Depression

Improve the Symptoms of Central Pain Sensitization Syndromes with Mindfulness

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Improve the Symptoms of Central Pain Sensitization Syndromes with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Central sensitization, in short, is a hypersensitivity to stimuli from things that are not typically painful. . . Stress can heighten pain even more, so various forms of stress management may be recommended to patients. This may include practices such as yoga, mindfulness, or meditation.” – Southern Pain

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. Central Pain Sensitization Syndromes such as fibromyalgia and Migraine headaches are particularly difficult to deal with as they have triggers that are not normally painful.

 

The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain. There is an accumulating volume of research findings that demonstrate that mindfulness practices, in general, are effective in treating pain.

 

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.

 

The research on the effectiveness of Acceptance and Commitment Therapy (ACT) for  Central Pain Sensitization Syndromes has been accumulating. So, it makes sense to pause and review what has been learned. In today’s Research News article “Effectiveness of Acceptance and Commitment Therapy in Central Pain Sensitization Syndromes: A Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8235706/ ) Galvez-Sánchez and colleagues review and summarize the published research evidence on the effectiveness of Acceptance and Commitment Therapy (ACT) for  Central Pain Sensitization Syndromes. They identified 21 published studies that included a total of 1090 adult participants.

 

They report that 8 studies found that Acceptance and Commitment Therapy (ACT) significantly improved the symptoms of fibromyalgia especially anxiety and depression and improved pain acceptance, self-efficacy, and psychological flexibility. Six studies found that ACT improved the patient’s acceptance of irritable bowel syndrome and the psychological distress produced by IBS. In 7 studies ACT was shown to significantly improve migraine pain and the affective distress resulting from the disease including anxiety and depression. These improvements were greater than those seen with pharmacological and psychoeducational interventions.

 

Mindfulness training has been shown to improve the symptoms of fibromyalgia, irritable bower syndrome, and migraine headache. The finding from the currently published research studies of the effectiveness of the mindfulness training of Acceptance and Commitment Therapy (ACT) suggests that it is similarly effective in treating the symptoms from Central Pain Sensitization Syndromes particularly the psychological distress produced by them and improve the patients’ health related quality of life.

 

So, improve the symptoms of Central Pain Sensitization Syndromes with mindfulness.

 

“The goal of meditation is not to eliminate pain or anxiety, but rather to get patients to focus on breathing and relaxation techniques. . . to reverse some of the negative central sensitization that can occur with chronic pain.” – Mel Pohl

 

MCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Galvez-Sánchez, C. M., Montoro, C. I., Moreno-Padilla, M., Reyes Del Paso, G. A., & de la Coba, P. (2021). Effectiveness of Acceptance and Commitment Therapy in Central Pain Sensitization Syndromes: A Systematic Review. Journal of clinical medicine, 10(12), 2706. https://doi.org/10.3390/jcm10122706

 

Abstract

Objectives: Acceptance and commitment therapy (ACT) is considered by the American Psychological Association as an evidence-based treatment for a variety of disorders, including chronic pain. The main objective of the present systematic review was to determine the effectiveness of ACT in patients with central pain sensitization syndromes (CPSS). Methods: This systematic review was conducted according to the guidelines of the Cochrane Collaboration and PRISMA statements. The protocol was registered in advance in the Prospective Register of Systematic Reviews (PROSPERO) international database. The selected articles were evaluated using the Cochrane risk of bias (ROB) assessment tool. The PubMed, Scopus, and Web of Science databases were searched. Results: The literature search identified 21 studies (including investigations of fibromyalgia syndrome, irritable bowel syndrome, and migraine) eligible for the systematic review. There were no studies regarding the effectiveness of ACT for chronic tension-type headache (CTTH), interstitial cystitis (IC), or temporomandibular disorder (TMD). The evaluation of ROB showed that 12 of the selected studies were of low quality, 5 were of moderate quality, and 4 were high quality. ACT reduces some clinical symptoms, such as anxiety, depression, and pain. This positive effect of ACT might be mediated by pain acceptance, psychological flexibility, optimism, self-efficacy, or adherence to values. ACT showed better results in comparison to non-intervention (e.g., “waiting list”) conditions, as well as pharmacological and psychoeducational interventions. It is not entirely clear whether extended ACT treatments are more advantageous than briefer interventions. Conclusions: There are few studies about the effectiveness of ACT on CPSS. However, ACT seems to reduce subjective CPSS symptoms and improve the health-related quality of life of these patients. The absence of studies on the effectiveness of ACT in CTTH, IC, and TMD, indicate the pressing need for further ACT studies in these CPSS.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8235706/

Improve the Symptoms of Lupus with Mindfulness

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Improve the Symptoms of Lupus with Mindfulness

 

By John M. de Castro, Ph.D.

 

“However it strikes, pain is a persistent part of daily life for many people living with lupus. . . mindfulness-based interventions decrease the intensity of pain for people dealing with chronic pain.” – Lupus Foundation

 

Autoimmune diseases occur when the body’s systems that are designed to ward off infection attack the individual’s own tissues. Lupus is an autoimmune disease that affects a variety of organ systems including kidneys, joints, skin, blood, brain, heart and lungs. Lupus can produce fever, joint pain, stiffness and swelling, butterfly-shaped rash on the face or rashes elsewhere on the body, skin lesions that appear or worsen with sun exposure, fingers and toes that turn white or blue when exposed to cold or during stressful periods, shortness of breath, chest pain, dry eyes, headaches, confusion and memory loss. Lupus strikes between 10 to 25 people per 100,000, or about 322,000 cases in the U.S.

 

The symptoms of Lupus can look like a number of other diseases, so it is hard to diagnose lupus. It is tipped off in many patients by the distinctive facial rash. There are no known cures for lupus and treatment is targeted at symptom relief. Drug treatments include pain relievers, corticosteroids, immunosuppressants, and even antimalarial drugs. Mindfulness practices have been shown to be effective for a wide variety of illnesses and to improve the immune system. So, it is not surprising that mindfulness training can improve Lupus and its symptoms.

