Depression

Decrease Stress’ Ability to Produce Depression with Mindfulness

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Decrease Stress’ Ability to Produce Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness has become a popular way to help people manage their stress and improve their overall well-being — and a wealth of research shows it’s effective.” – American Psychological Association

 

In the modern world education is a key for success. Where a high school education was sufficient in previous generations, a college degree is now required to succeed in the new knowledge-based economies. There is a lot of pressure on university students to excel so that they can get the best jobs after graduation. As a result, parents and students are constantly looking for ways to improve student performance in school. The primary tactic has been to pressure the student and clear away routine tasks and chores so that the student can focus on their studies. But, this might in fact be counterproductive as the increased pressure can actually lead to stress, depression, and anxiety which can impede the student’s mental health, well-being, and school performance.

 

It is, for the most part, beyond the ability of the individual to change the environment to reduce stress, so it is important that methods be found to reduce the college students’ responses to stress; to make them more resilient when high levels of stress occur. Contemplative practices including meditation, mindfulness training, and yoga practice have been shown to reduce the psychological and physiological responses to stress. So, it would seem important to examine various techniques to relieve the stress and its consequent symptoms of depression in college students.

 

In today’s Research News article “Moderating Effect of Mindfulness on the Influence of Stress on Depression According to the Level of Stress among University Students in South Korea.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7560191/ ) Park and colleagues recruited non-freshman college students and had them complete measures of life stress, mindfulness, and depression. These data were then subjected to multiple regression analysis.

 

They found that stress and depression were significantly higher in female than male students, in low economic status students and in students with low subjective health. They report that the higher the levels of stress, the higher the levels of depression and the higher the levels of mindfulness, the lower the levels of both stress and depression. They also found that high levels of mindfulness interrupted the relationship between stress and depression in the students with low levels of stress but not in the students with high levels of stress.

 

These results are interesting but conclusions must be tempered with the understanding that the study was correlative and causation cannot be determined. It would seem to make sense that money and health issues would be associated with greater stress and depression levels. The fact that stress and depression were higher in female students has also been reported in multiple studies. So, life conditions and gender are important factors in generating stress and depression.

 

It has been well established in prior research that mindfulness training lowers stress and depression. So, the associations seen in the present study are likely due to causal relations. This suggests the mindfulness lowers depression directly and also by reducing the effects of low levels of stress on depression. These results suggest that mindfulness training may be effective, then, for improving the mental health of college students.

 

So, decrease stress’ ability to produce depression with mindfulness.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Park, K. H., Kim, H., & Kim, J. (2020). Moderating Effect of Mindfulness on the Influence of Stress on Depression According to the Level of Stress among University Students in South Korea. International journal of environmental research and public health, 17(18), 6634. https://doi.org/10.3390/ijerph17186634

 

Abstract

Stress and depression are representative of the mental health problems of university students worldwide. This cross-sectional study explored the moderating effect of mindfulness on the influence of stress on depression according to the degree of life stress. The participants were 738 university students in years 2–4 in five 4-year universities in South Korea. Depression was positively correlated with stress and negatively with mindfulness at a statistically significant level. In multiple regression analysis, stress was found to have an effect by increasing depression, and mindfulness by relieving depression. In the moderated multiple regression analysis, mindfulness had a moderating effect on the impact of stress on depression only in low-stress groups, showing that the interaction of stress with mindfulness was significantly negative (β = −0.11, t = −2.52, p = 0.012) and the inclusion of this interaction significantly increased the explanatory power for depression variation (F change 6.36, p = 0.012) in the full model. In conclusion, we suggest considering stress levels in the development of mindfulness-based intervention strategies to effectively manage the depression of university students.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7560191/

 

Mindfulness Improves Mental Health in Spite of the Covid-19 Pandemic

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Mindfulness Improves Mental Health in Spite of the Covid-19 Pandemic

 

By John M. de Castro, Ph.D.

 

“Practicing mindfulness is an easy, free and natural way to boost your anxiety coping skills. Not only that, but it also helps our ability to manage emotions, and with some aspects of our physical health. If the coronavirus lockdowns has left you with some extra time, make this crisis into an opportunity for you to start (or strengthen) a healthy habit – mindfulness practice.” – Paul Green

 

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 “Positive Impact of Mindfulness Meditation on Mental Health of Female Teachers during the COVID-19 Outbreak in Italy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7559290/ ) Matiz and colleagues recruited female school teachers in Italy and provided them with a mindfulness training program that was scheduled for 8 weekly 2-hour meetings with 30 minutes of daily home practice. But, the lockdown in Italy from Covid-19 occurred a few weeks into the program. So, the last few weeks of mindfulness training was provided online. They were measured before and after training for mindfulness, empathy, personality, interoceptive awareness, psychological well-being, anxiety, depression, teacher burnout, and evaluation of the mindfulness training course. They separated the teachers into high and low resilience groups based upon their personality resilience score.

 

They found that from baseline to follow-up both groups increased in mindfulness and the personality factors of cooperativeness and self-transcendence, but the high resilience group had significantly greater increases. Both groups increased in psychological well-being but the low resilience group had a significantly greater increase in the positive relations with others subscale. Both groups decreased in anxiety and depression but the low resilience group had significantly greater decreases. Both groups had significant improvements in empathy, interoceptive awareness, and teacher burnout.

