Interrupt Drinking to Cope with Depression with Mindfulness

November 22, 2016 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“Mindfulness also helps people learn to relate to discomfort differently. When an uncomfortable feeling like a craving or anxiety arises, people . . . are able to recognize their discomfort, and observe it with presence and compassion, instead of automatically reaching for a drug to make it go away.” – Sarah Bowen

Inappropriate use of alcohol is a major societal problem. In fact, about 25% of US adults have engaged in binge drinking in the last month and 7% have what is termed an alcohol use disorder. Alcohol abuse is very dangerous and frequently fatal. Nearly 88,000 people in the US and 3.3 million globally die from alcohol-related causes annually, making it the third leading preventable cause of death in the United States. Drunk driving accounted for over 10,000 deaths; 31% of all driving fatalities. Excessive alcohol intake has been shown to contribute to over 200 diseases including alcohol dependence, liver cirrhosis, cancers, and injuries. It is estimated that over 5% of the burden of disease and injury worldwide is attributable to alcohol consumption.

Alcohol abuse often develops during adolescence and it on display with college students where about four out of five college students drink alcohol and about half of those consume alcohol through binge drinking. About 25 percent of college students report academic consequences of their drinking including missing class, falling behind, doing poorly on exams or papers, and receiving lower grades overall. More than 150,000 students develop an alcohol-related health problem. This drinking has widespread consequence for not only the students but also the college communities, and families. More than 690,000 students are assaulted by another student who has been drinking. More than 97,000 students are victims of alcohol-related sexual assault or date rape. 599,000 students receive unintentional injuries while under the influence of alcohol. Significantly, 1,825 college students die each year from alcohol-related unintentional injuries and between 1.2 and 1.5 percent of students indicate that they tried to commit suicide within the past year due to drinking or drug use.

These facts clearly highlight the need to explore methods to control excessive alcohol intake. One potential method is mindfulness as it has been shown to assist in the control of alcohol intake and in recovery from alcohol addiction . So it would make sense to further explore the effects of mindfulness on alcohol intake in college students. Many indicate that they drink to cope with problems including depression. In today’s Research News article “Depressive Symptoms and Alcohol-Related Problems Among College Students: A Moderated-Mediated Model of Mindfulness and Drinking to Cope.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1388915171132405/?type=3&theater

or see summary below. Bravo and colleagues recruited college students who had consumed alcohol at least one day in the past month and had them complete a questionnaire measuring mindfulness, depression, alcohol consumption, alcohol related problems, and drinking motives.

They found that the higher the level of the students’ mindfulness, the lower the levels of depression, alcohol related problems, and drinking to cope motives while the higher the levels of depression the greater the drinking to cope motives and alcohol related problems. They also found that the students’ depression levels were associated this drinking to cope which was, in turn, associated with alcohol related problems and this was moderated by mindfulness with this relationship weaker in highly mindful students and stronger in low mindfulness students.

These findings suggest that depression energizes the motivation to find a way to cope with the depression and this, in turn, leads to using alcohol intake for coping problems. This then leads to more problems related to alcohol consumption. But, mindfulness appears to interrupt this process by reducing the motivation to cope, it decreases the number of problems resulting from alcohol consumption. It can be speculated that mindfulness helps with the depression reducing the need to find a way to cope with it. This then produces a healthier relationship with alcohol intake.

These are potentially important findings. That mindfulness reduces depression is well known. But, these results suggest that this reduces the need to use alcohol intake to cope with the student’s negative emotional state. They further suggest that mindfulness training for college students could help to address alcohol intake problems that are so rampant in that population. It will take future studies to assess this speculation.

So, interrupt drinking to cope with depression with mindfulness.

“There are a few strategies for drinking mindfully. First, we meditated to set our intentions for drinking. While trying to remain in the present moment, we asked ourselves, “Am I drinking because I want to unwind…Or to drown my sorrows?” “Alcohol in itself is not good or bad. It’s our relationship to it that matters.” – Lodro Rinzler

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Bravo AJ, Pearson MR, Stevens LE, Henson JM. Depressive Symptoms and Alcohol-Related Problems Among College Students: A Moderated-Mediated Model of Mindfulness and Drinking to Cope. J Stud Alcohol Drugs. 2016 Jul;77(4):661-6. DOI: http://dx.doi.org/10.15288/jsad.2016.77.661

Abstract

OBJECTIVE: In college student samples, the association between depressive symptoms and alcohol-related problems has been found to be mediated by drinking-to-cope motives. Mindfulness-based interventions suggest that mindfulness may attenuate the conditioned response of using substances in response to negative emotional states, and trait mindfulness has been shown to be a protective factor associated with experiencing fewer alcohol-related problems. In the present study, we examined trait mindfulness as a moderator of the indirect associations of depressive symptoms on alcohol-related problems via drinking-to-cope motives.

METHOD: Participants were undergraduate students at a large, southeastern university in the United States who drank at least once in the previous month (n = 448). Participants completed an online survey regarding their personal mental health, coping strategies, trait mindfulness, and alcohol use behaviors. The majority of participants were female (n = 302; 67.4%), identified as being either White non-Hispanic (n = 213; 47.5%) or African American (n = 119; 26.6%), and reported a mean age of 22.74 (SD = 6.81) years. Further, 110 (25%) participants reported having a previous and/or current experience with mindfulness mediation.

RESULTS: As hypothesized, the indirect effects from depressive symptoms to alcohol-related problems via drinking-to-cope motives were weaker among individuals reporting higher levels of mindfulness than among individuals reporting lower and average levels of mindfulness.

CONCLUSIONS: The present study suggests a possible mechanism through which mindfulness-based interventions may be efficacious among college students: decoupling the associations between depressive symptoms and drinking-to-cope motives.

Reduce Depression with Mindfulness and Spirituality

November 20, 2016 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“If you have unproductive worries you can train yourself to experience those thoughts completely differently. You might think ‘I’m late, I might lose my job if I don’t get there on time, and it will be a disaster!’ Mindfulness teaches you to recognize, ‘Oh, there’s that thought again. I’ve been here before. But it’s just that—a thought, and not a part of my core self,’” – Elizabeth Hoge.

Clinically diagnosed depression is the most common form of mental illness, affecting over 6% of the population. It is difficult to treat and is generally treated with antidepressant medications. But, drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences. Hence, it is important to develop alternatives to drug treatment to help relieve the misery of depression.

