Depression

Improve College Student Psychological Well-Being with Mindfulness and Relaxation

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Improve College Student Psychological Well-Being with Mindfulness and Relaxation

 

By John M. de Castro, Ph.D.

 

“mindfulness helps focus by tuning out distractions, improving memory, decision-making and attention skills. . . It is not a panacea; it is not for everyone. However, it is very worth trying. It may be the next evolution in health care and well-being.” – Affordable Colleges

 

In the modern world education is a key for success. There is a lot of pressure on college students to excel so that they can get the best jobs after graduation. The pressure can lead to stress, anxiety, and depression which can impede the student’s mental health, well-being, and school performance. So it is important that methods be found to reduce the college students’ responses to stress; to make them more resilient.

 

Contemplative practices including meditation, mindfulness training, exercise, Tai Chi and Qigong, and yoga practice have been shown to reduce the psychological and physiological responses to stress, relieve anxiety, and reduce depression .  A therapeutic technique that contains mindfulness training and Cognitive Behavioral Therapy (CBT) is Acceptance and Commitment Therapy (ACT). It focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. This suggests that ACT may be effective in improving the psychological well-being of college students.

 

In today’s Research News article “Effect of Acceptance and Commitment Therapy Combined with Music Relaxation Therapy on the Self-Identity of College Students.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8853795/ ) Yin recruited college students and assigned them to receive either  a 2-month program of Acceptance and Commitment Therapy (ACT) plus systematic muscle relaxation with music, or conventional self-identity intervention, including health education, regular communication, and regular follow-up. They were measured before and after the treatments for anxiety, depression, resilience, and quality of life.

 

They found that in comparison to baseline and the control condition Acceptance and Commitment Therapy (ACT) plus relaxation produced significant reductions in anxiety and depression and significant increases in resilience and quality of life. It cannot be determined if the combination of ACT and relaxation was necessary for the benefits or is each individually may have been effective.

 

So, improve college student psychological well-being with mindfulness and relaxation.

 

“mindfulness . . . can also be a great tool for students, reducing stress and increasing well-being and productivity.” – Rebecca Enderby

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Yin J. (2022). Effect of Acceptance and Commitment Therapy Combined with Music Relaxation Therapy on the Self-Identity of College Students. Journal of healthcare engineering, 2022, 8422903. https://doi.org/10.1155/2022/8422903

 

Abstract

This paper analyzes various effects of acceptance and commitment therapy combined with music relaxation therapy on the self-identity of the college students. Through open recruitment and following the principle of voluntary and confidential, 80 college students were selected from our school, and then they were divided into two groups: the control group (40 cases) and the observation group (40 cases). The observation group received acceptance and commitment therapy combined with music relaxation therapy. For the control group, conventional mental health interventions were administered. Two months after intervention, psychological status, mental resilience, and quality of life scores were compared between the two groups. Before intervention, there was no significant difference in SAS and SDS scores between the two groups (P > 0.05). After intervention, SAS and SDS scores were significantly higher than those in the control group, and the difference between the two groups was statistically significant (P < 0.05). Before intervention, there was no significant difference in the scores of toughness, strength, and optimism between the two groups (P > 0.05). After intervention, the scores of toughness, strength, and optimism in the two groups were all improved, and the scores of mental resilience in the observation group were higher than those in the control group, with statistical significance (P < 0.05). Before intervention, there was no significant difference in the quality of life scores between the observation group and the control group (P > 0.05). After intervention, the quality of life score of the observation group was higher than that of the control group, and the difference between the two groups was statistically significant (P < 0.05). The combined application of acceptance and commitment therapy and music relaxation therapy can help college students to improve their mental state, improve their mental resilience, enhance their evaluation of life quality, improve their sense of self-identity, and reduce the probability of the occurrence of unhealthy emotions such as depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8853795/

 

Different Mindfulness Facets Have Differing Associations with Depersonalization Symptoms

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Different Mindfulness Facets Have Differing Associations with Depersonalization Symptoms

 

By John M. de Castro, Ph.D.

 

“Depersonalization symptoms can be tough to deal with, especially when you’re experiencing them 24/7. But just remember they’re caused by anxiety, and they’re part of your body’s defense mechanism to protect you from a traumatic experience.” – Shaun O’Conner

 

Depersonalization is defined as “Depersonalization/derealization disorder involves a persistent or recurring feeling of being detached from one’s body or mental processes, like an outside observer of one’s life (depersonalization), and/or a feeling of being detached from one’s surroundings (derealization).” – Merck Manuals. It is not known what the relationship is between mindfulness and depersonalization. In some ways it would be expected that mindfulness would be the antithesis of depersonalization. But in others it may actually exacerbate it as there are similarities with spiritual awakening.

 

In today’s Research News article Mindfulness and Depersonalization: a Nuanced Relationship.(See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9043097/ ) Levin and colleagues recruited healthy adults online and had them complete measures of depersonalization symptoms, anxiety, depression, perceived stress, and the five facets of mindfulness.

 

They found that the higher the levels of depersonalization symptoms the higher the levels of psychological distress and the observing and nonreactivity facets of mindfulness and the lower the levels of the acting with awareness and nonjudging facets. The relationships of depersonalization with the mindfulness facets were still significant even after controlling for the levels of psychological distress.