 

This is an interesting natural experiment with the Covid-19 pandemic lockdown intervening in the middle of an otherwise simple study of mindfulness training effects on school teachers’ mental health. Obviously, there is no control condition. So, the before and after training results are confounded by the lockdown. As a result, no clear conclusions can be reached. But, the Covid-19 lockdown had to have been very upsetting to the teachers. So, a decrease in their mental well-being would be expected. In prior studies it has been well established that mindfulness training lowers anxiety depression, and burnout and increases well-being, interoceptive awareness and empathy. Indeed, in the present study after the mindfulness course the teachers’ mental well-being was improved. So, mindfulness training appears to improve the mental health of the teachers in spite of the inferred negative effect of the pandemic lockdown. In addition, these effects appear to be modulated by the teachers’ levels of resilience.

 

So, mindfulness improves mental health in spite of the Covid-19 pandemic.

 

“Fear leaves people feeling helpless and exhausted, seeing that “we’re in it together” helps ease the emotional burden we feel and encourages more agency—the sense that we can do something constructive to fight the pandemic.” – Jill Suttie

 

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

 

Matiz, A., Fabbro, F., Paschetto, A., Cantone, D., Paolone, A. R., & Crescentini, C. (2020). Positive Impact of Mindfulness Meditation on Mental Health of Female Teachers during the COVID-19 Outbreak in Italy. International journal of environmental research and public health, 17(18), 6450. https://doi.org/10.3390/ijerph17186450

 

Abstract

The Covid-19 pandemic and subsequent public health measures were shown to impact negatively on people’s mental health. In particular, women were reported to be at higher risk than men of developing symptoms of stress/anxiety/depression, and resilience was considered a key factor for positive mental health outcomes. In the present study, a sample of Italian female teachers (n = 66, age: 51.5 ± 7.9 years) was assessed with self-report instruments one month before and one month after the start of the Covid-19 lockdown: mindfulness skills, empathy, personality profiles, interoceptive awareness, psychological well-being, emotional distress and burnout levels were measured. Meanwhile, they received an 8-week Mindfulness-Oriented Meditation (MOM) course, through two group meetings and six individual video-lessons. Based on baseline personality profiles, analyses of variance were performed in a low-resilience (LR, n = 32) and a high-resilience (HR, n = 26) group. The LR and HR groups differed at baseline in most of the self-report measures. Pre–post MOM significant improvements were found in both groups in anxiety, depression, affective empathy, emotional exhaustion, psychological well-being, interoceptive awareness, character traits and mindfulness levels. Improvements in depression and psychological well-being were higher in the LR vs. HR group. We conclude that mindfulness-based training can effectively mitigate the psychological negative consequences of the Covid-19 outbreak, helping in particular to restore well-being in the most vulnerable individuals.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7559290/

 

Reduce Anxiety in Women Undergoing Fertility Treatment with Yoga

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Reduce Anxiety in Women Undergoing Fertility Treatment with Yoga

 

By John M. de Castro, Ph.D.

 

“yoga is a relaxing activity. And there are some researched benefits regarding yoga, infertility, and the exercise’s ability to help couples release mental stress and physical tension.” – Ashley Marcin

 

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

 

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

 

In today’s Research News article “Effect of Yoga on Psychological Distress among Women Receiving Treatment for Infertility.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336944/ ) Dumbala and colleagues review and summarize the published research studies on the effectiveness of yoga practice for the relief of the psychological symptoms produced by infertility.

 

They identified 3 published research studies all of which found that yoga practice reduced anxiety levels in women being treated for infertility. They also report that the research found that yoga improved the quality of life and reduced depression levels in these women. It has previously been shown that yoga practice reduces anxiety and depression and improves quality of life in a wide variety of healthy and ill individuals. The present review demonstrates that these benefits also extend to women being treated for infertility. The review and the included studies did not study whether yoga increased the likelihood of conception. But improving the psychological state of these women could only be helpful.

 

So, reduce anxiety in women undergoing fertility treatment with yoga.

 

“Yoga also offers a safe space for us to work through challenge and build resilience. It allows us to sit with discomfort by challenging us to hold a pose longer than we’d like, knowing it’s temporary. This is a valuable skill, not only for the fertility process, but it also helps prepare us for birth and parenthood (which combine discomfort, joy, and everything in between!)” – Kate Potvin

 

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

 

Dumbala, S., Bhargav, H., Satyanarayana, V., Arasappa, R., Varambally, S., Desai, G., & Bangalore, G. N. (2020). Effect of Yoga on Psychological Distress among Women Receiving Treatment for Infertility. International journal of yoga, 13(2), 115–119. https://doi.org/10.4103/ijoy.IJOY_34_19

 

Abstract

Background:

Infertility among women has been associated with significant psychological distress, anxiety, and depression. yoga therapy has been found to be useful in the management of anxiety, depression and psychological distress.

Aim:

To review studies on the effectiveness of yoga in reducing psychological distress and improving clinical outcomes among women receiving treatment for infertility.

Methodology:

PubMed, ScienceDirect, and Google Scholar databases were searched for studies using the following inclusion criteria: studies published in English, those published between 2000 and 2018, published in peer-reviewed journals, and those with Yoga as an intervention. Review articles, studies without any yoga interventions for infertility, and male infertility were excluded. The keywords included for the literature search were: Yoga, Mindfulness, Relaxation technique, Stress, Distress, Anxiety, Infertility, In Vitro Fertilization (IVF), and Assisted Reproductive Technology (ART).

Results:

Three studies satisfied the selection criteria. Two studies involved Hatha yoga intervention and one study used structured yoga program. The variables assessed in these studies were: (1) anxiety, (2) depression, (3) emotional distress, and (4) fertility-related quality of life. All the studies reported an improvement in the anxiety scores after yoga intervention.