Mindfulness training has been shown to be effective for depression alone or in combination with drug therapy. A commonly used form of mindfulness training Mindfulness-Based Stress Reduction (MBSR) has been found to be effective for a myriad of physical and psychological problems including depression. MBSR contains meditation, yoga, and body scan. These are ancient practices that were used primarily as spiritual practices. MBSR, however, was developed as a secular practice, divorced from its spiritual roots, to help improve physical and mental health. It is possible that MBSR, even as a secular practice, has spiritual consequences and these may, in turn, affect depression. Indeed, spirituality has been shown to be associated with reduced depression.

In today’s Research News article “Decreased Symptoms of Depression After Mindfulness-Based Stress Reduction: Potential Moderating Effects of Religiosity, Spirituality, Trait Mindfulness, Sex, and Age.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1386882204669035/?type=3&theateror see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4365440/

Greeson and colleagues investigate whether the effectiveness of Mindfulness-Based Stress Reduction (MBSR) for depression might be mediated by increased spirituality. They recruited MBSR participants and had them complete measures, both before and after training of mindfulness, anxiety, depression, spirituality, and religiosity.

They found, as have numerous other studies, that MBSR training resulted in a clinically significant (25%) decrease in depression scores. Additionally, they found that the greater the increases in mindfulness and in spirituality the greater the decreases in depression. A sophisticated statistical mediation modelling technique was applied to these data and revealed that the effectiveness of MBSR in reducing depression occurred as a result of the increased mindfulness and spirituality produced by MBSR. Hence, they found that MBSR reduces depression by increasing mindfulness and spirituality.

These are interesting results that suggest that even though MBSR was developed as a secular practice, divorced from its spiritual roots, it still produces increased spirituality. They further suggest that these increases in spirituality are as influential as the increases in mindfulness in reducing depression. This suggests that perhaps MBSR may be even more effective for depression if its spiritual aspects were reinserted into the program. It will take future research to test this speculation.

So, reduce depression with mindfulness and spirituality.

“Mindfulness helps to train individuals in bringing back the attention time and time again when it has wandered. And it is precisely through helping individuals to not get carried away by their thoughts that mindfulness has been shown to be so effective for conditions like anxiety and depression.” – 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

Study Summary

Greeson, J. M., Smoski, M. J., Suarez, E. C., Brantley, J. G., Ekblad, A. G., Lynch, T. R., & Wolever, R. Q. (2015). Decreased Symptoms of Depression After Mindfulness-Based Stress Reduction: Potential Moderating Effects of Religiosity, Spirituality, Trait Mindfulness, Sex, and Age. Journal of Alternative and Complementary Medicine, 21(3), 166–174. http://doi.org/10.1089/acm.2014.0285

Abstract

Objective: Mindfulness-based stress reduction (MBSR) is a secular meditation training program that reduces depressive symptoms. Little is known, however, about the degree to which a participant’s spiritual and religious background, or other demographic characteristics associated with risk for depression, may affect the effectiveness of MBSR. Therefore, this study tested whether individual differences in religiosity, spirituality, motivation for spiritual growth, trait mindfulness, sex, and age affect MBSR effectiveness.

Methods: As part of an open trial, multiple regression was used to analyze variation in depressive symptom outcomes among 322 adults who enrolled in an 8-week, community-based MBSR program.

Results: As hypothesized, depressive symptom severity decreased significantly in the full study sample (d=0.57; p<0.01). After adjustment for baseline symptom severity, moderation analyses revealed no significant differences in the change in depressive symptoms following MBSR as a function of spirituality, religiosity, trait mindfulness, or demographic variables. Paired t tests found consistent, statistically significant (p<0.01) reductions in depressive symptoms across all subgroups by religious affiliation, intention for spiritual growth, sex, and baseline symptom severity. After adjustment for baseline symptom scores, age, sex, and religious affiliation, a significant proportion of variance in post-MBSR depressive symptoms was uniquely explained by changes in both spirituality (β=−0.15; p=0.006) and mindfulness (β=−0.17; p<0.001).

Conclusions: These findings suggest that MBSR, a secular meditation training program, is associated with improved depressive symptoms regardless of affiliation with a religion, sense of spirituality, trait level of mindfulness before MBSR training, sex, or age. Increases in both mindfulness and daily spiritual experiences uniquely explained improvement in depressive symptoms.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4365440/

Get Mindful On-Line and Get Feeling Better

October 27, 2016 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“mindfulness exercises delivered in face-to-face settings or remotely via the Internet seem to yield similar changes in symptoms. The remote delivery does not seem to lessen the efficacy of mindfulness interventions.”– Johanna Boettcher

Mindfulness training has been shown through extensive research to be effective in improving the physical and psychological condition of otherwise healthy people and also treating the physical and psychological issues of people with illnesses. Techniques such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) as well as Yoga practice and Tai Chi or Qigong practice have been demonstrated to be particularly effective. This has led to an increasing adoption of these mindfulness techniques for the health and well-being of both healthy and ill individuals.

The vast majority of the mindfulness training techniques, adopted so far, require a certified trained therapist. This produces costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules. As a results, there has been attempts to develop on-line mindfulness training programs. These have tremendous advantages in decreasing costs and making training schedules much more flexible. But, the question arises as to whether these programs are as effective as their traditional counterparts. Many believe that the presence of a therapist is a crucial component to the success of the programs and the lack of an active therapist in on-line programs may greatly reduce their effectiveness.

In today’s Research News article “Mindfulness Interventions Delivered by Technology Without Facilitator Involvement: What Research Exists and What Are the Clinical Outcomes?” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1362554723768450/?type=3&theater

or see summary below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010616/

Fish and colleagues review the published research literature on the effectiveness of technology-based mindfulness training programs that did not include an active facilitator’s participation. They found 10 studies published, 9 of which were web-based programs. They found that, in general, the mindfulness programs produced increases in mindfulness and reductions in perceived stress, depression, anxiety, and rumination and these effects were maintained at follow-ups occurring as much as 6-months later. Unfortunately, compliance was relatively low and drop-out rates were relatively high.

These are encouraging findings and suggest that mindfulness can be effectively trained with web-based materials and that this can produce psychologically beneficial results. But, there were no direct comparisons to traditional programs. So, it cannot be determined if the web-based programs are as effective as traditional programs. In addition, there methods need to be developed to help maintain compliance and decrease dropping out of web-based programs. Regardless, the benefits are substantial and the results are sufficiently positive to encourage further research.

