Distress

Spirituality is Associated with Reduced Emotional Distress in Lung Cancer Survivors

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Spirituality is Associated with Reduced Emotional Distress in Lung Cancer Survivors

 

By John M. de Castro, Ph.D.

 

“However you define spirituality, studies show that it can play an important role in coping with the recovery and healing process from cancer treatment and its after effects.” – LungCancer.org

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotional distress and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis.

 

Religion and spirituality become much more important to people when they’re diagnosed with cancer or when living with cancer. It is thought that people take comfort in the spiritual when facing mortality. Hence, spirituality may be a useful tool for the survivors of cancer to cope with their illness and the consequent emotional distress. Thus, it makes sense to study the relationships of spirituality with the mental health of cancer survivors.

 

In today’s Research News article “Spirituality and Emotional Distress Among Lung Cancer Survivors.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6859202/ ) Gudenkauf and colleagues recruited adult patients with lung cancer and had them complete questionnaires measuring spirituality, emotional distress, and quality of life. within 1 year of their diagnosis and 1 year later.

 

They found that the lung cancer survivors, not surprisingly, were generally high in emotional distress. But those survivors who were high in spirituality, including the meaning, peace, and faith dimensions, were high in quality of life and low in emotional distress. In addition, those survivors who were high in distress at the first measurement, if they were also high in spirituality meaning, were more likely to have low emotional distress 1 year later.

 

It should be kept in mind that the present study was observational and as a result causation cannot be determined. But it appears that in these lung cancer survivors, spirituality is associated with better quality of life and lower emotional distress and that spirituality tends to predict lower emotional distress a year later. Hence, spirituality appears to help survivors cope with their emotional reactions to their diagnosis. Future studies should investigate whether promoting spirituality in these survivors may improve their emotions and quality of life.

 

So, spirituality is associated with reduced emotional distress in lung cancer survivors.

 

“While having a spiritual or religious foundation can’t change your diagnosis or the effectiveness of treatment, some patients find their beliefs help them find meaning and cope. “It may not impact your prognosis, but it can help improve your overall outlook during treatment,” – Tiffany Meyer

 

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

 

Gudenkauf, L. M., Clark, M. M., Novotny, P. J., Piderman, K. M., Ehlers, S. L., Patten, C. A., Nes, L. S., Ruddy, K. J., Sloan, J. A., & Yang, P. (2019). Spirituality and Emotional Distress Among Lung Cancer Survivors. Clinical lung cancer, 20(6), e661–e666. https://doi.org/10.1016/j.cllc.2019.06.015

 

Abstract

Background:

Emerging research is highlighting the importance of spirituality in cancer survivorship as well as the importance of early distress screening. The purpose of this study was to prospectively examine the relationships among spirituality, emotional distress, and sociodemographic variables during the early period of lung cancer survivorship.

Patients and Methods:

864 lung cancer survivors completed the Functional Assessment of Chronic Illness Therapy – Spiritual Well-Being (FACIT-Sp), and the Short-Form-8 (SF-8) for emotional distress within the first year following lung cancer diagnosis, and 474 of these survivors completed the survey again one year later.

Results:

At baseline, spirituality was associated with lower prevalence of emotional distress, being married, fewer years of cigarette smoking, and better ECOG performance status. Additionally, high baseline spirituality was associated with lower rates of high emotional distress at one-year follow-up.

Conclusion:

These findings suggest that spirituality may serve as a protective factor for emotional distress among lung cancer survivors. Further research is warranted to explore the role of spirituality in promoting distress management among lung cancer survivors.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6859202/

 

Improve Psychological Health with a Self-Guided, Smartphone-Based Mindfulness App

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Improve Psychological Health with a Self-Guided, Smartphone-Based Mindfulness App

 

By John M. de Castro, Ph.D.

 

“Another part of the appeal of smartphone-based apps is their anonymity. “The apps also allow for privacy and confidentiality and can be a safe space for individuals who may be too ashamed to admit their mental health issues in person or who may feel that they will be negatively labeled or stigmatized by others,” – Sal Raichback

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health. But the vast majority of the mindfulness training techniques, however, require a trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. As an alternative, mindfulness training with smartphone apps has 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. In addition, research has indicated that mindfulness training via smartphone apps can be effective for improving the health and well-being of the participants.

 

In today’s Research News article “Testing the Efficacy of a Multicomponent, Self-Guided, Smartphone-Based Meditation App: Three-Armed Randomized Controlled Trial. JMIR mental health.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732708/ ) Goldberg and colleagues recruited adults who did not have extensive meditation experience and randomly assigned them to a wait-list control condition or to receive either of 2 8-week smartphone app mindfulness training with the Healthy Minds Program. They received 4 weeks of awareness training including awareness of breathing and awareness of sounds. They were then again randomly assigned to receive 4 weeks of either Connection training consisting or gratitude and kindness practices or Insight Training consisting of “the changing nature of the phenomenon (ie, impermanence) and examining how thoughts and emotions influence perception” practices. They were measured before after the first 4-week module and after the second 4-week module for mindfulness, psychological distress, perceived stress, interpersonal connections, interpersonal reactivity, compassion, self-reflection, rumination, and defusion.

