Depression

Mindfulness’ Reduction of Depression is not Related to Patient Engagement, Therapist Adherence or Interpersonal Skills

psyjdc Leave a comment

Mindfulness’ Reduction of Depression is not Related to Patient Engagement, Therapist Adherence or Interpersonal Skills

 

By John M. de Castro, Ph.D.

 

“Mindfulness training helps improve a patient’s engagement with their health, particularly in patients with chronic pain. It fosters a sense of bodily engagement and improves an individual’s ability to promote their health and well-being outside of the clinical setting.” – Caroline Meade

 

Psychotherapy is an interpersonal transaction. Its effectiveness in treating the ills of the client is to some extent dependent upon the chemistry between the therapist and the client, termed the therapeutic alliance. Research has demonstrated that there is a positive relationship with moderate effect sizes between treatment outcomes and the depth of the therapeutic alliance. The personality and characteristics of the therapist are essential ingredients in forming a therapeutic alliance. Research has shown that effective therapists are able to express themselves well. They are astute at sensing what other people are thinking and feeling. In relating to their clients, they show warmth and acceptance, empathy, and a focus on others, not themselves.

 

There are also other factors that may be important for successful therapy. The client’s engagement in the process may be as important as the therapists. In addition, the therapist’s adherence to the therapeutic program or interpersonal skills may also be important ingredients in producing successful therapeutic outcomes. There is little known, however, of the role of these characteristics in the effectiveness of treatment for mental health issues such as depression.

 

In today’s Research News article “Explaining variability in therapist adherence and patient depressive symptom improvement: The role of therapist interpersonal skills and patient engagement. Clinical psychology & psychotherapy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6585745/), Snippe and colleagues recruited adults with diabetes and comorbid depression and randomly assigned them to receive either Mindfulness-Based Cognitive Therapy (MBCT), Cognitive Behavioral Therapy, or to a wait-list. Treatments occurred in 8 weekly 45-60-minute sessions.  MBCT was specifically developed to treat depression and involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms, particularly depression.

 

The patients were measured before and after treatment for depression. “Therapists received a structured treatment manual including specific instructions on exercises, inquiry, and homework assignments per session.” All treatment sessions were video recorded. The recordings were viewed and coded by 2 blinded evaluators who rated the sessions according to the therapists’ adherence to the manual, therapists’ interpersonal skills, and client engagement in the sessions.

 

They found that although depression levels were significantly reduced by both treatments, the degree of improvement was not related to either the therapists’ adherence to the manual, therapists’ interpersonal skills, or to the clients’ engagement in the sessions. They found that the clients’ engagement in the sessions was positively associated with the therapists’ adherence to the manual. They also found that non-adherence to the manual occurred with verbose clients, when no symptoms were present, and with the clients’ life events during the week.

 

The results are interesting and reveal, as has previously been reported, that Mindfulness-Based Cognitive Therapy (MBCT) and Cognitive Behavioral Therapy (CBT) are both effective in reducing depression. It is interesting that the degree of effectiveness was not related to therapists’ adherence to the manual, therapists’ interpersonal skills, or to the clients’ engagement in the sessions. It remains for future research to identify the factors responsible for differing therapeutic outcomes.

 

So, mindfulness’ reduction of depression is not related to patient engagement, therapist adherence or interpersonal skills.

 

“When you are looking at primary care, this is the single most important thing. Can your intervention help enhance people’s capacity for self-management and health behavior change, especially among those who struggle most with self-regulation? Because at the heart of accountable care and patient-centered care is people being able to self-manage their own illness.” – Zev Schuman-Olivier

 

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

 

Snippe, E., Schroevers, M. J., Tovote, K. A., Sanderman, R., Emmelkamp, P., & Fleer, J. (2019). Explaining variability in therapist adherence and patient depressive symptom improvement: The role of therapist interpersonal skills and patient engagement. Clinical psychology & psychotherapy, 26(1), 84–93. doi:10.1002/cpp.2332

 

Abstract

Understanding why therapists deviate from a treatment manual is crucial to interpret the mixed findings on the adherence–outcome association. The current study aims to examine whether therapists’ interpersonal behaviours and patients’ active engagement predict treatment outcome and therapist adherence in cognitive behaviour therapy (CBT) and mindfulness‐based cognitive therapy (MBCT) for depressive symptoms. In addition, the study explores rater’s explanations for therapist nonadherence at sessions in which therapist adherence was low. Study participants were 61 patients with diabetes and depressive symptoms who were randomized to either CBT or MBCT. Depressive symptoms were assessed by the Beck Depression Inventory‐II. Therapist adherence, therapist interpersonal skills (i.e., empathy, warmth, and involvement), patients’ active engagement, and reasons for nonadherence were assessed by two independent raters (based on digital video recordings). Therapist adherence, therapists’ interpersonal skills, and patients’ active engagement did not predict posttreatment depressive symptom reduction. Patients’ active engagement was positively associated with therapist adherence in CBT and in MBCT. This indicates that adherence may be hampered when patients are not actively engaged in treatment. Observed reasons for nonadherence mostly covered responses to patient’s in‐session behaviour. The variety of reasons for therapist nonadherence might explain why therapist adherence was not associated with outcomes of CBT and MBCT.

Key Practitioner Message

  • Therapist adherence was not associated with posttreatment depressive symptom improvement after CBT and MBCT
  • Patient engagement was positively associated with therapist adherence to CBT and MBCT
  • A broad variety of patient‐related reasons for therapist nonadherence were observed, of which some may not result in poorer treatment outcomes and may rather reflect therapist flexibility.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6585745/

 

Improve Psychopathology with Meditation

psyjdc Leave a comment

Improve Psychopathology with Meditation

 

By John M. de Castro, Ph.D.

 

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

 

There are vast numbers of people who suffer with mental illnesses; psychopathology. In the United states it has been estimated that in any given year 1 in 5 people will experience a mental illness. Many are treated with drugs. But drug treatment can produce unwanted side effects, don’t work for many patients, and often can lose effectiveness over time. Mindfulness practices provide a safe alternative treatment. They have been found to be helpful with coping with these illnesses and in many cases reducing the symptoms of the diseases. Hence, it appears that mindfulness practices are safe and effective treatments for a variety of psychiatric conditions including anxiety, depression, psychoses, addictions, etc.. Since there has accumulated a large amount of research, it makes sense to step back and summarize what has been discovered.