So, get mindful on-line and get feeling better.

“Internet delivery of mindfulness training may be a viable alternative if an evidence base can be established. It can be self-paced, less costly, and more accessible while additionally allowing for participant anonymity. “ – David Messer

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Fish, J., Brimson, J., & Lynch, S. (2016). Mindfulness Interventions Delivered by Technology Without Facilitator Involvement: What Research Exists and What Are the Clinical Outcomes? Mindfulness, 7(5), 1011–1023. http://doi.org/10.1007/s12671-016-0548-2

Abstract

New cost-effective psychological interventions are needed to contribute to treatment options for psychiatric and physical health conditions. This systematic review aims to investigate the current literature on one potentially cost-effective form of mindfulness-based therapy, those delivered through technological platforms without any mindfulness facilitator input beyond the initial design of the programme. Three electronic databases (Ovid Medline, PsychINFO and Embase) were searched for relevant keywords, titles, medical subject headings (MeSH) and abstracts using search terms derived from a combination of two subjects: ‘mindfulness’ and ‘technology’. Overall, ten studies were identified. The majority of studies were web-based and similar in structure and content to face-to-face mindfulness-based stress reduction courses. Clinical outcomes of stress (n = 5), depression (n = 6) and anxiety (n = 4) were reported along with mindfulness (n = 4), the supposed mediator of effects. All eight studies that measured significance found at least some significant effects (p < .05). The highest reported effect sizes were large (stress d = 1.57, depression d = .95, both ps > .005). However, methodological issues (e.g. selection bias, lack of control group and follow-up) which reflect the early nature of the work mean these largest effects are likely to be representative of maximal rather than average effects. Whilst there are important differences in the construction, length and delivery of interventions, it is difficult to draw firm conclusions about the most effective models. Suggestions of key characteristics are made though, needing further investigation preferably in standardised interventions. Given the existing research and the speed at which technology is making new platforms and tools available, it seems important that further research explores two parallel lines: first, refinement and thorough evaluation of already established technology-based mindfulness programmes and second, exploration of novel approaches to mindfulness training that combine the latest technological advances with the knowledge and skills of experienced meditation teachers.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010616/

Improve Cellular Molecular Health with a Meditation Retreat

October 24, 2016 psyjdc 2 Comments

By John M. de Castro, Ph.D.

“Researchers globally are continuing to explore how telomerase activity can be a measure of the effects of psychological stress on physical health. As they study the different types of meditation in more detail and uncover more of the benefits for cell aging, we will gain a deeper understanding of the new-found link between mind and body health. In the meantime, it seems that any type of meditation can do some good for your longevity.” – Courtney Danyel

Meditation practice has been shown to improve health and longevity. One way it appears to act is by altering the genes which govern cellular processes in our bodies. One of the most fundamental of these processes is cell replication. Our bodies are constantly turning over cells. Dying cells or damaged are replaced by new cells. The cells turn over at different rates but most cells in the body are lost and replaced between every few days to every few months. Needless to say were constantly renewing ourselves.

As we age the tail of the DNA molecule called the telomere shortens. When it gets very short cells have a more and more difficult time reproducing and become more likely to produce defective cells. On a cellular basis this is what produces aging. There is an enzyme in the body called telomerase that helps to prevent shortening of the telomere. So, processes that increase telomerase activity tend to slow the aging process. Contemplative practice has been shown to increase telomerase activity thus helping to prevent cellular aging. It is thought that this protection of telomeres could protect the body’s cells from aging and deterioration and be the basis for the increased longevity in contemplative practitioners. So, it is important to further investigate the effects of contemplative practices on telomeres and telomerase.

In today’s Research News article “Meditation and vacation effects have an impact on disease-associated molecular phenotypes.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1359334237423832/?type=3&theater

or see summary below, Epel and colleagues studied the impact of a 5-day intensive meditation retreat on the genes associated with health and longevity. They compared two groups of people participating in a meditation retreat, novices and experienced meditators to a novel vacation control group which spent a comparable amount of time in a spa in the same location at the same time simply relaxing. The participants were measured before and after the retreat or vacation and 1-month and 12 months later for depression, stress, mindfulness, vitality, and blood was drawn for genetic analysis.

They found that all three groups showed significant improvements in depression, stress, mindfulness and vitality after the treatment, which was maintained 1-month later, while the novice meditators on the retreat maintained the improvements in depression and stress at the 10-month follow-up. There were marked changes in gene expressions that were present in all groups that included genes involved in the suppression of stress-related responses and immune function related to acute-phase wound healing and inflammation. Hence, the retreat and the vacation produced change in gene expressions that reflected lower stress, wounding, and inflammation, all of which signal improved health and well-being. In addition, the experienced meditator group showed increased expression for genes associated with healthy aging and in increased telomerase levels. Hence, meditation appears to promote healthy aging and longevity by protecting the telomeres from shortening which signals aging.

These are outstanding results and demonstrate that a week’s break either in the form of a meditation retreat or as a simple vacation produces improved mental health and vitality and decreased stress and gene expressions reflecting reduced stress and inflammation. This is a marked endorsement of the importance of a vacation to the individual’s health and well-being. But, the addition of meditation produces additional benefits which signal healthy aging and longevity. This is a marked endorsement of meditation retreat to not only improve current well-being but also to produce healthier aging.

So, improve cellular molecular health with a meditation retreat.

