Depression

Tai Chi Practice Improves the Symptoms of Multiple Diseases

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Tai Chi Practice Improves the Symptoms of Multiple Diseases

 

By John M. de Castro, Ph.D.

 

“In addition to easing balance problems, and possibly other symptoms, tai chi can help ease stress and anxiety and strengthen all parts of the body, with few if any harmful side effects.” Peter Wayne

 

Tai Chi is an ancient mindfulness practice involving slow prescribed movements. It is gentle and completely safe, can be used with the elderly and sickly, is inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, it can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Indeed, studies have shown that Tai Chi practice is effective in improving the symptoms of many different diseases. The evidence is accumulating. So, it makes sense to step back and summarize what has been learned about the effectiveness of different Tai Chi practices for different disease conditions.

 

In today’s Research News article “.Clinical Evidence of Tai Chi Exercise Prescriptions: A Systematic Review” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972853/ ) Huang and colleagues review and summarize the published randomized controlled trials on the effectiveness of different Tai Chi practices for different disease conditions. They identified 139 published randomized controlled trials utilizing a number of different Tai Chi styles and numbers of forms. Yang style was by far the most frequent style and 24 forms was the most frequent number of forms employed.

 

They report that the published research found that Tai Chi practice produced significant improvement in the symptoms of musculoskeletal system or connective tissue diseases such as osteoarthritis, fibromyalgia, and chronic low back pain.; on circulatory system diseases such as hypertension, stroke, coronary heart disease, and chronic heart failure; on mental and behavioral disorders such as depression, cognitive impairment, and intellectual disabilities; on nervous system diseases such as Parkinson’s disease, dementia, and sleep disorders; on chronic obstructive pulmonary disease (COPD); on endocrine, nutritional, or metabolic diseases such as type 2 diabetes and metabolic syndrome; on the physical and mental state of cancer patients, and on traumatic brain injury and urinary tract disorders; on balance control and flexibility and falls in older adults.

 

These are remarkable findings. Tai Chi practice appears to be a safe and effective treatment for the symptoms of a wide variety of diseases. It doesn’t cure the disease. Rather if alleviates the symptoms. It is not known the mechanisms by which Tai Chi has these benefits. Future research needs to further explore what facets or effects of Tai Chi practice are responsible for the disease symptom improvements.

 

So, Tai Chi practice improves the symptoms of multiple diseases.

 

“Tai Chi and Qigong are evidence-based approaches to improve health-related quality of life, and they may be effective for a range of physical health conditions.” – Ryan Abbott

 

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

 

Huang, J., Wang, D., & Wang, J. (2021). Clinical Evidence of Tai Chi Exercise Prescriptions: A Systematic Review. Evidence-based Complementary and Alternative Medicine : eCAM, 2021, 5558805. https://doi.org/10.1155/2021/5558805

 

Abstract

Objectives

This systematic review aims to summarize the existing literature on Tai Chi randomized controlled trials (RCTs) and recommend Tai Chi exercise prescriptions for different diseases and populations.

Methods

A systematic search for Tai Chi RCTs was conducted in five electronic databases (PubMed, Cochrane Library, EMBASE, EBSCO, and Web of Science) from their inception to December 2019. SPSS 20.0 software and Microsoft Excel 2019 were used to analyze the data, and the risk of bias tool in the RevMan 5.3.5 software was used to evaluate the methodological quality of RCTs.

Results

A total of 139 articles were identified, including diseased populations (95, 68.3%) and healthy populations (44, 31.7%). The diseased populations included the following 10 disease types: musculoskeletal system or connective tissue diseases (34.7%), circulatory system diseases (23.2%), mental and behavioral disorders (12.6%), nervous system diseases (11.6%), respiratory system diseases (6.3%), endocrine, nutritional or metabolic diseases (5.3%), neoplasms (3.2%), injury, poisoning and certain other consequences of external causes (1.1%), genitourinary system diseases (1.1%), and diseases of the eye and adnexa (1.1%). Tai Chi exercise prescription was generally classified as moderate intensity. The most commonly applied Tai Chi style was Yang style (92, 66.2%), and the most frequently specified Tai Chi form was simplified 24-form Tai Chi (43, 30.9%). 12 weeks and 24 weeks, 2-3 times a week, and 60 min each time was the most commonly used cycle, frequency, and time of exercise in Tai Chi exercise prescriptions.

