Depression

Improve Smartphone Addiction with Mindfulness

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Improve Smartphone Addiction with Mindfulness

 

By John M. de Castro, Ph.D.

 

“As we get more connected to our wireless technology, we appear to run the risk of damaging our brains’ wiring, and disconnecting from the face-to-face interaction that our social and psychological systems need. With its emphasis on harnessing attention with intention (i.e. redirecting it on purpose), mindfulness—with all its scientifically-established health and well-being benefits—has the potential to keep us from drifting hopelessly away from one another.” – Mitch Abblett

 

Over the last few decades, the internet has gone from a rare curiosity to the dominant mode of electronic communications. In fact, it has become a dominant force in daily life, occupying large amounts of time and attention. As useful as the internet may be, it can also produce negative consequences. “Problematic Internet Use” is now considered a behavioral addiction, with almost half of participants in one study considered “Internet addicts”, developing greater levels of “tolerance” and experiencing “withdrawal” and distress when deprived. This phenomenon is so new that there is little understanding of its nature, causes, and consequences and how to treat it. The dominant mode of accessing the internet is through smartphones creating smartphone addictions.

 

Future time perspective is the ability to anticipate and plan to bring about desired outcomes in the future. Most addictions involve being completely driven by present needs. So, future time perspective is contrary to addiction and may help to overcome addiction. Mindfulness training has been shown to be helpful with each of the components of addictions, decreasing cravings, impulsiveness, and psychological and physiological responses to stress, and increasing emotion regulation.  Mindfulness has also been shown to be associated with a balanced time perspective. It is no wonder then that mindfulness training has been found to be effective for the treatment of a variety of addictions. Hence, there is a need to further explore the relationships of smartphone addiction with future time perspective and mindfulness.

 

In today’s Research News article “Smartphone use disorder and future time perspective of college students: the mediating role of depression and moderating role of mindfulness.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6969420/), Zhang and colleagues recruited freshman and sophomore college students aged 18-22 years. The completed measures of future time perspective, smartphone use disorder, depression, and mindfulness.

 

They found that the higher the levels of mindfulness the higher the levels of future time perspective and the lower the levels of depression and smartphone use disorder. They also found that the higher the levels of future time perspective the higher the levels of mindfulness and the lower the levels of depression and smartphone use disorder. They then performed a mediation analysis and found that future time perspective had not only a direct and relationship with smartphone use disorder but also was indirectly related via depression such that future time perspective was negatively related to depression which, in turn, was positively related to. smartphone use disorder. Finally, they found that mindfulness moderated the indirect path with high mindfulness decreasing the relationship of future time perspective on depression and decreasing the relationship of depression with smartphone use disorder.

 

This study is correlational and as such causation cannot be determined. Nevertheless, the results suggest that the ability of college students to focus on the future is associated with lower depression and smartphone addictions. Also, college students’ addictions to smartphones are lower when mindfulness is present. This relationship occurs directly and as a result of moderating the relationships between thinking and planning for the future, depression, and smartphone use disorder. It remains for future research to train students in mindfulness to determine if mindfulness can be used to treat addictions to smartphones.

 

So, improve smartphone addiction with mindfulness.

 

“just as technology is increasingly being developed to attract and hold our attention, with mindfulness we can develop the capability to be much more aware of where the spotlight of our attention is being drawn to, and consciously choose to direct and place our attention and energy on an activity of our choosing.” – Neil Tranter

 

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

 

Zhang, Y., Lv, S., Li, C., Xiong, Y., Zhou, C., Li, X., & Ye, M. (2020). Smartphone use disorder and future time perspective of college students: the mediating role of depression and moderating role of mindfulness. Child and adolescent psychiatry and mental health, 14, 3. doi:10.1186/s13034-020-0309-9

 

Abstract

Background

Smartphone use disorder (SUD) of college students has drawn increasing attention. Although future time perspective (FTP) may be an important protective factor for individual SUD, the moderating and mediating mechanisms underlying this relationship remain unknown. We tested the individual roles of depression and mindfulness as moderators of this relationship.

Methods

A cross-sectional study was conducted in two colleges in Shandong and Chongqing in China using a sample of 1304 college students recruited by stratified cluster sampling. Data were collected through a validated self-report instrument. A moderation–mediation model was constructed, and an SPSS PROCESS macro was used to analyse the data.

Results

The correlation analyses showed that FTP was negatively associated with SUD of college students. The mediation model revealed that depression partially mediated the link between FTP and SUD of college students. The moderation–mediation model suggested that mindfulness moderates two direct paths: FTP to depression and depression to SUD. In the first path (FTP to depression), a high level of mindfulness among college students had weakened the relationship between FTP and depression. Here, the relationship is strengthened by a low level of mindfulness. In the second path (depression to SUD), low levels of mindfulness strengthen the link between depression and FTP. In contrast, significant association was not found with high levels of mindfulness.