 

In today’s Research News article “Mindfulness Meditation and Psychopathology.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6597263/), Wielgosz and colleagues review and summarize the published research studies investigating the efficacy of mindfulness meditation practices for the treatment of a variety of psychopathologies.

 

They report that mindfulness meditation produces significant improvements in depression and in anxiety disorders in comparison to inactive and active control conditions. Efficacy is equivalent to that of other evidence-based treatments. The research suggests that meditation reduces depression by decreasing rumination and anxiety by reducing repetitive negative thinking. Hence, meditation training is an excellent safe and effective treatment for these prevalent mental illnesses.

 

They also report that mindfulness meditation produces significant improvements in chronic pain intensity and unpleasantness in comparison to inactive but not active control conditions. Efficacy is equivalent to that of other evidence-based treatments. This is true for chronic low back pain fibromyalgia, migraine, and chronic pelvic pain. Meditation also appears to improve the quality of life of chronic pain patients. The research suggests that meditation reduces chronic pain by decreasing negative emotional reactivity. Such reactivity appears to intensify pain and meditation reduces this reactivity and thereby reduces pain.

 

They report that mindfulness meditation produces significant improvements in substance abuse disorders in comparison to inactive and active control conditions and even in comparison to other evidence-based treatments. It appears to reduce substance use frequency, use-related problems, and craving. This is important as addictions are very difficult to treat and frequently relapse.

 

There is evidence that mindfulness meditation is effective in the treatment of attention deficit hyperactivity disorder (ADHD) both in children and adults and also post-traumatic stress disorder (PTSD). But there are currently no comparisons to the effects of other active or evidence-based treatments. It will be important to have randomized controlled trials with active controls to better assess the efficacy of meditation for the treatment of ADHD and PTSD.

 

There is emerging evidence that mindfulness meditation may be effective for eating disorders, and major mental illnesses such as bipolar disorder, major depression, and psychosis. But there is a need for more, better controlled research.

 

Hence, this comprehensive review suggests that mindfulness meditation is a useful treatment for a variety of types of psychopathology. It is amazing that such a simple practice as meditation can have such wide-ranging benefits for such diverse mental illnesses. Meditation appears to act indirectly by strengthening cognitive, emotional, and stress related process that in turn have beneficial effects on the psychopathologies. Hence, it is clear that mindfulness meditation is a safe and effective treatment for psychopathologies that can be used alone or in combination with other treatments.

 

So, improve psychopathology with meditation.

 

“When they’re depressed, people are locked in the past. They’re ruminating about something that happened that they can’t let go of. When they’re anxious, they’re ruminating about the future — it’s that anticipation of what they can’t control. In contrast, when we are mindful, we are focused on the here and now. Mindfulness trains individuals to turn their attention to what is happening in the present moment.” – Carolyn Gregoire

 

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

 

Wielgosz, J., Goldberg, S. B., Kral, T., Dunne, J. D., & Davidson, R. J. (2019). Mindfulness Meditation and Psychopathology. Annual review of clinical psychology, 15, 285–316. doi:10.1146/annurev-clinpsy-021815-093423

 

Abstract

Mindfulness meditation is increasingly incorporated into mental health interventions, and theoretical concepts associated with it have influenced basic research on psychopathology. Here, we review the current understanding of mindfulness meditation through the lens of clinical neuroscience, outlining the core capacities targeted by mindfulness meditation and mapping them onto cognitive and affective constructs of the Research Domain Criteria matrix proposed by the National Institute of Mental Health. We review efficacious applications of mindfulness meditation to specific domains of psychopathology including depression, anxiety, chronic pain, and substance abuse, as well as emerging efforts related to attention disorders, traumatic stress, dysregulated eating, and serious mental illness. Priorities for future research include pinpointing mechanisms, refining methodology, and improving implementation. Mindfulness meditation is a promising basis for interventions, with particular potential relevance to psychiatric comorbidity. The successes and challenges of mindfulness meditation research are instructive for broader interactions between contemplative traditions and clinical psychological science.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6597263/

Mindfulness is Associated with Better Mental Health in Firefighters

psyjdc Leave a comment

Mindfulness is Associated with Better Mental Health in Firefighters

 

By John M. de Castro, Ph.D.

 

“mindfulness practices work at both a preventative and remedial level by assisting them to maintain higher levels of resilience to deal with their emergency responder roles and helping to reduce and cease distressing reactions after difficult personal and traumatic incidents.” – Mark Molony

 

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime with 7%-8% of the population developing Post-Traumatic Stress Disorder (PTSD). First responders such as firefighters and police experience traumatic events as part of their jobs and many develop symptoms of PTSD. This is responsible for the fact that wore firefighters and police officers die by suicide than all line-of-duty deaths combined. 103 firefighters and 140 police officers died by suicide in 2017, compared to 93 firefighter and 129 officer line-of-duty deaths.

 

Obviously, stress and trauma effects are troubling problems for firefighters that need to be addressed. There are a number of therapies that have been developed to treat PTSD. One of which, mindfulness training has been found to be particularly effective.  Indeed, mindfulness has been shown to has been shown to reduce the physiological and psychological responses to stress, to reduce suicidality and to reduce the impact of trauma on the individual. So, a firefighter’s level of mindfulness may be associated with better mental health.

 

In today’s Research News article “Mental health and mindfulness amongst Australian fire fighters.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6570940/), Counson and colleagues recruited healthy firefighters who had experienced trauma in the last 6 months. The firefighters completed measures of mindfulness, anxiety, depression, and psychological well-being.

 

They found that the higher the firefighters’ levels of mindfulness, the lower the levels of anxiety and depression and the higher the levels of psychological well-being. Hence, mindfulness was found to be associated with better mental health in these firefighters who are exposed to trauma. This study is correlational and no conclusions regarding causation can be reached. But previous research has demonstrated that mindfulness has causal effects on anxiety, depression, and psychological well-being. So, it is likely that the associations seen here were due to causal connections.

 

These results suggest that mindful firefighters are resistant to the effects of trauma. It has been shown the mindfulness is effective in treating Post-Traumatic Stress Disorder (PTSD). The present results then combined with these previous findings suggest that mindfulness may help to protect firefighters from trauma making it less likely that they’ll develop PTSD.