 

The reported relationships of depersonalization with the acting with awareness and nonjudging facets of mindfulness makes sense that they are clearly indicative of attachment with the outside environment. On the other hand, the positive relationships with observing internal experience and nonreactivity makes sense as they have internal focus and depersonalization involves detachment from the internal experiences. So, using mindfulness training as a treatment for depersonalization is probably not a good idea.

 

So, mindfulness has a complex relationship with depersonalization.

 

“Sufferers of depersonalization and long-term meditators make surprisingly similar reports about reductions in their experience of being agents of their actions and as owners of their thoughts and behaviors.” – George Deane

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Levin, K. K., Gornish, A., & Quigley, L. (2022). Mindfulness and Depersonalization: a Nuanced Relationship. Mindfulness, 1–11. Advance online publication. https://doi.org/10.1007/s12671-022-01890-y

 

Abstract

Objectives

Although depersonalization has been described as the antithesis of mindfulness, few studies have empirically examined this relationship, and none have considered how it may differ across various facets of mindfulness, either alone or in interaction. The present study examined the relationship between symptoms of depersonalization and facets of dispositional mindfulness in a general population sample.

Methods

A total of 296 adult participants (139 male, 155 female, 2 other) were recruited online via Qualtrics and completed the Cambridge Depersonalisation Scale; Depression, Anxiety, and Stress Scale; and Five Facet Mindfulness Questionnaire.

Results

Controlling for general distress, depersonalization symptoms were positively associated with Observe, Describe, and Nonreactivity facets and negatively associated with Acting with Awareness and Nonjudgment facets. After controlling for intercorrelations among the facets, depersonalization symptoms remained significantly associated with higher Nonreactivity and lower Acting with Awareness. The overall positive relationship between depersonalization symptoms and the Observe facet was moderated by both Nonjudgment and Nonreactivity. Specifically, higher Observing was related to increased depersonalization symptoms at low levels of Nonjudgment and to decreased symptoms at low levels of Nonreactivity.

Conclusions

The current study provides novel insight into the relationship between depersonalization symptoms and various aspects of mindfulness. Experiences of depersonalization demonstrated divergent relationships with mindfulness facets, alone and in interaction. The results may inform theoretical models of depersonalization and mindfulness-based interventions for depersonalization.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9043097/

 

Improve Anxiety and the Gut Microbiome with Mindfulness

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Improve Anxiety and the Gut Microbiome with Mindfulness

 

By John M. de Castro, Ph.D.

 

“A healthy gut can be different iterations of bacteria for different people, because it is this diversity that maintains wellness.” – Jennifer Wolkin

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. A characterizing feature of anxiety disorders is that the sufferer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Anxiety disorders have generally been treated with drugs. But there are considerable side effects, and these drugs are often abused. There are several psychological therapies for anxiety. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders.

 

The GI tract contains intestinal micro-organisms, flora, bacteria, known as the microbiome, that have major effects throughout the body through the bacteria-intestinal-brain axis. This can affect overall health and well-being including anxiety. So, it would make sense to investigate the relationship of mindfulness practice with anxiety and intestinal micro-organisms.

 

Mindfulness-Based Cognitive Therapy (MBCT) has been shown to be effective in treating anxiety disorders. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior. But whether MBCT affects both anxiety and the microbiome has not been investigated.

 

In today’s Research News article “Gut Microbiota Associated with Effectiveness And Responsiveness to Mindfulness-Based Cognitive Therapy in Improving Trait Anxiety.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8908961/ ) Wang and colleagues recruited young adults with high anxiety levels and a similar control group with normal anxiety levels. The high anxiety group were provided with 8 weekly 2.5 hour sessions of Mindfulness-Based Cognitive Therapy (MBCT). They were measured before and after treatment for anxiety, depression, resilience, and mindfulness. In addition, their feces were measured for microbiota.

 

They found that after Mindfulness-Based Cognitive Therapy (MBCT) there were significant decreases in anxiety and depression and significant increases in resilience and mindfulness. The gut microbiome significantly differed between the high anxiety group and the controls before trteatment in that the high anxiety participants had less bacterial diversity in the gut. But after MBCT the bacterial diversity levels increased to the levels of the healthy controls.

 

Hence, mindfulness training improves the psychological health of highly anxious young adults and simultaneously normalizes the deficiency in the bacterial diversity in the gut.

 

Mindfulness training is good for both physical and mental health.

 

“During stress, an altered gut microbial population affects the regulation of neurotransmitters mediated by the microbiome and gut barrier function. Meditation helps regulate the stress response, thereby suppressing chronic inflammation states and maintaining a healthy gut-barrier function.” – Ayman Mukerji Househam

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Wang, Z., Liu, S., Xu, X., Xiao, Y., Yang, M., Zhao, X., Jin, C., Hu, F., Yang, S., Tang, B., Song, C., & Wang, T. (2022). Gut Microbiota Associated With Effectiveness And Responsiveness to Mindfulness-Based Cognitive Therapy in Improving Trait Anxiety. Frontiers in cellular and infection microbiology, 12, 719829. https://doi.org/10.3389/fcimb.2022.71982

 

Abstract

Objective

Mindfulness-based interventions have been widely demonstrated to be effective in reducing stress, alleviating mood disorders, and improving quality of life; however, the underlying mechanisms remained to be fully understood. Along with the advanced research in the microbiota-gut-brain axis, this study aimed to explore the impact of gut microbiota on the effectiveness and responsiveness to mindfulness-based cognitive therapy (MBCT) among high trait anxiety populations.