 

They found that compared to baseline and the wait-list control group both intervention conditions produced significant increases in mindfulness, social connection, self-reflection and defusion and significant decreases in psychological distress, and rumination with no significant differences between the smartphone interventions. There were no differences between the wait-list controls and the intervention in compassion and empathy.

 

These are interesting findings that correspond to the finding in prior research that training the increases mindfulness produces significant increases in social connection, self-reflection and defusion and significant decreases in psychological distress, and rumination. They demonstrate that smartphone trainings that improve mindfulness produce improvement in the psychological health of the participants.

 

It was a bit surprising that the benefits of the awareness plus connection training did not significantly differ from the benefits of awareness plus insight training. But since both trainings equivalently higher mindfulness and increased mindfulness has been shown to produce these benefits, it is reasonable to conclude that any training the improves mindfulness will improve psychological health..

 

So, improve psychological health with a self-guided, smartphone-based mindfulness App.

 

“Using a smartphone app, may provide immediate effects on mood and stress while also providing long-term benefits for attentional control. . . there is evidence that with continued usage, [mindfulness training] via a smartphone app may provide long-term benefits in changing how one relates to their inner and outer experiences.” – Kathleen Marie Walsh

 

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

 

Goldberg, S. B., Imhoff-Smith, T., Bolt, D. M., Wilson-Mendenhall, C. D., Dahl, C. J., Davidson, R. J., & Rosenkranz, M. A. (2020). Testing the Efficacy of a Multicomponent, Self-Guided, Smartphone-Based Meditation App: Three-Armed Randomized Controlled Trial. JMIR mental health, 7(11), e23825. https://doi.org/10.2196/23825

 

Abstract

Background

A growing number of randomized controlled trials (RCTs) suggest psychological benefits associated with meditation training delivered via mobile health. However, research in this area has primarily focused on mindfulness, only one of many meditative techniques.

Objective

This study aims to evaluate the efficacy of 2 versions of a self-guided, smartphone-based meditation app—the Healthy Minds Program (HMP)—which includes training in mindfulness (Awareness), along with practices designed to cultivate positive relationships (Connection) or insight into the nature of the self (Insight).

Methods

A three-arm, fully remote RCT compared 8 weeks of one of 2 HMP conditions (Awareness+Connection and Awareness+Insight) with a waitlist control. Adults (≥18 years) without extensive previous meditation experience were eligible. The primary outcome was psychological distress (depression, anxiety, and stress). Secondary outcomes were social connection, empathy, compassion, self-reflection, insight, rumination, defusion, and mindfulness. Measures were completed at pretest, midtreatment, and posttest between October 2019 and April 2020. Longitudinal data were analyzed using intention-to-treat principles with maximum likelihood.

Results

A total of 343 participants were randomized and 186 (54.2%) completed at least one posttest assessment. The majority (166/228, 72.8%) of those assigned to HMP conditions downloaded the app. The 2 HMP conditions did not differ from one another in terms of changes in any outcome. Relative to the waitlist control, the HMP conditions showed larger improvements in distress, social connectedness, mindfulness, and measures theoretically linked to insight training (d=–0.28 to 0.41; Ps≤.02), despite modest exposure to connection- and insight-related practice. The results were robust to some assumptions about nonrandom patterns of missing data. Improvements in distress were associated with days of use. Candidate mediators (social connection, insight, rumination, defusion, and mindfulness) and moderators (baseline rumination, defusion, and empathy) of changes in distress were identified.

Conclusions

This study provides initial evidence of efficacy for the HMP app in reducing distress and improving outcomes related to well-being, including social connectedness. Future studies should attempt to increase study retention and user engagement.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732708/

 

Mindfulness is Associated with Reduced Psychological Distress in Kindergarten Teachers

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Mindfulness is Associated with Reduced Psychological Distress in Kindergarten Teachers

 

By John M. de Castro, Ph.D.

 

“mindfulness—the ability to stay focused on one’s present experience with nonjudgmental awareness—can help us to promote the calm, relaxed, but enlivened classroom environment that children need to learn. Mindfulness can also help us to be more effective at reducing conflict and developing more positive ways of relating in the classroom, which can help us feel more job satisfaction.” – Patricia Jennings

 

Stress is epidemic in the workplace with almost two thirds of workers reporting high levels of stress at work. This often produces burnout; fatigue, cynicism, emotional exhaustion, and professional inefficacy. In a school setting, this burnout and exhaustion not only affects teachers and administrators personally, but also the students and schools, as it produces a loss of enthusiasm, empathy, and compassion.

 

Hence, there is a need to identify methods of reducing stress and improving teachers’ psychological health. Mindfulness has been demonstrated to be helpful in reducing the psychological and physiological responses to stress and for treating and preventing burnout in a number of work environments. But the effects of mindfulness on kindergarten teachers has not been explored.

 

In today’s Research News article “Mindfulness and Psychological Distress in Kindergarten Teachers: The Mediating Role of Emotional Intelligence.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7664406/ ) Cheng and colleagues recruited kindergarten teachers in China and had them complete measures of mindfulness in teaching, emotional intelligence, perceived stress, anxiety, and depression. These data were then subjected to regression and mediation analyses.