“At the retreat, the teacher warned us over and over not to look for major shifts in our lives when we got home. But my constellation of little changes seemed just evidence, really, that with continuous effort, I could change the way my mind worked. I could decouple, however briefly, my sense of self from the meat sack of mind and body. And that decoupling gave me the ability to actually control where that sack was headed next.” – Zoe Schlanger

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Epel ES, Puterman E, Lin J, Blackburn EH, Lum PY, Beckmann ND, Zhu J, Lee E, Gilbert A, Rissman RA, Tanzi RE, Schadt EE. Meditation and vacation effects have an impact on disease-associated molecular phenotypes. Translational Psychiatry (2016) 6, e880; doi:10.1038/tp.2016.164. Published online 30 August 2016

Abstract

Meditation is becoming increasingly practiced, especially for stress-related medical conditions. Meditation may improve cellular health; however, studies have not separated out effects of meditation from vacation-like effects in a residential randomized controlled trial. We recruited healthy women non-meditators to live at a resort for 6 days and randomized to either meditation retreat or relaxing on-site, with both groups compared with ‘regular meditators’ already enrolled in the retreat. Blood drawn at baseline and post intervention was assessed for transcriptome-wide expression patterns and aging-related biomarkers. Highly significant gene expression changes were detected across all groups (the ‘vacation effect’) that could accurately predict (96% accuracy) between baseline and post-intervention states and were characterized by improved regulation of stress response, immune function and amyloid beta (Aβ) metabolism. Although a smaller set of genes was affected, regular meditators showed post-intervention differences in a gene network characterized by lower regulation of protein synthesis and viral genome activity. Changes in well-being were assessed post intervention relative to baseline, as well as 1 and 10 months later. All groups showed equivalently large immediate post-intervention improvements in well-being, but novice meditators showed greater maintenance of lower distress over time compared with those in the vacation arm. Regular meditators showed a trend toward increased telomerase activity compared with randomized women, who showed increased plasma Aβ42/Aβ40 ratios and tumor necrosis factor alpha (TNF-α) levels. This highly controlled residential study showed large salutary changes in gene expression networks due to the vacation effect, common to all groups. For those already trained in the practice of meditation, a retreat appears to provide additional benefits to cellular health beyond the vacation effect

Reduce Anxiety and Depression with Mindfulness and Yoga

October 22, 2016 psyjdc 1 Comment

By John M. de Castro, Ph.D.

“But for many patients dealing with depression, anxiety, or stress, yoga may be a very appealing way to better manage symptoms. Indeed, the scientific study of yoga demonstrates that mental and physical health are not just closely allied, but are essentially equivalent. The evidence is growing that yoga practice is a relatively low-risk, high-yield approach to improving overall health.” – Harvard Mental Health Letter

Many people have fond memories of their college years. It is likely, however, that they forgot about the stress and angst of those years. The truth is that college is generally very stressful for most students, from the uncertainty of freshman year, to the social stresses of emerging adulthood, to the anxiety of launching into a career after senior year. Evidence for the difficulties of these years can be found in college counseling centers which are swamped with troubled students. In fact, it’s been estimated that half of all college students report significant levels of anxiety and depression.

In recent years, it has become apparent that contemplative practices are powerful treatment options for depression and anxiety disorders either alone or in combination with other therapies. Both mindfulness training and yoga practice have been found to be effective. But, there has not been a direct comparison. In today’s Research News article “Controlled Trial of Mindfulness Versus Yoga: Effects on Depression and/or Anxiety in College Students.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1357219097635346/?type=3&theater

or see summary below, Falsafi recruited college students, with a diagnosis of wither anxiety disorder or depression, and randomly assigned them to receive 8 weeks, 75 minutes per week, plus 20 minutes per day of home practice, of either mindfulness training or Hatha yoga practice, or to a no-treatment control condition. All groups also continued their usual treatments of drugs or psychotherapy. The students were assessed for mindfulness, depression, anxiety, stress, and self-compassion prior to treatment, mid treatment (week 4), the end of treatment (week 8) and a follow-up at week 12.

They found that in comparison to the no-treatment control condition both the mindfulness training and yoga practice groups had significant decreases in anxiety, depression, and stress, and increases in mindfulness and these improvements were maintained at the 12-week follow-up. There were no significant differences found between the effects of mindfulness training or yoga practice, except that only the mindfulness training groups showed a significant increase in self-compassion. This latter difference was probably due to the fact that the mindfulness training included specific exercises to improve self-compassion including loving-kindness meditation practice.

These findings confirm previous findings that both mindfulness training and yoga practice produce clinically significant improvements in mindfulness, anxiety, depression, and stress, and that mindfulness improves self-compassion. The interesting aspect of this study is that comparable amounts of mindfulness and yoga practice did not differ in effectiveness. This is useful as different people prefer mindfulness training or yoga practice. So, individuals with anxiety and depression can choose which practice they are most comfortable with. This should increase participation and compliance and as a result effectiveness.

So, reduce anxiety and depression with mindfulness and yoga.

“People with anxiety have a problem dealing with distracting thoughts that have too much power. They can’t distinguish between a problem-solving thought and a nagging worry that has no benefit. If you have unproductive worries, you can train yourself to experience those thoughts completely differently. You might think ‘I’m late, I might lose my job if I don’t get there on time, and it will be a disaster!’ Mindfulness teaches you to recognize, ‘Oh, there’s that thought again. I’ve been here before. But it’s just that—a thought, and not a part of my core self,’” – Elizabeth Hoge

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Falsafi N. A Randomized Controlled Trial of Mindfulness Versus Yoga: Effects on Depression and/or Anxiety in College Students. J Am Psychiatr Nurses Assoc. 2016 Aug 26. pii: 1078390316663307. [Epub ahead of print]

Abstract

BACKGROUND: Depression and anxiety disorders are two of the most common mental disorders in the United States. These disorders are prevalent among college students.

OBJECTIVE: The main objective of this study is to compare the effectiveness of two different types of intervention practices (mindfulness vs. yoga) and a noninterventional control group in mitigating the effects of depression and/or anxiety in college students.

METHOD: A sample of 90 students (both genders) over age 18 who had a diagnosis of anxiety and/or depression was recruited from 11,500 undergraduate college students in a mid-size university. The study’s design included stratified-randomized controlled repeated measures with three groups: a mindfulness intervention group, a yoga-only intervention group, and a noninterventional group. Participants were randomly assigned to the aforementioned three groups. Participants in the intervention groups received an 8-week training either in mindfulness or yoga. Depressive, anxiety, stress symptoms, self-compassion, and mindfulness were measured at baseline, Week 4, Week 8, and Week 12.

RESULTS: Depressive, anxiety, and stress symptoms decreased significantly (p < .01) from baseline to follow-up conditions in both the mindfulness and yoga intervention groups. The changes in mindfulness scores were also significant in both groups. However, the changes in self-compassion scores were significant only in the mindfulness intervention group. No significant changes in the control group were demonstrated.

CONCLUSIONS: The findings from this study can provide useful information to nurses and other health care providers. This study may have implications for a cost-effective treatment for depression and anxiety.