Conclusion:

Yoga therapy may be potentially useful in improving anxiety scores among women suffering from infertility. More studies are needed in this area to establish role of yoga as an adjuvant during the treatment of infertility.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336944/

 

Improve Mindfulness’ Benefits for Cancer Survivors with Smart-Messaging

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Improve Mindfulness’ Benefits for Cancer Survivors with Smart-Messaging

 

By John M. de Castro, Ph.D.

 

“Cancer is a traumatic event that changes a person’s life. Utilizing mindfulness tools can provide peace and hope. Practicing mindfulness on a daily basis can assist with long term effects of happiness and positivity.” – Erin Murphy-Wilczek

 

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. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. Mindfulness-Based Cognitive Therapy (MBCT) consists of mindfulness training and Cognitive Behavioral Therapy (CBT). During therapy the patient is trained to investigate and alter aberrant thought patterns underlying their reactions to cancer. MBCT has been found to help relieve the symptoms of cancer survivors. It makes sense to explore ways to improve the effectiveness of MBCT for cancer patients.

 

In today’s Research News article “Using smart-messaging to enhance mindfulness-based cognitive therapy for cancer patients: A mixed methods proof of concept evaluation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004102/ ) Wells and colleagues evaluated whether providing text message reminders could enhance the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for the relief of anxiety and depression in cancer patients. They recruited adult cancer patients with mild to moderate anxiety and/or depression and provided them with 8 weekly sessions of MBCT along with 40 minutes daily home practice. The patients could refuse messaging or opt to receive text messages 3 times per week reminding them of their home practice and could request up to 9 more messages per week. They were measured before and after each session and 1 month after the completion of the training for depression, anxiety, and general mental health.

 

They found that 87% of the patients receiving smart messaging completed the 8-week Mindfulness-Based Cognitive Therapy (MBCT) program while only 38% of the non-messaging patients completed the MBCT program. Both groups had significant reductions in anxiety and depression that were maintained 1 month after treatment. But the smart messaging group had significantly greater reductions in depression.

 

This is a proof of concept study which demonstrated that smart messaging could be effectively used in conjunction with Mindfulness-Based Cognitive Therapy (MBCT). The results, though, need to be interpreted with great caution. The patients decided whether to receive the messages or not and very different patients might have opted in compared those that refused the messaging. These differences in the groups could account for the observed differences in participation and depression. But this study establishes that this smart messaging method is feasible with cancer patients with suggestions of improved impact of the therapy. A randomized controlled trial is now needed.

 

So, improve mindfulness’ benefits for cancer survivors with smart-messaging.

 

“It turns out that some of the most difficult elements of the cancer experience are very well-suited to a mindfulness practice.” – Linda Carlson

 

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

 

Wells, C., Malins, S., Clarke, S., Skorodzien, I., Biswas, S., Sweeney, T., Moghaddam, N., & Levene, J. (2020). Using smart-messaging to enhance mindfulness-based cognitive therapy for cancer patients: A mixed methods proof of concept evaluation. Psycho-oncology, 29(1), 212–219. https://doi.org/10.1002/pon.5256

 

Abstract

Objective

Depression and anxiety lead to reduced treatment adherence, poorer quality of life, and increased care costs amongst cancer patients. Mindfulness‐based cognitive therapy (MBCT) is an effective treatment, but dropout reduces potential benefits. Smart‐message reminders can prevent dropout and improve effectiveness. However, smart‐messaging is untested for MBCT in cancer. This study evaluates smart‐messaging to reduce dropout and improve effectiveness in MBCT for cancer patients with depression or anxiety.

Methods

Fifty‐one cancer patients attending MBCT in a psycho‐oncology service were offered a smart‐messaging intervention, which reminded them of prescribed between‐session activities. Thirty patients accepted smart‐messaging and 21 did not. Assessments of depression and anxiety were taken at baseline, session‐by‐session, and one‐month follow‐up. Logistic regression and multilevel modelling compared the groups on treatment completion and clinical effectiveness. Fifteen post‐treatment patient interviews explored smart‐messaging use.

Results

The odds of programme completion were eight times greater for patients using smart‐messaging compared with non‐users, controlling for age, gender, baseline depression, and baseline anxiety (OR = 7.79, 95% CI 1.75 to 34.58, p = .007). Smart‐messaging users also reported greater improvement in depression over the programme (B = ‐2.33, SEB = .78, p = .004) when controlling for baseline severity, change over time, age, and number of sessions attended. There was no difference between groups in anxiety improvement (B = ‐1.46, SEB = .86, p = .097). In interviews, smart‐messaging was described as a motivating reminder and source of personal connection.

Conclusions

Smart‐messaging may be an easily integrated telehealth intervention to improve MBCT for cancer patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004102/

 

Reduce College Students Self-Criticism with Mindful Lovingkindness Training

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Reduce College Students Self-Criticism with Mindful Lovingkindness Training

 

By John M. de Castro, Ph.D.

 

“What’s so amazing about mindfulness practice is we can use mindfulness to be aware when we have those self-critical voices, and we can label that voice as “judging”. We can notice when we have those judging voices because we have a mindfulness practice that allows us to have quite a bit more self-awareness, more ability to regulate emotions, and all of the positive things that come with the mindfulness practice.“ – Diana Winston

 

In the modern world education is a key for success. Where a high school education was sufficient in previous generations, a college degree is now required to succeed in the new knowledge-based economies. There is a lot of pressure on students to excel so that they can get the best jobs after graduation. This stress might in fact be counterproductive as the increased pressure can actually lead to stress and anxiety which can impede the student’s physical and mental health, well-being, and school performance. This is particularly true in very competitive Asian countries like Korea. This can lead to extreme self-criticism where the individual is never happy with themselves producing great unhappiness and psychological distress.