 

They found that the higher the levels of mindfulness in the teachers the higher the levels of emotional intelligence including self-emotional appraisal, others-emotional appraisal, use of emotion, and regulation of emotion. They also found that the higher the levels of mindfulness, the lower the levels of anxiety, depression, psychological distress, and perceived stress. In addition, the higher the levels of emotional intelligence, the lower the levels of anxiety, depression, psychological distress, and perceived stress.

 

They performed a mediation analysis on the data and found that the association of mindfulness with psychological distress was both direct and indirect via emotional intelligence. That is mindfulness was not only associated directly with lower levels of psychological distress but also indirectly by being associated with higher levels of emotional intelligence which, in turn, was associated with lower levels of psychological distress. Further mediation analyses revealed that regulation of emotion was the aspect of emotional intelligence that was responsible for the mediation.

 

It should be kept in mind that these results are correlational and causation cannot be definitively concluded. But, it has been established in previous research the mindfulness training produces increased emotional intelligence and decreased levels of anxiety, depression, psychological distress, and perceived stress. So, the present results likely represent causal effects. Hence, it appears that mindfulness in teaching improves the psychological and emotional well-being of kindergartner teachers. This should not only make the teachers more effective in the classroom but also reduce the likelihood of teacher burnout.

 

So, mindfulness is associated with reduced psychological distress in kindergarten teachers.

 

“Practicing mindfulness in your own life can organically lead to integrating it into your classes in a variety of ways, whether by inviting students to take two feet one breath or by beginning class with a moment of mindful breathing.” – Alison Cohen

 

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

 

Cheng, X., Ma, Y., Li, J., Cai, Y., Li, L., & Zhang, J. (2020). Mindfulness and Psychological Distress in Kindergarten Teachers: The Mediating Role of Emotional Intelligence. International journal of environmental research and public health, 17(21), 8212. https://doi.org/10.3390/ijerph17218212

 

Abstract

Kindergarten teachers are often exposed to great stress. Considering that, mindfulness has been demonstrated to act as a critical role in the psychological well-being of kindergarten teachers. The present study assessed mindfulness in teaching (MT), psychological distress and emotional intelligence (EI) among 511 kindergarten teachers in mainland China and investigated the mediating role of EI to explore the association mechanism between kindergarten teachers’ MT and psychological distress. The major results suggested that kindergarten teachers’ MT was negatively related to their psychological distress (depression, anxiety, and stress). Results of path analyses indicated that the total score of EI and dimension of regulation of emotion (ROE) could serve as significant mediators. The findings suggest that mindfulness might be beneficial to relieve kindergarten teachers’ psychological distress through the mediating role of EI.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7664406/

 

Manage Symptoms in Cancer Survivors with Yoga

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Manage Symptoms in Cancer Survivors with Yoga

 

By John M. de Castro, Ph.D.

 

“when it’s used alongside conventional medical treatment, yoga may help relieve some of the symptoms linked to cancer.” – American Cancer Society

 

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. This is particularly true with metastatic cancer. 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 . Yoga is both an exercise and a mindfulness practice that has also been shown to be helpful with the residual symptoms in cancer survivors, the psychological and physical ability to deal with cancer treatment and improves sleep. So, it’s reasonable to review what has been learned about the benefits of yoga practice to improve the residual symptoms of patients who have survived cancer.

 

In today’s Research News article “Yoga for symptom management in oncology: A review of the evidence base and future directions for research.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6541520/ ) Danhauer and colleagues review and summarize the published randomized controlled studies of the effectiveness of yoga practice for the treatment of the symptoms of cancer survivors. They identified 29 published randomized controlled trials, 13 conducted during treatment, 12 after treatment, and 4 both before and after.

 

They report that the published research found that yoga during treatment for cancer significantly improved the patient’s quality of life, including physical, emotional social, and cognitive quality of life. They also report that yoga significantly reduced fatigue, distress, perceived stress, and biomarkers of stress and inflammation. Yoga after treatment completion was found to significantly reduce fatigue and sleep disturbance and improve quality of life. There were no serious adverse events resulting from yoga practice reported.

 

The published research then suggests that yoga practice is a safe and effective treatment both during and after cancer treatment for the relief of the patients’ residual physical and psychological symptoms. Yoga practice is a complex of practices that includes postures, breath control, and meditation. It has not been clearly established which of these components or which combination of components are required for the benefits. So, conclusions cannot be made regarding mechanisms of action by which yoga produces its benefits. But it can be concluded that yoga practice is very beneficial for cancer sufferers.

 

So, manage symptoms in cancer survivors with yoga.