Improve the Brain for Better memory in Aging with Yoga

September 28, 2016 psyjdc 1 Comment

By John M. de Castro, Ph.D.

“Yoga has been shown to reverse the aging process by the positive impact the practice has upon the body. It gives elasticity to your muscles, tones tendons and ligaments, reduces fat and slows weight gain, calms your heart rate, and eases your mind promoting a bodily as well as a spiritual peace.” – Amy Koller

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, the brain included. This includes our mental abilities which decline with age including impairments in memory, attention, and problem solving ability. It is inevitable and cannot be avoided. Using modern neuroimaging techniques, scientists have been able to view the changes that occur in the nervous system with aging. In addition, they have been able to investigate various techniques that might slow the process of neurodegeneration that accompanies normal aging. They’ve found that mindfulness practices reduce the deterioration of the brain that occurs with aging restraining the loss of neural tissue. Indeed, the brains of practitioners of meditation and yoga have been found to degenerate less with aging than non-practitioners.

There is some hope for age related cognitive decline, however, as there is evidence that they can be slowed. There are some indications that physical and mental exercise can reduce the rate of cognitive decline and lower the chances of dementia. 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. Mindfulness practices have been shown to improve cognitive processes while gentle mindful exercises such as Tai Chi and Qigong have been shown to slow age related cognitive decline.

Since the global population of the elderly is increasing at unprecedented rates, it is imperative to investigate methods to slow physical and mental aging and mitigate its effects. It would seem reasonable to hypothesize that yoga practice, which is both a mindfulness practice and a physical exercise, might decrease age related cognitive decline and the associated changes in the nervous system. In today’s Research News article “Changes in Neural Connectivity and Memory Following a Yoga Intervention for Older Adults: A Pilot Study.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1335144686509454/?type=3&theater

or see summary below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4927889/

Eyre and colleagues recruited elderly, over 55 years of age, and randomly assigned them to either 12-weeks of yoga training or 12-weeks of memory enhancement training. Depression levels, and memory ability were assessed at baseline and at 12-weeks after the interventions. In addition, the participants’ brains were scanned before and after training with Functional Magnetic Imaging (f-MRI) to ascertain the connectivity of various brain systems.

They found that the yoga group had significant improvements in depression and visuospatial memory. But, there were no significant differences between the yoga and memory enhancement training groups. They also investigated the relationships of the memory changes with changes in connectivity within the brain’s Default Mode Network (DMN) and found that the greater the increases in connectivity, the greater the improvements in memory in the elderly. The Default Mode Network (DMN) is known to be involved in memory, in particular in episodic memory retrieval, prospective memory encoding, and autobiographical memory retrieval. So, it makes sense that its connectivity would be increased in parallel to memory enhancements.

These results suggest that both yoga and memory enhancement training improve the interactions (connectivity) between structures of the brain that are involved in memory processing and that this results in improved memory ability in the elderly. It is interesting that yoga increased DMN connectivity in this study as contemplative practices have been shown to decrease the size and activity of the DMN. This suggests that yoga practice either may act differently or that just the memory components of the DMN are enhanced. It will take further research to clarify this.

The present results make it clear that yoga practice helps to slow the cognitive decline that occurs with aging. But, yoga is known to have a myriad of other physical, psychological, and physical benefits. It appears to be an excellent practice to allow for healthy aging. So, improve the brain for better memory in aging with yoga.

CMCS – Center for Mindfulness and Contemplative Studies

“It is a known fact that yoga imparts more energy, strength and flexibility. Some people turn to yoga for a reduction in stress, and then stick with it because it makes them feel, look, and remain young. Unlike traditional exercises, yoga blends moves that enhance circulation, flexibility, balance and strength, along with meditative techniques, including deep breathing. In fact, Yoga serves as a natural face-lift-it cleanes, relaxes, and restores. Yoga reduces signs of ageing considerably.” – Larry Payne

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

Study Summary

Eyre, H. A., Acevedo, B., Yang, H., Siddarth, P., Van Dyk, K., Ercoli, L., … Lavretsky, H. (2016). Changes in Neural Connectivity and Memory Following a Yoga Intervention for Older Adults: A Pilot Study. Journal of Alzheimer’s Disease, 52(2), 673–684. http://doi.org/10.3233/JAD-150653

Abstract

Background: No study has explored the effect of yoga on cognitive decline and resting-state functional connectivity.

Objectives: This study explored the relationship between performance on memory tests and resting-state functional connectivity before and after a yoga intervention versus active control for subjects with mild cognitive impairment (MCI).

Methods: Participants ( ≥ 55 y) with MCI were randomized to receive a yoga intervention or active “gold-standard” control (i.e., memory enhancement training (MET)) for 12 weeks. Resting-state functional magnetic resonance imaging was used to map correlations between brain networks and memory performance changes over time. Default mode networks (DMN), language and superior parietal networks were chosen as networks of interest to analyze the association with changes in verbal and visuospatial memory performance.

Results: Fourteen yoga and 11 MET participants completed the study. The yoga group demonstrated a statistically significant improvement in depression and visuospatial memory. We observed improved verbal memory performance correlated with increased connectivity between the DMN and frontal medial cortex, pregenual anterior cingulate cortex, right middle frontal cortex, posterior cingulate cortex, and left lateral occipital cortex. Improved verbal memory performance positively correlated with increased connectivity between the language processing network and the left inferior frontal gyrus. Improved visuospatial memory performance correlated inversely with connectivity between the superior parietal network and the medial parietal cortex.

Conclusion: Yoga may be as effective as MET in improving functional connectivity in relation to verbal memory performance. These findings should be confirmed in larger prospective studies.

Keywords: Aging, cognitive decline, memory training, mild cognitive impairment, mind-body, older adults, subjective memory complaints, yoga

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4927889/

Be a Better Parent with Self-Compassion

September 24, 2016 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“Parental depression negatively affects fathers’ and mothers’ caregiving, material support, and nurturance, and is associated with poor health and developmental outcomes for children of all ages, including prenatally. Depressed mothers are more likely than non-depressed mothers to have poor parenting skills and to have negative interactions with their children.” – Child Trends

Clinically diagnosed depression is the most common form of mental illness, affecting over 6% of the population. In general, it involves feelings of sadness, emptiness or hopelessness, irritability or frustration, loss of interest or pleasure in most or all normal activities, sleep disturbances, tiredness and lack of energy, anxiety, agitation, feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things that aren’t your responsibility, suicidal thoughts, suicide attempts or suicide. Needless to say individuals with depression are miserable.