Design

A standard MBCT was performed among 21 young adults with high trait anxiety. A total of 29 healthy controls were matched for age and sex. The differences in gut microbiota between the two groups were compared. The changes in fecal microbiota and psychological indicators were also investigated before and after the intervention.

Results

Compared with healthy controls, we found markedly decreased bacterial diversity and distinctive clusters among high trait anxiety populations, with significant overgrowth of bacteria such as Streptococcus, Blautia, and Romboutsia, and a decrease in genera such as Faecalibacterium, Coprococcus_3, and Lachnoclostridium. Moreover, MBCT attenuated trait anxiety and depression, improved mindfulness and resilience, and increased the similarity of gut microbiota to that of healthy controls. Notably, a high presence of intestinal Subdoligranulum pre-MBCT was associated with increased responsiveness to MBCT. Decreases in Subdoligranulum post-MBCT were indicative of ameliorated trait anxiety. The tryptophan metabolism pathways were significantly over-represented among high responders compared to low responders.

Conclusion

The significantly increased diversity post-MBCT added evidence to gut-brain communication and highlighted the utility of mycobiota-focused strategies for promoting the effectiveness and responsiveness of the MBCT to improve trait anxiety.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8908961/

 

Improve Psychological Health During Addiction Recovery with Qigong

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Improve Psychological Health During Addiction Recovery with Qigong

 

By John M. de Castro, Ph.D.

 

“For people in the early stages of recovery whose emotions may be all over the map, Tai Chi can help stabilize moods, provide mental focus and clarity, and smooth out the rough spots. “ – Pinnacle

 

Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use which includes unintentional overdoses, suicides, HIV and AIDS, and trauma. Obviously, there is a need to find effective methods to prevent and treat substance abuse. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers relapse and return to substance abuse. Hence, it is important to find an effective method to both treat substance abuse disorders and to prevent relapses.

 

Mindfulness practices have been shown to improve recovery from various addictions. Tai Chi is a mindfulness practice that has documented benefits for the individual’s psychological and physical health and well-being. Tai Chi and Qigong are ancient mindfulness practices involving slow prescribed movements. Since Tai Chi and Qigong are both mindfulness practices and gentle exercises, that may be an acceptable and effective treatment for patients recovering from addictions. Studies on the use of Tai Chi and Qigong practices to treat substance abuse have been accumulating and there is a need to pause and summarize what has been learned.

 

In today’s Research News article “The Impact of Qigong and Tai Chi Exercise on Drug Addiction: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8957847/ ) Cui and colleagues review, summarize, and perform a meta-analysis of the published research studies on the effects of Tai Chi and Qigong practice during substance abuse treatment. They identified 11 studies including a total of 1072 participants.

 

They report that the published research found that Tai Chi and Qigong practices during substance abuse treatment produced significant reduction in depression, and anxiety, and significant improvements in quality of life, and sleep quality. Qigong practice appears to be superior to Tai Chi practice in producing these benefits.

 

Hence, the published research suggests that Tai Chi and Qigong practices improve the psychological health of the patients during addiction recovery.

 

 

“Tai chi can also be continued in life following treatment. It can serve as an important part of an aftercare plan that enhances well-being and reduces the likelihood of relapse.” – Footprints to Recovery

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Cui, J., Liu, F., Liu, X., Li, R., Chen, X., & Zeng, H. (2022). The Impact of Qigong and Tai Chi Exercise on Drug Addiction: A Systematic Review and Meta-Analysis. Frontiers in psychiatry, 13, 826187. https://doi.org/10.3389/fpsyt.2022.826187

 

Abstract

Background

Previous preliminary studies have found that qigong exercises produced significant effects in healthy people and in various clinical populations. The purpose of this study was to systematically review the effects of qigong and tai chi exercise on individuals with drug addiction.

Methods

A systematic search of seven English databases and three Chinese databases was conducted to identify randomized controlled trials (RCTs) and non-randomized comparative studies (NRS) assessing the effects of qigong and tai chi on drug addiction. Study quality was assessed using the Checklist for the Evaluation of Non-Pharmaceutical Trial Reports (CLEAR-NPT).

Results

Two RCTs and nine NRS studies were included in this study, including a total of 1072 patients with drug addiction (age range, 27–43 years). The results showed that qigong and tai chi exercise had a significant overall effect on depression (SMD = −0.353, 95%CI [−0.548, −0.159]), anxiety (SMD = −0.541, 95%CI [−0.818, −0.264]), quality of life (SMD = 0.673, 95%CI [0.438, 0.907]), and sleep quality (SMD = −0.373, 95%CI [−0.631, −0.116]). The subgroup analysis found that qigong outperformed tai chi on the improving depression, anxiety, and sleep quality.

Conclusion

Existing studies suggest that qigong and tai chi are effective at improving depression, anxiety, and quality of life in drug users; however, the evidence from rigorous randomized controlled group trials is lacking.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8957847/

 

Improve Depression by Changing the Brain with Mindfulness

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Improve Depression by Changing the Brain with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness-based cognitive therapy is just as effective as medication in preventing depression relapse among adults with a history of recurrent depression, and in reducing depressive symptoms among those with active depression.” – Deborah Yip

 

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

 

Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering, and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering. Mindfulness training has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail.