 

So, mindfulness is associated with better mental health in firefighters.

 

“targeted mindfulness training program increases some aspects of firefighter resilience (distress tolerance, positive adjustment, and perseverance). . . . The more lessons firefighters completed, the greater their improvements in both mindfulness and resilience.” – AMRA

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are available at the Contemplative Studies Blog http://contemplative-studies.org/wp/

They are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Counson, I., Hosemans, D., Lal, T. J., Mott, B., Harvey, S. B., & Joyce, S. (2019). Mental health and mindfulness amongst Australian fire fighters. BMC psychology, 7(1), 34. doi:10.1186/s40359-019-0311-2

 

Abstract

Background

While extensive research has highlighted the positive mental health outcomes associated with mindfulness, little work has examined how mindfulness may protect the mental health of first responders exposed to trauma. This is important as there is increasing evidence that mindfulness skills, if protective, can be taught to groups of at-risk workers. The purpose of the current research was to examine the potential role mindfulness may have in supporting the mental health of Australian fire fighters.

Methods

The sample consisted of 114 professional fire fighters who completed demographic and job-related questions followed by measures of mindfulness (FMI-14), well-being (WHO-5), depression (HADS-D) and anxiety (HADS-A). Hierarchical multiple linear regressions were performed to determine whether levels of mindfulness were associated with anxiety, depression and wellbeing after accounting for age and number of years of fire service.

Results

High levels of mindfulness were associated with decreased depression (p ≤ .001) and anxiety (p ≤ .001) as well as increased psychological well-being (p ≤ .001). Measures of mindfulness were able to explain a substantial amount of the variability in well-being (26.8%), anxiety (23.6%) and depression (22.4%), regardless of age and years of fire service.

Conclusions

The present study provides evidence for robust associations between dispositional mindfulness and mental health markers of depression, anxiety and well-being in Australian fire fighters recently exposed to trauma. Mindfulness is a psychological characteristic that may be able to be modified, although further research is required to substantiate these findings and to formally test mindfulness interventions. Such studies would allow greater insight into the underlying mechanisms through which mindfulness may exert its beneficial effects.

Electronic supplementary material

The online version of this article (10.1186/s40359-019-0311-2) contains supplementary material, which is available to authorized users.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6570940/

 

Improve Depression by Modulating the Autonomic Nervous System in the Elderly with Tai Chi

psyjdc Leave a comment

Improve Depression by Modulating the Autonomic Nervous System in the Elderly with Tai Chi

 

By John M. de Castro, Ph.D.

 

“The ancient Chinese practice of tai chi appears to relieve symptoms of depression in older people.” – Tara Parker-Pope

 

Human life is one of constant change. We revel in our increases in physical and mental capacities during development, but regret their decreases during aging. The aging process involves a systematic progressive decline in every system in the body. It is inevitable and cannot be avoided. This includes our mental abilities which decline with age including impairments in memory, attention, and problem-solving ability, and in emotion regulation. Depression is very common in the elderly. The elderly cope with increasing loss of friends and family, deteriorating health, as well as concerns regarding finances on fixed incomes. In addition, many elderly experience withdrawal and isolation from social interactions producing increased loneliness, worry and anxiety.

 

There is some hope for age related decline, however, as there is evidence that it can be slowed. There are some indications that physical and mental exercise can reduce the rate of decline. For example, contemplative practices such as meditation, yoga, and Tai Chi or qigong have all been shown to be beneficial in slowing or delaying physical and mental decline with aging and with improving depression. There is, however, been very little research on the mechanisms by which Tai Chi practice improves depression in the elderly.

 

In today’s Research News article “The Effects of Tai Chi on Heart Rate Variability in Older Chinese Individuals with Depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313592/), Liu and colleagues recruited elderly (aged 60 and older) who were not taking antidepressant medications or drinking alcohol, but who scored as having mild depression on an elderly depression scale. They were randomly assigned to either receive Tai Chi training for 60 minutes, 3 times per week for 24 weeks, or to a no-treatment control condition. The elderly were measured before and after treatment for depression, and heart rate variability, a measure of autonomic nervous system activity.

 

They found that in comparison to baseline and the control group the Tai Chi participants had significantly decreased levels of depression and significant decreases in low frequency heart rate variability and significant increases in high frequency heart rate variability. The higher the levels of high frequency heart rate variability the lower the levels of depression and the lower the levels of low frequency heart rate variability the lower the levels of depression.

 

These findings are interesting and suggest that Tai Chi training reduces depression in the elderly. The results further suggest that Tai Chi training may do so by creating balance between the sympathetic and parasympathetic nervous systems. High frequency heart rate variability is suggestive of parasympathetic (relaxation) activity and this was increased by Tai Chi training while low frequency heart rate variability is suggestive of sympathetic (activation) activity and this was decreased by Tai Chi training. Hence, the results suggest that Tai Chi training may lead to less activation and greater relaxation and this may counter depression.

 

So, improve depression by modulating the autonomic nervous system in the elderly with Tai Chi

 

 “Tai chi has many physical and emotional benefits. Some of the benefits of tai chi include decreased anxiety and depression and improvements in cognition. It may also help you manage symptoms of some chronic diseases.” – Healthline

 

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

 

Liu, J., Xie, H., Liu, M., Wang, Z., Zou, L., Yeung, A. S., … Yang, Q. (2018). The Effects of Tai Chi on Heart Rate Variability in Older Chinese Individuals with Depression. International journal of environmental research and public health, 15(12), 2771. doi:10.3390/ijerph15122771

 

Abstract

Background Very little research has been done to simultaneously investigate the effects of Tai Chi (TC) on depression and heart rate variability (HRV). This study, therefore, attempted to explore the effects of TC on depression and on HRV parameters. Methods Sixty older individuals with depression score of 10 or above (the Geriatric Depression Scale, GDS) were randomly assigned into two groups: TC (n = 30) and control group (n = 30). Participants in the experimental group participated in a 24-week TC training program (three 60-min sessions per week), whereas individuals in the control group maintained their unaltered lifestyle. Depression and HRV were measured using the GDS and digital electrocardiogram at baseline and after the 24-week intervention. Results The TC had produced significant positive chances in depression and some HRV parameters (mean heart rate, RMSSD, HF, LFnorm, and HFnorm) (p < 0.05), whereas these positive results were not observed in the control group. Conclusions The results of this study indicated that TC may alleviate depression of the elderly through modulating autonomous nervous system or HRV parameters. This study adds to a growing body of research showing that TC may be effective in treating depression of the elderly. Tai Chi as a mild to moderate mind-body exercise is suitable for older individuals who suffer from depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313592/

 

Improve Adolescent Emotion Regulation and Mental Health with Mindfulness

psyjdc Leave a comment

Improve Adolescent Emotion Regulation and Mental Health with Mindfulness

 

By John M. de Castro, Ph.D.