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological reactions to stress and resilience in the face of stress. It has also been found to promote the well-being of college students. Mindfulness has been found to improve self-esteem.  One understudied meditation technique is Loving Kindness Meditation. It is designed to develop kindness and compassion to oneself and others. The individual systematically pictures different individuals from self, to close friends, to enemies and wishes them happiness, well-being, safety, peace, and ease of well-being. Although Loving Kindness Meditation has been practiced for centuries, it has received very little scientific research attention. But it may be effective in counteracting the effects of stress and self-criticism.

 

In today’s Research News article “Psychological and Physiological Effects of the Mindful Lovingkindness Compassion Program on Highly Self-Critical University Students in South Korea.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2020.585743/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1463957_69_Psycho_20201022_arts_A ) Noh and colleagues recruited healthy Korean college students who were high in self-criticism and randomly assigned them to either a wait-list control condition or to receive a Mindful Lovingkindness Compassion program. The training consisted of 8 2-hour sessions over 6 weeks of mindfulness meditation and Loving Kindness Meditation. They were measured before and after training and one and three months later for self-criticism, self-reassurance, mindfulness, compassion, shame, anxiety, depression, fears of compassion, satisfaction with life, and heart rate variability.

 

They found that in comparison to baseline and the wait-list control group, the Mindful Lovingkindness Compassion group had significantly higher self-reassurance, mindfulness, compassion, and satisfaction with life, and significantly lower self-criticism, shame, anxiety, depression, and fears of compassion. These improvements continued to be present 1 and 3 months after the completion of training. In addition, the Mindful Lovingkindness Compassion group had significantly higher heart rate variability.

 

The interpretation of these results has to be tempered with the knowledge that the comparison, control, condition was passive. This opens the study up to a number of potential confoundings. Nevertheless, the results are similar to those of prior research that found that mindfulness training produces higher self-reassurance, compassion, and satisfaction with life, and lower self-criticism, shame, anxiety, and depression. Hence, the current study suggests that Mindful Lovingkindness Compassion training produces improved psychological health in highly self-critical college students. In addition, the increased heart rate variability observed suggests that the trained students had greater physiological relaxation, probably indicating a great resistance to the effects of stress.

 

This is important for the well-being of college students. They are under great pressure to perform especially in Asian countries like Korea. Combining that with high levels of self-criticism is a formula for psychological and physical problems. The kind of mindfulness and loving kindness training employed here appears to be able to markedly counteract the deleterious effects of these forces and produce greater relaxation and overall well-being.

 

So, reduce college students’ self-criticism with Mindful Lovingkindness training.

 

“Self-criticism is an unhelpful habit that can sometimes be destructive and cause emotional ill-health. . . Through practicing mindfulness and self-compassion you can loosen up old self-critical habits that may have been present from childhood and develop a kinder, more appreciative way of being with yourself.” – Linda Hall

 

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

 

Noh S and Cho H (2020) Psychological and Physiological Effects of the Mindful Lovingkindness Compassion Program on Highly Self-Critical University Students in South Korea. Front. Psychol. 11:585743. doi: 10.3389/fpsyg.2020.585743

 

Objectives: Self-critical behavior is especially relevant for university students who face academic and non-academic stressors, leading to negative outcomes such as mental distress and psychopathologies. To address this behavior, mindfulness and compassion are important factors to decrease self-criticism and ensure positive outcomes. This study examined the psychological and physiological effects of an intervention, the Mindful Lovingkindness Compassion Program (MLCP), on highly self-critical university students in South Korea.

Methods: Thirty-eight university students with a high level of self-criticism were assigned to an MLCP group (n = 18) or waitlist (WL) group (n = 20). Self-report measures of self-criticism, self-reassurance, psychological distress, and other mental health variables were completed, and the physiological measure of heart rate variability (HRV) was conducted before and after the intervention with both groups. In addition, 1- and 3-month follow-up assessments were conducted using self-report measurements.

Results: Compared to the WL group, participants in the MLCP group experienced significantly greater reductions in self-criticism and psychological distress, and a greater increase in self-reassurance, mental health, and HRV. The improvements in the self-report measures were maintained when assessed 1 and 3 months later.

Conclusions: MLCP could be a promising intervention for alleviating self-criticism and increasing self-reassurance among self-critical individuals.

https://www.frontiersin.org/articles/10.3389/fpsyg.2020.585743/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1463957_69_Psycho_20201022_arts_A

Improve the Psychological Health of Health Care Professionals with Mindfulness

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Improve the Psychological Health of Health Care Professionals with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The front lines for health care providers may feel overwhelming. . . turning to mindfulness practice can help us settle, help us get out of all that thinking for a moment. We can try to settle down and maybe give ourselves a little rest or see a situation with a little different clarity. “ – Mindful

 

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 the negative psychological consequences of stress in healthcare professionals has to be a priority. 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, and improving sleep. Mindfulness-Based Stress Reduction (MBSR) is a mindfulness training program that was developed to help deal with stress. MBSR  consists of discussion, meditation, yoga and body scan practices. The evidence has been accumulating regarding MBSR’s effectiveness for the treatment of healthcare professionals, so it makes sense to summarize what has been learned.

 

In today’s Research News article “The Effectiveness of Mindfulness-Based Stress Reduction on the Psychological Functioning of Healthcare Professionals: a Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7511255/ ) Kriakous and colleagues review and summarize the published research studies of the benefits of Mindfulness-Based Stress Reduction (MBSR) for the psychological health of healthcare workers. They identified 30 published research studies.