Conclusions

Results suggest that interventions, such as improving the individual level of FTP and mindfulness, should be conducted. These interventions, in turn, help control the level of depression in college students and ultimately decrease their level of SUD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6969420/

 

Improve the Psychological Well-Being of Patients Living with HIV/AIDS with Mindfulness

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Improve the Psychological Well-Being of Patients Living with HIV/AIDS with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Given the stress-reduction benefits of mindfulness meditation training, these findings indicate there can be health protective effects not just in people with HIV but in folks who suffer from daily stress,” – – David Creswell

 

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

 

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

 

The research is accumulating. So, it makes sense to step back and review what has been learned about the effectiveness of mindfulness training for the treatment of the symptoms of living with HIV/AIDS. In today’s Research News article “Mindfulness-Based Interventions for Adults Living with HIV/AIDS: A Systematic Review and Meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6344266/), Scott-Sheldon and colleagues review, summarize, and perform a meta-analysis of the effectiveness of Mindfulness-Based Interventions (MBIs) for the treatment of the symptoms experienced by people living with HIV/AIDS.

 

They identified 16 published research studies containing a total of 1059 participants. Of these studies 11 employed Mindfulness-Based Stress Reduction (MBSR) while 5 studies employed Mindfulness-Based Cognitive Therapy (MBCT). All studies compared pre- to post-treatment measures while 9 of these studies also had a control comparison group.

 

They report that the published research found that in comparison to baseline after treatment with Mindfulness-Based Interventions (MBIs) there were significant improvements in quality of life and positive emotions and significant reductions in anxiety and depression. The reductions in depression were significantly greater for those participants who received Mindfulness-Based Cognitive Therapy (MBCT). No significant effects were reported for improvements in immune system function (CD4 counts).

 

This analysis of the available research suggests that Mindfulness-Based Interventions (MBIs) are a safe and effective treatment to improve the psychological health of patients diagnosed with HIV/AIDS. The fact that Mindfulness-Based Cognitive Therapy (MBCT) was more effective for depression was not surprising as MBCT was specifically developed to treat depression. It has been well established the Mindfulness-Based Interventions (MBIs) are effective in reducing anxiety and depression and improving positive emotions and quality of life in a wide variety of patients. The present analysis simply extends types of patients for which Mindfulness-Based Interventions (MBIs)are beneficial to patients diagnosed with HIV/AIDS.

 

So, improve the psychological well-being of patients living with HIV/AIDS with mindfulness.

 

“mindfulness-based therapies . . . had a long-term effect on stress and both a short- and long-term effect on depression in people living with an HIV infection.” – Xu Tian

 

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

 

Scott-Sheldon, L., Balletto, B. L., Donahue, M. L., Feulner, M. M., Cruess, D. G., Salmoirago-Blotcher, E., … Carey, M. P. (2019). Mindfulness-Based Interventions for Adults Living with HIV/AIDS: A Systematic Review and Meta-analysis. AIDS and behavior, 23(1), 60–75. doi:10.1007/s10461-018-2236-9

 

Abstract

This meta-analysis examined the effects of mindfulness-based interventions (MBIs) on stress, psychological symptoms, and biomarkers of disease among people living with HIV/AIDS (PLWHA). Comprehensive searches identified 16 studies that met the inclusion criteria (N = 1,059; M age = 42 years; 20% women). Participants had been living with HIV for an average of 8 years (range = <1 to 20 years); 65% were currently on antiretroviral therapy. Between-group analyses indicated that depressive symptoms were reduced among participants receiving the MBIs compared to controls (d+ = 0.37, 95% CI = 0.03, 0.71). Within-group analyses showed reductions in psychological symptoms (i.e., less anxiety, fewer depressive symptoms) and improved quality of life over time among MBI participants (d+s = 0.40–0.85). No significant changes were observed for immunological outcomes (i.e., CD4 counts) between- or within- groups. MBIs may be a promising approach for reducing psychological symptoms and improving quality of life among PLWHA. Studies using stronger designs (i.e., randomized controlled trials) with larger sample sizes and longer follow-ups are needed to clarify the potential benefits of MBIs for PLWHA.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6344266/

 

Spirituality is Associated with Better Mental and Physical Health and Cognitive Ability in African Americans

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Spirituality is Associated with Better Mental and Physical Health and Cognitive Ability in African Americans

 

By John M. de Castro, Ph.D.

 

“all black religious expression has most of the following attributes: It is animistic, or spirit-filled; anthropocentric, or human-centered; dynamic; expressionistic; shamanistic (believing in communicating with spirits); and thaumaturgic (belief in miracle working).” – Diana Hayes

 

The immune system is designed to protect the body from threats like stress, infection, injury, and toxic chemicals. One of its tools is the Inflammatory response. This response works quite well for short-term infections and injuries. But when inflammation is protracted and becomes chronic, it can itself become a threat to health. It can produce autoimmune diseases such as colitis, Chron’s disease, arthritis, heart disease, increased cancer risk, lung disease, sleep disruption, gum disease, decreased bone health, psoriasis, and depression. Needless to say, chronic inflammation can create major health problems. Indeed, the presence of chronic inflammation is associated with reduced longevity. So, it is important for health to control the inflammatory response, allowing it to do its job in fighting off infection but reducing its activity when no external threat is apparent.

 

Depression is linked with increase inflammatory responses. Mind-body techniques such as yoga, Tai Chi and meditation have been shown to adaptively reduce the inflammatory response.  In addition, spirituality has been shown to be associated with reduced depression. African Americans have significantly greater incidences of disease. So, it is reasonable to investigate the relationships of spirituality, depression, inflammation and health in African Americans.

 

In today’s Research News article “Influence of Spirituality on Depression-Induced Inflammation and Executive Functioning in a Community Sample of African Americans.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6478044/), Herren and colleagues recruited healthy adult African Americans and measured them for depression, daily spiritual experiences, cognitive ability, and response inhibition. Blood was drawn and measured for inflammatory cytokines; IL-1a, TNF-a and IL-6.