 

“But a growing body of evidence suggests that mindfulness practice could be beneficial to teens, helping them cultivate empathy, as well as skills for concentration and impulse control. In short, mindfulness can help adolescents navigate the challenges of adolescence.” – Sarah Rudell Beach

 

Adolescence is a time of mental, physical, social, and emotional growth. But adolescence can be a difficult time, fraught with challenges. During this time the child transitions to young adulthood; including the development of intellectual, psychological, physical, and social abilities and characteristics. There are so many changes occurring during this time that the child can feel overwhelmed and unable to cope with all that is required. Indeed, up to a quarter of adolescents suffer from depression or anxiety disorders, and an even larger proportion struggle with subclinical symptoms.

 

Mindfulness training in adults has been shown to reduce anxiety, depression, and perceived stress levels and improve emotional regulation. In addition, in adolescents it has been shown to improve emotion regulation and to benefit the psychological and emotional health. There is a need to explore the relationship between these effects of mindfulness training in adolescents.

 

In today’s Research News article “Adolescents’ Mindfulness and Psychological Distress: The Mediating Role of Emotion Regulation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567674/), Ma and Fang recruited middle school students between the ages of 12-18 years and had them complete scales measuring mindfulness, anxiety, depression, perceived stress, difficulties with emotion regulation, and emotion regulation.

 

They found that the higher the levels of mindfulness, the lower the levels of anxiety, depression, perceived stress, and difficulties with emotion regulation, including all subscales; “lack of emotional clarity (Clarity), difficulty in engaging in goal-directed behavior under negative emotions (Goals), loss of control under negative emotions (Impulse), limited strategies for emotion regulation (Strategies), and non-acceptance of emotional responses (Non-acceptance).” Using a mediation model, they found that high levels of mindfulness were related to lower levels of anxiety, depression, and perceived stress directly and indirectly as a results of mindfulness’ negative relationship with difficulties with emotion regulation. In other words, mindfulness was directly related to lower levels of psychological distress and also indirectly by its relationship with lower levels of difficulties with emotion regulation which were in turn related to less psychological distress.

 

The study is correlational and as such causation cannot be concluded. But prior research has demonstrated that mindfulness causes reductions in anxiety, depression, perceived stress, and difficulties with emotional regulation. Hence, it would be reasonable to conclude that the present findings were also due to the effects of mindfulness on psychological health.

 

Adolescence is a time of strong emotions that the adolescents have not yet learned how to effectively regulate. This makes this period of life very difficult with high levels of emotional distress. The finding though indicate that mindfulness may be a way to mitigate the emotional upheavals of adolescence of improve the psychological health of the teens by improving their ability to deal with their emotions.

 

So, improve adolescent emotion regulation and mental health with mindfulness.

 

“Mindfulness teaches teenagers to recognize the downward spiral of thoughts before it gets out of hand, perhaps learning to label it as simply “worrying.” They can acknowledge the anxiety without getting caught up in it, without it leading to the rumination that ultimately ruins their mood.” – Sarah Rudell Beach

 

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

 

Ma, Y., & Fang, S. (2019). Adolescents’ Mindfulness and Psychological Distress: The Mediating Role of Emotion Regulation. Frontiers in psychology, 10, 1358. doi:10.3389/fpsyg.2019.01358

 

Abstract

Mindfulness has been widely linked with psychological well-being in general population. There are emerging studies supporting the relationship between adolescents’ mindfulness and their mental health. However, the mechanisms through which mindfulness may influence adolescents’ psychological distress have only recently been explored, and more related research is still needed. This study investigated the relationship between adolescents’ dispositional mindfulness and psychological symptoms of depression, anxiety and stress. The mediating variables were also explored in perspective of two common emotion regulation theories, which were measured through Difficulties in Emotion Regulation Scale (DERS) and Emotion Regulation Questionnaire (ERQ). DERS has been used as a comprehensive assessment of emotion regulation difficulties. ERQ is also widely accepted to measure the emotion regulation process including dimensions of cognitive reappraisal and expressive suppression. Measures assessing mindfulness, emotion regulation, and psychological distress were administered to 1067 adolescents in mainland China. The results confirmed that adolescents’ dispositional mindfulness was negatively associated with depression, anxiety, and stress. DERS, especially the sub-dimensions of Acceptance and Strategies, significantly mediated the relationship between mindfulness and symptoms of depression, anxiety and stress. Whereas, ERQ including subscales of cognitive reappraisal and expressive suppression exerted limited mediating effect. These findings provided insights for the potential underlying mechanism between adolescents’ mindfulness and psychological distress, demonstrating that DERS might be more pervasive than ERQ. Further research was suggested to explore other mediating variables underlying mindfulness and psychological distress among adolescents and develop mindfulness-based programs to improve adolescents’ mindfulness and emotion regulation ability.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567674/

 

Improve Mental Health Postpartum with Perinatal Mindfulness Training

psyjdc Leave a comment

Improve Mental Health Postpartum with Perinatal Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“the ideal treatment plan for perinatal depression and anxiety often includes mindfulness techniques. Exercises such as deep breathing, progressive muscle relaxation, and meditation, for example, have been shown to reduce blood pressure and promote recovery from many illnesses.” – Edith Gettes

 

The birth of a child is most often a joyous occasion. But often the joy turns to misery. Immediately after birth it is common for the mother to experience mood swings including what has been termed “baby blues,” a sadness that may last for as much as a couple of weeks. But some women experience a more intense and long-lasting negative mood called postpartum depression. This occurs usually 4-6 weeks after birth in about 15% of births; about 600,000 women in the U.S. every year. For 50% of the women the depression lasts for about a year while about 30% are still depressed 3 years later.