 

In today’s Research News article “Mindfulness-Based Stress Reduction for Systemic Lupus Erythematosus: A Mixed-Methods Pilot Randomized Controlled Trial of an Adapted Protocol.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509215/ ) Taub and colleagues recruited adult patients with Systemic Lupus Erythematosus and randomly assigned them to either a wait-list control or to receive 10 weekly 2-hour sessions and a full day retreat of Mindfulness-Based Stress Reduction (MBSR) adapted for Lupus. MBSR consists of practice with meditation, body scan, and yoga, and with group discussions and home practice. They were measured before and after training and 6 months later for lupus activity, health, depression, quality of life, psychological inflexibility to pain, shame, and illness identity. In addition, a sub-sample of patients underwent semi-structured qualitative interviews.

 

They found that in comparison to baseline and the wait-list control group, immediately after training the group that received Mindfulness-Based Stress Reduction (MBSR) had significantly reduced depression, fusion with pain, shame and illness identity and increases quality of life. At the 6-month follow-up, depression, fusion with pain, shame and illness identity remained significantly reduced. The qualitative interviews revealed 6 distinct themes; changes related to mindfulness; stress reduction; improvement in general physical functioning; changes in illness identity and illness perception; and the group as a mechanism of psychological change.

 

The interpretation of the findings is limited by the fact that there was a passive (wait-list) control condition. This leaves open a number of potential confounding explanations such as placebo effects, attention effects, experimenter bias, etc. Future research should have an active control condition such as aerobic exercise. Nevertheless, the results are suggestive that Mindfulness-Based Stress Reduction (MBSR) training is effective in producing enduring improvements in the psychological symptoms produced by Systemic Lupus Erythematosus, helping to relieve the patient’s suffering.

 

So, improve the symptoms of Lupus with mindfulness.

 

“If you have lupus and you feel stressed, or you would like to boost your pain tolerance while reducing sensitivity to pain itself, speak to your doctor about the desirability of meditation. Because this activity has no side effects and is easy and affordable to carry out, your family can join you in sessions, as a way to battle stress.” – Jess Walter

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Taub, R., Horesh, D., Rubin, N., Glick, I., Reem, O., Shriqui, G., & Agmon-Levin, N. (2021). Mindfulness-Based Stress Reduction for Systemic Lupus Erythematosus: A Mixed-Methods Pilot Randomized Controlled Trial of an Adapted Protocol. Journal of Clinical Medicine, 10(19), 4450. https://doi.org/10.3390/jcm10194450

 

Abstract

Background: The psychological effects of systemic lupus erythematosus (SLE) are tremendous. This pilot mixed-methods randomized controlled trial aimed to evaluate the effects of a mindfulness-based stress reduction (MBSR) adapted protocol on psychological distress among SLE patients. Methods: 26 SLE patients were randomly assigned to MBSR group therapy (n = 15) or a waitlist (WL) group (n = 11). An adapted MBSR protocol for SLE was employed. Three measurements were conducted: pre-intervention, post-intervention and 6-months follow up. A sub-sample (n = 12) also underwent qualitative interviews to assess their subjective experience of MBSR. Results: Compared to the WL, the MBSR group showed greater improvements in quality of life, psychological inflexibility in pain and SLE-related shame. Analysis among MBSR participants showed additional improvements in SLE symptoms and illness perception. Improvements in psychological inflexibility in pain and SLE-related shame remained stable over six months, and depression levels declined steadily from pre-treatment to follow-up. Qualitative analysis showed improvements in mindfulness components (e.g., less impulsivity, higher acceptance), as well as reduced stress following MBSR. Conclusions: These results reveal the significant therapeutic potential of MBSR for SLE patients. With its emphasis on acceptance of negative physical and emotional states, mindfulness practice is a promising treatment option for SLE, which needs to be further applied and studied.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509215/

 

Psychedelic Drugs are Theorized to have Aided in Human Social Evolution

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Psychedelic Drugs are Theorized to have Aided in Human Social Evolution

 

By John M. de Castro, Ph.D.

 

“psychedelics have profound cognitive, emotional, and social effects that inspired the development of cultures and religions worldwide.” – Michael J. Winkelman

 

Psychedelic substances such as peyote, mescaline, LSD, Bufotoxin, ayahuasca and psilocybin have been used almost since the beginning of recorded history to alter consciousness and produce spiritually meaningful experiences. Psychedelics produce effects that are similar to those that are reported in spiritual awakenings, a positive mood, with renewed energy and enthusiasm. It is easy to see why people find these experiences so pleasant and eye opening. They often report that the experiences changed them forever.

 

It is not known why the use of psychedelic substances have been so widely used throughout human evolution. Natural selection suggests that the use of these substances must confer some adaptive advantage, or their use would have ceased. What exactly are those advantages is a source of active debate in the scientific community. In today’s Research News article “Psychedelics, Sociality, and Human Evolution.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.729425/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1750137_a0P58000000G0YfEAK_Psycho_20211012_arts_A ) Arce and colleagues provide an evidence backed theoretical argument regarding the role of psychedelic substances in the evolution of humankind.

 

There is substantial evidence that early hominids routinely ingested fungi including mushroom that contained psychedelic substances. Early recorded history includes description of psychedelic uses in Mesoamerican societies. Indeed, psychedelic use has been recorded in early societies in Africa, Asia, Europe, Middle East, South America, Artic and Subarctic, and Central America. This suggests that there must be some instrumental effect of these substances that enhances the survival of humans.

 

Psilocybin and related psychedelics do not have physically toxic side effects. So, they can be ingested safely. The only evident problem is a change in cognition that could open “the possibility for errors in judgment, false perceptions, distortions, and illusions that could undermine an individual’s capacity for alertness, strategic thinking, and decision-making”. But early humans learned to use these substances in particular circumstances, such as rituals,  where the consequences of altered cognition could be minimized.

 

In their favor, psychedelic substances have been shown to improve coping with stress which was likely high in early hominid development. In addition, psychedelic substances have been used throughout history for the treatment of diseases and in recent years have been found to be effective in promoting recovery from a cancer diagnosis, relieving depression, and even in smoking cessation.

 

Psychedelic substances have traditionally been used in groups particularly around rituals and religious ceremonies which would improve social bonds, group cohesion, and pro-social behavior. This would facilitate social cooperation that was essential for early hominid group survival. Psychedelic substances have also been shown to enhance creative thinking and problem solving which would be of great use in adapting to changing environments.