Conclusions

We recommend the more commonly used Tai Chi exercise prescriptions for different diseases and populations based on clinical evidence of Tai Chi. Further clinical research on Tai Chi should be combined with principles of exercise prescription to conduct large-sample epidemiological studies and long-term prospective follow-up studies to provide more substantive clinical evidence for Tai Chi exercise prescriptions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972853/

 

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

 

jenny.rickardsson@ki.se

 

Improve Psychological Well-Being in Covid-19 Lockdown with Online Mindfulness Training

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Improve Psychological Well-Being in Covid-19 Lockdown with Online Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“mindfulness is one tool that can help promote mental wellness throughout the COVID-19 pandemic and beyond.” – Julie Dunn

 

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

 

In today’s Research News article “A Brief Online Mindfulness-Based Group Intervention for Psychological Distress Among Chinese Residents During COVID-19: a Pilot Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972025/ ) Zhang and colleagues recruited online Chinese adults who were staying at home during the Covid-19 lockdown. They were randomly assigned to a wait-list control condition or to receive online mindfulness training with an abbreviated group version of Mindfulness-Based Stress Reduction (MBSR). The training consisted of a 2-hour training followed by 13 days of 1.5 hours per day of practice separated into 3 30-minute sessions. Once training was complete for the mindfulness group, the wait-list group received the same 2-week mindfulness training. They were measured before and after the training for mindfulness and psychological distress, including somatization, depression, and anxiety.

 

They found that in comparison to baseline and the wait-list control group, the mindfulness training produced significantly higher mindfulness levels and significantly lower levels of psychological distress, including somatization, depression, and anxiety levels. The wait-list group after they received the mindfulness training had similar significant improvements in their psychological well-being.

 

These results are consistent with previous findings that mindfulness training produces decreases in distress, including somatization, depression, and anxiety. But the present study demonstrates that online mindfulness training can produce similar benefits for individuals locked down during a pandemic. Since the training is online, it could be made available to widespread individuals at low cost and thus would be ideal for maintaining the psychological health of people in lock down.

 

So, improve psychological well-being in covid-19 lockdown with online mindfulness training.

 

“In many ways, COVID-19 has shown us just how connected and how much the same we really are. All of us—and some of us more than others—are vulnerable to getting sick and none of us wants to become ill. Viewed through the lens of interconnectedness, practicing mindfulness as the coronavirus spreads is not only a way to care for ourselves but a way to care for everyone around us.” – Kelly Barron

 

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

 

Hui Zhang, Anao Zhang, Chengbin Liu, Jian Xiao, Kaipeng Wang. A Brief Online Mindfulness-Based Group Intervention for Psychological Distress Among Chinese Residents During COVID-19: a Pilot Randomized Controlled Trial, Mindfulness (N Y) 2021 Mar 18 : 1–11. doi: 10.1007/s12671-021-01618-4

 

Abstract

Objectives

The coronavirus (COVID-19) global pandemic has increased psychological distress among the general population. The objective of this study is to evaluate a mindfulness-based intervention for psychological distress among Chinese residents during COVID-19.

Methods

This study used a switching replications design to test the feasibility and efficacy of a brief online mindfulness-based intervention for Chinese residents’ psychological distress. Fifty-one residents in the Hubei province were randomly allocated to two groups (experimental group and waitlist control group) with three waves of measurement at time 1, time 2, and time 3 for changes in mindfulness and psychological distress.

Results

In addition to significant within-group improvements over time for both groups, OLS linear regression with full information likelihood estimation revealed statistically significant between-group treatment effects across outcome domains, including mindfulness awareness, b = 2.84, p < 0.001, g = 6.92, psychological distress, b = −21.33, p < 0.001, g = 6.62, somatic symptoms, b = −6.22, p < 0.001, g = 4.42, depressive symptoms, b = −7.16, p < 0.001, g = 5.07, and anxiety symptoms, b = −8.09, p < 0.001, g = 6.84.

