hope, secure emotional expression, awareness of relational impact, and social learning. Finally, they received structured interviews exploring mindfulness practices and impact of treatment.

 

They found that the over treatment and follow-up the groups had significantly increased mindfulness and significantly decreased anxiety, depression and stress. They found that the higher the ratings of the instructors. the ratings of the groups and the amounts of formal meditation practice the greater the changes. In general, the instructor and group factors had stronger relationships to the psychological improvements than the amount of formal meditation and the amount of informal meditation practice had no relationship with the improvements. The analysis of the structured interviews indicated that the participants found the instructor and group factors including bonding, instilling hope, and expressing feelings were important to their improvements.

 

These results are interesting replicate previous findings of mindfulness-based therapies produce improvements in anxiety, depression, and stress. The results suggest that mindfulness-based therapies have complex effects and changes in mindfulness may be less important than the social environment produced by the instructor and the group. These social factors may account for a large proportion of the benefits to the participants. These results are important as they suggest that empathizing the social interactions involved in therapy may improve the impact of the therapy on the patients’ psychological well-being.

 

So, mindfulness-based therapies benefits are greatly affected by social factors in therapy.

 

“Mindfulness’ strength is in helping us to see more clearly, by giving us the room to not be so quickly reactive. And over time the event does not have to jump to emotional distress, like a grasshopper leaping over a stream.” – Barry 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

 

Canby, N. K., Eichel, K., Lindahl, J., Chau, S., Cordova, J., & Britton, W. B. (2021). The Contribution of Common and Specific Therapeutic Factors to Mindfulness-Based Intervention Outcomes. Frontiers in psychology, 11, 603394. https://doi.org/10.3389/fpsyg.2020.603394

 

Abstract

While Mindfulness-Based Interventions (MBIs) have been shown to be effective for a range of patient populations and outcomes, a question remains as to the role of common therapeutic factors, as opposed to the specific effects of mindfulness practice, in contributing to patient improvements. This project used a mixed-method design to investigate the contribution of specific (mindfulness practice-related) and common (instructor and group related) therapeutic factors to client improvements within an MBI. Participants with mild-severe depression (N = 104; 73% female, M age = 40.28) participated in an 8-week MBI. Specific therapeutic factors (formal out-of-class meditation minutes and informal mindfulness practice frequency) and social common factors (instructor and group ratings) were entered into multilevel growth curve models to predict changes in depression, anxiety, stress, and mindfulness at six timepoints from baseline to 3-month follow-up. Qualitative interviews with participants provided rich descriptions of how instructor and group related factors played a role in therapeutic trajectories. Findings indicated that instructor ratings predicted changes in depression and stress, group ratings predicted changes in stress and self-reported mindfulness, and formal meditation predicted changes in anxiety and stress, while informal mindfulness practice did not predict client improvements. Social common factors were stronger predictors of improvements in depression, stress, and self-reported mindfulness than specific mindfulness practice-related factors. Qualitative data supported the importance of relationships with instructor and group members, involving bonding, expressing feelings, and instilling hope. Our findings dispel the myth that MBI outcomes are exclusively the result of mindfulness meditation practice, and suggest that social common factors may account for much of the effects of these interventions. Further research on meditation should take into consideration the effects of social context and other common therapeutic factors.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874060/

 

Mindfulness is Associated with Lower Stress and Improved Parkinson’s Disease Symptoms

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Mindfulness is Associated with Lower Stress and Improved Parkinson’s Disease Symptoms

 

By John M. de Castro, Ph.D.

 

“By training your mind to be present, you can feel the benefits in your everyday life. It can be particularly helpful when facing challenges that Parkinson’s brings.” – Parkinson’s UK

 

Parkinson’s Disease (PD) is an incurable progressive degenerative disease of the central nervous system. The condition is caused by the death of nerve cells in the brain that produce the neurotransmitter dopamine. There are around seven million people worldwide and one million people in the U.S. living with PD and about 60,000 people are diagnosed with PD every year. PD is associated with aging as the vast majority of patients are diagnosed after age 50. In fact, it has been speculated that everyone would eventually develop PD if they lived long enough.