 

These findings and arguments suggest that ingesting psychedelic substances may have been adaptive for humans increasing their chances of survival and procreation. It seems counterintuitive that ingesting substances that for the short term may make the individual less responsive and capable in the environment could actually improve survival. But that is what psychedelic substances appear to do. In this way ingesting psychedelic substances may be adaptive and thus be promoted in evolution.

 

So, psychedelic drugs are theorized to have aided in human social evolution

 

“psychedelic drugs. By simulating the effects of religious transcendence, they mimic states of mind that played an evolutionarily valuable role in making human cooperation possible – and with it, greater numbers of surviving descendants.” – James Carney

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Rodríguez Arce JM and Winkelman MJ (2021) Psychedelics, Sociality, and Human Evolution. Front. Psychol. 12:729425. doi: 10.3389/fpsyg.2021.729425

 

Our hominin ancestors inevitably encountered and likely ingested psychedelic mushrooms throughout their evolutionary history. This assertion is supported by current understanding of: early hominins’ paleodiet and paleoecology; primate phylogeny of mycophagical and self-medicative behaviors; and the biogeography of psilocybin-containing fungi. These lines of evidence indicate mushrooms (including bioactive species) have been a relevant resource since the Pliocene, when hominins intensified exploitation of forest floor foods. Psilocybin and similar psychedelics that primarily target the serotonin 2A receptor subtype stimulate an active coping strategy response that may provide an enhanced capacity for adaptive changes through a flexible and associative mode of cognition. Such psychedelics also alter emotional processing, self-regulation, and social behavior, often having enduring effects on individual and group well-being and sociality. A homeostatic and drug instrumentalization perspective suggests that incidental inclusion of psychedelics in the diet of hominins, and their eventual addition to rituals and institutions of early humans could have conferred selective advantages. Hominin evolution occurred in an ever-changing, and at times quickly changing, environmental landscape and entailed advancement into a socio-cognitive niche, i.e., the development of a socially interdependent lifeway based on reasoning, cooperative communication, and social learning. In this context, psychedelics’ effects in enhancing sociality, imagination, eloquence, and suggestibility may have increased adaptability and fitness. We present interdisciplinary evidence for a model of psychedelic instrumentalization focused on four interrelated instrumentalization goals: management of psychological distress and treatment of health problems; enhanced social interaction and interpersonal relations; facilitation of collective ritual and religious activities; and enhanced group decision-making. The socio-cognitive niche was simultaneously a selection pressure and an adaptive response, and was partially constructed by hominins through their activities and their choices. Therefore, the evolutionary scenario put forward suggests that integration of psilocybin into ancient diet, communal practice, and proto-religious activity may have enhanced hominin response to the socio-cognitive niche, while also aiding in its creation. In particular, the interpersonal and prosocial effects of psilocybin may have mediated the expansion of social bonding mechanisms such as laughter, music, storytelling, and religion, imposing a systematic bias on the selective environment that favored selection for prosociality in our lineage.

https://www.frontiersin.org/articles/10.3389/fpsyg.2021.729425/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1750137_a0P58000000G0YfEAK_Psycho_20211012_arts_A

 

Spirituality is Related to Reduced Depression but Negative Religiosity is Associated with Suicidality

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Spirituality is Related to Reduced Depression but Negative Religiosity is Associated with Suicidality

 

By John M. de Castro, Ph.D.

 

“The trouble is that just as it is hard to feel connected to other people while depressed, it is difficult to feel connected to God. A leap of trust and faith is frequently needed to be spiritual while depressed.” – Healthtalk.org

 

Depression and other mood disorders are the number-one risk factor for suicide. More than 90% of people who kill themselves have a mental disorder, whether depression, bipolar disorder or some other diagnosis. So, the best way to prevent suicide may be to treat the underlying cause. For many this means treating depression.

 

Spirituality is defined as “one’s personal affirmation of and relationship to a higher power or to the sacred. There have been a number of studies of the influence of spirituality on the physical and psychological well-being of practitioners mostly showing positive benefits, with spirituality encouraging personal growth and mental health. Spirituality may help to provide meaning and prevent suicide. But there is scant research on the relationship of spirituality and religiosity and suicide.

 

In today’s Research News article “Comparison of religiosity and spirituality in patients of depression with and without suicidal attempts.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8221206/ ) Dua and colleagues

CMCS – Center for Mindfulness and Contemplative Studies recruited 2 groups of patients both with depression and suicidal ideation and one with an additional suicide attempt. They also recruited age and gender matched healthy control participants. They completed measures of the depression, impulsivity, hopelessness, anxiety, irritability, mania, suicide severity, centrality of religion and spiritual attitudes.

 

They found that the depressed groups did not differ in purpose, hope, and organized, nonorganized religious activities and intrinsic religiosity. On the other hand, patients with suicidal ideation generally had a family history of suicide. Patients who had attempted suicide were significantly higher in hopelessness and suicide ideation and lower on social support than patients who had nor attempted suicide. They also had significantly higher levels of negative religious coping. Compared to the healthy controls the depressed groups were significantly lower in religiosity. They also found that the lower the levels of religiosity the greater the levels of suicidal ideation and the higher the number of suicide attempts. But, in the suicide attempters higher levels of ideological religiosity was associated with greater severity of suicide ideation.

 

These are interesting but correlative findings and as such causation cannot be determined. Nevertheless, the results suggest that spirituality, although associated with lower depression, is not significantly related to suicide ideation or attempts. On the other hand, negative religious coping, ideological religiosity, and low religiosity were. In other words, being religious, in general is not a problem. But adhering to the ideology or using negative religious coping are associated with suicidality.

 

Negative religious coping involves struggling with religion, questioning, guilt, and perceived distance from and negative views of god. This type of coping does not provide support in times of psychological distress and in fact may exacerbate feelings of hopelessness. Regardless, it appears that non-spiritual uses and ideas about religion and god my be associated with more thoughts about suicide and an increased likelihood of attempting suicide.

 

So, spirituality is related to reduced depression but negative religiosity is associated with suicidality.

 

“Whether your depression manifests itself as a loss of appetite, decreased sense of self-worth, lost productivity, feelings of helplessness, prolonged worry or any other symptom, spirituality can absolutely help an individual along their journey toward purpose.” – Pyramid Healthcare

 

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

 

Study Summary

 

Dua, D., Padhy, S., & Grover, S. (2021). Comparison of religiosity and spirituality in patients of depression with and without suicidal attempts. Indian journal of psychiatry, 63(3), 258–269. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_246_20

 

Abstract

Aim:

This study is aimed to compare the religiosity and spirituality of patients with first-episode depression with suicidal ideation and those with recent suicidal attempts. Additional aim was compare the religiosity and spirituality of patients with first-episode depression with healthy controls.