Depression does not occur in isolation. When an individual in a family is depressed it affects all of the members of the family. When it is a parent, it affects how the child is raised and what he/she experiences during the formative years. This can have long-lasting effects on the child. So, it is important to study how depression affects childrearing and the child and what are the factors that might mitigate or eliminate the effects of parental depression on the child.

A characteristic of western society is that many people don’t seem to like themselves. The term used to describe this that I prefer is self-dislike. This is often highly associated with depression. Its opposite is self-compassion; being kind and understanding toward yourself in the face of inadequacies or short-comings. So, it would make sense to investigate the relationship of self-compassion with depression and child rearing. In today’s Research News article “Self-Compassion and Parenting in Mothers and Fathers with Depression.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1331610153529574/?type=3&theater

or see summary below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923280/

Psychogiou and colleagues do just that. They recruited parents of young children (2-6 years of age) who were also suffering with depression. They measured them for depression, self-compassion, parental emotions, children’s internalizing and externalizing, and parental coping with children’s negative emotions.

They found that for both mothers and fathers, low levels of depression were significantly associated with high levels of self-compassion. Parenting ability was also associated with self-compassion, with mother who were high in self-compassion expressing fewer critical comments and more positive comments toward their children. In addition, parents who were high in self-compassion had fewer distressed reactions to their children’s behavior. High parental self-compassion was also significantly associated with the children having low internalizing and externalizing symptoms. Hence, depressed parents who have high levels of self-compassion are less critical of their children, responded better to their children’s behaviors, and produced less self-blame (internalizing) in their children.

These findings suggest that self-compassion may be to some extent an antidote to depression and to mitigate the effects of that depression on parenting. It would appear that if the parent is kind and understanding toward themselves it reduces their depression level and the kindness and understanding appears to transfer to their children producing more positive and productive parenting behaviors. But, the interpretation of these findings must be tempered as the results are correlational and as such do not demonstrate causation. Future studies should attempt to manipulate self-compassion and determine the effects of increasing it on depression and parenting. Since, mindfulness practices are known to increase self-compassion and improve caregiving and parenting, it would make sense to apply mindfulness training to depressed parents and observe its effects.

So, be a better parent with self-compassion.

“We are all used to working on our self-esteem by asking ourselves, “Am I being a good parent or a bad parent?” The problem is that having high self-esteem is contingent upon experiencing success. If we don’t meet our own standards, we feel terrible about ourselves. Self-compassion, in contrast, is not a way of judging ourselves positively or negatively. It is a way of relating to ourselves kindly and embracing ourselves as we are, flaws and all.” – Kristin Neff

CMCS – Center for Mindfulness and Contemplative Studies

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Study Summary

Psychogiou, L., Legge, K., Parry, E., Mann, J., Nath, S., Ford, T., & Kuyken, W. (2016). Self-Compassion and Parenting in Mothers and Fathers with Depression. Mindfulness, 7, 896–908. http://doi.org/10.1007/s12671-016-0528-6

Abstract

Depression in parents impairs parenting and increases the risk of psychopathology among their children. Prevention and intervention could be informed by knowledge of the mechanisms that break the inter-generational transmission of psychopathology and build resilience in both parents and their children. We used data from two independent studies to examine whether higher levels of self-compassion were associated with better parenting and fewer emotional and behavioral problems in children of parents with a history of depression. Study 1 was a pilot trial of mindfulness-based cognitive therapy that included 38 parents with recurrent depression. Study 2 was a longitudinal study that consisted of 160 families, including 50 mothers and 40 fathers who had a history of depression. Families were followed up approximately 16 months after the first assessment (time 2; n = 106 families). In both studies, self-compassion was assessed with the Self-Compassion Scale. Parents reporting higher levels of self-compassion were more likely to attribute the cause of their children’s behavior to external factors, were less critical, and used fewer distressed reactions to cope with their children’s emotions. Parents’ self-compassion was longitudinally associated with children’s internalizing and externalizing problems, but these associations became nonsignificant after controlling for child gender, parent education, and depressive symptoms. Future larger scale and experimental designs need to examine whether interventions intended to increase self-compassion might reduce the use of negative parenting strategies and thereby the inter-generational transmission of psychopathology.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923280/

Mindfulness Training Equals Drugs in Effectiveness for Depression

September 8, 2016 psyjdc Leave a comment

Mindfulness Training Equals Drugs in Effectiveness for Depression

By John M. de Castro, Ph.D.

“People at risk for depression are dealing with a lot of negative thoughts, feelings and beliefs about themselves and this can easily slide into a depressive relapse. MBCT helps them to recognize that’s happening, engage with it in a different way and respond to it with equanimity and compassion.” – Willem Kuyken

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. It is distinguishable from everyday sadness or grief by the depth, intensity, and range of symptoms. These can include feelings of sadness, tearfulness, emptiness or hopelessness, worthlessness , angry outbursts, irritability or frustration, even over small matters, loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports, sleep disturbances, tiredness and lack of energy, so even small tasks take extra effort, changes in appetite, anxiety, agitation or restlessness, slowed thinking, suicidal thoughts, and suicide attempts or suicide. Needless to say individuals with depression are miserable.

Depression is generally episodic, coming and going. Some people only have a single episode but most have multiple reoccurrences of depression. Depression appears to be the result of a change in the nervous system that is primarily treated with drugs that alter the affected neurochemical systems. But, depression can be difficult to treat. 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. Being depressed and not responding to treatment 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 be applied when the typical treatments fail.

Mindfulness training is another alternative treatment for depression. It has been shown to be an effective treatment and is also effective for the prevention of its recurrence. Mindfulness Based Cognitive Therapy (MBCT) was specifically developed to treat depression and can be effective even in the cases where drugs fail. The combination of drugs along with MBCT has been shown to be quite effective in treating depression and preventing relapse. Since, drugs have troubling side effects and can lose effectiveness over time, it is important to determine if after remission, MBCT can continue to prevent relapse if the drugs are removed. In other words, after MBCT can the drugs be withdrawn.