 

“yoga can combat fatigue and improve strength and range of motion for patients undergoing cancer treatment,” – Dr. Maggie DiNome

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Danhauer, S. C., Addington, E. L., Cohen, L., Sohl, S. J., Van Puymbroeck, M., Albinati, N. K., & Culos-Reed, S. N. (2019). Yoga for symptom management in oncology: A review of the evidence base and future directions for research. Cancer, 125(12), 1979–1989. https://doi.org/10.1002/cncr.31979

 

Abstract

As yoga is increasingly recognized as a complementary approach to cancer symptom management, patients/survivors and providers need to understand its potential benefits and limitations both during and after treatment. We reviewed randomized controlled trials (RCTs) of yoga conducted at these points in the cancer continuum (N=29; n=13 during treatment, n=12 post-treatment, n=4 with mixed samples). Findings both during and after treatment demonstrated efficacy of yoga to improve overall quality of life (QOL), with improvement in subdomains of QOL varying across studies. Fatigue was the most commonly measured outcome, and most RCTs conducted during or after cancer treatment reported improvements in fatigue. Results additionally suggest that yoga can improve stress/distress during treatment and post-treatment disturbances in sleep and cognition. A number of RCTs showed evidence that yoga may improve biomarkers of stress, inflammation, and immune function. Outcomes with limited or mixed findings (e.g., anxiety, depression, pain, cancer-specific symptoms such as lymphedema, positive psychological outcomes such as benefit-finding and life satisfaction) warrant further study. Important future directions for yoga research in oncology include: enrolling participants with cancer types other than breast, standardizing self-report assessments, increasing use of active control groups and objective measures, and addressing the heterogeneity of yoga interventions, which vary in type, key components (movement, meditation, breathing), dose, and delivery mode.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6541520/

 

Distress Is Lower during a COVID-19 Pandemic Lockdown in Mindful People

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Distress Is Lower during a COVID-19 Pandemic Lockdown in Mindful People

 

By John M. de Castro, Ph.D.

 

“During the current pandemic, there is so much uncertainty concerning the future, and many threats to our security (physical, social, emotional, and financial). It is totally natural and normal to feel anxious, fearful, and frustrated. . . 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

 

Modern living is stressful under the best of conditions. But with the COVID-19 pandemic the levels of stress have been markedly increased. These conditions markedly increase anxiety. This is true for everyone but especially for healthcare workers and people caring for patients with COVID-19 and for people with pre-existing conditions that makes them particularly vulnerable. But it is also true for healthy individuals who worry about infection for themselves or loved ones.

 

The COVID-19 pandemic has also produced considerable economic stress, with loss of employment and steady income. For the poor this extends to high levels of food insecurity. This not only produces anxiety about the present but also for the future. It is important for people to engage in practices that can help them control their responses to the stress and their levels of anxiety. Mindfulness practices have been found routinely to reduce the psychological and physiological responses to stress, reduce anxiety levels, and improve mood.

 

In today’s Research News article “Mindfulness, Age and Gender as Protective Factors Against Psychological Distress During COVID-19 Pandemic.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2020.01900/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1437459_69_Psycho_20200922_arts_A ) Conversano and colleagues solicited adult participants online during a government ordered lockdown and had them complete measures of COVID-19 experiences, mindfulness, psychological distress, and mental illness symptoms.

 

They found strong negative relationships between mindfulness and psychological distress. They found that the higher the levels of mindfulness the lower the levels of psychological distress including somatic symptoms, symptoms of obsessive-compulsive disorder, internalizing symptoms, depression, anxiety, hostility, phobia, paranoia, psychoticism, and sleep disturbance. They also found weak relationships with age and gender such that younger and female participants tended to have higher psychological distress.

 

It needs to be kept in mind that these results are correlational and as such causation cannot be determined. Mindfulness may produce reduced distress or conversely distress may produce reduced mindfulness or some third factor may produce both. Nevertheless, the results show that during a pandemic lockdown that the people who have high levels of mindfulness also have low levels of psychological distress.

 

So, distress is lower during a COVID-19 pandemic lockdown in mindful people.

 

“In many ways, COVID-19 has shown us just how connected and how much the same we really are. All of us—and some of us more than others—are vulnerable to getting sick and none of us wants to become ill. Viewed through the lens of interconnectedness, practicing mindfulness as the coronavirus spreads is not only a way to care for ourselves but a way to care for everyone around us.” – Kelly Baron

 

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

 

Conversano C, Di Giuseppe M, Miccoli M, Ciacchini R, Gemignani A and Orrù G (2020) Mindfulness, Age and Gender as Protective Factors Against Psychological Distress During COVID-19 Pandemic. Front. Psychol. 11:1900. doi: 10.3389/fpsyg.2020.01900

 

Objective: Mindfulness disposition is associated with various psychological factors and prevents emotional distress in chronic diseases. In the present study, we analyzed the key role of mindfulness dispositions in protecting the individual against psychological distress consequent to COVID-19 social distancing and quarantining.

Methods: An online survey was launched on March 13, 2020, with 6,412 responses by April 6, 2020. Socio-demographic information, exposure to the pandemic, and quarantining were assessed together with psychological distress and mindfulness disposition. Multivariate linear regression analysis was performed to study the influence of predictive factors on psychological distress and quality of life in Italian responders during the early days of lockdown. Pearson correlations were calculated to study the relationship between mindfulness and psychiatric symptoms.

Results: Multivariate linear regression run on socio-demographics, COVID-19-related variables, and mindfulness disposition as moderators of overall psychological distress showed that mindfulness was the best predictor of psychological distress (β = −0.504; p < 0.0001). High negative correlations were found between mindfulness disposition and the overall Global Severity Index (r = −0.637; p < 0.0001), while moderate to high associations were found between mindfulness and all SCL-90 sub-scales.