Methods:

Patients of first episode depression with suicidal ideation and healthy controls were assessed by Centrality of Religiosity Scale (CRS), Duke University Religion Index (DUREL), Brief Religious coping scale (R-COPE), and Spiritual Attitude Inventory (SAI).

Results:

Patients with depression were divided into two groups based on the presence (n = 53) or absence (n = 62) of suicidal attempts in the previous 14 days. Both the patients with and without suicide attempts were matched for depression severity. Both the patient groups did not differ in terms of religiosity and spirituality as assessed using CRS and SAI. Both depression groups had lower scores on religiosity as compared to healthy controls as assessed on CRS. The two groups also had a lower score on the “sense of hope” which is a part of SAI, when compared to healthy controls. Compared to patients without suicide attempts (i.e., ideators group) and healthy controls, subjects with suicide attempts more often used negative religious coping. Total numbers of lifetime suicide attempts in the attempt group were associated with the ideology domain of the CRS.

Conclusion:

Compared with healthy controls, patients with depression have lower levels of religiosity and spirituality. In the presence of comparable severity of depression, higher use of negative religious coping is associated with suicide attempts.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8221206/

Reduce Depression in Older Adults with Mind-Body Practices and Exercise

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Reduce Depression in Older Adults with Mind-Body Practices and Exercise

 

By John M. de Castro, Ph.D.

 

“Complementary use of mindful exercise, such as Tai Chi and yogic meditation, can improve clinical outcomes of mood disorders in older adults-as demonstrated in brain scans, biomarkers of cellular aging, and mental health rating scales.” – Arline Kaplan

 

The aging process involves a systematic progressive decline in every system in the body, the brain included. This includes our cognitive (mental) abilities and mood. It is inevitable and cannot be avoided. There is some hope for age related decline, however, as there is evidence that it can be slowed. There are some indications that physical and mental exercise can reduce the rate of decline. For example, contemplative practices such as meditation, yoga, and Tai Chi or qigong have all been shown to be beneficial in slowing or delaying physical and mental decline with aging and with improving depression. The research has been accumulating. So, it makes sense to pause and review and summarize what has been learned.

 

In today’s Research News article “Aerobic, resistance, and mind-body exercise are equivalent to mitigate symptoms of depression in older adults: A systematic review and network meta-analysis of randomised controlled trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191520/ ) Miller and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials of the effectiveness of mind-body practices, aerobic exercise, and resistance exercise on depression in older adults (over 65 years of age). They identified 69 published research studies including a total of 5,379 elderly participants.

 

They report that the published research found that in comparison to usual care, wait-list controls, or attention controls that mind-body practices, aerobic exercise, and resistance exercise all significantly reduced depression in the elderly participants. Although no significant differences were found between the practices, on average, the effectiveness of the practices were rank ordered mind-body practices followed by aerobic exercise followed by resistance exercise.

 

All three practices involve exercise. Mind-body practices include yoga, Tai Chi, and Qigong all of which provide gentle mild exercise intensity. Aerobic exercise on the other hand provides moderate intensity exercise. This suggests that the intensity of exercise is not important for the relief of depression. What does appear to be important is that exercise be incorporated into the activities of the elderly to raise mood and reduce depression. Hence, the results suggest that the depression that is common in the elderly can be ameliorated with exercise.

 

So, reduce depression in older adults with mind-body practices and exercise.

 

“Higher physical activity levels among older adults in particular may have a preventive effect on the development of depression.36 Recent findings point to the potential efficacy of exercise as a treatment of depression in older adults, in some cases with similar efficacy to antidepressants.” – Maren Nyer

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Miller, K. J., Areerob, P., Hennessy, D., Gonçalves-Bradley, D. C., Mesagno, C., & Grace, F. (2020). Aerobic, resistance, and mind-body exercise are equivalent to mitigate symptoms of depression in older adults: A systematic review and network meta-analysis of randomised controlled trials. F1000Research, 9, 1325. https://doi.org/10.12688/f1000research.27123.2

 

Abstract

Background: Exercise has been identified as an allied health strategy that can support the management of depression in older adults, yet the relative effectiveness for different exercise modalities is unknown. To meet this gap in knowledge, we present a systematic review and network meta-analysis of randomised controlled trials (RCTs) to examine the head-to-head effectiveness of aerobic, resistance, and mind-body exercise to mitigate depressive symptoms in adults aged ≥ 65 years.

Methods: A PRISMA-NMA compliant review was undertaken on RCTs from inception to September 12 th, 2019. PubMed, Web of Science, CINAHL, Health Source: Nursing/Academic Edition, PsycARTICLES, PsycINFO, and SPORTDiscus were systematically searched for eligible RCTs enrolling adults with a mean age ≥ 65 years, comparing one or more exercise intervention arms, and which used valid measures of depressive symptomology. Comparative effectiveness was evaluated using network meta-analysis to combine direct and indirect evidence, controlling for inherent variation in trial control groups.

Results: The systematic review included 82 RCTs, with 69 meeting eligibility for the network meta-analysis ( n = 5,379 participants). Pooled analysis found each exercise type to be effective compared with controls (Hedges’ g = -0.27 to -0.51). Relative head-to-head comparisons were statistically comparable between exercise types: resistance versus aerobic (Hedges’ g = -0.06, PrI = -0.91, 0.79), mind-body versus aerobic (Hedges’ g = -0.12, PrI = -0.95, 0.72), mind-body versus resistance (Hedges’ g = -0.06, PrI = -0.90, 0.79). High levels of compliance were demonstrated for each exercise treatment.