 

The most used mindfulness technique for the treatment of depression is Mindfulness-Based Cognitive Therapy (MBCT).  MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. MBCT has been shown to be as effective as antidepressant drugs in relieving the symptoms of depression and preventing depression reoccurrence and relapse. In addition, it appears to be effective as either a supplement to or a replacement for these drugs. It is unclear, however if MBCT is also effective in treating late life depression in the elderly.

 

In today’s Research News article “Mindfulness-Based Cognitive Therapy Regulates Brain Connectivity in Patients With Late-Life Depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8882841/ ) Li and colleagues recruited older adults (over 60 years of age) with late life depression and randomly assigned them to receive 8 weekly sessions of Mindfulness-Based Cognitive Therapy (MBCT) with daily home practice or treatment as usual. They were measured before and after training and 3 months later for depression, anxiety, and cognitive function, they also underwent functional magnetic resonance imaging (fMRI).

 

They found that in comparison to baseline and the treatment as usual group, those that received Mindfulness-Based Cognitive Therapy (MBCT) had significantly lower depression after training and at the 3 month follow-up. In addition, the greater the amount of home meditation practice the greater the reductions in depression. They also found that after treatment there was a significant increase in functional connectivity between the amygdala and cerebral cortex. In addition, the greater the increase in functional connectivity, the greater the reductions in depression.

 

These findings suggest that Mindfulness-Based Cognitive Therapy (MBCT) is a safe and effective treatment for late life depression. But they also suggest that changes in the connectivity between brain areas may underlie the improvements in depression.

 

So, change the brain to improve late life depression with mindfulness.

 

“MBCT (combined with antidepressants or delivered alongside antidepressant tapering/discontinuation) is comparable to maintenance antidepressants alone in preventing subsequent relapse.” – Oxford Mindfulness Centre

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Li, H., Yan, W., Wang, Q., Liu, L., Lin, X., Zhu, X., Su, S., Sun, W., Sui, M., Bao, Y., Lu, L., Deng, J., & Sun, X. (2022). Mindfulness-Based Cognitive Therapy Regulates Brain Connectivity in Patients With Late-Life Depression. Frontiers in psychiatry, 13, 841461. https://doi.org/10.3389/fpsyt.2022.841461

 

Abstract

Late-life depression (LLD) is an important public health problem among the aging population. Recent studies found that mindfulness-based cognitive therapy (MBCT) can effectively alleviate depressive symptoms in major depressive disorder. The present study explored the clinical effect and potential neuroimaging mechanism of MBCT in the treatment of LLD. We enrolled 60 participants with LLD in an 8-week, randomized, controlled trial (ChiCTR1800017725). Patients were randomized to the treatment-as-usual (TAU) group or a MBCT+TAU group. The Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) were used to evaluate symptoms. Magnetic resonance imaging (MRI) was used to measure changes in resting-state functional connectivity and structural connectivity. We also measured the relationship between changes in brain connectivity and improvements in clinical symptoms. HAMD total scores in the MBCT+TAU group were significantly lower than in the TAU group after 8 weeks of treatment (p < 0.001) and at the end of the 3-month follow-up (p < 0.001). The increase in functional connections between the amygdala and middle frontal gyrus (MFG) correlated with decreases in HAMA and HAMD scores in the MBCT+TAU group. Diffusion tensor imaging analyses showed that fractional anisotropy of the MFG-amygdala significantly increased in the MBCT+TAU group after 8-week treatment compared with the TAU group. Our study suggested that MBCT improves depression and anxiety symptoms that are associated with LLD. MBCT strengthened functional and structural connections between the amygdala and MFG, and this increase in communication correlated with improvements in clinical symptoms.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8882841/

 

Reduce Opioid Dependence in Chronic Pain Patients with Mindfulness

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Reduce Opioid Dependence in Chronic Pain Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“meditation involves endogenous opioid pathways, mediating its analgesic effect and growing resilient with increasing practice to external suggestion.” – Haggai Sharon

 

Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use. Obviously, there is a need to find effective methods to prevent and treat substance abuse. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers’ relapse and return to substance abuse.

 

Hence, it is important to find an effective method to treat substance abuse and prevent relapse, but an effective treatment has been elusive. Most programs and therapies to treat addictions have poor success rates. Recently, mindfulness training has been found to be effective in treating addictions and preventing relapses. Mindfulness-Oriented Recovery Enhancement (MORE) was developed to treat patients with opioid addictions. It involves mindful breathing and body scan meditations, cognitive reappraisal to decrease negative emotions and craving, and savoring to augment natural reward processing and positive emotion.

 

In today’s Research News article “Mindfulness-Oriented Recovery Enhancement vs Supportive Group Therapy for Co-occurring Opioid Misuse and Chronic Pain in Primary Care: A Randomized Clinical Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8886485/ ) Garland and colleagues recruited chronic pain patients being treated with opioid drugs who were misusing opioids. They were randomly assigned to receive 8 weekly 2-hour sessions of Mindfulness-Oriented Recovery Enhancement (MORE) or supportive psychotherapy. They were measured before and after treatment and 3, 6, and 9 months later for chronic pain, opioid misuse, daily opioid dose, opioid craving, anxiety, depression, perceived stress, and adverse events.

 

They found that at the 9 month follow up 45% of the Mindfulness-Oriented Recovery Enhancement (MORE) were no longer misusing opioids while only 24% of the supportive psychotherapy were no longer misusing. The MORE group also had significantly greater reductions in pain severity, opioid dosage, depression, and pain-related functional interference.