Conclusions

Results suggest that a brief online mindfulness-based intervention can be a feasible and promising intervention for improving mindfulness and decreasing psychological distress among Chinese residents staying at home during the COVID-19 outbreak. The study used a small convenience sample which led to a concern of external generalizability and with limited evaluation of long-term change.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972025/

 

Reduce Stress and Improve Healthcare Worker Well-Being with Mindfulness

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Reduce Stress and Improve Healthcare Worker Well-Being with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The therapeutic applications of mindfulness are considerable and its impact on clinical practice itself appears to be profound. Indeed, several commentators characterize mindfulness as inciting nothing short of a revolution in the way we conduct our mental lives both within the clinic and without.” – Matias P. Raski

 

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. It is estimated that over 45% of healthcare workers experience burnout. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout, in fact, it is a threat to the entire healthcare system. Currently, over a third of healthcare workers report that they are looking for a new job. Hence, burnout contributes to the shortage of doctors and nurses.

 

Preventing burnout has to be a priority. Unfortunately, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout. So, it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices have been shown to reduce the psychological and physiological responses to stress and improve well-being. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, improving sleep and reduce stress.

 

In today’s Research News article “Reducing stress and promoting well-being in healthcare workers using mindfulness-based cognitive therapy for life.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903308/ ) Strauss and colleagues recruited healthy adult healthcare workers and randomly assigned them to either a wait-list control condition or to receive 8 weekly 2-hour group sessions of Mindfulness-Based Cognitive Therapy (MBCT) along with 40 minutes of daily practice.  MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior. MBCT was developed specifically to treat depression. For this study it was modified to be more appropriate for the general population. The participants were measured before and after training for attendance and practice amounts, stress, anxiety, depression, mental well-being, burnout, presenteeism, compassion, and mindfulness.

 

They found that in comparison to baseline and the wait-list control group after Mindfulness-Based Cognitive Therapy (MBCT) there were significant increases in mindfulness, mental well-being, and self-compassion, and significant decreases in anxiety, depression, and stress. They also found that the greater the increases in mindfulness and self-compassion produced by MBCT the greater the increase in mental well-being and the decrease in stress.

 

These findings are similar to those found in previous research with different groups that Mindfulness training increases well-being and self-compassion, and decreases anxiety, depression, and stress. Hence, mindfulness training improves the psychological well-being of healthcare workers. This should help protect them against burnout and increase their resilience in the face of high workplace stress.

 

So, reduce stress and improve healthcare worker well-being with mindfulness.

 

“As we become more adept at dwelling in the living presence of our own experience, we begin to connect more deeply with patients, as well as co-workers and family members. Mindfulness practice provides a simple and practical way to recapture the calling of healing.” – Penn Medicine

 

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

 

Strauss, C., Gu, J., Montero-Marin, J., Whittington, A., Chapman, C., & Kuyken, W. (2021). Reducing stress and promoting well-being in healthcare workers using mindfulness-based cognitive therapy for life. International journal of clinical and health psychology : IJCHP, 21(2), 100227. https://doi.org/10.1016/j.ijchp.2021.100227

 

Background/Objective

Healthcare workers play a critical role in the health of a nation, yet rates of healthcare worker stress are disproportionately high. We evaluated whether mindfulness-based cognitive therapy for life (MBCT-L), could reduce stress in healthcare workers and target a range of secondary outcomes. Method: This is the first parallel randomised controlled trial of MBCT-L. Participants were NHS workers, who were randomly assigned (1:1) to receive either MBCT-L or wait-list. The primary outcome was self-reported stress at post-intervention. Secondary variables were well-being, depression, anxiety, and work-related outcomes. Mixed regressions were used. Mindfulness and self/other-compassion were explored as potential mechanisms of effects on stress and wellbeing. Results: We assigned 234 participants to MBCT-L (n = 115) or to wait-list (n = 119). 168 (72%) participants completed the primary outcome and of those who started the MBCT-L 73.40% (n = 69) attended the majority of the sessions. MBCT-L ameliorated stress compared with controls (B = 2.60, 95% CI = 1.63‒3.56; d = -0.72; p < .0001). Effects were also found for well-being, depression and anxiety, but not for work-related outcomes. Mindfulness and self-compassion mediated effects on stress and wellbeing. Conclusions: MBCT-L could be an effective and acceptable part of a wider healthcare workers well-being and mental health strategy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903308/

 

The Well-Being and Quality of Life in Cancer Patients are Related to Spirituality

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The Well-Being and Quality of Life in Cancer Patients are Related to Spirituality

 

By John M. de Castro, Ph.D.