Conclusions: Aerobic, resistance, and mind-body exercise demonstrate equivalence to mitigate symptoms of depression in older adults aged ≥ 65 years, with comparably encouraging levels of compliance to exercise treatment. These findings coalesce with previous findings in clinically depressed older adults to encourage personal preference when prescribing exercise for depressive symptoms in older adults.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191520/

 

Reduce Adolescent Internalizing Symptoms, and Impulsivity with Mindfulness

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Reduce Adolescent Internalizing Symptoms, and Impulsivity with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness appears to be a way of engaging with our internal and external environment and approaching emotion that is an asset for avoiding excessively heightened internalizing symptoms.” – Sarah Clear

 

Adolescence is a time of mental, physical, social, and emotional growth. But it can be a difficult time, fraught with challenges. During this time the child transitions to young adulthood; including the development of intellectual, psychological, physical, and social abilities and characteristics. There are so many changes occurring during this time that the child can feel overwhelmed and unable to cope with all that is required. This can lead to emotional and behavioral problems. Indeed, up to a quarter of adolescents suffer from internalizing symptoms such as depression or anxiety disorders, and an even larger proportion struggle with subclinical symptoms. Mindfulness training has been shown to improve emotion regulation and to benefit the psychological and emotional health of adolescents

 

In today’s Research News article “Longitudinal Associations between Internalizing Symptoms, Dispositional Mindfulness, Rumination and Impulsivity in Adolescents.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8416885/ ) Royuela-Colomer and colleagues recruited healthy adolescents (aged 11 to 17 years) and had them complete measures of mindfulness, rumination, impulsivity, and internalizing symptoms, including anxiety, depression, and perceived stress. The measures were completed again one year later.

 

They found that adolescent boys had significantly lower levels of rumination, impulsivity, and internalizing symptoms and higher levels of mindfulness than girls. They also found that at both measurement periods the higher the levels of mindfulness the lower the levels of all dependent variables. They further found that the higher the levels of mindfulness at the first measurement the lower the levels of depression, perceived stress, and impulsivity a year later. This latter finding was true both for boys and girls.

 

These findings are correlational. So, no conclusions about causation can be made. But in previous controlled studies mindfulness has been found to improve the psychological well-being of adolescents and to produce lower levels of depression, perceived stress, and impulsivity. So, the correlations obtained here likely occurred due to causal connections between the variables. These results then suggest that mindfulness may be protective against internalizing symptoms and impulsivity in adolescents. This further suggests that mindfulness training should be made part of the education of adolescents to improve their psychological well-being and reducing their destructive tendencies toward impulsive behavior.

 

So, reduce adolescent internalizing symptoms, and impulsivity with mindfulness.

 

“Mindfulness not only directly impacted on adolescents’ internalizing problems, but also indirectly improved their anxious and depression emotions via the reduction of rumination and the increase of acceptance.” – Meng Yu

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Royuela-Colomer, E., Fernández-González, L., & Orue, I. (2021). Longitudinal Associations between Internalizing Symptoms, Dispositional Mindfulness, Rumination and Impulsivity in Adolescents. Journal of youth and adolescence, 50(10), 2067–2078. https://doi.org/10.1007/s10964-021-01476-2

 

Abstract

Mindfulness has been associated with fewer negative mental health symptoms during adolescence, but fewer studies have examined longitudinal associations between mindfulness and symptoms in conjunction with two vulnerability factors for psychopathology with mindfulness: rumination and impulsivity. This study examined longitudinal associations between internalizing symptoms (depression, anxiety, stress), mindfulness, rumination, and impulsivity over a one-year period among 352 Spanish adolescents (57.4% girls; M = 14.47, SD = 1.34). Participants completed self-reported measures of symptoms, mindfulness, rumination, and impulsivity at two time points. Mindfulness negatively predicted stress and depressive symptoms, and a bidirectional negative association was found between mindfulness and impulsivity. Impulsivity positively predicted stress, and anxiety positively predicted depressive symptoms, stress, and rumination. This study highlights the importance of mindfulness as a protective factor and impulsivity and anxiety as risk factors for internalizing symptoms throughout adolescence. These findings build on previous studies that examined longitudinal associations between mindfulness and symptoms by including rumination and impulsivity’s roles.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8416885/

 

Improve the Psychological Health of College Students with Mindfulness

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Improve the Psychological Health of College Students with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness can help students who might be struggling, in particular medical students, find new ways of relating to the difficulties that arise in their clinical work, studying and wellbeing.” – Alice Malpass

 

In the modern world education is a key for success. Where a high school education was sufficient in previous generations, a college degree is now required to succeed in the new knowledge-based economies. There is a lot of pressure on university students to excel so that they can get the best jobs after graduation. This stress might in fact be counterproductive as the increased pressure can lead to stress and anxiety which can impede the student’s physical and mental health, well-being, and school performance.

 

It is, for the most part, beyond the ability of the individual to change the environment to reduce stress, so it is important that methods be found to reduce the college students’ responses to stress; to make them more resilient when high levels of stress occur. Contemplative practices including meditation, mindfulness training, and yoga practice have been shown to reduce the psychological and physiological responses to stress. Indeed, these practices have been found to reduce stress and improve psychological health in college students. So, it would seem important to summarize what has been learned about mindfulness-based approaches to improve the psychological well-being of college students studying to become health professionals.

 

In today’s Research News article “Mindfulness-Based Approaches for Managing Stress, Anxiety and Depression for Health Students in Tertiary Education: a Scoping Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8435111/ ) Parsons and colleagues review and summarize the published research studies investigating the effectiveness of mindfulness-based approaches to improve the psychological well-being of college students studying to become health professionals. They identified 24 published research studies.

 

They report that the published research studies found that mindfulness-based training produced significant reductions in perceived stress, anxiety, and depression in the health students. Hence, these health students had similar responses to mindfulness training as has been observed in a large number of studies with a variety of healthy and ill participants. This suggests that it would be beneficial to incorporate mindfulness training in the curriculum of college students studying to become health professionals. This should improve their ability to learn their professions and become more resilient and effective professionals.

 

So, improve the psychological health of college health students with mindfulness.

 

“Mindfulness-based interventions decrease stress, anxiety, and depression and improve mindfulness, mood, self-efficacy, and empathy in health profession students.” – Janet McConville

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Parsons, D., Gardner, P., Parry, S., & Smart, S. (2021). Mindfulness-Based Approaches for Managing Stress, Anxiety and Depression for Health Students in Tertiary Education: a Scoping Review. Mindfulness, 1–16. Advance online publication. https://doi.org/10.1007/s12671-021-01740-3

 

Abstract

Objectives

High rates of depression, anxiety and stress are reported in tertiary health students. Mindfulness-based programs have been included in the training of health students to help them manage depression, anxiety and stress; however, to date, there has been no review of best practice implementation of mindfulness for health students. The aim of this review was to evaluate the outcomes of mindfulness-based practice for health students to inform best practice with this population.