 

They found that the higher the levels of depression the lower the levels of cognitive ability (executive function). This relationship was in part mediated by the levels of the inflammatory cytokine, IL-6, such that depression was associated with higher levels of IL-6 which in turn were associated with lower cognitive ability. Interestingly, they also found that the higher the frequency of daily spiritual experiences the lower the levels of depression and the higher the levels of cognitive ability and response inhibition. In addition, spirituality moderated the relationships of IL-6 with cognitive ability, such that the greater the frequency of spiritual experiences the smaller the negative relationship of IL-6 with cognitive ability.

 

These findings are interesting but they are correlational and causation cannot be determined. But they suggest that spirituality is associated with better physical and psychological health in African Americans. It is associated with lower depression levels and better cognitive performance. Additionally, it was associated with a lessened negative relationship between the inflammatory response and cognitive ability.

 

African Americans are generally more religious and spiritual than other groups. The present findings may help to explain why. Their spirituality is associated with better mental and physical health and cognitive ability. It remains for future research to determine if these relationships are causal and spirituality produces these benefits. It also remains to be seen if these relationships are present in other ethnic and racial groups.

 

Spirituality is associated with better mental and physical health and cognitive ability in African Americans.

 

“Changing our thoughts, feelings and behaviour to positivity, optimism, hope, acceptance and love boosts immunity at the physical, cognitive, emotional and spiritual levels.” – Sunnyside

 

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

 

Herren, O. M., Burris, S. E., Levy, S. A., Kirk, K., Banks, K. S., Jones, V. L., … Campbell, A. L. (2019). Influence of Spirituality on Depression-Induced Inflammation and Executive Functioning in a Community Sample of African Americans. Ethnicity & disease, 29(2), 267–276. doi:10.18865/ed.29.2.267

 

Abstract

African Americans (AAs) are disproportionately affected by cerebrovascular pathology and more likely to suffer from premature cognitive decline. Depression is a risk factor for poorer cognitive functioning, and research is needed to identify factors that serve to mitigate its negative effects. Studies have demonstrated positive influences of spirituality within the AA community. Determining whether spirituality attenuates the effects of depressive symptoms on cognitive functioning and the pathophysiological mechanisms that explain these relationships in AAs is paramount. This study examines the influence of daily spiritual experiences on the relationship between depressive symptoms and cognitive functioning, and how inflammatory markers may partially explain these associations. A sample of 212 (mean age= 45.6) participants completed the Daily Spiritual Experience Scale (DSES), Beck Depression Inventory-II (BDI-II), Trail Making Test A and B (TMT) and Stroop Color and Word Test (Stroop). Blood samples were collected to measure inflammatory mediators (IL-6, IL-1a, TNF-a). Linear regression analyses were used to evaluate associations. Higher BDI-II scores were associated with poorer psychomotor speed and visual scanning, measured by TMT A (B=1.49, P=.01). IL-6 explained a significant amount of variance in this relationship (B=.24, CI 95% [.00, .64]). IL-6 also significantly mediated the relationship between depressive symptoms and psychomotor speed and mental flexibility, measured by TMT B performance (B=.03, CI 95% [.003, .095]). Frequent spiritual experiences among AAs may ameliorate the negative influence of depressive symptoms on cognitive functioning.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6478044/

 

Further Improve Depression Treated with Drugs and Counseling with Yoga

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Further Improve Depression Treated with Drugs and Counseling with Yoga

 

By John M. de Castro, Ph.D.

 

“I feel like the creator of my own reality, rather than the victim of my own circumstance. Yoga has also allowed me to form healthy boundaries and relationships without the highs and the lows.” – Kacey DeGuardia

 

Depression affects over 6% of the population. Depression can be difficult to treat. It is usually treated with antidepressant medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time. Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering.

 

Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail.  Another effective alternative treatment is exercise. But it is difficult to get depressed people, who lack energy, to engage in regular exercise. Yoga is a contemplative practice that is both a mindfulness practice and an exercise. It has been shown to be effective in the treatment of depression. So, it makes sense to further study the effectiveness of yoga for depression.

 

In today’s Research News article “Effect of adjunct yoga therapy in depressive disorders: Findings from a randomized controlled study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6862972/), Kumar and colleagues recruited adult patients diagnosed with depression and randomly assigned them to either receive standard treatment or standard treatment plus yoga therapy. Standard treatment included antidepressant medication and counseling. Yoga therapy sessions included training in breath awareness, postures, and mindful relaxation and occurred 5 times per week for 45 minutes for 4 weeks. They were measured before, during, and after treatment for depression, anxiety, depression severity, and clinical improvement.

 

They found that in comparison to baseline and the treatment as usual control condition, the group who received yoga therapy had significantly decreased depression, anxiety, and depression severity, and a significant increase in clinical improvement. These results are encouraging and suggest that yoga therapy works to improve depression even in patients continuing to receive drugs and counseling.

 

Yoga therapy is a complex technique including training in breath awareness, various postures, and mindful relaxation. Future research needs to examine which of these components or combination of components of the yoga therapy program are necessary and sufficient for the improvement. In addition, there’s a need to study the long-term effectiveness of yoga therapy. The results, however, suggest that yoga therapy is safe and effective as an adjunctive treatment for depression producing further improvements.