 

They report that the published research studies found that Mindfulness-Based Stress Reduction (MBSR) significantly reduced healthcare workers’ levels of perceived stress, anxiety, and depression and increased mindfulness and self-compassion. Mindfulness practices have been previously reported to decrease perceived stress, anxiety, and depression and increase self-compassion in a wide variety of healthy and ill individuals. The present research summarizes these benefits for stressed healthcare professionals. These benefits of mindfulness training are important for reducing burnout, improving the psychological health of healthcare workers, and maintaining the workforce, and thereby improving the levels of care delivered to patients.

 

So, improve the psychological health of health care professionals with mindfulness.

 

“health care workforce. There is increasing evidence that learning to practice mindfulness can result in decreased burnout and improved well-being. Mindfulness is a useful way of cultivating self-kindness and compassion, including by bringing increased awareness to and acceptance of those things that are beyond our control.” – Kate Fitzpatrick

 

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

 

Kriakous, S. A., Elliott, K. A., Lamers, C., & Owen, R. (2020). The Effectiveness of Mindfulness-Based Stress Reduction on the Psychological Functioning of Healthcare Professionals: a Systematic Review. Mindfulness, 1–28. Advance online publication. https://doi.org/10.1007/s12671-020-01500-9

 

Abstract

Objectives

Burnout and occupational stress are frequently experienced by healthcare professionals (HCPs). Mindfulness-based stress reduction (MBSR) has been found to improve the psychological health outcomes of HCPs. To date, systematic reviews and meta-analyses have primarily focused upon empirical investigations into the reduction of stress amongst HCPs using MBSR and are limited to empirical studies published before December 2019. This systematic review aimed to update the current evidence base and broaden our understanding of the effectiveness of MBSR on improving the psychological functioning of HCPs.

Methods

Three electronic databases (Medline, Psych Info and Web of Science) were searched without time frame restrictions. Quantitative studies included randomised controlled trials, clinical controlled trials, pre-post designs and studies with up to a 12-month follow-up period. All studies included in the review employed a MBSR programme, standardised measures of psychological functioning and qualified HCPs as participants.

Results

Using PRISMA guidelines thirty studies were included in the review. The reviewed literature suggested that MBSR was effective in reducing HCPs experiences of anxiety, depression and stress. MBSR was also found to be effective in increasing HCP levels of mindfulness and self-compassion. However, MBSR did not appear as effective in reducing burnout or improving resilience amongst HCPs. Abbreviated MBSR programmes were found to be as effective as the traditional 8-week MBSR programmes.

Conclusions

MBSR is an effective intervention which can help improve the psychological functioning of HCPs. Recommendations include improving the overall quality of the studies by employing more robust controlled designs with randomisation, increased sample sizes with heterogeneous samples, and making active comparisons between interventions used.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7511255/

 

Distress Is Lower during a COVID-19 Pandemic Lockdown in Mindful People

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Distress Is Lower during a COVID-19 Pandemic Lockdown in Mindful People

 

By John M. de Castro, Ph.D.

 

“During the current pandemic, there is so much uncertainty concerning the future, and many threats to our security (physical, social, emotional, and financial). It is totally natural and normal to feel anxious, fearful, and frustrated. . . Mindfulness can help us acknowledge this situation, without allowing us to be carried away with strong emotions; it can, in turn, help bring ourselves back to a centered calm. Only then can we see more clearly what it is we have control over and what it is that we do not.” – Michigan Medicine

 

Modern living is stressful under the best of conditions. But with the COVID-19 pandemic the levels of stress have been markedly increased. These conditions markedly increase anxiety. This is true for everyone but especially for healthcare workers and people caring for patients with COVID-19 and for people with pre-existing conditions that makes them particularly vulnerable. But it is also true for healthy individuals who worry about infection for themselves or loved ones.

 

The COVID-19 pandemic has also produced considerable economic stress, with loss of employment and steady income. For the poor this extends to high levels of food insecurity. This not only produces anxiety about the present but also for the future. It is important for people to engage in practices that can help them control their responses to the stress and their levels of anxiety. Mindfulness practices have been found routinely to reduce the psychological and physiological responses to stress, reduce anxiety levels, and improve mood.

 

In today’s Research News article “Mindfulness, Age and Gender as Protective Factors Against Psychological Distress During COVID-19 Pandemic.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2020.01900/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1437459_69_Psycho_20200922_arts_A ) Conversano and colleagues solicited adult participants online during a government ordered lockdown and had them complete measures of COVID-19 experiences, mindfulness, psychological distress, and mental illness symptoms.

 

They found strong negative relationships between mindfulness and psychological distress. They found that the higher the levels of mindfulness the lower the levels of psychological distress including somatic symptoms, symptoms of obsessive-compulsive disorder, internalizing symptoms, depression, anxiety, hostility, phobia, paranoia, psychoticism, and sleep disturbance. They also found weak relationships with age and gender such that younger and female participants tended to have higher psychological distress.

 

It needs to be kept in mind that these results are correlational and as such causation cannot be determined. Mindfulness may produce reduced distress or conversely distress may produce reduced mindfulness or some third factor may produce both. Nevertheless, the results show that during a pandemic lockdown that the people who have high levels of mindfulness also have low levels of psychological distress.

 

So, distress is lower during a COVID-19 pandemic lockdown in mindful people.

 

“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 Baron

 

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

 

Conversano C, Di Giuseppe M, Miccoli M, Ciacchini R, Gemignani A and Orrù G (2020) Mindfulness, Age and Gender as Protective Factors Against Psychological Distress During COVID-19 Pandemic. Front. Psychol. 11:1900. doi: 10.3389/fpsyg.2020.01900

 

Objective: Mindfulness disposition is associated with various psychological factors and prevents emotional distress in chronic diseases. In the present study, we analyzed the key role of mindfulness dispositions in protecting the individual against psychological distress consequent to COVID-19 social distancing and quarantining.