 

Its physical symptoms include resting tremor, slow movements, muscle rigidity, problems with posture and balance, loss of automatic movements, and slurring of speech. PD itself is not fatal but is often associated with related complications which can reduce life expectancy, such as falls, choking, and cardiovascular problems. PD also has psychological effects, especially cognitive decline, anxiety, and depression. Balance is a particular problem as it effects mobility and increases the likelihood of falls, restricting activity and reducing quality of life.

 

There are no cures for Parkinson’s Disease (PD) or even treatments to slow its progression. There are only treatments that can produce symptomatic relief. So, there is a need to discover new and different treatments. Mindfulness training has been found to improve the psychological symptoms and the quality of life with PD patients.  If mindfulness is indeed a help to PD patients, then the relationship between mindfulness and PD symptoms should be present in everyday, real world, patients.

 

In today’s Research News article “Stress and mindfulness in Parkinson’s disease – a survey in 5000 patients.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7813889/ ) van der Heide and colleagues sent online surveys to Parkinson’s Disease (PD) patients and normal control participants. The surveys contained measures of mindfulness, self-compassion, perceived stress, rumination, Parkinson’s anxiety, and additional questions about PD symptoms, stress, and other factors associated with the disease.

 

They found that the Parkinson’s Disease (PD) patients in comparison to controls had significantly lower levels of mindfulness and significantly higher levels stress, and depression. They also found that the higher the levels of stress that the PD patients reported the lower the levels of mindfulness, self-compassion and quality of life and the higher the levels of rumination and disease severity. When the patients were asked what strategies, they used to reduce stress they reported that they used exercise and mindfulness most often. The patients reported that mindfulness improved all of their symptoms, including tremor, gait, slowness of movement, dyskinesia, anxiety, depression, and sleeping problems. In addition, the more the patients used mindfulness, the better their symptoms.

 

These are interesting but correlational findings, so causation cannot be determined. But previous studies have shown the mindfulness training reduces stress and improves the symptoms of Parkinson’s Disease (PD). So, the present associations are probably due to causal connections between mindfulness, stress, and PD symptoms. It appears that stress exacerbates PD symptoms and mindfulness reduces stress and PD symptoms. This further suggests that mindfulness practices should be taught to PD patients. This potentially would improve their well-being and reduce their suffering.

 

So, mindfulness is associated with lower stress and improved Parkinson’s Disease symptoms.

 

“well-structured mindfulness programs have been proven to be quite effective in areas that directly affect Parkinson’s, such as reducing stress levels, combating depression, and refining body image.” – Matt Zepelin

 

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

 

van der Heide, A., Speckens, A., Meinders, M. J., Rosenthal, L. S., Bloem, B. R., & Helmich, R. C. (2021). Stress and mindfulness in Parkinson’s disease – a survey in 5000 patients. NPJ Parkinson’s disease, 7(1), 7. https://doi.org/10.1038/s41531-020-00152-9

 

Abstract

Many Parkinson’s disease (PD) patients notice that motor symptoms worsen during stress, and experience stress-related neuropsychiatric symptoms such as anxiety and depression. Here we investigated which personal and disease characteristics are associated with perceived stress in PD, which PD symptoms are sensitive to stress, and we assessed self-reported benefits of stress-reducing strategies such as mindfulness. We sent an online survey to the Fox Insight cohort (n = 28,385 PD patients, n = 11,413 healthy controls). The survey included specific questions about the influence of stress on PD symptoms, use of stress-reducing strategies, and several validated scales measuring perceived stress, anxiety, dispositional mindfulness, rumination, and self-compassion. We received completed surveys from 5000 PD patients and 1292 controls. Patients perceived more stress than controls. Among patients, stress was correlated with increased rumination (R = 0.65), lower quality of life (R = −0.56), lower self-compassion (R = −0.65), and lower dispositional mindfulness (R = −0.48). Furthermore, patients indicated that stress significantly worsened both motor symptoms – especially tremor – and non-motor symptoms. Physical exercise was most frequently used to reduce stress (83.1%). Mindfulness was practiced by 38.7% of PD respondents, who noticed improvement in both motor and non-motor symptoms. Among non-users, 43.4% were interested in gaining mindfulness skills. We conclude that PD patients experience greater levels of stress than controls, and that stress worsens both motor and non-motor symptoms. Mindfulness may improve PD symptom severity, with the strongest effects on anxiety and depressed mood. These findings justify further controlled studies to establish the merits of mindfulness and other stress-alleviating interventions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7813889/