In today’s Research News article “The effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse/recurrence: results of a randomised controlled trial (the PREVENT study).” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1317432901613966/?type=3&theater

or see summary below or view the full text of the study at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4781448/ Kuyken and colleagues randomly assigned patients with major depression who are taking antidepressant medications to either continue their medication or taper off the drugs and receive Mindfulness Based Cognitive Therapy (MBCT). Patients were followed for two years. They found that MBCT was as effective as continuing drugs in preventing reoccurrence of the depression, and reducing the number of depression free days, symptoms of depression, quality of life, and other psychological problems. Hence, MBCT was found to be a safe and effective alternative to continued drug treatment.

These results are striking. Mindfulness Based Cognitive Therapy (MBCT) can be used to replace drugs. It is not superior, but it appears to be equal to drug treatments in relieving depression and preventing its reoccurrence. The fact that its benefits were still present two years later indicates that MBCT produces lasting effects. Since MBCT does not have the troubling side effects that typically accompany the drugs, it may be a superior treatment. So, MBCT should be strongly considered to replace antidepressant drugs in the treatment of recurrent major depression

“Mindfulness is a valuable practice for improving the cognitive symptoms of depression, such as distorted thinking and distractibility. It helps individuals recognize these more subtle symptoms, realize that thoughts are not facts and refocus their attention to the present.” –

Margarita Tartakovsky

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

Study Summary

Kuyken, W., Hayes, R., Barrett, B., Byng, R., Dalgleish, T., Kessler, D., … Byford, S. (2015). The effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse/recurrence: results of a randomised controlled trial (the PREVENT study). Health Technology Assessment (Winchester, England), 19(73), 1–124. http://doi.org/10.3310/hta19730

Abstract

BACKGROUND: Individuals with a history of recurrent depression have a high risk of repeated depressive relapse/recurrence. Maintenance antidepressant medication (m-ADM) for at least 2 years is the current recommended treatment, but many individuals are interested in alternatives to m-ADM. Mindfulness-based cognitive therapy (MBCT) has been shown to reduce the risk of relapse/recurrence compared with usual care but has not yet been compared with m-ADM in a definitive trial.

OBJECTIVES: To establish whether MBCT with support to taper and/or discontinue antidepressant medication (MBCT-TS) is superior to and more cost-effective than an approach of m-ADM in a primary care setting for patients with a history of recurrent depression followed up over a 2-year period in terms of preventing depressive relapse/recurrence. Secondary aims examined MBCT’s acceptability and mechanism of action.

DESIGN: Single-blind, parallel, individual randomised controlled trial.

SETTING: UK general practices.

PARTICIPANTS: Adult patients with a diagnosis of recurrent depression and who were taking m-ADM.

INTERVENTIONS: Participants were randomised to MBCT-TS or m-ADM with stratification by centre and symptomatic status. Outcome data were collected blind to treatment allocation and the primary analysis was based on the principle of intention to treat. Process studies using quantitative and qualitative methods examined MBCT’s acceptability and mechanism of action.

MAIN OUTCOMES MEASURES: The primary outcome measure was time to relapse/recurrence of depression. At each follow-up the following secondary outcomes were recorded: number of depression-free days, residual depressive symptoms, quality of life, health-related quality of life and psychiatric and medical comorbidities.

RESULTS: In total, 212 patients were randomised to MBCT-TS and 212 to m-ADM. The primary analysis did not find any evidence that MBCT-TS was superior to m-ADM in terms of the primary outcome of time to depressive relapse/recurrence over 24 months [hazard ratio (HR) 0.89, 95% confidence interval (CI) 0.67 to 1.18] or for any of the secondary outcomes. Cost-effectiveness analysis did not support the hypothesis that MBCT-TS is more cost-effective than m-ADM in terms of either relapse/recurrence or quality-adjusted life-years. In planned subgroup analyses, a significant interaction was found between treatment group and reported childhood abuse (HR 1.89, 95% CI 1.06 to 3.38), with delayed time to relapse/recurrence for MBCT-TS participants with a more abusive childhood compared with those with a less abusive history. Although changes in mindfulness were specific to MBCT (and not m-ADM), they did not predict outcome in terms of relapse/recurrence at 24 months. In terms of acceptability, the qualitative analyses suggest that many people have views about (dis)/continuing their ADM, which can serve as a facilitator or a barrier to taking part in a trial that requires either continuation for 2 years or discontinuation.

CONCLUSIONS: There is no support for the hypothesis that MBCT-TS is superior to m-ADM in preventing depressive relapse/recurrence among individuals at risk for depressive relapse/recurrence. Both treatments appear to confer protection against relapse/recurrence. There is an indication that MBCT may be most indicated for individuals at greatest risk of relapse/recurrence. It is important to characterise those most at risk and carefully establish if and why MBCT may be most indicated for this group.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4781448/

Detach from Depression with Mindfulness

September 1, 2016 psyjdc Leave a comment

By John M. de Castro, Ph.D.

Depression is epidemic. Major depressive disorder affects approximately 14.8 million American adults, or about 6.7 percent of the U.S. population age 18 and older in a given year. It also affects children with one in 33 children and one in eight adolescents having clinical depression. It is so serious that it can be fatal as about 2/3 of suicides are caused by depression. It makes lives miserable, not only the patients but also associates and loved ones, interferes with the conduct of normal everyday activities, and can come back repeatedly. Even after complete remission, 42% have a reoccurrence.

Depression appears to be the result of a change in the nervous system that can generally only be reached with drugs that alter the affected neurochemical systems. But, of the patients treated initially with drugs only about a third attain remission and even after repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attain remission. In addition, the drugs can lose effectiveness over time and can have problematic side effects, So, it is important that other safe and effective treatments be identified.

Depression has also been long hypothesized to have roots in early childhood. Patterns of mother-child interactions are thought to produce different forms of attachment styles in the infant, including secure, insecure, avoidant, ambivalent, fearful, preoccupied, and disorganized attachment styles. All of these styles, save secure attachment style, have been found to be associated with depression.

Mindfulness training has been shown to be effective for depression alone or in combination with drug therapy. One way that mindfulness may effect depression is by altering the effects of attachment style on depression. In today’s Research News article “Mediating Role of Mindfulness as a Trait Between Attachment Styles and Depressive Symptoms.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1310795515611038/?type=3&theater

or see summary below. Linares and colleagues investigate this hypothesis. They recruited over 500 adults and measured depression, emotional distress, mindfulness, decentering and attachment styles and statistically investigate the interrelationships between these variables.