Methods

A comprehensive search was conducted of three electronic databases (PsychINFO, Medline and Embase) guided by the five-step systematic process for conducting scoping reviews to investigate mindfulness-based intervention programs for students enrolled in a tertiary institution in a health-related course.

Results

Twenty-four papers met the eligibility criteria and were reviewed in detail. Findings suggested that mindfulness-based intervention approaches are useful in decreasing depression, anxiety and stress in health students; however, challenges exist in student engagement and retention. Generalization of results was limited by the heterogeneous population, intervention designs and delivery methods, as well as a lack of standardized outcome measures.

Conclusion

The inclusion of mindfulness-based programs within tertiary curricula can be an effective approach to assist with managing depression, stress and anxiety in health students. Providing academic credit to students, improving translation of skills to working with future clients, and embedding mindfulness-based programs within the curriculum could improve engagement and retention.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8435111/

 

Improve Eating Disorders with Dialectical Behavior Therapy

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Improve Eating Disorders with Dialectical Behavior Therapy

 

By John M. de Castro, Ph.D.

 

“Dialectical behavioral therapy encourages change but also promotes acceptance. The term dialectic means that two opposite ideas can be correct at the same time. This is helpful for individuals in eating disorder treatment as most of these clients adopt an “all or nothing view”. The dialectical view appeals to many as they navigate recovery; they can accept their difficulties and work towards changing them.” – Discovery

 

Around 30 million people in the United States of all ages and genders suffer from an eating disorder: either anorexia nervosa, bulimia, or binge eating disorder. 95% of those who have eating disorders are between the ages of 12 and 26. Eating disorders are not just troubling psychological problems, they can be deadly, having the highest mortality rate of any mental illness. Binge eating disorder involves eating a large amount of food within a short time-period while experiencing a sense of loss of control over eating.

 

Eating disorders can be difficult to treat because eating is necessary and cannot be simply stopped as in smoking cessation or abstaining from drugs or alcohol. One must learn to eat appropriately not stop. So, it is important to find methods that can help prevent and treat eating disorders. Contemplative practices, mindfulness, and mindful eating have shown promise for treating eating disorders. Dialectical Behavior Therapy (DBT) produces behavior change by focusing on changing the thoughts and emotions that precede problem behaviors, as well as by solving the problems faced by individuals that contribute to problematic thoughts, feelings, and behaviors. In DBT five core skills are practiced; mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness. It is likely, then that DBT is effective in treating eating sidorders.

 

There is accumulating evidence of the effectiveness of Dialectical Behavior Therapy (DBT) for the treatment of eating disorders. So, it makes sense to review what has been learned. In today’s Research News article “.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8470932/ ) Rozakou-Soumalia and colleagues review, summarize, and perform a meta-analysis of the published controlled research studies of the effectiveness of DBT in the treatment of eating disorders.

 

They identified 11 published studies, 10 of which were randomized controlled trials. They report that the published research found that Dialectical Behavior Therapy (DBT) produced a significant increase in emotion regulation and a significant decrease in depression, body mass index, and the severity of eating disorders symptoms, including binge eating episodes.

 

These findings of the published research suggest that Dialectical Behavior Therapy (DBT) is an effective treatment for eating disorders, reducing the severity of the symptoms. A core issue for patients with eating disorders is an inability to effectively deal with their emotions. The findings suggest that one way that DBT improves eating disorders is by increasing the patient’s ability to effectively regulate their emotions. Mindfulness training, which is contained in DBT has been shown in a wide range of research studies to improve emotion regulation and this may be the mechanism by which DBT improves eating disorders.

 

So, improve eating disorders with Dialectical Behavior Therapy.

 

“DBT techniques equip eating disorder sufferers with methods for identifying triggers and improving responses to stress, (such as engaging in breathing and relaxation exercises), and applying mindful eating.” – Eating Disorders Hope

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Rozakou-Soumalia, N., Dârvariu, Ş., & Sjögren, J. M. (2021). Dialectical Behaviour Therapy Improves Emotion Dysregulation Mainly in Binge Eating Disorder and Bulimia Nervosa: A Systematic Review and Meta-Analysis. Journal of Personalized Medicine, 11(9), 931. https://doi.org/10.3390/jpm11090931

 

Abstract

Emotion dysregulation is a transdiagnostic phenomenon in Eating Disorders (ED), and Dialectical Behaviour Therapy (DBT) (which was developed for reducing dysregulated emotions in personality disorders) has been employed in patients with ED. This systematic review and meta-analysis investigated whether the effect of DBT was stronger on emotion dysregulation, general psychopathology, and Body Mass Index (BMI) in participants with ED, when compared to a control group (active therapy and waitlist). Eleven studies were identified in a systematic search in accordance with PRISMA guidelines. Most studies included participants with Binge Eating Disorder (BED) (n = 8), some with Bulimia Nervosa (BN) (n = 3), and only one with Anorexia Nervosa (AN). The pooled effect of DBT indicated a greater improvement in Emotion Regulation (ER) (g = −0.69, p = 0.01), depressive symptoms (g = −0.33, p < 0.00001), ED psychopathology (MD = −0.90, p = 0.005), Objective Binge Episodes (OBE) (MD = −0.27, p = 0.003), and BMI (MD = −1.93, p = 0.01) compared to the control group. No improvement was detected in eating ER following DBT (p = 0.41). DBT demonstrated greater efficacy compared with the control group in improving emotion dysregulation, ED psychopathology, and BMI in ED. The limitations included the small number of studies and high variability.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8470932/

 

Improve Post-Traumatic Stress Disorder (PTSD) Symptoms with Loving Kindness Meditation

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Improve Post-Traumatic Stress Disorder (PTSD) Symptoms with Loving Kindness Meditation

 

By John M. de Castro, Ph.D.