 

Mindfulness training has been shown to improve anxiety and depression in general and to relieve maternal anxiety and depression during pregnancy. But it is not known if the effectiveness of mindfulness training during the perinatal period carries over to the postpartum period. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression and consists of mindfulness training and Cognitive Behavioral Therapy (CBT). During therapy the patient is trained to investigate and alter aberrant thought patterns underlying depression. So, it would make sense to study the effectiveness of MBCT administered during the perinatal period on postpartum mental health issues.

 

In today’s Research News article “Postpartum Outcomes and Formal Mindfulness Practice in Mindfulness-Based Cognitive Therapy for Perinatal Women.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6070304/), Luberto and colleagues recruited pregnant women (average of 15.5 weeks pregnant) and provide them with an 8-week program of Mindfulness-Based Cognitive Therapy (MBCT). They were measured before and after training and 3 months postpartum for anxiety, depression, worry, mindfulness, self-compassion, meditation frequency, and home practice.

 

They found that after treatment there were significant increases in mindfulness and self-compassion and significant decreases in anxiety, depression, and worry. These improvements were maintained at 3-months postpartum except for depression that had a further significant decline. After the intervention 91% of the women continued to practice meditation and 65% continued practicing yoga. During the postpartum period 55% of the women continued to practice meditation and 25% continued practicing yoga. There were no significant differences in the outcomes for women who continued to practice versus those that didn’t.

 

These results are important in that they demonstrate that Mindfulness-Based Cognitive Therapy (MBCT)  produces important benefits for the mental health of pregnant women that endure into the postpartum period. This is important as “baby blues” and postpartum depression are frequent and difficult consequences of childbirth. The findings suggest that MBCT training during pregnancy may help to prevent “baby blues” and postpartum depression. Hence, MBCT the produces lasting improvements in the psychological state of women during both the perinatal and postpartum periods.

 

So, improve mental health postpartum with perinatal mindfulness training.

 

“By paying attention, by being mindful, I was able to accept things that spun me out previously. I still had low points, but I was better equipped to manage and accept them as feelings and moments, and move on. . . . What I thought was caused by hormone fluctuations and “baby blues” was actually much more severe.” – Kristi Pahr

 

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

 

Luberto, C. M., Park, E. R., & Goodman, J. H. (2018). Postpartum Outcomes and Formal Mindfulness Practice in Mindfulness-Based Cognitive Therapy for Perinatal Women. Mindfulness, 9(3), 850–859. doi:10.1007/s12671-017-0825-8

 

Abstract

Anxiety is common during pregnancy and associated with poorer outcomes for mother and child. Our single-arm pilot study of an eight-week Mindfulness-Based Cognitive Therapy (MBCT) intervention for pregnant women with elevated anxiety showed significant pre- to post-intervention improvements in anxiety, depression, worry, mindfulness, and self-compassion. It remains unclear whether these improvements are maintained post-partum and whether amount of formal mindfulness practice is correlated with outcomes. The current study examined whether 1) improvements in psychosocial outcomes were maintained three months postpartum; 2) women were adherent to formal practice recommendations; and 3) amount of mindfulness practice was correlated with outcomes. Twenty-three pregnant women (Mage=33.5, SD=4.40; 75% White; 71% with Generalized Anxiety Disorder) completed home practice logs throughout the intervention, and self-report measures before and after the intervention and three months postpartum. Results indicated that previously reported post-intervention improvements in anxiety, worry, mindfulness, and self-compassion were maintained postpartum (p’s<.05), and reductions in depression further improved (p<.001). Participants were generally adherent to mindfulness practice recommendations during the intervention (54%-80% weekly adherence; M=17.31 total practice hours [SD=7.45]), and many continued practicing one-week post-intervention (91%) and postpartum (55%). Mindfulness practice during the intervention was not significantly correlated with any outcome at post-intervention or postpartum. Mindfulness practice postpartum was only marginally related to improved worry postpartum (p=.05). MBCT may be associated with maintained improvements in psychosocial outcomes for women during pregnancy and postpartum, but the role of mindfulness practice is unclear. Research using larger samples and randomized controlled designs is needed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6070304/

 

Improve Children and Adolescents Mental Health with Mindfulness

psyjdc Leave a comment

Improve Children and Adolescents Mental Health with Mindfulness

 

By John M. de Castro, Ph.D.

 

“In the last few years mindfulness has emerged as a way of treating children and adolescents with conditions ranging from ADHD to anxiety, autism spectrum disorders, depression and stress. And the benefits are proving to be tremendous.” – Julianne Garey

 

Childhood is a miraculous period during which the child is dynamically absorbing information from every aspect of its environment. This occurs almost without any intervention from the adults as the child appears to be programmed to learn. It is here that behaviors, knowledge, skills, and attitudes are developed that shape the individual.

 

Adolescence is a time of mental, physical, social, and emotional growth. It is during this time that higher levels of thinking, sometimes called executive function, develops. But adolescence can be a difficult time, fraught with challenges. During this time the child transitions to young adulthood; including the development of intellectual, psychological, physical, and social abilities and characteristics. There are so many changes occurring during this time that the child can feel overwhelmed and unable to cope with all that is required.

 

Mindfulness training for children and adolescents has been shown to have very positive effects. These include academic, cognitive, psychological, and social domains. Mindfulness training has been shown to improve emotion regulation and to benefit the psychological and emotional health of adolescents. Importantly, mindfulness training with children and adolescents appears to improve the self-concept, improves attentional ability and reduces stress. The research findings and evidence are accumulating. So, it makes sense to step back and review and summarize what has been learned regarding the effectiveness of mindfulness training for the cognitive growth and mental health and well-being of children and adolescents.

 

In today’s Research News article “Research Review: The effects of mindfulness-based interventions on cognition and mental health in children and adolescents – a 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/PMC6546608/), Dunning and colleagues review, summarize and perform a meta-analysis of randomized controlled trials of the effects of mindfulness training on the cognitive ability, psychological health, and well-being of children and adolescents. They identified 33 published randomized controlled trials, 17 of which had active control conditions.

 

They found that over all published studies, mindfulness training resulted in improved cognition and executive function, with larger effects for older children and adolescents. Mindfulness training also produced significantly increased mindfulness and decreased negative behaviors, stress, anxiety and depression. increased mindfulness and decreased stress, anxiety and depression were still significant. But when mindfulness practices were compared to active control conditions cognitive improvements were no longer significant but there were still significant increases in mindfulness and decreases in stress, anxiety and depression.