 

The finding support the ability of Mindfulness-Oriented Recovery Enhancement (MORE) to improve opioid misuse and improve the psychological well-being of chronic pain patients.

 

“That is not because pain is psychological. It’s because all pain is processed in the brain and mindfulness changes how the brain processes the signals of damage from the body,” – Eric Garland

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Garland, E. L., Hanley, A. W., Nakamura, Y., Barrett, J. W., Baker, A. K., Reese, S. E., Riquino, M. R., Froeliger, B., & Donaldson, G. W. (2022). Mindfulness-Oriented Recovery Enhancement vs Supportive Group Therapy for Co-occurring Opioid Misuse and Chronic Pain in Primary Care: A Randomized Clinical Trial. JAMA internal medicine, 182(4), 407–417. https://doi.org/10.1001/jamainternmed.2022.0033

 

Key Points

Question

Does a mindfulness-based intervention reduce comorbid chronic pain and opioid misuse in the primary care setting more than supportive psychotherapy?

Findings

In this randomized clinical trial that included 250 adults with both chronic pain and opioid misuse, 45.0% of participants receiving Mindfulness-Oriented Recovery Enhancement (MORE) were no longer misusing opioids after 9 months of follow-up compared with 24.4% of participants receiving supportive group psychotherapy. Participants receiving MORE also reported significant improvements in chronic pain symptoms compared with those receiving supportive psychotherapy.

Meaning

In this study, MORE appeared to be an efficacious treatment for opioid misuse among adults with chronic pain.

Go to:

Abstract

Importance

Successful treatment of opioid misuse among people with chronic pain has proven elusive. Guidelines recommend nonopioid therapies, but the efficacy of mindfulness-based interventions for opioid misuse is uncertain.

Objective

To evaluate the efficacy of Mindfulness-Oriented Recovery Enhancement (MORE) for the reduction of opioid misuse and chronic pain.

Design, Setting, and Participants

This interviewer-blinded randomized clinical trial enrolled patients from primary care clinics in Utah between January 4, 2016, and January 16, 2020. The study included 250 adults with chronic pain receiving long-term opioid therapy who were misusing opioid medications.

Interventions

Treatment with MORE (comprising training in mindfulness, reappraisal, and savoring positive experiences) or supportive group psychotherapy (control condition) across 8 weekly 2-hour group sessions.

Main Outcomes and Measures

Primary outcomes were (1) opioid misuse assessed by the Drug Misuse Index (self-report, interview, and urine screen) and (2) pain severity and pain-related functional interference, assessed by subscale scores on the Brief Pain Inventory through 9 months of follow-up. Secondary outcomes were opioid dose, emotional distress, and ecological momentary assessments of opioid craving. The minimum intervention dose was defined as 4 or more completed sessions of MORE or supportive group psychotherapy.

Results

Among 250 participants (159 women [63.6%]; mean [SD] age, 51.8 [11.9] years), 129 were randomized to the MORE group and 121 to the supportive psychotherapy group. Overall, 17 participants (6.8%) were Hispanic or Latino, 218 (87.2%) were White, and 15 (6.0%) were of other races and/or ethnicities (2 American Indian, 3 Asian, 1 Black, 2 Pacific Islander, and 7 did not specify). At baseline, the mean duration of pain was 14.7 years (range, 1-60 years), and the mean (SD) morphine-equivalent opioid dose was 101.0 (266.3) mg (IQR, 16.0-90.0 mg). A total of 203 participants (81.2%) received the minimum intervention dose (mean [SD], 5.7 [2.2] sessions); at 9 months, 92 of 250 participants (36.8%) discontinued the study. The overall odds ratio for reduction in opioid misuse through the 9-month follow-up period in the MORE group compared with the supportive psychotherapy group was 2.06 (95% CI, 1.17-3.61; P = .01). At 9 months, 36 of 80 participants (45.0%) in the MORE group were no longer misusing opioids compared with 19 of 78 participants (24.4%) in the supportive psychotherapy group. Mixed models demonstrated that MORE was superior to supportive psychotherapy through 9 months of follow-up for pain severity (between-group effect: 0.49; 95% CI, 0.17-0.81; P = .003) and pain-related functional interference (between-group effect: 1.07; 95% CI, 0.64-1.50; P < .001). Participants in the MORE group reduced their opioid dose to a greater extent than those in the supportive psychotherapy group. The MORE group also had lower emotional distress and opioid craving.

Conclusions and Relevance

In this randomized clinical trial, among adult participants in a primary care setting, the MORE intervention led to sustained improvements in opioid misuse and chronic pain symptoms and reductions in opioid dosing, emotional distress, and opioid craving compared with supportive group psychotherapy. Despite attrition caused by the COVID-19 pandemic and the vulnerability of the sample, MORE appeared to be efficacious for reducing opioid misuse among adults with chronic pain.

Improve Mental Health with Mantra-Based Meditation

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Improve Mental Health with Mantra-Based Meditation

 

By John M. de Castro, Ph.D.

 

“Many people find that using a mantra can boost awareness and improve concentration. Since it helps you stay focused, it could lead to improved results from meditation.” – Timothy Legg

 

Meditation training has been shown to improve health and well-being. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. But many people have difficulty quieting the mind and maintaining concentration during meditation. Repeating a mantra during meditation has been thought to help prevent intrusive thoughts and improve concentration and focus during meditation. There have been a number of studies of the psychological benefits of mantra-based meditations. It makes sense then to summarize what has been learned.