Methods: An online survey was launched on March 13, 2020, with 6,412 responses by April 6, 2020. Socio-demographic information, exposure to the pandemic, and quarantining were assessed together with psychological distress and mindfulness disposition. Multivariate linear regression analysis was performed to study the influence of predictive factors on psychological distress and quality of life in Italian responders during the early days of lockdown. Pearson correlations were calculated to study the relationship between mindfulness and psychiatric symptoms.

Results: Multivariate linear regression run on socio-demographics, COVID-19-related variables, and mindfulness disposition as moderators of overall psychological distress showed that mindfulness was the best predictor of psychological distress (β = −0.504; p < 0.0001). High negative correlations were found between mindfulness disposition and the overall Global Severity Index (r = −0.637; p < 0.0001), while moderate to high associations were found between mindfulness and all SCL-90 sub-scales.

Discussion: Findings showed that high dispositional mindfulness enhances well-being and helps in dealing with stressful situations such as the COVID-19 pandemic. Mindfulness-based mental training could represent an effective intervention to stem post-traumatic psychopathological beginnings and prevent the onset of chronic mental disorders.

https://www.frontiersin.org/articles/10.3389/fpsyg.2020.01900/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1437459_69_Psycho_20200922_arts_A

 

Improve Autonomic Nervous System Function and Well-Being in Cancer Survivors with Mind-Body Practices.

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Improve Autonomic Nervous System Function and Well-Being in Cancer Survivors with Mind-Body Practices.

 

By John M. de Castro, Ph.D.

 

“Tai Chi and Qigong are ancient forms of exercise that fit the bill for helping patients with cancer get moving and improve their overall sense of well-being. Tai Chi practice can help with pain conditions, especially pain involving muscles and joints; it can also reduce stress and anxiety and improve the quality of sleep.” – Susan Yaguda

 

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. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress, sleep disturbance, fear, and anxiety and depression. Mind-body practices such as Tai Chi or Qigong, and yoga have been shown to be effective in improving the psychological symptoms occurring in breast cancer patients. These practices work to relieve the emotional distress of cancer survivors.

 

A potential mechanism by which mind-body practices may relieve emotional distress is by altering the balance in the autonomic nervous system. A measure of this balance is Heart Rate Variability (HRV). It refers to the change in the time intervals between consecutive heart beats. Higher levels of HRV are indicative of flexibility in the Autonomic Nervous System and are associated with adaptability to varying environments. Increased heart rate variability signals greater relaxation in the autonomic nervous system with a predominance of parasympathetic (relaxation) activity over sympathetic (activation) activity. This all signals greater physiological relaxation.

 

In today’s Research News article “Mind-Body and Psychosocial Interventions May Similarly Affect Heart Rate Variability Patterns in Cancer Recovery: Implications for a Mechanism of Symptom Improvement.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425257/ ) Larkey and colleagues recruited female breast cancer survivors and randomly assigned them to receive 12 weeks of either Tai Chi or Sham-Tai Chi practice. Sham-Tai Chi used the same movements but did not incorporate breath control or meditative states. They were measured before and after training for fatigue, sleep, and depression and the electrocardiogram was measured and analyzed for Heart Rate Variability (HRV).

 

They found that after Tai Chi Practice, but not Sham-Tai Chi, there were significant reductions in fatigue and depression and significant improvements in sleep. In addition, in the Tai Chi group there was a significant reduction in low coherence Heart Rate Variability (HRV). Also, the greater the change, over training, in high coherence HRV the greater the reduction in depression levels.

 

This study replicates previous findings that Tai Chi practice reduces fatigue, and depression, and improves sleep. And produces changes in Heart Rate Variability (HRV). But this study used a unique control, comparison, condition of Sham-Tai Chi that had the same movements but lacked the breath control and meditative state of true Tai Chi practice. This suggests that it is not the movements of Tai Chi that produces the benefits but the mindfulness components that are essential.

 

The study also presents some evidence as to the mechanism by which Tai Chi practice improves that physical and psychological state of cancer survivors. The observed changes in Heart Rate Variability (HRV) are indicative of greater relaxation in the autonomic nervous system with a predominance of parasympathetic (relaxation) activity over sympathetic (activation) activity. This suggests that Tai Chi practice results in a physiological relaxation that in turn may be responsible for the physical and psychological benefits of the practice.

 

Some advantages of Tai Chi practice include the facts that it is not strenuous, involves slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It can also be practiced without professional supervision and in groups making it inexpensive to deliver and fun to engage in. This makes Tai Chi practice an excellent means to improve the physical and psychological symptoms experienced by cancer survivors.

 

So, improve autonomic nervous system function and well-being in cancer survivors with mind-body practices.

 

“Research in breast cancer patients has shown that tai chi may help to increase strength, balance, flexibility, heart and lung function, [and] feelings of well-being.” – Breast Cancer.org

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

 

Larkey, L., Kim, W., James, D., Kishida, M., Vizcaino, M., Huberty, J., & Krishnamurthi, N. (2020). Mind-Body and Psychosocial Interventions May Similarly Affect Heart Rate Variability Patterns in Cancer Recovery: Implications for a Mechanism of Symptom Improvement. Integrative cancer therapies, 19, 1534735420949677. https://doi.org/10.1177/1534735420949677

 

Abstract

Background:

Advancements in early detection and treatment of cancer have led to increased survival rates and greater need to identify effective supportive care options for resolving symptoms of survivorship. Many non-pharmacological approaches to symptom management during and after cancer treatment involve emotional self-regulation as a central strategy for improving well-being. Identifying commonalities among these strategies’ mechanisms of action may facilitate understanding of what might be useful for optimizing intervention effects. Heart rate variability (HRV) parameters are indicative of improved autonomic nervous system (ANS) balance and resiliency and reduced emotional distress and are thus identified as a mechanism to discuss as a marker of potential for intervention efficacy and a target for optimization.