They found that high levels of depression were associated with low mindfulness, decentering, and secure attachment styles and with high levels of anxiety and preoccupied and fearful attachment styles. The preoccupied and fearful attachment styles had primarily direct influences with depression. There were small but significant mediation effects for the non-judging facet of mindfulness and for decentering.

These results suggest that attachment styles do indeed affect depression, but mainly do so directly. Non-judging mindfulness and decentering are affected by attachment styles but only have a small effect on the attachment style effects on depression. As has been demonstrated repeatedly in the research literature, mindfulness reduces depression and attachment styles can increase depression, but appear to do so relatively independently. Since they seem to act on depression relatively independently, it may be reasonable to test the combination of mindfulness treatment and treatment for attachment styles for the relief of depression.

So, detach from depression 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

Study Summary

Linares L, Jauregui P, Herrero-Fernández D, Estévez A. Mediating Role of Mindfulness as a Trait Between Attachment Styles and Depressive Symptoms. J Psychol. 2016 Jul 28:1-16. [Epub ahead of print] DOI: 10.1080/00223980.2016.1207591

Abstract

Attachment styles and dysfunctional symptoms have been associated. This relationship could be affected by metacognitive capacity. The aim of this study is to clarify the relationship between depressive symptoms, attachment styles, and metacognitive capacity. In addition, the mediating role of metacognition between attachment and depressive symptoms has been studied. A total of 505 participants recruited from the general population of the province of Bizkaia (Spain) completed questionnaires regarding depression, anxiety, mindfulness, decentering, and attachment. Results showed positive and significant relations between (a) dysfunctional symptoms and insecure attachment styles and (b) metacognitive capacity and secure attachment style. Additionally, the mediating role of metacognition between attachment and depressive symptoms was confirmed. Intervention in metacognitive abilities such as mindfulness could be a useful therapeutic tool for depressive symptoms.

Reduce Depression and PTSD Symptoms in Caregivers for Dying Children with Mindfulness

August 30, 2016 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“Mindfulness Self-Compassion turns the usual self-critical paradigm around and asks the care partner, in the midst of a difficult caregiving moment; become aware of the emotions that arise in the moment and where they reside in your body (Mindfulness), recognize that there are others who suffer in this way (Common Humanity), and then offer yourself what you need in the moment (Self-Kindness). Again, this is not to change the moment of suffering for the person you are caring for or for yourself, but because you are suffering too! In the end this supports both of you in a softer way and provides the circumstances, not necessarily for ‘cure’ but for healing.” – Sarel Rowe

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations burnout is all too prevalent. This is the fatigue, cynicism, and professional inefficacy that comes with work-related stress. Burnout is associated with depression-like symptoms and often post-traumatic stress disorder (PTSD)-like symptoms. Healthcare is a high stress occupation. It is estimated that over 45% of healthcare workers experience burnout.

Providing care for the dying can be can be a very satisfying, rewarding, and even joyful experience. But, over time, caregiving can wear the caregiver out and can lead to burnout. Indeed, 62% of physicians involved with end of life care report symptoms of burnout. This is magnified many times when the patient is a child. This is supposed to be the beginning of life, not its end. It is often the case that caregivers for the dying become personally attached to their patient. With a child, that attachment becomes deep and profoundly emotional. This level of emotional stress is difficult to repeatedly endure. So, there is a need to find ways to help the healthcare professionals who provide care in general, but particularly for those working with children to cope with the stress and emotional drain.

It has recently been demonstrated that mindfulness training can help caregivers cope with the stress. It has also been shown to help to prevent burnout in multiple occupations and particularly in healthcare workers. So, it would make sense to investigate the effectiveness of mindfulness training in preventing burnout in healthcare workers providing end of life care to children. In today’s Research News article “Multimodal Mindfulness Training to Address Mental Health Symptoms in Providers Who Care for and Interact with Children in Relation to End-of-Life Care.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1308949565795633/?type=3&theater

or see summary below. O’Mahoney and colleagues recruited palliative care and other health-care professionals who were involved in caring for terminally ill children. They received a 9-week mindfulness training program meeting once a week for 2 hours in the evening. They were measured before and after training for experiential avoidance, cognitive fusion (taking thoughts as true and upsetting), depression, burnout, and PTSD symptoms.

They found that the mindfulness training resulted in significant decreases in depression and post-traumatic stress disorder (PTSD) symptoms. These are interesting preliminary results. But, there is a need to follow this up with a randomized controlled trial to determine unequivocally if the training was responsible for the improvements. The effects do seem reasonable as mindfulness training has been shown in different contexts to reduce depression and improve PTSD symptoms. These findings simply extend these general understandings of the effects of mindfulness training to end of life care for children. But, again demonstrate the usefulness of mindfulness training to relieve the psychological effects of caregiving.

So, reduce depression and PTSD symptoms in caregivers for dying children with mindfulness.

CMCS – Center for Mindfulness and Contemplative Studies

“We are set up for short-term stress, but caregiving is long-term stress. Mindfulness 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.” – Griffiths Vega

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

Study Summary

O’Mahony S, Gerhart J, Abrams I, Greene M, McFadden R, Tamizuddin S, Levy MM. A Multimodal Mindfulness Training to Address Mental Health Symptoms in Providers Who Care for and Interact With Children in Relation to End-of-Life Care. Am J Hosp Palliat Care. 2016 Jul 21. pii: 1049909116660688. [Epub ahead of print]

Abstract

AIM: Medical providers may face unique emotional challenges when confronted with the suffering of chronically ill, dying, and bereaved children. This study assessed the preliminary outcomes of participation in a group-based multimodal mindfulness training pilot designed to reduce symptoms of burnout and mental health symptoms in providers who interact with children in the context of end-of-life care.

METHODS: A total of 13 medical providers who care for children facing life-threatening illness or bereaved children participated in a 9-session multimodal mindfulness session. Mental health symptoms and burnout were assessed prior to the program, at the program midpoint, and at the conclusion of the program.

RESULTS: Participation in the pilot was associated with significant reductions in depressive and posttraumatic stress disorder (PTSD) symptoms among providers (P < .05).

CONCLUSION: Mindfulness-based programs may help providers recognize and address symptoms of depression and PTSD. Additional research is needed to enhance access and uptake of programming among larger groups of participan