 

So, further improve depression treated with drugs and counseling with yoga.

 

‘That yoga seems to be effective is good news for people struggling with depression. . . . the practice has far fewer side effects and potential drug interactions than mood-altering medications.” – Amanda MacMillan

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Kumar, S., Subramaniam, E., Bhavanani, A. B., Sarkar, S., & Balasundaram, S. (2019). Effect of adjunct yoga therapy in depressive disorders: Findings from a randomized controlled study. Indian journal of psychiatry, 61(6), 592–597. doi:10.4103/psychiatry.IndianJPsychiatry_173_19

 

Abstract

Background:

Depression causes significant burden both to the individual and to society, and its treatment by antidepressants has various disadvantages. There is preliminary evidence that adds on yoga therapy improves depression by impacting the neurotransmitters involved in the regulation of mood, motivation, and pleasure. Our study aimed to find the effect of adjunctive yoga therapy on outcome of depression and comorbid anxiety.

Materials and Methods:

A randomized controlled study involving patients with major depressive disorder (n = 80) were allocated to two groups, one received standard therapy (antidepressants and counseling) and the other received adjunct yoga therapy along with standard therapy. Ratings of depression and anxiety were done using Montgomery–Asberg Depression Rating Scale and Hospital Anxiety and Depression Scale at baseline, 10th and 30th day. Clinical Global Impression (CGI) Scale was applied at baseline and 30th day to view the severity of illness and clinical improvement.

Results:

By the 30th day, individuals in the yoga group had significantly lower scores of depression, anxiety, and CGI scores, in comparison to the control group. The individuals in the yoga group had a significant fall in depression scores and significant clinical improvement, compared to the control group, from baseline to 30th day and 10th to 30th day. In addition, the individuals in the yoga group had a significant fall in anxiety scores from baseline to 10th day.

Conclusion:

Anxiety starts to improve with short-term yoga sessions, while long-term yoga therapy is likely to be beneficial in the treatment of depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6862972/

 

Reduce Depression with Qigong Practice

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Reduce Depression with Qigong Practice

 

By John M. de Castro, Ph.D.

 

“practice of the Chinese martial art tai chi led to significantly reduced symptoms of depression in Chinese-Americans not receiving any other treatments.” – Science Daily

 

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

 

Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering. Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail.  Mindful Movement practices such as Qigong and Tai Chi have been found to be effective for depression. Research has been accumulating. So, it is important to step back and examine what has been learned regarding the application of Qigong practice for depression.

 

In today’s Research News article “The Neurophysiological and Psychological Mechanisms of Qigong as a Treatment for Depression: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6880657/?report=classic), So and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials of Qigong practice for depression. They identified 9 published trials that included depression and biological measures.

 

They report that the research found that Qigong practice resulted in a significant reduction in depression with small to moderate effect sizes. They also report that there was a significant reduction in systolic blood pressure produced by  Qigong practice. There were indications that Qigong practice also reduced inflammation and stress hormones and increased well-being but there were insufficient studies to conduct a meta-analysis.

 

The results suggest that Qigong practice is a safe and mildly effective treatment for depression. There is a need for more research on the effects of Qigong practice on the biological processes that may underlie its effectiveness and also of the psychological well-being of the depressed individuals.

 

It’s important to note that Qigong is a gentle and safe mindfulness practice. It is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It is inexpensive to administer, can be performed in groups or alone, at home or in a facility, and can be quickly learned. In addition, it can be practiced in social groups. This can make it fun, improving the likelihood of long-term engagement in the practice.

 

So, reduce depression with Qigong practice.

 

“Qi Gong is one path for overcoming depression that has no harmful side effects. Furthermore, it can coincide with any other course of intervention or treatment.” – Ian Drogin

 

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

 

So, W., Cai, S., Yau, S. Y., & Tsang, H. (2019). The Neurophysiological and Psychological Mechanisms of Qigong as a Treatment for Depression: A Systematic Review and Meta-Analysis. Frontiers in psychiatry, 10, 820. doi:10.3389/fpsyt.2019.00820

 

Abstract

Objective: An increasing number of studies have shown the anti-depressive effect of qigong. However, its underlying mechanism remains poorly understood. This study aims to systematically review and meta-analyze existing literature on the mechanism of qigong in reducing depression.

Method: The review process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized controlled trials of qigong were searched from PsycINFO, PubMed, Embase, ScienceDirect, and Academic Search Premier from inception to December 2018. Studies which involved depression and any neurophysiological or psychological mechanisms as outcomes were included. Publication bias was tested before conducting meta-analysis. Two independent raters were involved for the entire review process.

Results: A total of nine studies were identified which covered both neurophysiological and psychological mechanisms. Among these selected studies, seven were involved in meta-analysis, which suggested that qigong was effective in alleviating depression (standardized mean difference, SMD = −0.27, p < 0.05, I 2 = 27%). A significant effect was also found for diastolic blood pressure (SMD = −1.64, p < 0.05, I 2 = 31%). However, no significant effect was found for cortisol level and systolic blood pressure.