Discussion: Findings showed that high dispositional mindfulness enhances well-being and helps in dealing with stressful situations such as the COVID-19 pandemic. Mindfulness-based mental training could represent an effective intervention to stem post-traumatic psychopathological beginnings and prevent the onset of chronic mental disorders.

https://www.frontiersin.org/articles/10.3389/fpsyg.2020.01900/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1437459_69_Psycho_20200922_arts_A

 

Lower Suicide Risk in College Students with Mindfulness

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Lower Suicide Risk in College Students with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Zhongyong thinking still plays an important role in regulating mental distress and maintaining subjective well-being among contemporary Chinese young adults.” – Xeuling Yang

 

Around 43,000 people take their own lives each year in the US. Someone dies from suicide every 12.3 minutes. Worldwide over 800,000 people die by suicide every year. The problem is far worse than these statistics suggest as it has been estimated that for every completed suicide there were 12 unsuccessful attempts. In other words, about a half a million people in the U.S. attempt suicide each year. Yet compared with other life-threatening conditions there has been scant research on how to identify potential suicide attempters, intervene, and reduce suicidality.

 

Mindfulness training has been shown to reduce suicidality. Dialectical Behavior Therapy (DBT) is a mindfulness-based therapy targeted at changing the problem behaviors including self-injury and suicide. Behavior change is accomplished through 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.

 

Zhong‐Yong thinking emphasizes pursuing the middle ground and never going to extremes and is characterized by acting appropriately and flexibly under different situations. It would seem to be compatible with the kinds of training occurring in Dialectical Behavior Therapy (DBT) and would tend to be an antidote for suicidal thinking. Although it would seem reasonable combining Zhong‐Yong thinking with DBT would improve its effectiveness in lowering the risk of suicide, there have been no systematic studies.

 

In today’s Research News article “Effectiveness of Zhong-Yong thinking based dialectical behavior therapy group skills training versus supportive group therapy for lowering suicidal risks in Chinese young adults: A randomized controlled trial with a 6-month follow-up.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7303376/) Yang and colleagues recruited high suicide risk college students and randomly assigned them to either a wait-list control condition or to receive a 2-hour once a week for 12 weeks program of either Dialectical Behavior Therapy (DBT) modified for inclusion of Zhong‐Yong thinking or a supportive group therapy program based upon interpersonal psychology focusing on emotional regulation and interpersonal effectiveness. They were measured before and after training and 6 months later for suicide behaviors and ideation, hopelessness, psychological distress, and psychopathological symptoms.

 

They found that in comparison to baseline and the wait-list control group, the groups that received either treatment has significant reductions in suicide behaviors and ideation, hopelessness, psychological distress, and psychopathological symptoms. But at the 6-month follow up the treatment groups differed with the Zhong-Yong thinking based Dialectical Behavior Therapy (DBT) group producing significantly greater improvements of obsessive compulsive, anxiety, hostility, phobic, and psychotic symptoms in comparison to supportive group therapy.

 

The results are promising that Zhong-Yong thinking based Dialectical Behavior Therapy (DBT) can reduce suicidality and risk factors for suicide in college students and maintain the benefits for 6 months after the end of active treatment. Although supportive therapy was equally beneficial on the short-term, it was less effective on the long-term. So, Zhong-Yong thinking based DBT would appear to be the superior treatment. It would be important in future research to compare Zhong-Yong thinking based DBT to traditional DBT to determine if the addition of training in Zhong-Yong thinking increases the benefits.

 

So, lower suicide risk in college students with mindfulness.

 

“those who scored high on the Zhongyong Thinking Scale had substantially lower scores on anxiety and depressive symptoms, and had higher scores on self-esteem and life satisfaction.” – Xeuling Yang

 

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

 

Yang, X., Liu, D., Wang, Y., Chen, Y., Chen, W., Yang, C., Zhang, P., Ding, S., & Zhang, X. (2020). Effectiveness of Zhong-Yong thinking based dialectical behavior therapy group skills training versus supportive group therapy for lowering suicidal risks in Chinese young adults: A randomized controlled trial with a 6-month follow-up. Brain and behavior, 10(6), e01621. https://doi.org/10.1002/brb3.1621

 

Abstract

Background

Dialectical behavior therapy (DBT) is a first‐line treatment for the prevention of suicide. Zhong‐Yong thinking could be viewed as a Chinese way of dialectical thinking, has long been a culturally dictating thinking style in China. To enhance cultural adaptability, we integrated Zhong‐Yong thinking into DBT group skills training and examined its efficacy in suicidal prevention compared with a supportive group therapy and a wait‐list group in high‐risk suicidal Chinese college students.

Methods

A total of 97 suicidal participants were randomized to either Zhong‐Yong thinking based DBT group skills training (DBTZYT, n = 33), or supportive group therapy (SGT; n = 32), or wait‐list group (WL; n = 32). DBTZYT was a 12‐week program based on Zhong‐Yong thinking instead of dialectical thinking, coaching participants mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness. Supportive group therapy was a 12‐week program aiming at improving interpersonal effectiveness and emotion regulation skills. Outcome measures were assessed at pre‐ and post‐treatment and 6‐month follow‐up.