 

These results are interesting and suggest that mindfulness training produces significant improvements in the mental health of children and adolescents. The results, however, suggest that reported improvements in cognition and behavior may be due to placebo or experimenter bias effects as these same improvements occurred with active control conditions. The improvements in cognitive ability appears to be maximized in adolescents when high level executive functions are developing. The lack of significant effects in studies with active control conditions may have been due to the small number of studies, 7, that had active controls and studied cognition.

 

Regardless, the accumulated research suggests that training children and adolescents in mindfulness may help them navigate the difficult emotional challenges confronting them during development.

 

So, improve children and adolescents’ mental health with mindfulness.

 

“For children, mindfulness can offer relief from whatever difficulties they might be encountering in life. It also gives them the beauty of being in the present moment.” – Annaka Harris

 

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

 

Dunning, D. L., Griffiths, K., Kuyken, W., Crane, C., Foulkes, L., Parker, J., & Dalgleish, T. (2019). Research Review: The effects of mindfulness-based interventions on cognition and mental health in children and adolescents – a meta-analysis of randomized controlled trials. Journal of child psychology and psychiatry, and allied disciplines, 60(3), 244–258. doi:10.1111/jcpp.12980

 

Abstract

Background

Mindfulness based interventions (MBIs) are an increasingly popular way of attempting to improve the behavioural, cognitive and mental health outcomes of children and adolescents, though there is a suggestion that enthusiasm has moved ahead of the evidence base. Most evaluations of MBIs are either uncontrolled or nonrandomized trials. This meta-analysis aims to establish the efficacy of MBIs for children and adolescents in studies that have adopted a randomized, controlled trial (RCT) design.

Methods

A systematic literature search of RCTs of MBIs was conducted up to October 2017. Thirty-three independent studies including 3,666 children and adolescents were included in random effects meta-analyses with outcome measures categorized into cognitive, behavioural and emotional factors. Separate random effects meta-analyses were completed for the seventeen studies (n = 1,762) that used an RCT design with an active control condition.

Results

Across all RCTs we found significant positive effects of MBIs, relative to controls, for the outcome categories of Mindfulness, Executive Functioning, Attention, Depression, Anxiety/Stress and Negative Behaviours, with small effect sizes (Cohen’s d), ranging from .16 to .30. However, when considering only those RCTs with active control groups, significant benefits of an MBI were restricted to the outcomes of Mindfulness (d = .42), Depression (d = .47) and Anxiety/Stress (d = .18) only.

Conclusions

This meta-analysis reinforces the efficacy of using MBIs for improving the mental health and wellbeing of youth as assessed using the gold standard RCT methodology. Future RCT evaluations should incorporate scaled-up definitive trial designs to further evaluate the robustness of MBIs in youth, with an embedded focus on mechanisms of action.

Key points

  • Mindfulness based interventions (MBIs) are a popular way of attempting to improve the mental and physical health outcomes of children and adolescents.
  • This is the first meta-analysis of MBIs with youth composed exclusively of randomized controlled trials (RCTs) including RCTs with active control groups – the gold standard in intervention studies.
  • When using the gold standard research design results showed that MBIs are useful in improving Depression and Anxiety outcomes, but not behavioural or cognitive outcomes,
  • The meta-analysis advocates the use of MBIs for improving mental health in young people.
  • Future RCT evaluations should incorporate scaled-up definitive trial designs to further evaluate the robustness of MBIs in youth, with an embedded focus on mechanisms of action.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6546608/

 

Alter Brain Activation Regardless of Depression with Mindfulness

psyjdc Leave a comment

Alter Brain Activation Regardless of Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Now, as the popularity of mindfulness grows, brain imaging techniques are revealing that this ancient practice can profoundly change the way different regions of the brain communicate with each other – and therefore how we think – permanently.” – Tom Ireland

 

The nervous system is a dynamic entity, constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. These changes in the brain can be relatively permanent and are called neuroplasticity. Over the last decade neuroscience has been studying the effects of contemplative practices on the brain and has identified neuroplastic changes in widespread areas. In other words, meditation practice appears to mold and change the brain, producing psychological, physical, and spiritual benefits.

 

The brain produces rhythmic electrical activity that can be recorded from the scalp. The neuroplastic changes in the brain may be seen by recording the brain’s electrical activity with the electroencephalogram (EEG). It is possible that the EEG can be used to indirectly observe the activity of the brain and changes in the brain activation produced by mindfulness training and its consequent improvements in mental health.

 

In today’s Research News article “Spiking Neural Network Modelling Approach Reveals How Mindfulness Training Rewires the Brain.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6478904/), Doborjeh and colleagues recruited adults and provided them with a 6-week, once a week for 90-120 minutes, mindfulness training. They separated the participants based upon a paper and pencil measure of depression into low depression, no depression, and high depression groups. Before and after training they measured the participants brain electrical activity with an electroencephalogram (EEG). They then employed a sophisticated data analysis algorithm to follow bursts of electrical activity through the brain (Spiking Neural Network).

 

They found that the no depression and low depression groups had overall higher activation than the high depression group. After mindfulness training the high depression group had higher activation at the frontal, temporal, frontocentral, and centroparietal sites, while the no depression group had higher activation of the frontal and occipitalparietal cortical areas, and the low depression group had higher activation at the frontal, temporal, and frontocentral sites.

 

The results are interesting and suggest that the Spiking Neural Network analysis of the electroencephalogram (EEG) can detect differences in brain activation in groups varying in levels of depression and can also detect neuroplastic changes resulting from mindfulness training. This is an important demonstration as it verifies that the easy, non-invasive, and economical EEG recording technique can be used to assess the details of neural function and the changes in neural function that may occur after an intervention.

 

Additionally, the results suggest that depressed individuals have quite low levels of brain activation which may, in part, be responsible for their depression. The results also show that mindfulness training in these depressed individuals can, to some extent, raise the levels of brain activation. This may be responsible, in part, for the ability of mindfulness training to decrease depression levels in depressed individuals. In addition, the results suggest that even in low and non-depressed individuals, mindfulness training can further increase brain activation. This may be responsible for the improvement in emotion regulation and mood in normal individuals that is produced by mindfulness training.

 

So, alter brain activation regardless of depression with mindfulness.