Conclusions: This review shows that qigong is effective in reducing depression through activating the parasympathetic nervous system. Future studies with higher quality of research methodology with less selection and attrition bias should be conducted to unravel the possible anti-depressive effect of qigong.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6880657/?report=classic

 

Moderate the Negative Psychological Effects of Racism with Mindfulness

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Moderate the Negative Psychological Effects of Racism with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness and related practices do assist in increasing focus and raising awareness, and have been shown to assist in minimizing bias.” – Rhonda Magee

 

Discrimination based upon race, religion, gender, national origin, sexual orientation, etc. has been going on since the beginning of recorded history. Even though quite common, it can have considerable negative impact for all who are involved but especially for the subject of the discrimination. General well-being, self-esteem, self-worth, and social relations can be severely impacted as a result of discrimination. This can, in turn, result in anxiety and depression.

 

It is important that we identify methods to deal with the consequences of discrimination. Mindfulness practices have been shown to reduce prejudice. It has also been shown to reduce depression and enhance positive emotions and reduce the negative effects of discrimination. So perhaps mindfulness can modulate the impact of discrimination on the individual.

 

In today’s Research News article “The Experience of Racism on Behavioral Health Outcomes: The Moderating Impact of Mindfulness.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402779/?report=classic), Zapolski and colleagues recruited African American college students aged 18 to 24 years. They completed an on-line questionnaire measuring demographics, frequency of experiencing racial discrimination, anxiety, depression, alcohol use, and mindfulness.

 

They found that 57% of the African American students had experienced racial discrimination over the last year. A correlational analysis revealed that the greater the frequency of racial discrimination reported, the greater the levels of anxiety, depression, and alcohol use. They also found that the higher the levels of mindfulness the lower the levels of anxiety, depression, and alcohol use. A mediation analysis of these data revealed that mindfulness moderated the effects of racial discrimination on anxiety, depression, and alcohol use such that the higher the levels of mindfulness the smaller the impact of racial discrimination on anxiety, depression, and alcohol use.

 

The study was correlational and as such causation cannot be concluded. Nevertheless, the results suggest that racial discrimination is associated with the individuals’ levels of psychological health and alcohol use but that these associations are weaker when mindfulness levels are high. This suggests that mindfulness may be helpful in mitigating the negative consequences of experience racism. It remains to be established if mindfulness training can immunize the individual from the impact of racism on their psychological health.

 

So, moderate the negative psychological effects of racism with mindfulness.

 

“Mindfulness can help us with a lot of the really subtle difficulties of doing the work that must be done to dismantle these patterns and habits that draw us to reinvest in segregation.” – Rhonda Magee

 

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

 

Zapolski, T., Faidley, M. T., & Beutlich, M. (2019). The Experience of Racism on Behavioral Health Outcomes: The Moderating Impact of Mindfulness. Mindfulness, 10(1), 168–178. doi:10.1007/s12671-018-0963-7

 

Abstract

Research shows that racial discrimination results in adverse behavioral health outcomes for African American young adults, including risk for depression, anxiety, and substance use. Although high levels of mindfulness have been shown to reduce risk for such health outcomes, it is unknown whether mindfulness can reduce risk as a consequence of racial discrimination, particularly among African Americans. Three-hundred and eighty-eight African American young adults between the ages of 18–24 (M=20.6, 62% female) completed measures assessing past year experiences of racial discrimination, depressive symptoms, anxiety symptoms, alcohol use, and trait mindfulness. A positive correlation was found between racial discrimination and the behavioral health outcomes, as well as a negative correlation between mindfulness and the behavioral health outcomes. Moreover, mindfulness was found to significantly moderate the effect of racial discrimination on mood symptoms. Although mindfulness was found to lessen the effect of racial discrimination on alcohol use, this difference was not statistically significant. In line with previous literature, racial discrimination was shown to have a negative impact on behavioral health outcomes among African Americans. Moreover, our findings provide support for the buffering effect of mindfulness on mood symptoms as a consequence discrimination. This suggests that increasing mindfulness may be an effective strategy to include in interventions targeting improvement in mood symptoms for African American young adults. However, alternative strategies may be more appropriate to address outcomes, such as alcohol use, as a consequence of racial discrimination.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402779/?report=classic

 

Improve Gulf War Illness in Veterans with Tai Chi

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Improve Gulf War Illness in Veterans with Tai Chi

 

By John M. de Castro, Ph.D.

 

“A prominent condition affecting Gulf War Veterans is a cluster of medically unexplained chronic symptoms that can include fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, and memory problems.” – US Department of Veterans Affairs

 

Engaging in warfare has many consequences to society and individuals, including the warriors themselves. Post-Traumatic Stress Disorder (PTSD) is a common problem among military veterans with between 11% to 20% of veterans who were involved in combat developing PTSD. There is a specific syndrome that has been identified in about 36% of veterans of the Persian Gulf war of 1991. The cluster of symptoms include fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, and memory problems.

 

It has been demonstrated that mindfulness training is effective for PTSD symptoms . In addition, Yoga practice is a mindfulness practice that has been shown to be helpful for PTSD. Mindful movement practices such as Tai Chi and Qigong have been found to be beneficial for individuals with a myriad of physical and psychological problems. This raises the possibility that Tai Chi practice may be beneficial for veterans suffering from Gulf War Illness.

 

In today’s Research News article “The Effects of Tai Chi Mind-Body Approach on the Mechanisms of Gulf War Illness: an Umbrella Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6600798/), Reid and colleagues review and summarize the published research studies of the effectiveness of Tai Chi practice in relieving the symptoms of participants whose symptoms were similar to Gulf War Illness. They identified multiple randomized controlled trials and meta-analyses of Tai Chi practice for these symptoms.