 

In today’s Research News article “Effectiveness of Mantra-Based Meditation on Mental Health: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8949812/ ) Álvarez-Pérez and colleagues review, summarize, and perform a meta-analysis of the effects of mantra-based meditations on mental health. They found 51 published research studies.

 

They report that the published research studies found that mantra-based meditations produced significant reduction in anxiety, depression, perceived stress, post-traumatic stress disorder (PTSD) symptoms, and psychopathology, and significant increases in health-related quality of life. All of these effects had small to moderate effect sizes.

 

So, the published research demonstrate that mantra-based meditations produce significant improvements in mental health.

 

“Mantra meditation is not magic, but the results can be magical.”— Thomas Ashley-Farrand”

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Álvarez-Pérez, Y., Rivero-Santana, A., Perestelo-Pérez, L., Duarte-Díaz, A., Ramos-García, V., Toledo-Chávarri, A., Torres-Castaño, A., León-Salas, B., Infante-Ventura, D., González-Hernández, N., Rodríguez-Rodríguez, L., & Serrano-Aguilar, P. (2022). Effectiveness of Mantra-Based Meditation on Mental Health: A Systematic Review and Meta-Analysis. International journal of environmental research and public health, 19(6), 3380. https://doi.org/10.3390/ijerph19063380

 

Abstract

Background: Meditation is defined as a form of cognitive training that aims to improve attentional and emotional self-regulation. This systematic review aims to evaluate the available scientific evidence on the effectiveness and safety of mantra-based meditation techniques (MBM), in comparison to passive or active controls, or other active treatment, for the management of mental health symptoms. Methods: MEDLINE, EMBASE, Cochrane Library, and PsycINFO databases were consulted up to April 2021. Randomised controlled trials regarding meditation techniques mainly based on the repetition of mantras, such as transcendental meditation or others, were included. Results: MBM, compared to control conditions, was found to produce significant small-to-moderate effect sizes in the reduction of anxiety (g = −0.46, IC95%: −0.60, −0.32; I2 = 33%), depression (g = −0.33, 95% CI: −0.48, −0.19; I2 = 12%), stress (g = −0.45, 95% CI: −0.65, −0.24; I2 = 46%), post-traumatic stress (g = −0.59, 95% CI: −0.79, −0.38; I2 = 0%), and mental health-related quality of life (g = 0.32, 95% CI: 0.15, 0.49; I2 = 0%). Conclusions: MBM appears to produce small-to-moderate significant reductions in mental health; however, this evidence is weakened by the risk of study bias and the paucity of studies with psychiatric samples and long-term follow-up.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8949812/

Mindfulness Improves Obsessive Compulsive Disorder as well as Drug Treatment

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Mindfulness Improves Obsessive Compulsive Disorder as well as Drug Treatment

 

By John M. de Castro, Ph.D.

 

“most OCD sufferers I know who practice mindfulness find it very helpful in fighting their disorder. To be able to focus on what is really happening in any given moment, as opposed to dwelling on the past or anticipating the future, takes away the power of OCD.” – Janet Singer

 

Obsessive-Compulsive Disorder (OCD) sufferers have repetitive anxiety producing intrusive thoughts (obsessions) that result in repetitive behaviors to reduce the anxiety (compulsions). In a typical example of OCD, the individual is concerned about germs and is unable to control the anxiety that these thoughts produce. Their solution is to engage in ritualized behaviors, such as repetitive cleaning or hand washing that for a short time relieves the anxiety. The obsessions and compulsions can become so frequent that they become a dominant theme in their lives. Hence OCD drastically reduces the quality of life and happiness of the sufferer and those around them. About 2% of the population, 3.3 million people in the U.S., are affected at some time in their life.

 

Fortunately, Obsessive-Compulsive Disorder (OCD) can be treated. Mindfulness training including Mindfulness-Based Cognitive Therapy (MBCT) has been shown to be effective in treating OCD.  A therapeutic technique that contains mindfulness training and Cognitive Behavioral Therapy (CBT) is Acceptance and Commitment Therapy (ACT). It focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. This suggests that ACT may be an effective treatment for obsessive-compulsive disorder (OCD),

 

In today’s Research News article “A randomized clinical trial: Comparison of group acceptance and commitment therapy with drug on quality of life and depression in patients with obsessive-compulsive disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8943588/ ) and colleagues recruited patients with Obsessive-Compulsive Disorder (OCD) and either treated them with drugs (SSRIs) or with Acceptance and Commitment Therapy (ACT) twice weekly for 1 hour for 4 weeks. They were measured before and after treatment and 3 months later for depression, anxiety, perceived stress, and quality of life.

 

They found that in comparison to baseline both groups had significant decreases in depression and significant increases in quality of life and these improvements were maintained the 3-month follow-up. Hence, Mindfulness training is as effective as drugs in treating Obsessive-Compulsive Disorder (OCD).

