Depression

Mindfulness Improves Depression in Real-World Healthcare Applications

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Mindfulness Improves Depression in Real-World Healthcare Applications

 

By John M. de Castro, Ph.D.

 

“Rather than try to avoid or eliminate sadness or other negative emotions, one learns to change their relationship with these emotions by practicing meditation and other mindfulness exercises.” – Psychology Today

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. 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 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. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior.

 

There has been considerable research demonstrating that Mindfulness-Based Cognitive Therapy (MBCT) is effective in treating depression. Most of the work has been done in controlled research situations. At this point an examination is needed of how effective MBCT is when employed routinely in healthcare settings.

 

In today’s Research News article “The Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) in Real-World Healthcare Services.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995449/), Tickell and colleagues extracted the data from 1554 participants in group Mindfulness-Based Cognitive Therapy (MBCT) programs. They obtained data on the patients sociodemographic status, depression levels and attendance at MBCT sessions.

 

On average the patients attended 6.37 of the 8 MBCT sessions. They report that after the Mindfulness-Based Cognitive Therapy (MBCT) program there was significant reductions in depression with small to medium effect sizes. Of those participants who were clinically depressed 45% were recovered and 34% were reliably recovered after MBCT. There were no differences in improvement in depression for different ages or genders.

 

These results were not from highly controlled randomized clinical trials. Rather they were from real-world clinical applications of Mindfulness-Based Cognitive Therapy (MBCT) for the treatment of depression. There is ample evidence from controlled trials that mindfulness training and MBCT in particular are effective in reducing depression. The strength of the current study is that it demonstrates that when MBCT is implemented by clinicians in typical treatment settings it is also effective in reducing depression.

 

So, mindfulness improves depression in real-world healthcare applications.

 

“Mindfulness and other meditations, particularly combined with cognitive therapy, work just as well for anxiety or depression as the medications do, but they don’t have those side effects,” – Daniel Goleman

 

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

 

Tickell, A., Ball, S., Bernard, P., Kuyken, W., Marx, R., Pack, S., Strauss, C., Sweeney, T., & Crane, C. (2020). The Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) in Real-World Healthcare Services. Mindfulness, 11(2), 279–290. https://doi.org/10.1007/s12671-018-1087-9

 

Abstract

Depression is common with a high risk of relapse/recurrence. There is evidence from multiple randomised controlled trials (RCTs) demonstrating the efficacy of mindfulness-based cognitive therapy (MBCT) for the prevention of depressive relapse/recurrence, and it is included in several national clinical guidelines for this purpose. However, little is known about whether MBCT is being delivered safely and effectively in real-world healthcare settings. In the present study, five mental health services from a range of regions in the UK contributed data (n = 1554) to examine the impact of MBCT on depression outcomes. Less than half the sample (n = 726, 47%) entered with Patient Health Questionnaire (PHQ-9) scores in the non-depressed range, the group for whom MBCT was originally intended. Of this group, 96% sustained their recovery (remained in the non-depressed range) across the treatment period. There was also a significant reduction in residual symptoms, consistent with a reduced risk of depressive relapse. The rest of the sample (n = 828, 53%) entered treatment with PHQ-9 scores in the depressed range. For this group, 45% recovered (PHQ-9 score entered the non-depressed range), and overall, there was a significant reduction in depression severity from pre-treatment to post-treatment. For both subgroups, the rate of reliable deterioration (3%) was comparable to other psychotherapeutic interventions delivered in similar settings. We conclude that MBCT is being delivered effectively and safely in routine clinical settings, although its use has broadened from its original target population to include people experiencing current depression. Implications for implementation are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995449/

 

Reduce Anxiety and Depression in Patients with Spinal Cord Injury with Mindfulness

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Reduce Anxiety and Depression in Patients with Spinal Cord Injury with Mindfulness

 

By John M. de Castro, Ph.D.