 

They report that the published research indicates that Tai Chi practice significantly improves mood, sleep, global cognitive function, and respiratory function and significantly decreases insomnia, anxiety, depression, stress, and chronic pain. Hence Tai Chi practice has been shown to be effective in relieving symptoms that commonly occur in Gulf War Illness. This suggests that Tai Chi practice should be tried directly to treat veterans with Gulf War Syndrome. It remains for future research to test this hypothesis.

 

So, improve Gulf War Illness in veterans with Tai Chi.

 

“Mindfulness-based stress reduction may provide significant benefits to symptoms associated with Gulf War Illness in veterans.” – Laura Stiles

 

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

 

Reid, K. F., Bannuru, R. R., Wang, C., Mori, D. L., & Niles, B. L. (2019). The Effects of Tai Chi Mind-Body Approach on the Mechanisms of Gulf War Illness: an Umbrella Review. Integrative medicine research, 8(3), 167–172. doi:10.1016/j.imr.2019.05.003

 

Abstract

Gulf War illness (GWI) is a chronic and multisymptom disorder affecting military veterans deployed to the 1991 Persian Gulf War. It is characterized by a range of acute and chronic symptoms, including but not limited to, fatigue, sleep disturbances, psychological problems, cognitive deficits, widespread pain, and respiratory and gastrointestinal difficulties. The prevalence of many of these chronic symptoms affecting Gulf War veterans occur at markedly elevated rates compared to nondeployed contemporary veterans. To date, no effective treatments for GWI have been identified. The overarching goal of this umbrella review was to critically evaluate the evidence for the potential of Tai Chi mind-body exercise to benefit and alleviate GWI symptomology. Based on the most prevalent GWI chronic symptoms and case definitions established by the Centers for Disease Control and Prevention and the Kansas Gulf War Veterans Health Initiative Program, we reviewed and summarized the evidence from 7 published systematic reviews and meta-analyses. Our findings suggest that Tai Chi may have the potential for distinct therapeutic benefits on the major prevalent symptoms of GWI. Future clinical trials are warranted to examine the feasibility, efficacy, durability and potential mechanisms of Tai Chi for improving health outcomes and relieving symptomology in GWI.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6600798/

 

Improve the Rehabilitation of Cardiac Patients with Mindfulness

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Improve the Rehabilitation of Cardiac Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Meditation practice may be clinically useful in the secondary prevention of cardiovascular disease [the prevention of further heart or stroke events for people who already have the condition].” – British Heart Foundation

 

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

 

Contemplative practices have been shown to be safe and effective alternative treatments for cardiovascular disease. Practices such as meditation, tai chi, and yoga, have been shown to be helpful for heart health and to reduce the physiological and psychological responses to stress. Additionally, they have been shown to be helpful for producing the kinds of lifestyle changes needed to prevent heart disease such as smoking cessation, and weight reduction. They have also been shown to be effective in maintaining cardiovascular health and the treatment of cardiovascular disease. Hence it is reasonable to continue studying the effects of mindfulness training on patients with cardiovascular disease.

 

In today’s Research News article “Randomized Trial of Mindfulness-Based Stress Reduction in Cardiac Patients Eligible for Cardiac Rehabilitation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6895078/), Niijar and colleagues performed a pilot randomized controlled trial of the effectiveness of mindfulness training for the mental and physical health of cardiovascular disease patients.

 

They recruited patients with cardiovascular disease who were participating in an exercise-based cardiac rehabilitation program. The patients were randomly assigned to receive either usual care or an 8-week Mindfulness-Based Stress Reduction (MBSR) program that met once a week for 2.5 hours and consisted of meditation, body scan, and yoga practices and discussion along with daily home practice. They were measured at baseline and 3 and 9 months later for depressive symptoms, anxiety, perceived stress, health-related quality of life, health history, medication usage, heart rate, heart rate variability, blood pressure, and blood triglycerides and HbA1c.

 

They found that in comparison to baseline and the usual care group, the group that received the Mindfulness-Based Stress Reduction (MBSR) had significantly lower levels of depression and anxiety and non-significant trends for lower levels of perceived stress and systolic blood pressure and higher levels of health related quality of life and self-rated health. They also found that the lower the levels of depression and anxiety at 3 months follow-up, the lower the cardiovascular risk factors at the 9-month follow-up, including systolic blood pressure, blood triglycerides, HbA1c, and body mass index.

 

This was a small pilot study that did not have sufficient statistical power to detect small group differences. In addition, all participants received exercise based cardiac rehabilitation program that would be expected to produce improvements by itself. Nevertheless, the study found that the additional participation in a mindfulness training produced significant improvements in the psychological health of the participants and also found trends toward improvements in physiological health. The results suggest that a large randomized controlled trial is justified.

 

The results suggest that a Mindfulness-Based Stress Reduction (MBSR) program may be an effective treatment as a supplement to exercise based cardiac rehabilitation program for the long-term improvement of the mental and physical health of these at-risk patients. This suggests that participation in MBSR in conjunction with exercise may reduce the risk of another cardiovascular event and improve the longevity and mental health of these vulnerable patients.

 

So, improve the rehabilitation of cardiac patients with mindfulness.