Methods:

HRV data from 2 studies, 1 examining a mind-body intervention and 1 examining a psychosocial intervention, are presented as a point of discussion about preliminary associations between the interventions, change in HRV, and emotional distress reduction.

Results:

HRV significantly decreased in sympathetic activity in response to a mind-body intervention (Qigong/Tai Chi), and increased vagal tone in response to a psychosocial (storytelling) intervention. In both, these changes in HRV parameters were associated with improved emotional states.

Conclusion:

Our preliminary data suggest that HRV may serve as an important marker of underlying changes that mediate emotional regulation; this observation deserves further investigation. If identified as a worthy target, focusing on interventions that improve HRV within the context of interventions for cancer patients may be important to key outcomes and clinical practice.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425257/

 

Improve Depression in International Students with Positive Coping with Mindfulness

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Improve Depression in International Students with Positive Coping with Mindfulness

 

“with practice, meditation can help many people control how they react to the stress and anxiety that often leads to depression,” – John Denninger

 

By John M. de Castro, Ph.D.

 

Depression affects over 6% of the population. It is common in college students. There is a lot of pressure on college students to excel so that they can get the best jobs after graduation. This can lead to stress, anxiety and depression which can impede the student’s physical and mental health, well-being, and school performance. International students face the additional stress of being immersed in an alien culture and being separated from family and friends. Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail. It is important to determine if mindfulness training can help to relieve depression in international college students.

 

In today’s Research News article “The Mediating Effects of Coping Style on the Effects of Breath Count Mindfulness Training on Depressive Symptoms among International Students in China.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7474765/ ) Gu and colleagues recruited foreign college students in china and randomly assigned them to receive no treatment, but encouraged to exercise, or 8-weeks for 2-hours per week of either normal college counseling or Mindfulness-Based Cognitive Therapy (MBCT) program that emphasized attention to the breath. They were measured before and after training for depression, life events including family life, work and study life, and family and friends’ life, and positive and negative coping. In addition, saliva samples were taken and assayed for cortisol levels.

 

They found that in general international college students had mild levels of depression and that the higher the levels of depression the greater the problems with life events and the lower the coping ability. They found that both mindfulness training and normal counseling, but not exercise, resulted in significant reductions in depression and cortisol levels. In addition, those students who had positive coping styles had greater reductions in depression after mindfulness training than either of the other groups.

 

That mindfulness training can reduce depression, especially with or Mindfulness-Based Cognitive Therapy (MBCT) has been well documented in prior research. Additionally, it found that students with positive coping styles benefited the most from the therapy. Additionally, it found that students with positive coping styles benefited the most from the therapy. In addition, mindfulness training reduced cortisol levels suggesting a reduction in stress levels in these students. Again, mindfulness training has been previously been shown to reduce cortisol levels and stress. The contribution of the present study is that it demonstrates that mindfulness training is effective in reducing stress and depression in international students.

 

It is interesting that MBCT training was no more effective than traditional college counseling. MBCT training was specifically developed to treat depression. So, it is surprising that it was not superior to normal counselling. It is possible that since the students were only mildly depressed in the first place there was limited ability to show improvement creating a floor effect. Indeed, depression index levels at the end of training indicated no depression was present at all following training. Perhaps if the students were more depressed to start with, MBCT training would have a greater opportunity to demonstrate superiority. Nevertheless, it is clear that mindfulness training can reduce the depression found in international students especially in students who have strong positive coping ability.

 

So, improve depression in international students with positive coping with mindfulness.

 

“Depression makes someone more likely to react to life’s setbacks with negative, judgmental thinking, which can lower their mood and trigger a new episode. Mindfulness helps create mental space around these thoughts, enabling people at risk to observe, with kindness, the patterns of the mind that might otherwise drag them down.” – Ed Halliwell

 

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

 

Gu, S., Li, Y., Liang, F., Feng, R., Zeng, Z., & Wang, F. (2020). The Mediating Effects of Coping Style on the Effects of Breath Count Mindfulness Training on Depressive Symptoms among International Students in China. Neural plasticity, 2020, 8859251. https://doi.org/10.1155/2020/8859251

 

Abstract

Mindfulness training has gained popularity in the scientific field and has been proposed as an efficient way for emotional regulation. Mindfulness-based cognitive therapy (MBCT) is designed especially for depressive people in reducing risk of depression relapse and is recommended in national guidelines as a treatment choice for relapse prevention in recurrent depression. The aim of the current study was to investigate the effects of mindfulness training on depressive symptoms of international students and probe into the mediating role of mindfulness in stressful events and depression. In addition, we introduced a new kind of mindfulness training, the breathing exercise-based mindfulness training, which is based on the integration of Buddhism and Daoism. Self-report questionnaires assessing the coping style, abnormal depressive behavior, and stressful live events were completed in 260 international students in China (mean age = 21.4 years). The results showed that (1) many international students showed depression symptoms, (2) stressful life events play a completely mediating role in the initiation of depression and anxiety, and (3) mindfulness training for 8 weeks significantly reduced the depressive symptoms, and it was also related to a positive coping style. This study has certain theoretical significance in exploring the mechanism of the occurrence and development of depression among international students and provides useful tools for this special group of international students. In addition, the international students can also learn Chinese culture through the training. These findings indicate that mindfulness training and positive coping style are interrelated with treating depressive symptoms for international students.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7474765/