 

“You probably know that symptoms of posttraumatic stress disorder (PTSD) often include anxiety, unwanted memories, anger and avoidance. But did you know that meditation may be able to help? Meditative practices have been linked to decreases in hyperarousal, depression and insomnia.” – Jill Bormann

 

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime. But only a fraction will develop Post-Traumatic Stress Disorder (PTSD). But this still results in a frightening number of people with 7%-8% of the population developing PTSD at some point in their life. For military personnel, it’s much more likely for PTSD to develop with about 11%-20% of those who have served in a war zone developing PTSD.

 

PTSD involves a number of troubling symptoms including reliving the event with the same fear and horror in nightmares or with a flashback. PTSD sufferers avoid situations that remind them of the event this may include crowds, driving, movies, etc. and may avoid seeking help because it keeps them from having to think or talk about the event. They often experience negative changes in beliefs and feelings including difficulty experiencing positive or loving feelings toward other people, avoiding relationships, memory difficulties, or see the world as dangerous and no one can be trusted. Sufferers may feel hyperarousal, feeling keyed up and jittery, or always alert and on the lookout for danger. They may experience sudden anger or irritability, may have a hard time sleeping or concentrating, may be startled by a loud noise or surprise.

 

Obviously, these are troubling symptoms that need to be addressed. There are a number of therapies that have been developed to treat PTSD. One of which, mindfulness training has been found to be particularly effective.  Increasing self-compassion is important for improvement in PTSD symptoms. Mindfulness has been shown to increase self-compassion.  In Loving Kindness Meditation the individual systematically pictures different individuals from self, to close friends, to enemies and wishes them happiness, well-being, safety, peace, and ease of well-being. So, Loving Kindness Meditation may be an effective treatment for the symptoms of PTSD.

 

In today’s Research News article “Loving-Kindness Meditation vs Cognitive Processing Therapy for Posttraumatic Stress Disorder Among Veterans: A Randomized Clinical Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8052593/ ) Kearney and colleagues recruited military veterans who were diagnosed with Post-Traumatic Stress Disorder (PTSD) and randomly assigned them to receive 2 weekly 90-minute group sessions of either Loving Kindness Meditation or Cognitive Processing Therapy (CPT). CPT “combines cognitive restructuring with emotional processing of trauma-related content”. They were measured before and after treatment and 3 and 6 months later for PTSD symptom severity and depression.

 

They found that in comparison to baseline both groups had significant but modest reductions in PTSD symptom severity and depression that were maintained 6 months after the end of treatment. The therapy groups did not differ in PTSD symptom severity but the group that practiced Loving Kindness Meditation had significantly lower level of depression after treatment and 6 months later.

 

These are interesting findings that suggest that both Loving Kindness Meditation and Cognitive Processing Therapy (CPT) produce modest relief of the symptoms of PTSD and depression in military veterans. But Loving Kindness Meditation produces better outcomes in relieving depression. Loving Kindness Meditation is known to improve mindfulness and compassion for the self and others, and this appears to help relieve the psychological consequences of trauma. This suggests that trauma, to some extent, produces a degree of self-blame which may be responsible for some of the symptoms. But these therapies produce only modest improvements suggesting that Loving Kindness Meditation is not a cure but may be useful as a component in the treatment of PTSD.

 

So, improve Post-Traumatic Stress Disorder (PTSD) symptoms with Loving Kindness Meditation.

 

“veteran participants self-reported a significant decrease in their PTSD symptoms and a high degree of satisfaction with the compassion meditation program.” – Laura McArdle

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Kearney, D. J., Malte, C. A., Storms, M., & Simpson, T. L. (2021). Loving-Kindness Meditation vs Cognitive Processing Therapy for Posttraumatic Stress Disorder Among Veterans: A Randomized Clinical Trial. JAMA network open, 4(4), e216604. https://doi.org/10.1001/jamanetworkopen.2021.6604

 

Question

Is group loving-kindness meditation noninferior to group cognitive processing therapy for treatment of posttraumatic stress disorder (PTSD) among veterans?

Findings

In this randomized clinical trial, 184 veterans with PTSD were assigned to group loving-kindness meditation or group cognitive processing therapy; the differences in the decrease from baseline to 6-month follow-up for measures of PTSD and depression were very similar and within predefined margins considered not meaningfully different. Attendance was better for loving-kindness meditation.

Meaning

This study adds to the evidence indicating that interventions without a specific focus on trauma, including meditation-based interventions, can yield results similar to trauma-focused therapies.

Importance

Additional options are needed for treatment of posttraumatic stress disorder (PTSD) among veterans.

Objective

To determine whether group loving-kindness meditation is noninferior to group cognitive processing therapy for treatment of PTSD.

Design, Setting, and Participants

This randomized clinical noninferiority trial assessed PTSD and depression at baseline, posttreatment, and 3- and 6-month follow-up. Veterans were recruited from September 24, 2014, to February 5, 2018, from a large Veternas Affairs medical center in Seattle, Washington. A total of 184 veteran volunteers who met Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) criteria for PTSD were randomized. Data collection was completed November 28, 2018, and data analyses were conducted from December 10, 2018, to November 5, 2019.

Interventions

Each intervention comprised 12 weekly 90-minute group sessions. Loving-kindness meditation (n = 91) involves silent repetition of phrases intended to elicit feelings of kindness for oneself and others. Cognitive processing therapy (n = 93) combines cognitive restructuring with emotional processing of trauma-related content.

Main Outcomes and Measures

Co–primary outcomes were change in PTSD and depression scores over 6-month follow-up, assessed by the Clinician-Administered PTSD Scale (CAPS-5; range, 0-80; higher is worse) and Patient-Reported Outcome Measurement Information System (PROMIS; reported as standardized T-score with mean [SD] of 50 [10] points; higher is worse) depression measures. Noninferiority margins were 5 points on the CAPS-5 and 4 points on the PROMIS depression measure.