 

“For people with spinal cord injury, the Mindfulness for Health course was effective in reducing symptoms of depression, anxiety, pain unpleasantness, and pain catastrophizing.” – Breathworks

 

“Spinal cord injury (SCI) occurs when the spinal cord is damaged (such as through traumatic injury), and often leads to partial or complete loss of motor and/or sensory function below the level of injury.” Spinal cord injury is devastating to the individual. It results in a permanent cutting off the central nervous system from control of the muscles of the body and as a result paralysis. The severity of the paralysis depends on the location of the injury of the spine with the higher up the injury is on the spine the more widespread the paralysis. In the U.S. there are approximately 17,000 new cases of spinal cord injury each year. The World Health Organization summarizes the problem: “Every year, around the world, between 250 000 and 500 000 people suffer a spinal cord injury (SCI)”.

 

Beyond, the devastating physical consequences of spinal cord injury are difficult psychological, behavioral, emotional, and social issues. The vast majority of patients experience chronic pain and a decreased quality of life. In addition, depression and anxiety disorders are common. Since, spinal cord injury is permanent, it is important to address the pain and psychosocial consequences of the injury that may be present throughout the lifetime. Mindfulness training may help. It has shown to be effective in reducing chronic pain, treat depression and anxiety disorders, and improve quality of life following a variety of diseases.  Hence, it would seem reasonable to examine the ability of mindfulness training in treating the psychological consequences of spinal cord injury.

 

In today’s Research News article “Mindfulness for pain, depression, anxiety, and quality of life in people with spinal cord injury: a systematic review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971852/), Hearn and Cross review and summarize the published research studies of the effectiveness of mindfulness training for the pain and psychological issues resulting from spinal cord injury. They identified 5 published research studies employing a variety of mindfulness -based intervention techniques including yoga practice.

 

They report that the published studies found that mindfulness training produced significant decreases in depression and anxiety in the patients. Overall, however, the studies did not report significant improvements in pain or quality of life. A limiting factor is that the quality of the study methodologies and analyses were low with only one randomized controlled study.

 

Hence, the results suggest that mindfulness-based intervention improve the mental health of spinal cord patients. This is important as depression, in particular, is a serious problem with patients with spinal cord injuries. There is a need for more, larger, and better controlled trials in the future.

 

So, reduce anxiety and depression in patients with spinal cord injury with mindfulness.

 

“mindfulness training intervention for people with reduced sensory and motor function arising from SCI. . . offered greater improvements in symptoms of depression and anxiety, pain catastrophizing.” – Jasmine Heath Hearn

 

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

 

Hearn, J. H., & Cross, A. (2020). Mindfulness for pain, depression, anxiety, and quality of life in people with spinal cord injury: a systematic review. BMC neurology, 20(1), 32. https://doi.org/10.1186/s12883-020-1619-5

 

Abstract

Background

Populations with reduced sensory and motor function, such as spinal cord injury (SCI) are at increased risk of depression, anxiety, pain, and poorer quality of life (QoL). Mindfulness-Based Interventions (MBIs) have been developed with the aim of improving outcomes for people with SCI. To understand the value of MBIs, a systematic review was conducted pertaining to the use of MBIs, and interventions including elements of mindfulness, with people with SCI.

Methods

Databases were reviewed from 1996 to October 2018 (updated January 2020). Eligibility criteria included the assessment of at least one of the common secondary consequences of SCI (i.e. risk of depression, anxiety, pain, and QoL), describe the use of mindfulness training as a component part of an intervention, or as the whole intervention. The Cochrane Collaboration Risk of Bias and The Effective Public Health Practice Project Quality Assessment Tools were utilised for quality appraisals. Two assessors appraised the studies and demonstrated good agreement (Cohen’s k = .848, p < .001).

Results

Five papers met the inclusion criteria, and demonstrated a range of results of interventions delivered individually, in a group format, in person, and online. Only one study reported significant reductions in pain-related outcomes (with moderate effect sizes), with the remaining studies (n = 4) demonstrating no change. Four studies described reductions in depressive symptoms and three reported reductions in anxiety. Despite the importance of good QoL as a goal for people with SCI, few studies (n = 2) assessed this as an outcome with no improvements reported. Study quality ranged from high to low/weak.