 

Improve Mental Health with Mindfulness

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Improve Mental Health with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is recommended as a treatment for people with mental ill-health as well as those who want to improve their mental health and wellbeing.” – Mental Health Foundation

 

Over the last several decades, research and anecdotal experiences have accumulated an impressive evidential case that the development of mindfulness has positive benefits for the individual’s mental, physical, and spiritual life. Mindfulness appears to be beneficial both for healthy people and for people suffering from a myriad of mental and physical illnesses. It appears to be beneficial across ages, from children, to adolescents, to the elderly. And it appears to be beneficial across genders, personalities, race, and ethnicity. The breadth and depth of benefits is unprecedented. There is no other treatment or practice that has been shown to come anyway near the range of mindfulness’ positive benefits.

 

There is a vast array of techniques for the development of mindfulness. It is important to establish the most efficacious techniques and their dosages for the treatment of common mental illnesses. It is particularly important, for reasons of affordability, to employ techniques that qualify for insurance reimbursement.

 

In today’s Research News article “Insurance-Reimbursable Mindfulness for Safety-Net Primary Care Patients: 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/PMC7009938/ ) Gawande and colleagues recruited adults with a non-severe mental health diagnosis and randomly assigned them to receive either a high or low dose mindfulness training. The high dose training consisted of 8 weeks of twice a week 1-hour mindfulness trainings along with daily 30-45 minutes of home practice. The mindfulness training was adapted from Mindfulness-Based Cognitive Therapy (MBCT) including meditation, trauma-informed practices, and self-compassion training. The low dose mindfulness training consisted of a single 60-minute introduction to mindfulness and encouragement to practice mindfulness. They were measured before and after training for anxiety, depression, perceived stress, disease self-efficacy, mindfulness, self-compassion, and perceived control of disease.

 

The most common disorders were anxiety disorders in 37% and depression in 32% of the participants. They found that in comparison to baseline the high dose mindfulness group had significant reductions in anxiety, depression, and perceived stress and significant increases in disease self-efficacy, mindfulness, and self-compassion. The low dose mindfulness group had only a significant reduction in perceived stress. The high dose mindfulness group had significant greater increases in mindfulness and self-compassion and decreases in anxiety than the low dose group. Importantly, the high dose mindfulness intervention was accepted for reimbursement by insurance companies.

 

The study is important in that it demonstrated that insurance would cover the high dose treatment. This is important for making the treatment affordable for insured clients. The study demonstrated as have a variety of other research studies that mindfulness training produces significant reductions in anxiety, depression, and perceived stress and significant increases in disease self-efficacy, mindfulness, and self-compassion. But the study had a unique control condition of a low dose mindfulness training. The high dose intervention produced significant improvements in mental illness disease symptoms that were for the most part better than those of the low dose. This establishes that participant expectancies and positive biases toward mindfulness training cannot account for the improvements. It also demonstrates that greater doses of mindfulness training produce greater benefits for patients with non-severe mental health issues.

 

So, improve mental health with mindfulness.

 

“The research is strong for mindfulness’ positive impact in certain areas of mental health, including stress reduction, emotion and attention regulation, reduced rumination, for reducing mild to moderate depression and anxiety, and preventing depressive relapse.” – Kelle Walsh

 

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

 

Gawande, R., Pine, E., Griswold, T., Creedon, T., Vallejo, Z., Rosenbaum, E., Lozada, A., & Schuman-Olivier, Z. (2019). Insurance-Reimbursable Mindfulness for Safety-Net Primary Care Patients: A Pilot Randomized Controlled Trial. Mindfulness, 10(9), 1744–1759. https://doi.org/10.1007/s12671-019-01116-8

 

Abstract

Objectives:

Mindfulness is effective for reducing anxiety and depression and increasing chronic disease self-management. An accessible, insurance-reimbursable model for implementation in patient-centered medical homes within US healthcare systems has promise for patients with multi-morbid conditions. Clarifying both the dose needed to impact anxiety, depression and self-management, and the design requirements for accessible primary care implementation, is essential.

Methods:

We tested feasibility, acceptability, and effectiveness of Mindfulness Training for Primary Care (MTPC), an 8-week, referral-based, insurance-reimbursable mindfulness program integrated within primary care, compared with a Low-Dose Comparator (LDC), consisting of a 60-minute mindfulness introduction plus referral to community and digital resources. Outcome measures were assessed at baseline and 8 weeks. MTPC is trauma-informed, incorporates mindfulness-oriented behavior change skills, and is designed to target anxiety, depression, stress, and chronic illness selfmanagement. Participants schedule a PCP visit to co-create a self-management action plan during week 6.

Results:

Primary care providers (PCP) referred 344 patients over 14 months. Eighty-one participants with DSM-V anxiety disorders, depressive disorders, trauma- and stress-related disorders participated in this pilot randomized-controlled comparative effectiveness trial [MTPC (n=54); LDC (n=27)]. These data suggest that MTPC was more effective than LDC for reducing anxiety (p=0.01), enhancing mindfulness (p=0.02) and self-compassion (p=0.001), and for catalyzing selfmanagement behavior change through action plan initiation (OR=4.34, p=0.03).

Conclusions:

MTPC was successfully integrated into a health system, was billed to insurance, and was acceptable to a diverse primary care population. Replication with a larger study and further accessibility adaptations are needed to confirm and expand these pilot results.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7009938/