 

Since mindfulness training, unlike drugs, doesn’t have significant side effects, it would appear to be the preferred treatment for Obsessive-Compulsive Disorder (OCD),

 

“The struggle of the OCD sufferer is one in which certain internal experiences (thoughts, etc.) are viewed as unacceptable, whereas others are allowed to pass by without critique. Mindfulness suggests a different perspective on the presence of these internal experiences, that they be simply noticed, not judged or pushed away.” – Sheppard Pratt

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Ebrahimi, A., Nasre Esfahan, E., Akuchekian, S., Izadi, R., Shaneh, E., & Mahaki, B. (2022). A randomized clinical trial: Comparison of group acceptance and commitment therapy with drug on quality of life and depression in patients with obsessive-compulsive disorder. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 27, 9. https://doi.org/10.4103/jrms.jrms_449_21

 

Abstract

Background:

Acceptance and commitment therapy (ACT) is one of the newest treatment strategies that has been developed rapidly to improve the treatment of patients with obsessive–compulsive disorder (OCD). The aim of this study was to evaluate and compare the effect of ACT and selective serotonin reuptake inhibitors (SSRIs) drugs on the severity of depression symptoms and quality of life (QOL) in obsessive–compulsive patients.

Materials and Methods:

A randomized clinical trial with a control group was conducted including 27 patients with OCD. Based on the Diagnostic and Statistical Manual of Mental Disorders-5 criteria for OCD diagnosis, participants were recruited from Tamasha Counseling Center and obsessive–compulsive clinic in the Psychosomatic Research Center in Isfahan, Iran. Selected patients were allocated to two groups (14 in ACT the group and 13 in the drug group with SSRI with a simple random sampling method. ACT group was treated by an ACT therapist in eight 1-h sessions. Data were collected by the World Health Organization QOL Questionnaire (WHOQOL-BREF) and Depression subscale of DASS-42 at admission, after the intervention, and 3 months thereafter. Therapists and evaluators were blind to each other’s work. Data were analyzed using analysis of variance with repeated measures method using IBM SPSS Statistics software (V 23, IBM Corporation, Armonk, NY, USA).

Results:

Results revealed that both treatments (ACT and SSRIs drug therapy) had significant impacts on reducing depression subscales scores and increasing WHOQOL-BREF scores at posttreatment (P < 0.05). There were no significant differences in QOL scores between the two groups after the intervention and follow-up (P > 0.05). Nevertheless, drug therapy presented a significantly greater improvement in depression scores of patients than those resulting from ACT (P = 0.005). The persistence of treatment effects continued after 3 months (follow-up) in both groups.

Conclusion:

ACT is equal to SSRIs drug therapy in terms of improving QOL in patients with OCD. However, SSRIs are more effective in treating depression in obsessive–compulsive patients. It may be presumed that ACT without any chemical side effect is equal to drug and is preferred for patients who either cannot use drugs or prefer not to have a drug treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8943588/

 

Improve Sexual Function in Women with Breast Cancer with Mindfulness

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Improve Sexual Function in Women with Breast Cancer with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is extraordinary; it is as if they replace you with someone else. Positive thinking increased my willingness to return to life.” – International Society for Sexual Medicine

 

Because of great advances in treatment, many patients today are surviving cancer. But cancer survivors frequently suffer from anxiety, depression, mood disturbance, post-traumatic stress disorder (PTSD), sleep disturbance, fatigue, sexual dysfunction, loss of personal control, impaired quality of life, and psychiatric symptoms which have been found to persist even ten years after remission. Also, cancer survivors can have to deal with a heightened fear of reoccurrence. So, safe and effective treatments for the symptoms in cancer and the physical and psychological effects of the treatments are needed.

 

Mindfulness training has been shown to help with general cancer recovery. Mindfulness practices have been shown to improve the residual symptoms in cancer survivors. The Mindfulness-Based Stress Reduction (MBSR) program is a mindfulness training program that includes meditation practice, body scan, yoga, and discussion along with daily home practice. MBSR has been shown to be beneficial for cancer patients in general and also specifically for the symptoms of breast cancer survivors. So, it makes sense to further explore the effectiveness of MBSR training for the treatment of sexual function in breast cancer survivors.

 

In today’s Research News article “Impact of mindfulness-based stress reduction on female sexual function and mental health in patients with breast cancer.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8799961/ ) Chang and colleagues recruited breast cancer survivors and provided them with either a 6-weeks of a Mindfulness-Based Stress Reduction (MBSR) program or treatment as usual. They were measured before and after for sexual function, anxiety, depression, perceived stress, and quality of life.

 

They found that Mindfulness-Based Stress Reduction (MBSR) produce significant increases in sexual arousal, lubrication, orgasm, and satisfaction and significant reductions in anxiety and perceived stress.

 

Because of the nature of the treatments for breast cancer, sexual confidence and performance may be challenged. It is very important to these women’s well-being that they return to normal engagement in sex. It is very encouraging that mindfulness training appears to improve sexual satisfaction in these women after treatment. This, in turn, markedly improves their mental health.

 

“Mindfulness-based stress reduction interventions are highly beneficial for reducing depression, fatigue, and stress in the short term. . . Breast cancer survivors are recommended to practice MBSR as part of their daily care routine.” – Yun-Chen Chang

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Chang, Y. C., Lin, G. M., Yeh, T. L., Chang, Y. M., Yang, C. H., Lo, C., Yeh, C. Y., & Hu, W. Y. (2022). Impact of mindfulness-based stress reduction on female sexual function and mental health in patients with breast cancer. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 30(5), 4315–4325. https://doi.org/10.1007/s00520-021-06540-y

 

Abstract

Purpose

There have been few studies using mindfulness-based stress reduction (MBSR) to improve sexual function in Asian women with breast cancer. This study aimed to evaluate the impact of mindfulness intervention on female sexual function, mental health, and quality of life in patients with breast cancer.