Conclusions

The findings in this review provide mixed support for the use of mindfulness to improve outcomes after SCI. In particular, findings indicate that mindfulness may be particularly effective for improving symptoms of depression and anxiety. This review highlights the requirement for more rigorous, high-quality research, particularly larger randomised-controlled trials with long-term follow-up, in this area. The small number of studies included in the present review mean that conclusions drawn are preliminary and thus reflects the paucity of the research in the area to date.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971852/

 

Improve the Long-Term Mental Health of Breast Cancer Survivors with Mindfulness

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Improve the Long-Term Mental Health of Breast Cancer Survivors with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness-based meditation can help ease the stress, anxiety, fear, and depression that often come along with a breast cancer diagnosis and treatment.” – Breast Cancer.org

 

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 fatigue, stress,  sleep disturbance, and anxiety and depression. Although there is considerable research on the topic, there is very little on the long-term effectiveness of mindfulness training on Hispanic breast cancer survivors.

 

In today’s Research News article “Long-Term Effect of a Nonrandomized Psychosocial Mindfulness-Based Intervention in Hispanic/Latina Breast Cancer Survivors.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971966/), Elimimian and colleagues recruited patients who had received a breast cancer diagnosis within the last 5 years. They provided them with a once a week for 2 hours, 8 week program of Mindfulness-Based Stress Reduction (MBSR). The program included meditation, body scan, yoga practices, and discussion along with daily home practice. They were measured before the program and every 3 months thereafter for 2 years for anxiety, depression, mental, emotional, and physical health, and physical and mental quality of life.

 

They found that after MBSR treatment and over the 2-year follow-up period that there were significant reductions in anxiety and depression, and significant improvements in mental quality of life. It should be noted that there wasn’t a control comparison condition present so the results must be interpreted with caution. But prior better controlled research studies have demonstrated that MBSR treatment is effective in improving symptoms in cancer survivors. So, it is likely that the present results were due to the effectiveness of the MBSR program and not to a confounding factor. The contribution of the present study is that it demonstrates that these mental health improvements also occur in Hispanic women.

 

So, improve the long-term mental health of breast cancer survivors with mindfulness.

 

“Results show promise for mindfulness-based interventions to treat common psychological problems such as anxiety, stress, and depression in cancer survivors and to improve overall quality of life.” – Linda E. 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

 

Elimimian, E., Elson, L., Bilani, N., Farrag, S. E., Dwivedi, A. K., Pasillas, R., & Nahleh, Z. A. (2020). Long-Term Effect of a Nonrandomized Psychosocial Mindfulness-Based Intervention in Hispanic/Latina Breast Cancer Survivors. Integrative cancer therapies, 19, 1534735419890682. https://doi.org/10.1177/1534735419890682

 

Abstract

Background: There is a paucity of research on the long-term impact of stress-reduction in Hispanic/Latina breast cancer (BC) survivors, a growing minority. In this article, we assess the long-term efficacy of an 8-week training program in mindfulness-based stress reduction (MBSR) on quality of life (QoL) in Hispanic BC survivors. Methods: Hispanic BC survivors, within the first 5 years of diagnosis, stages I to III BC, were recruited. Participants were enrolled in bilingual, 8-week intensive group training in MBSR and were asked to practice a- home, daily. They were also provided with audio recordings and a book on mindfulness practices. Patient-reported outcomes for QoL and distress were evaluated at baseline, and every 3 months, for 24 months. Results: Thirty-three self-identified Hispanic women with BC completed the MBSR program and were followed at 24 months. Statistically significant reduction was noted for the Generalized Anxiety Disorder measure (mean change −2.39, P=0.04); and Patient Health Questionnaire (mean change −2.27, P=0.04), at 24 months, compared with baseline. Improvement was noted in the Short-Form 36 Health-related QoL Mental Component Summary with an increase of 4.07 (95% confidence interval = 0.48-7.66, P=0.03). However, there was no significant change in the Physical Component Summary. Conclusions: Hispanic BC survivors who participated in an 8-week MBSR–based survivorship program reported persistent benefits with reduced anxiety, depression, and improved mental health QoL over 24 months of follow-up. Stress reduction programs are beneficial and can be implemented as part of a comprehensive survivorship care in BC patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971966/

 

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/