 

“There is emerging evidence that mindfulness meditation might cause neuroplastic changes in the structure and function of brain regions involved in regulation of attention, emotion and self-awareness.” – Britta Hőlzel

 

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

 

Doborjeh, Z., Doborjeh, M., Taylor, T., Kasabov, N., Wang, G. Y., Siegert, R., & Sumich, A. (2019). Spiking Neural Network Modelling Approach Reveals How Mindfulness Training Rewires the Brain. Scientific reports, 9(1), 6367. doi:10.1038/s41598-019-42863-x

 

Abstract

There has been substantial interest in Mindfulness Training (MT) to understand how it can benefit healthy individuals as well as people with a broad range of health conditions. Research has begun to delineate associated changes in brain function. However, whether measures of brain function can be used to identify individuals who are more likely to respond to MT remains unclear. The present study applies a recently developed brain-inspired Spiking Neural Network (SNN) model to electroencephalography (EEG) data to provide novel insight into: i) brain function in depression; ii) the effect of MT on depressed and non-depressed individuals; and iii) neurobiological characteristics of depressed individuals who respond to mindfulness. Resting state EEG was recorded from before and after a 6 week MT programme in 18 participants. Based on self-report, 3 groups were formed: non-depressed (ND), depressed before but not after MT (responsive, D+) and depressed both before and after MT (unresponsive, D−). The proposed SNN, which utilises a standard brain-template, was used to model EEG data and assess connectivity, as indicated by activation levels across scalp regions (frontal, frontocentral, temporal, centroparietal and occipitoparietal), at baseline and follow-up. Results suggest an increase in activation following MT that was site-specific as a function of the group. Greater initial activation levels were seen in ND compared to depressed groups, and this difference was maintained at frontal and occipitoparietal regions following MT. At baseline, D+ had great activation than D−. Following MT, frontocentral and temporal activation reached ND levels in D+ but remained low in D−. Findings support the SNN approach in distinguishing brain states associated with depression and responsiveness to MT. The results also demonstrated that the SNN approach can be used to predict the effect of mindfulness on an individual basis before it is even applied.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6478904/

 

Improve Caregiver Psychological Health by Changing the Brain Response with Mindfulness

psyjdc Leave a comment

Improve Caregiver Psychological Health by Changing the Brain Response with Mindfulness

 

By John M. de Castro, Ph.D.

 

“We are set up for short-term stress, but caregiving is long-term stress. Mindfulness is basically coming back into the present moment, so it works to inhibit the stress response. Most of us run around listening to our thoughts, and this is particularly true of caregivers, who are driven by the to-do list. They are never at rest.” – Joan Griffiths Vega

 

Dementia is a progressive loss of mental function produced by degenerative diseases of the brain. Dementia patients require caregiving particularly in the later stages of the disease. Caregiving for dementia patients is a daunting intense experience that can go on for four to eight years with increasing responsibilities as the loved one deteriorates. This places tremendous psychological and financial stress on the caregiver. Hence, there is a need to both care for the dementia patients and also for the caregivers. Mindfulness practice for caregivers has been shown to help them cope with the physical and psychological demands of caregiving. In addition, mindfulness training has been found to help protect aging individuals from physical and cognitive declines.

 

The nervous system is a dynamic entity, constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. These changes in the brain are called neuroplasticity.  Over the last decade neuroscience has been studying the effects of contemplative practices on the brain and has identified neuroplastic changes in widespread area. and have found that meditation practice appears to mold and change the brain, producing psychological, physical, and spiritual benefits.

 

In today’s Research News article “Grief, Mindfulness and Neural Predictors of Improvement in Family Dementia Caregivers.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6530345/), Jain and colleagues recruited dementia caregivers (91% female) and provided for them either 4 weeks of mindfulness training or 4 weeks of relaxation training. Training occurred in a once a week meeting along with home practice. The participants were measured before and after training for grief, depression, and mindfulness. They then had brain scans performed with functional Magnetic Resonance Imaging (fMRI) while they viewed pictures of their loved one with dementia or a stranger with the pictures labelled with either grief related words, e.g. disease, dementia, and sick or with neutral words e.g. village, planter and curve.

 

They found that at baseline grief and depression levels were high and strongly related. They also found that the higher the levels of mindfulness the lower the levels of grief and depression. After mindfulness training there were reductions in grief and depression and increases in mindfulness. These findings are similar to previous research of improvements in the mental health of caregivers after mindfulness training.

 

Interestingly, in comparison to pictures of strangers, when showed pictures of their loved ones with dementia the caregivers showed increases in brain activation in the dorsal anterior cingulate gyrus and precuneus. Viewing grief related words results in increased activity in the medial prefrontal cortex. The greater the decreases in grief following training the greater the activation of the medial prefrontal cortex and precuneus.

 

The structures showing activation to the caregiver’s loved one all are components of what is called the default mode network which is involved in self-referential thinking and thinking about others. It would appear that the mindfulness training resulted in greater thinking about the dementia patient and the self when viewing a picture of the patient. This may be reflective of heightened compassion for the self and the patient. This in turn, may produce improvements in the caregivers mental health.

 

So, improve caregiver psychological health by changing the brain response with mindfulness.

 

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

 

“By focusing on the fact that families and communities are producers of health and health care, not just clients or consumers, it empowers families and communities to co-create health interventions,” – Alicia Bazzano

 

Study Summary

 

Jain, F. A., Connolly, C. G., Moore, L. C., Leuchter, A. F., Abrams, M., Ben-Yelles, R. W., … Iacoboni, M. (2019). Grief, Mindfulness and Neural Predictors of Improvement in Family Dementia Caregivers. Frontiers in human neuroscience, 13, 155. doi:10.3389/fnhum.2019.00155

 

Abstract

Background: Family dementia caregivers often suffer from an immense toll of grief while caring for their loved ones. We sought to identify the clinical relationship between grief, depression and mindfulness and identify neural predictors of symptomatology and improvement.

Methods: Twenty three family dementia caregivers were assessed at baseline for grief, mindfulness and depression, of which 17 underwent functional magnetic resonance imaging (fMRI). During fMRI, caregivers were shown faces of either their dementia-stricken relative or that of a stranger, paired with grief-related or neutral words. In nine subjects, post fMRI scans were also obtained after 4 weeks of either guided imagery or relaxation. Robust regression was used to predict changes in symptoms with longitudinal brain activation (BA) changes as the dependent variable.