Results

At post‐treatment measures, the levels of suicidal ideation, hopelessness, psychache symptoms, and general psychopathology had significantly decreased in both intervention groups; at the 6‐month follow‐up measures, the intervention effects were better maintained in the DBTZYT group rather than in the SGT group. Specifically, DBTZYT was more effective in relieving participants’ long‐term obsessive‐compulsive, anxiety, hostility, phobic, psychotic, and additional symptoms.

Conclusions

Zhong‐Yong thinking not only could integrate with DBT skills training in Chinese young adult population, but also has special strength in enhancing DBT’s efficacy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7303376/

 

Improve Tolerance for Distress with Brief Mindfulness Training

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Improve Tolerance for Distress with Brief Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“when you are being mindful of your emotions you don’t fight the wave, but instead allow the wave to carry you over its crest and down the other side, or you might choose to surf the wave allowing it to carry you into shore.” – Lisa Saulsman

 

Psychological distress is related to an increase in physiological stress responses. That is, when the individual is anxious, ruminating, or having negative emotions, the physiology including the hormonal system reacts. The increased activity can be measured in heightened stress hormones in the blood and increased heart rate, blood pressure etc. These physiological stress responses on the short-term are adaptive and help to fight off infection, toxins, injury, etc. Unfortunately, psychological distress is often persistent and chronic and resulting in chronic stress which in turn can produce disease.

 

Many of the symptoms of psychological distress have been shown to be related to a lack of mindfulness. Anxiety is often rooted in a persistent dread of future negative events while rumination is rooted in the past, with persistent replaying of negative past events. Since mindfulness is firmly rooted in the present it is antagonistic toward anything rooted in the past or future. Hence, high levels of mindfulness cannot coexist with anxiety and rumination. In addition, high mindfulness has been shown to be related to high levels of emotion regulation and positive emotions. So, mindfulness would appear to be an antidote to psychological distress.

 

In today’s Research News article “The Effect of a Brief Mindfulness Training on Distress Tolerance and Stress Reactivity.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6494113/), Carpenter and colleagues recruited undergraduate students who had no experience with mindfulness or meditation practices and measured them for mindfulness, anxiety, depression, perceived stress. mindfulness use, and respiration. They were then measured for distress tolerance with a cold pressor task in which they were asked to keep their arm in very cold water for as long as they could (up to a maximum of 180 seconds). They were also asked to hyperventilate for as long as they could (up to a maximum of 300 seconds). After having completed these tasks they were randomly assigned to receive either 15 minutes of relaxation with music or mindfulness training with meditation and non-judgmental awareness. They then repeated the distress tasks. Finally, only after training they were asked to write a sentence stating that a good friend will be in a bad car accident and think about and visualize the scene. Participants were asked to rate their level of distress prior to each task and after the task to rate their maximal level of distress during the task,

 

They found that in comparison to baseline and the relaxation condition, after mindfulness training there was a significant increase in persistence of hyperventilation, time continuing to hyperventilate. The mindfulness participants also were less likely to attempt to neutralize feelings produced by stating and visualizing a friend in a future car accident. There were no significant effects of training on the reported levels of distress. They also found that using mindfulness nonjudging and nonreacting mediated the effect of mindfulness training on persistence in the cold pressor and urge to neutralize feelings in the car accident tasks, such that mindfulness training not only directly affected these outcomes but also indirectly by increasing these uses of mindfulness which in turn affected performance.

 

These results suggest that a brief mindfulness training produces a greater ability to tolerate physical and psychological distress. They also suggest that mindfulness has these effects in part by inducing mindful nonjudgment and nonreaction. The ability to engage in a stressful task appears to be improved by observing it in the present moment nonjudgmentally and nonreactively.

 

Mindfulness training has been previously shown to reduce distress, pain, and responding to stress. What is new and interesting here is that such a brief mindfulness training can have significant effects like these. This suggests that brief mindfulness training may be beneficially employed whenever and individual is about to engage in a distressful task, such as working through traumatic experiences, engaging in athletic endeavors, etc., making the individual better able to focus on the present moment and better cope with the distress.

 

So, improve tolerance for distress with brief mindfulness training.

 

“mindfulness is believed to facilitate increased distress tolerance and nonjudgmental acceptance of unpleasant experiences.” – Andrew Bliesner

 

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

 

Carpenter, J. K., Sanford, J., & Hofmann, S. G. (2019). The Effect of a Brief Mindfulness Training on Distress Tolerance and Stress Reactivity. Behavior therapy, 50(3), 630–645. https://doi.org/10.1016/j.beth.2018.10.003

 

Highlights

  • Mindfulness training increased distress tolerance on the hyperventilation challenge
  • Mindfulness training led to reduced urges to neutralize an upsetting thought
  • No effect of the intervention was seen on subjective distress
  • Lower trait awareness predicted a greater effect of mindfulness on hyperventilation