 

“meditation may promote heart health and reduce cardiovascular risk.” – American College of Cardiology

 

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

 

Nijjar, P. S., Connett, J. E., Lindquist, R., Brown, R., Burt, M., Pergolski, A., … Everson-Rose, S. A. (2019). Randomized Trial of Mindfulness-Based Stress Reduction in Cardiac Patients Eligible for Cardiac Rehabilitation. Scientific reports, 9(1), 18415. doi:10.1038/s41598-019-54932-2

 

Abstract

Currently, exercise-based cardiac rehabilitation (CR) is the only recommended secondary prevention strategy for cardiac patients that attempts to tackle stress and psychosocial wellbeing, but it is under-utilized and lacks a comprehensive curriculum for this purpose; hence there is a critical gap to address psychosocial needs of cardiac patients after an event. Mindfulness-based stress reduction (MBSR) has shown benefits in the general population but its role in cardiac patients is not clear. We conducted a pilot randomized controlled trial (RCT) of MBSR in CR-eligible cardiac patients during their initial year of recovery. Patients were allocated 2:1 (intervention:control) to an 8-week MBSR group intervention or usual care. Standard measures of depression, anxiety, perceived stress, health related quality of life (HRQOL), blood pressure, biomarkers (lipids, HbA1c, CRP) and 24-hour Holter monitoring were obtained at baseline, 3- and 9-months post-randomization. Sub-group analyses were performed for participants with at least mild depression (PHQ-9 ≥ 5). 47 patients [mean age 58.6 years; 38% female; 77% white] were enrolled in 2 cohorts. 87% of MBSR patients completed the intervention; study retention was >95% at each follow-up visit. At 3 months, compared to controls, MBSR patients showed improvements in depression [p = 0.01] and anxiety [p = 0.04] with a similar trend in HRQOL [p = 0.06]. The MBSR group showed greater improvement or less worsening of most CV risk factors, with an attenuation of treatment effects at 9 months. Participants with at PHQ-9 scores ≥5 at baseline showed greater improvement in psychosocial and CV outcomes, that persisted at 9 months. MBSR is a safe and well received secondary prevention strategy. This pilot RCT provides preliminary evidence of MBSR’s potential to improve short term psychosocial well-being in cardiac patients during their first year of recovery.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6895078/

 

Mindfulness Training Improves Anxiety and Depression in Japanese Patients

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Mindfulness Training Improves Anxiety and Depression in Japanese Patients

 

By John M. de Castro, Ph.D.

 

“meditation was never conceived of as a treatment for any health problem. Rather, it is a path one travels on to increase our awareness and gain insight into our lives.” – Madhav Goyal

 

Many of the symptoms of psychological distress have been shown to be related to a lack of mindfulness, a focus on the present moment. Anxiety is often rooted in a persistent dread of future negative events while depression and rumination are rooted in the past, with persistent replaying of negative past events. Since mindfulness is firmly rooted in the present it is antagonistic toward anything rooted in the past or future. Hence, high levels of mindfulness cannot coexist with anxiety and rumination. In addition, high mindfulness has been shown to be related to high levels of emotion regulation and positive emotions. So, mindfulness would appear to be an antidote to psychological distress. Indeed, mindfulness has been shown to reduce psychological distress, including anxiety and depression.

 

Most psychotherapies were developed to treat disorders in affluent western populations and may not be sensitive to the unique situations, cultures, and education levels of diverse populations. Hence, there is a need to investigate the effectiveness of psychological treatments with diverse populations. One increasingly popular treatment is mindfulness training. These include meditation, tai chi, qigong, yoga, guided imagery, prayer, etc. There are indications that mindfulness therapies may be effective in diverse populations. But there is a need for further investigation with different populations.

 

In today’s Research News article “Changes in depression and anxiety through mindfulness group therapy in Japan: the role of mindfulness and self-compassion as possible mediators.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378713/), Takahashi and colleagues recruited Japanese patients who suffered from anxiety or depression and provided them with an 8-week,  once a week for 2 hours, group mindfulness training that was a combination of Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT). They also practiced at home daily. They were measured before and after training and 2 months later for mindfulness, depression, anxiety, mind wandering, self-compassion, and behavioral activation.

 

They found that after mindfulness training there were significant reductions in anxiety and depression and significant increases in mindfulness and self-compassion that were maintained 2 months later. They also found that the greater the changes in the levels of mindfulness and self-compassion produced by the training, the greater the reductions in anxiety and depression. Hence, the mindfulness training produced lasting improvements in the mental health of Japanese patients suffering from anxiety or depression.

 

This study lacked a control group and is thus open to alternative confounding interpretations. But mindfulness training has been shown over a large number of well-controlled studies to improve self-compassion and to reduce anxiety and depression. So, the current improvements in mental health were also likely to be due to the mindfulness training. The major contribution of this research, however, is to add to the generalizability of mindfulness training’s ability to improve mental health by demonstrating that it is effective with Japanese patients with anxiety or depression.

 

So, mindfulness training improves anxiety and depression in Japanese patients.

 

“Mindfulness has been shown to help with people living with depression and anxiety. Americans often think a pill is the only way to fix things, but . . .  it doesn’t require any money to meditate so it seems like a purer way for people to live with these disorders.” – Katie Lindsley

 

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

 

Takahashi, T., Sugiyama, F., Kikai, T., Kawashima, I., Guan, S., Oguchi, M., … Kumano, H. (2019). Changes in depression and anxiety through mindfulness group therapy in Japan: the role of mindfulness and self-compassion as possible mediators. BioPsychoSocial medicine, 13, 4. doi:10.1186/s13030-019-0145-4

 

Abstract

Background

Mindfulness-based interventions are increasingly being implemented worldwide for problems with depression and anxiety, and they have shown evidence of efficacy. However, few studies have examined the effects of a mindfulness-based group therapy based on standard programs for depression and anxiety until follow-up in Japan. This study addresses that gap. Furthermore, this study explored the mechanisms of action, focusing on mindfulness, mind wandering, self-compassion, and the behavioral inhibition and behavioral activation systems (BIS/BAS) as possible mediators.