Results: Grief and depression symptoms were correlated (r = 0.50, p = 0.01), and both were negatively correlated with mindfulness (r = −0.70, p = 0.0002; r = −0.52, p = 0.01). Relative to viewing strangers, caregivers showed pictures of their loved ones (picture factor) exhibited increased activation in the dorsal anterior cingulate gyrus and precuneus. Improvement in grief but not mindfulness or depression was predicted by increased relative BA in the precuneus and anterior cingulate (different subregions from baseline). Viewing grief-related vs. neutral words elicited activity in the medial prefrontal cortex and precuneus.

Conclusions: Caregiver grief, depression and mindfulness are interrelated but have at least partially nonoverlapping neural mechanisms. Picture and word stimuli related to caregiver grief evoked brain activity in regions previously identified with bereavement grief. These activation foci might be useful as biomarkers of treatment response.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6530345/

Improve Psychological Well-Being of Recovered Cardiorespiratory Patients with Mindfulness

psyjdc Leave a comment

Improve Psychological Well-Being of Recovered Cardiorespiratory Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Meditation can be a useful part of cardiovascular risk reduction. I do recommend it, along with diet and exercise. It can also help decrease the sense of stress and anxiety.” – Deepak Bhatt

 

Patients who experience cardiorespiratory failure have now a high likelihood of survival if they are treated promptly in an intensive care unit. Unfortunately, after physical recovery and discharge the patients often experience negative physical and psychological consequences. These include physical symptoms and psychological issues such as depression, anxiety, and post-traumatic stress symptoms, stress, fear and foreboding, emotional disability, and social disruption. Treatments are needed to help alleviate these troubling residual symptoms.

 

Mindfulness practices have been shown to improve depression, anxiety, and post-traumatic stress disorder (PTSD), stress, fear and foreboding, emotional disability, and social function. It would seem reasonable then to project that mindfulness practice may be beneficial for the psychological well-being of patients who have recovered from cardiorespiratory failure. But such patients generally find it difficult or impossible to come to a clinic for treatment. As an alternative, mindfulness training can be delivered remotely with smartphone apps. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations for treatment. But the question arises as to the effectiveness of these programs.

 

In today’s Research News article “Effects of mindfulness training programmes delivered by a self-directed mobile app and by telephone compared with an education programme for survivors of critical illness: a pilot randomised clinical trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6460929/ ), Cox and colleagues recruited patients who had been released from the intensive care unit following cardiorespiratory failure and were at home. They were randomly assigned to receive a 4-session mindfulness training either by phone or smartphone app, or receive a web-based education program. They completed online measures of acceptability, feasibility, and usability and also were measured before and 3 months after the intervention for anxiety, depression, symptom severity, post-traumatic stress, physical distress, quality of life, coping skills, stress, and mindfulness.

 

The program was found to be acceptable, feasible, and usable as 83% of the patients completed the study with no significant differences between conditions. They found that in comparison to baseline and the education group, both mindfulness training groups had significant improvements in physical symptoms, posttraumatic stress symptoms, depression and anxiety. They also found that the greater the use of the mobile app the greater the improvement in depression.

 

The results of the study are encouraging and show that mindfulness training delivered either by telephone or a smartphone app is acceptable, feasible, and usable and is effective for the treatment of patients who were recovering from cardiorespiratory failure improving their physical and mental health. This is important as these patients are suffering and, like many others, have difficulty coming to a particular location at a particular time to receive therapist delivered mindfulness training. So, smartphone and phone-based programs are a valuable solution.

 

So, improve psychological well-being of recovered cardiorespiratory patients with mindfulness.

 

“Not only can meditation improve how your heart functions, but a regular practice can enhance your outlook on life and motivate you to maintain many heart-healthy behaviors, like following a proper diet, getting adequate sleep, and keeping up regular exercise,” – John Denninger

 

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

 

Cox, C. E., Hough, C. L., Jones, D. M., Ungar, A., Reagan, W., Key, M. D., … Porter, L. S. (2019). Effects of mindfulness training programmes delivered by a self-directed mobile app and by telephone compared with an education programme for survivors of critical illness: a pilot randomised clinical trial. Thorax, 74(1), 33–42. doi:10.1136/thoraxjnl-2017-211264

 

Abstract

Background:

Patients who are sick enough to be admitted to an intensive care unit (ICU) commonly experience symptoms of psychological distress after discharge, yet few effective therapies have been applied to meet their needs.

Methods:

Pilot randomized clinical trial with 3-month follow up conducted at two academic medical centers. Adult (≥18 years) ICU patients treated for cardiorespiratory failure were randomized after discharge home to one of three month-long interventions: a self-directed mobile app-based mindfulness program; a therapist-led telephone-based mindfulness program; or a web-based critical illness education program.

Results:

Among 80 patients allocated to mobile mindfulness (n= 31), telephone mindfulness (n=31), or education (n=18), 66 (83%) completed the study. For the primary outcomes, target benchmarks were exceeded by observed rates for all participants for feasibility (consent 74%, randomization 91%, retention 83%), acceptability (mean Client Satisfaction Questionnaire 27.6 [standard deviation 3.8]), and usability (mean Systems Usability Score 89.1 [SD 11.5]). For secondary outcomes, mean values (and 95% confidence intervals) reflected clinically significant group-based changes on the Patient Health Questionnaire depression scale (mobile (−4.8 [−6.6, −2.9]), telephone (−3.9 [−5.6, −2.2]), education (−3.0 [−5.3, 0.8]); the Generalized Anxiety Disorder scale (mobile −2.1 [−3.7, −0.5], telephone −1.6 [−3.0, −0.1], education −0.6 [−2.5, 1.3]), the Post-Traumatic Stress Scale (mobile −2.6 [−6.3, 1.2], telephone −2.2 [−5.6, 1.2], education −3.5 [−8.0, 1.0]), and the Patient Health Questionnaire physical symptom scale (mobile −5.3 [−7.0, −3.7], telephone −3.7 [−5.2, 2.2], education −4.8 [−6.8, 2.7]).

Conclusions:

Among ICU patients, a mobile mindfulness app initiated after hospital discharge demonstrated evidence of feasibility, acceptability, and usability and had a similar impact on psychological distress and physical symptoms as a therapist-led program. A larger trial is warranted to formally test the efficacy of this approach.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6460929/