Abstract

Distress tolerance (DT) is considered an underlying facet of anxiety, depression and a number of other psychological disorders. Mindfulness may help to increase DT by fostering an attitude of acceptance non-judgment toward distressing experiences. Accordingly, the present study examined the effects of a brief mindfulness training on tolerance of different types of distress, and tested whether trait mindfulness moderates the effect of such training. Undergraduates (n = 107) naïve to mindfulness completed a measure of trait mindfulness and underwent a series of stress tasks (cold pressor, hyperventilation challenge, neutralization task) before and after completing a 15-minute mindfulness training or a no-instruction control in which participants listened to relaxing music. Participants in the mindfulness condition demonstrated greater task persistence on the hyperventilation task compared to the control group, as well as a decreased urge to neutralize the effects of writing an upsetting sentence. No effect on distress ratings during the tasks were found. Overall trait mindfulness did not significantly moderate task persistence, but those with lower scores on the act with awareness facet of mindfulness demonstrated greater relative benefit of mindfulness training on the hyperventilation challenge. Mediation analyses revealed significant indirect effects of mindfulness training on cold pressor task persistence and urges to neutralize through the use of the non-judge and non-react facets of mindfulness. These results suggest that a brief mindfulness training can increase DT without affecting the subjective experience of distress.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6494113/

 

Online Mindfulness Training Improves Clinical Anxiety and Depression

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Online Mindfulness Training Improves Clinical Anxiety and Depression

 

By John M. de Castro, Ph.D.

 

“adding MMB [mindfulness training] to depression care led to greater reductions in depressive and anxious symptoms, higher rates of remission and higher levels of quality of life compared to patients receiving conventional depression care alone.” – Traci Pederson

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress. They have been shown to be very helpful in treating anxiety and depression. The vast majority of the mindfulness training techniques, however, require a certified trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient.

 

As an alternative, mindfulness training programs have been developed to be implemented over the internet. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. But, the question arises as to which forms of online mindfulness trainings are most effective for inducing mindfulness and improving the treatment of anxiety and depression.

 

In today’s Research News article “Transdiagnostic internet-delivered CBT and mindfulness-based treatment for depression and anxiety: A randomised controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044661/), Kladnitski and colleagues recruited online adults with a variety of either depression or anxiety disorders and randomly assigned them to receive either a 17-week internet-based cognitive behavioral therapy, mindfulness enhanced internet-based cognitive behavioral therapy, internet-based mindfulness training, or treatment-as-usual. “The programs consisted of six comic-style, story-based lessons, downloadable lesson summaries, reflective worksheets, and extra support materials including frequently asked questions and troubleshooting of common difficulties.” They were measured before, during, and after treatment and 3 months later for psychological illnesses, anxiety, depression, psychological distress, and functional impairment.

 

They found compared to baseline and the treatment-as-usual control group, there were large and highly significant decreases in anxiety, depression, functional impairment and psychological distress. These improvements were present both at the end of treatment and at the 3-month follow-up. There were no significant differences between the effectiveness of the 3 interventions. There were no adverse events reported. At the 3-month follow-up 60% to 73% of the treated participants improved to the point that they no longer met the criteria for a clinical diagnosis of an anxiety or depressive disorder.

 

It is interesting that the 3 different treatments did not differ in effectiveness. Each has been previously been demonstrated to be effective in treating anxiety and depressive disorders and it appears that their efficacy is almost equivalent. This suggests that patients can self-select the treatment that most appeals to them, improving completion rates, compliance, and perhaps effectiveness.

 

These are exciting and important findings. It has been previously demonstrated that mindfulness training can alleviate the symptoms of anxiety and depression. The advance here is in demonstrating that therapy delivered over the internet is safe, effective, and lasting in treating anxiety or depressive disorders. Internet delivery of treatment can be implemented conveniently, at low cost. and over wide areas making the therapy available to large numbers of patients who previously could not access treatment.

 

So, online mindfulness training improves clinical anxiety and depression.

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Kladnitski, N., Smith, J., Uppal, S., James, M. A., Allen, A. R., Andrews, G., & Newby, J. M. (2020). Transdiagnostic internet-delivered CBT and mindfulness-based treatment for depression and anxiety: A randomised controlled trial. Internet Interventions, 20, 100310. https://doi.org/10.1016/j.invent.2020.100310

 

Abstract

Aim

To examine the efficacy of transdiagnostic internet-delivered cognitive behavioural therapy (iCBT), mindfulness-enhanced iCBT, and stand-alone online mindfulness training compared with a usual care control group (TAU) for clinical anxiety and depression.

Method

Individuals (N = 158) with a DSM-5 diagnosis of a depressive and/or anxiety disorder were randomised to one of the three clinician-guided online interventions, or TAU over a 14-week intervention period. The primary outcomes were self-reported depression (PHQ-9) and anxiety (GAD-7) severity at post-treatment. Secondary outcomes included adherence rates, functional impairment (WHODAS-II), general distress (K−10), and diagnostic status at the 3-month follow-up (intervention groups).

Results

All three programs achieved significant and large reductions in symptoms of depression (g = 0.89–1.53), anxiety (g = 1.04–1.40), and distress (g = 1.25–1.76); and medium to large reductions in functional impairment (g = 0.53–0.98) from baseline to post-treatment and 3-month follow-up. Intention-to-treat linear mixed models showed that all three online programs were superior to usual care at reducing symptoms of depression (g = 0.89–1.18) and anxiety (g = 1.00–1.23).