 

“Many patients with cancer rely on spiritual or religious beliefs and practices to help them cope with their disease. This is called spiritual coping.” – National Cancer Institute

 

A cancer diagnosis has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing 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 surviving cancer is a challenge and there are no simple treatments for these psychological sequelae of cancer.

 

Religion and spirituality become much more important to people when they survive cancer. It is thought that people take comfort in the spiritual when facing mortality. Hence, spirituality may be useful for cancer patients to cope with their illness and the psychological difficulties resulting from the disease. Thus, there is a need to study the relationships of spirituality on the well-being and quality of life of cancer patients.

 

In today’s Research News article “Association between spiritual well-being, quality of life, anxiety and depression in patients with gynecological cancer in China.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7793354/) Chen and colleagues recruited women with primary gynecological cancer and had them complete measures of quality of life with cancer, global health, spiritual well-being, anxiety, and depression.

 

They found that the higher the levels of spiritual well-being the higher the levels of global health and quality of life and the lower the levels of depression and anxiety. Multiple regression analysis revealed that religion, depression, anxiety and quality of life were the strongest predictors of spiritual well-being.

 

These findings are correlational and as a result causation cannot be determined. Regardless, the results clearly show that spiritual well-being is significantly related to better health and quality of life and lower psychological problems in women with primary gynecological cancer. These findings are similar to those seen with other forms of cancer that spirituality is associated with the patient’s quality of life and well-being. This raises the possibility that promoting spirituality in cancer patients may improve their physical and psychological well-being. It remains for future research to explore this possibility.

 

So, the well-being and quality of life in cancer patients are related to spirituality.

 

“Consistent associations between spirituality, spiritual well-being, and health outcomes found in published studies highlight the importance of providing spiritual care to enhance cancer patients’ spiritual well-being and address their spiritual needs.” – Yi-Hui Lee

 

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

 

Chen, J., You, H., Liu, Y., Kong, Q., Lei, A., & Guo, X. (2021). Association between spiritual well-being, quality of life, anxiety and depression in patients with gynaecological cancer in China. Medicine, 100(1), e24264. https://doi.org/10.1097/MD.0000000000024264

 

Abstract

The physical and psychological condition of patients with gynaecological cancer has received much attention, but there is little research on spirituality in palliative care. This study aimed to investigate spiritual well-being and its association with quality of life, anxiety and depression in patients with gynaecological cancer. A cross-sectional study was conducted in China in 2019 with 705 patients diagnosed with primary gynaecological cancer. European Organisation for Research and Treatment of Cancer quality of life instruments (EORTC QLQ-SWB32 and EORTC QLQ-C30) and the Hospital Anxiety and Depression Scale were used to measure spiritual well-being, quality of life, anxiety and depression. Univariate and multiple linear regression analyses were performed to examine associations between spiritual well-being, quality of life, anxiety and depression. Functioning scales and global health status were positively correlated with spiritual well-being (P < .05). Anxiety and depression were negatively correlated with spiritual well-being (P < .05). Depression (−0.362, P < .001) was the strongest predictor of Existential score. Anxiety (−0.522, P < .001) was the only predictor of Relationship with self. Depression (−0.350, P < .001) and Global health (0.099, P = .011) were the strongest predictors of Relationship with others. Religion (−0.204, P < .001) and Depression (−0.196, P < .001) were the strongest predictors of Relationship with someone or something greater. Global health (0.337, P < .001) and Depression (−0.144, P < .001) were the strongest predictors of Global-SWB. Well spiritual well-being is associated with lower anxiety and depression, and better quality of life. Health providers should provide more spiritual care for non-religious patients and combine spiritual care with psychological counselling to help patients with gynaecological cancer, especially those who have low quality of life or severe symptoms, or experience anxiety or depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7793354/

 

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/