Methods

We examined 16 people who suffered from depression and/or anxiety in an 8-week mindfulness group therapy. Measurements were conducted using questionnaires on depression and trait-anxiety (outcome variables), mindfulness, mind wandering, self-compassion, and the BIS/BAS (process variables) at pre- and post-intervention and 2-month follow-up. Changes in the outcome and process variables were tested, and the correlations among the changes in those variables were explored.

Results

Depression and anxiety decreased significantly, with moderate to large effect sizes, from pre- to post-intervention and follow-up. In process variables, the observing and nonreactivity facets of mindfulness significantly increased from pre- to post-intervention and follow-up. The nonjudging facet of mindfulness and self-compassion significantly increased from pre-intervention to follow-up. Other facets of mindfulness, mind wandering, and the BIS/BAS did not significantly change. Improvements in some facets of mindfulness and self-compassion and reductions in BIS were significantly correlated with decreases in depression and anxiety.

Conclusions

An 8-week mindfulness group therapy program may be effective for people suffering from depression and anxiety in Japan. Mindfulness and self-compassion may be important mediators of the effects of the mindfulness group therapy. Future studies should confirm these findings by using a control group.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378713/

 

Improve the Physical and Psychological Health of Cancer Patients with Mindfulness

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Improve the Physical and Psychological Health of Cancer Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

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

 

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

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatigue, stress,  sleep disturbance, fear, and anxiety and depression. The evidence is accumulating. So, it is timely to review and summarize what has been learned.

 

In today’s Research News article “Mindfulness-based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta-analysis of randomized controlled trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6916350/), Cillessen and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials (RCTs) on the effectiveness of mindfulness training in treating the symptoms of cancer and its treatment. They found 29 RCTs that included a total of 3224 participants.

 

The summary of the published research reflected that mindfulness training produced significant reductions in psychological distress in the cancer patients including reductions in anxiety, depression, fatigue, and fear of cancer reoccurrence with small to moderate effects sizes. These improvements were found both immediately after treatment and also at follow-up from 3 to 24 months later. Further they found that mindfulness trainings that adhered to the protocols for Mindfulness-Based Stress Reduction (MBSR) or Mindfulness-Based Cognitive Therapy (MBCT) had the greatest effect sizes.

 

It has been repeatedly demonstrated that mindfulness training is effective in reducing psychological distress including reductions in anxiety, depression, fatigue, and fear in a wide variety of individuals with and without disease states. The present meta-analysis demonstrates the effectiveness of mindfulness training for the relief of psychological and physical suffering of cancer patients. It does not affect the disease process. Rather, it reduces the patients psychological suffering and does so for a prolonged period of time.

 

So, improve the physical and psychological health of cancer patients with mindfulness.

 

“patients who practice mindfulness begin to feel better despite their medical problems. Physical symptoms don’t necessarily go away, but that’s not the aim of mindfulness. Rather, the goal is to help you find a different perspective and a new way of coping with your illness.” – Eric Tidline

 

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

 

Cillessen, L., Johannsen, M., Speckens, A., & Zachariae, R. (2019). Mindfulness-based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta-analysis of randomized controlled trials. Psycho-oncology, 28(12), 2257–2269. doi:10.1002/pon.5214

 

Abstract

Objective

Mindfulness‐based interventions (MBIs) are increasingly used within psycho‐oncology. Since the publication of the most recent comprehensive meta‐analysis on MBIs in cancer in 2012, the number of published trials has more than doubled. We therefore conducted a systematic review and meta‐analysis of randomized controlled trials (RCTs), testing the efficacy of MBIs on measures of psychological distress (primary outcome) and other health outcomes in cancer patients and survivors.

Methods

Two authors conducted independent literature searches in electronic databases from first available date to 10 October 2018, selected eligible studies, extracted data for meta‐analysis, and evaluated risk of bias.

Results

Twenty‐nine independent RCTs (reported in 38 papers) with 3274 participants were included. Small and statistically significant pooled effects of MBIs on combined measures of psychological distress were found at post‐intervention (Hedges’s g = 0.32; 95%CI: 0.22‐0.41; P < .001) and follow‐up (g = 0.19; 95%CI: 0.07‐0.30; P < .002). Statistically significant effects were also found at either post‐intervention or follow‐up for a range of self‐reported secondary outcomes, including anxiety, depression, fear of cancer recurrence, fatigue, sleep disturbances, and pain (g: 0.20 to 0.51; p: <.001 to.047). Larger effects of MBIs on psychological distress were found in studies (a) adhering to the original MBI manuals, (b) with younger patients, (c) with passive control conditions, and (d) shorter time to follow‐up. Improvements in mindfulness skills were associated with greater reductions in psychological distress at post‐intervention.

Conclusions

MBIs appear efficacious in reducing psychological distress and other symptoms in cancer patients and survivors. However, many of the effects were of small magnitude, suggesting a need for intervention optimization research.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6916350/