Methods

Fifty-one women with breast cancer were allocated into 6-week MBSR (n=26) sessions or usual care (n=25), without differences in group characteristics. The research tools included the Female Sexual Function Index (FSFI), the Depression Anxiety Stress Scales-21 (DASS-21), and the EuroQol instrument (EQ-5D). The Greene Climacteric Scale (GCS) was used to verify the foregoing scale. The effects of MBSR were evaluated by the differences between the post- and pre-intervention scores in each scale. Statistical analyses consisted of the descriptive dataset and Mann-Whitney ranked-pairs test.

Results

Although MBSR did not significantly improve sexual desire and depression in patients with breast cancer, MBSR could improve parts of female sexual function [i.e., Δarousal: 5.73 vs. -5.96, Δlubrication: 3.35 vs. -3.48, and Δsatisfaction: 8.48 vs. 1.76; all p <.005], with a range from small to medium effect sizes. A significantly benefits were found on mental health [Δanxiety: -10.92 vs.11.36 and Δstress: -10.96 vs.11.40; both p <.001], with large effect sizes, ranging from 0.75 to 0.87.

Conclusion

Our study revealed that MBSR can improve female sexual function and mental health except for sexual desire and depression in women with breast cancer. Medical staff can incorporate MBSR into clinical health education for patients with breast cancer to promote their overall quality of life.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8799961/

Improve the Psychological Well-Being of Patients with Cardiovascular Disease with Tai Chi

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Improve the Psychological Well-Being of Patients with Cardiovascular Disease with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Tai Chi involves a series of graceful, gentle movements that can get your heart rate up while also relaxing your mind. It’s been called meditation in motion.” – Cleveland Heart Lab

 

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

 

Contemplative practices have been shown to be safe and effective alternative treatments for cardiovascular disease. Practices such as meditation, tai chi, and yoga, have been shown to be helpful for heart health and to reduce the physiological and psychological responses to stress. They have also been shown to be effective in maintaining cardiovascular health and the treatment of cardiovascular disease. The research has been accumulating. So, it makes sense to pause and take a look at what has been learned.

 

In today’s Research News article “Does tai chi improve psychological well-being and quality of life in patients with cardiovascular disease and/or cardiovascular risk factors? A systematic review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8725570/ ) Yang and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials of the effectiveness of Tai Chi practice for patients with cardiovascular disease. They identified 37 published trials.

 

They report that the published research found that Tai Chi practiced improved the psychological well-being of the patients including decreases in perceived stress, anxiety, depression, bodily pain and increases in mental health, self-efficacy, and mood.

 

Hence practicing Tai Chi improves the mental health and quality of life of patients with cardiovascular disease.

 

“practicing tai chi may help to modestly lower blood pressure. It’s also proved helpful for people with heart failure, who tend to be tired and weak as a result of the heart’s diminished pumping ability. The slow movements involve both the upper and lower body, which safely strengthens the heart and major muscle groups without undue strain.” – Harvard Health

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Yang, G., Li, W., Klupp, N., Cao, H., Liu, J., Bensoussan, A., Kiat, H., Karamacoska, D., & Chang, D. (2022). Does tai chi improve psychological well-being and quality of life in patients with cardiovascular disease and/or cardiovascular risk factors? A systematic review. BMC complementary medicine and therapies, 22(1), 3. https://doi.org/10.1186/s12906-021-03482-0

 

Abstract

Background

Psychological risk factors have been recognised as potential, modifiable risk factors in the development and progression of cardiovascular disease (CVD). Tai Chi, a mind-body exercise, has the potential to improve psychological well-being and quality of life. We aim to assess the effects and safety of Tai Chi on psychological well-being and quality of life in people with CVD and/or cardiovascular risk factors.

Methods

We searched for randomised controlled trials evaluating Tai Chi for psychological well-being and quality of life in people with CVD and cardiovascular risk factors, from major English and Chinese databases until 30 July 2021. Two authors independently conducted study selection and data extraction. Methodological quality was evaluated using the Cochrane Risk of Bias tool. Review Manager software was used for meta-analysis.

Results

We included 37 studies (38 reports) involving 3525 participants in this review. The methodological quality of the included studies was generally poor. Positive effects of Tai Chi on stress, self-efficacy, and mood were found in several individual studies. Meta-analyses demonstrated favourable effects of Tai Chi plus usual care in reducing anxiety (SMD − 2.13, 95% confidence interval (CI): − 2.55, − 1.70, 3 studies, I2 = 60%) and depression (SMD -0.86, 95% CI: − 1.35, − 0.37, 6 studies, I2 = 88%), and improving mental health (MD 7.86, 95% CI: 5.20, 10.52, 11 studies, I2 = 71%) and bodily pain (MD 6.76, 95% CI: 4.13, 9.39, 11 studies, I2 = 75%) domains of the 36-Item Short Form Survey (scale from 0 to 100), compared with usual care alone. Tai Chi did not increase adverse events (RR 0.50, 95% CI: 0.21, 1.20, 5 RCTs, I2 = 0%), compared with control group. However, less than 30% of included studies reported safety information.

Conclusions

Tai Chi seems to be beneficial in the management of anxiety, depression, and quality of life, and safe to practice in people with CVD and/or cardiovascular risk factors. Monitoring and reporting of safety information are highly recommended for future research. More well-designed studies are warranted to determine the effects and safety of Tai Chi on psychological well-being and quality of life in this population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8725570/