Results

Among the 184 veterans (mean [SD] age, 57.1 [13.1] years; 153 men [83.2%]; 107 White participants [58.2%]) included in the study, 91 (49.5%) were randomized to the loving-kindness group, and 93 (50.5%) were randomized to the cognitive processing group. The mean (SD) baseline CAPS-5 score was 35.5 (11.8) and mean (SD) PROMIS depression score was 60.9 (7.9). A total of 121 veterans (66%) completed 6-month follow-up. At 6 months posttreatment, mean CAPS-5 scores were 28.02 (95% CI, 24.72-31.32) for cognitive processing therapy and 25.92 (95% CI, 22.62-29.23) for loving-kindness meditation (difference, 2.09; 95% CI, −2.59 to 6.78), and mean PROMIS depression scores were 61.22 (95% CI, 59.21-63.23) for cognitive processing therapy and 58.88 (95% CI, 56.86-60.91) for loving-kindness meditation (difference, 2.34; 95% CI, −0.52 to 5.19). In superiority analyses, there were no significant between-group differences in CAPS-5 scores, whereas for PROMIS depression scores, greater reductions were found for loving-kindness meditation vs cognitive processing therapy (for patients attending ≥6 visits, ≥4-point improvement was noted in 24 [39.3%] veterans receiving loving-kindness meditation vs 9 (18.0%) receiving cognitive processing therapy; P = .03).

Conclusions and Relevance

Among veterans with PTSD, loving-kindness meditation resulted in reductions in PTSD symptoms that were noninferior to group cognitive processing therapy. For both interventions, the magnitude of improvement in PTSD symptoms was modest. Change over time in depressive symptoms was greater for loving-kindness meditation than for cognitive processing therapy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8052593/

 

Improve the Psychological Health of Obstetrics and Gynecology Patients during Covid-19 with a Mindfulness App

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The COVID-19 vaccine and pregnancy — what women need to know | Keck School of Medicine of USC

Improve the Psychological Health of Obstetrics and Gynecology Patients during Covid-19 with a Mindfulness App

 

By John M. de Castro, Ph.D.

 

“mindfulness meditation might be a viable low-cost intervention to mitigate the psychological impact of the COVID-19 crisis and future pandemics.” – Julie Lei Zhu

 

Mindfulness training has been shown to improve health and well-being in healthy individuals. 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. One of the primary effects of mindfulness that may be responsible for many of its benefits is that it improves the physiological and psychological responses to stress. The Covid-19 pandemic is extremely stressful particularly for patients who are pregnant or awaiting surgery. This training has been shown to improve the well-being of a wide variety of individuals. So, it should be helpful with these patients.

 

The vast majority of the mindfulness training techniques, however, require a trained teacher. The participants must be available to attend multiple sessions at scheduled times that may or may not be compatible with their schedules and at locations that may not be convenient. As an alternative, apps for smartphones have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. These should be particularly useful during the Covid-19 pandemic as attending in-person therapy sessions may not be safe or practicable. But the question arises as to the effectiveness of these apps in inducing mindfulness and reducing stress and improving psychological well-being in real-world medical patients.

 

In today’s Research News article “Mindfulness Effects in Obstetric and Gynecology Patients During the Coronavirus Disease 2019 (COVID-19) Pandemic: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8132566/ ) Smith and colleagues recruited adult

obstetrics and gynecology patients who were either pregnant or awaiting gynecological surgery delayed due to the Covid-19 pandemic. They were randomly assigned to receive either standard care or to practice mindfulness for 10 minutes per day for 30 days with a commercially available smartphone app “Calm”. They were measured before training, at 14 days into training, and after training for perceived stress, anxiety, depression, and sleep disturbance.

 

They found that in comparison to baseline and the usual care control group, the group that practiced mindfulness with the “Calm” app had significantly lower levels of perceived stress, anxiety, depression, and sleep disturbance at 14 days and 30 days. The mindfulness group also reported lower levels of perceived stress due to Covid-19 and less worry about infections in their families. A high degree of satisfaction with the “Calm” app was reported.

 

Covid-19 has affected the psychological health of virtually everyone and past research has shown that mindfulness improves their psychological health. The present study demonstrates that this occurs in pregnant women and women awaiting gynecological surgery. An important aspect of the present study was the use of a smartphone app to do the mindfulness training. These apps are particularly useful during the Covid-19 pandemic as attending in-person therapy sessions may not be safe or practicable. This allows for mindfulness training with its benefits for the well-being of the patients to occur even in the midst of a pandemic.

 

So, improve the psychological health of obstetrics and gynecology patients during covid-19 with a mindfulness app.

 

“Mindfulness can help us acknowledge this situation, without allowing us to be carried away with strong emotions; it can, in turn, help bring ourselves back to a centered calm. Only then can we see more clearly what it is we have control over and what it is that we do not.“ – Michigan Medicine

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Smith, R. B., Mahnert, N. D., Foote, J., Saunders, K. T., Mourad, J., & Huberty, J. (2021). Mindfulness Effects in Obstetric and Gynecology Patients During the Coronavirus Disease 2019 (COVID-19) Pandemic: A Randomized Controlled Trial. Obstetrics and gynecology, 137(6), 1032–1040. https://doi.org/10.1097/AOG.0000000000004316

 

Abstract

OBJECTIVE:

To assess the effect of a consumer-based mobile meditation application (app) on wellness in outpatient obstetric and gynecology patients during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS:

We conducted a randomized controlled trial at a university outpatient clinic of obstetric and gynecology patients during the COVID-19 pandemic. Women were randomly assigned to the intervention group, who was prescribed a mobile meditation app for 30 days, or the control group, which received standard care. The primary outcome was self-reported perceived stress. Secondary outcomes included self-reported depression, anxiety, sleep disturbance, and satisfaction with the meditation app. A sample size of 80 participants (40 per group) was calculated to achieve 84% power to detect a 3-point difference in the primary outcome.

RESULTS:

From April to May 2020, 101 women were randomized in the study—50 in the meditation app group and 51 in the control group. Analysis was by intention-to-treat. Most characteristics were similar between groups. Perceived stress was significantly less in the intervention group at days 14 and 30 (mean difference 4.27, 95% CI 1.30–7.24, P=.005, d=0.69 and mean difference 4.28, 95% CI 1.68–6.88, P=.002, d=0.69, respectively). Self-reported depression and anxiety were significantly less in the intervention group at days 14 and 30 (depression: P=.002 and P=.04; anxiety: P=.01, and P=.04, respectively). Sleep disturbance was significantly less in the intervention group at days 14 and 30 (P=.001 and P=.02, respectively). More than 80% of those in the intervention group reported high satisfaction with the meditation app, and 93% reported that mindfulness meditation improved their stress.

CONCLUSION:

Outpatient obstetric and gynecology patients who used the prescribed consumer-based mobile meditation app during the COVID-19 pandemic had significant reductions in perceived stress, depression, anxiety, and sleep disturbance compared with standard care.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8132566/