Conclusion

Transdiagnostic iCBT, mindfulness-enhanced iCBT and online mindfulness training are more efficacious for treating depression and anxiety disorders than usual care, and represent an accessible treatment option for these disorders.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044661/

 

Improve Emotional Distress in The Elderly with Type 2 Diabetes with Mindfulness

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Improve Emotional Distress in The Elderly with Type 2 Diabetes with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness based approaches has been found to be particularly effective in supporting diabetes management and the mental turmoil that is accompanied with a diagnosis of such as chronic physical illness. It can address the feelings of guilt, anger and aid self-acceptance to encourage the fulfilment of an unobstructed life. Mindfulness has also been found to have an enhanced clinical effect of glycemic control so not only aids psychological health but could potentially have a positive impact on the management of the physical condition.” – Diabetes UK

 

Diabetes is a major health issue. It is estimated that 30 million people in the United States have diabetes and the numbers are growing. Type 2 Diabetes results from a resistance of tissues, especially fat tissues, to the ability of insulin to promote the uptake of glucose from the blood. As a result, blood sugar levels rise producing hyperglycemia. Diabetes is the 7th leading cause of death in the United States. In addition, diabetes is heavily associated with other diseases such as cardiovascular disease, heart attacks, stroke, blindness, kidney disease, and circulatory problems leading to amputations. As a result, diabetes doubles the risk of death of any cause compared to individuals of the same age without diabetes.

 

Type 2 diabetes is largely preventable. One of the reasons for the increasing incidence of Type 2 Diabetes is its association with overweight and obesity which is becoming epidemic in the industrialized world. A leading cause of this is a sedentary life style. Current treatments for Type 2 Diabetes focus on diet, exercise, and weight control. Recently, mindfulness practices have been shown to be helpful in managing diabetes.

 

Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT). ACT 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 problems resulting from diabetes get magnified in the elderly. So, it is important to study the efficacy of ACT for Type 2 Diabetes in the elderly.

 

In today’s Research News article “Efficacy of Acceptance And Commitment Therapy For Emotional Distress In The Elderly With Type 2 Diabetes: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6802537/), Maghsoudi and colleagues recruited patients with Type 2 Diabetes over 60 years of age. They all continued on routine care while half were randomly selected to receive Acceptance and Commitment Therapy (ACT) in groups once a week for 90 minutes for 8 weeks. They were measured before and after training and 2 months later for diabetes-related emotional distress including the dimensions of emotional burden, physician-related distress, regimen-related distress and diabetes-related interpersonal distress.

 

They found that in comparison to baseline and the usual care group the patients who received Acceptance and Commitment Therapy (ACT) had significantly lower diabetes-related emotional distress. This lower diabetes-related emotional distress was maintained 2 months later. The study contained only a passive control condition, so caution must be exercised in interpreting the results. Nevertheless, ACT\ was a safe, effective, and lasting treatment to improve the emotions of elderly patients with Type 2 Diabetes.

 

So, improve emotional distress in the elderly with Type 2 Diabetes with mindfulness.

 

“Mindfulness training, including focused breathing and awareness training, helped U.S. veterans with diabetes significantly lower their diabetes-related distress and blood sugar levels and improve their self-management of the disease, researchers report.” – Science Daily

 

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

 

Maghsoudi, Z., Razavi, Z., Razavi, M., & Javadi, M. (2019). Efficacy Of Acceptance And Commitment Therapy For Emotional Distress In The Elderly With Type 2 Diabetes: A Randomized Controlled Trial. Diabetes, metabolic syndrome and obesity : targets and therapy, 12, 2137–2143. doi:10.2147/DMSO.S221245

 

Abstract

Introduction

Diabetes is among the common diseases in the elderly which results in depression, anxiety, and emotional distress in the elderly and impacts the disease control by the individual. This study was conducted with the aim of exploring the effectiveness of acceptance and commitment therapy (ACT) in the improvement of emotional distress in the elderly with type 2 diabetes.

Materials and methods

In this randomized control trial, 80 elderly with type 2 diabetes aged ≥60 years were randomly selected among the individuals visiting Yazd Diabetes Research Center. Then, the patients were randomly divided into two 40 individual groups, ie, the intervention group and the control group. The intervention group underwent group ACT during eight 90-min sessions. The diabetes-related emotional distress questionnaire was completed before the intervention, after the end of the group sessions and 2 months after that. The statistical software SPSS version 21 was used for data analysis.

Results

The emotional mean scores in the intervention and control groups were not significantly different before the intervention. However, the mean score of the intervention group was lower than of the control group immediately after the intervention (p=0.02) and 2 months after the intervention (p=0.02).

Conclusion

ACT results in the improvement of diabetes-related emotional distress in the intervention group. Considering the effectiveness of ACT, this therapeutic method is recommended to be used for the amelioration of emotional distress in the elderly with type 2 diabetes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6802537/

 

Improve the Physical and Psychological Health of Cancer Patients with Mindfulness

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Improve the Physical and Psychological Health of Cancer Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“It turns out that some of the most difficult elements of the cancer experience are very well-suited to a mindfulness practice.” – Linda Carlson

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatigue, stress,  sleep disturbance, fear, and anxiety and depression. The evidence is accumulating. So, it is timely to review and summarize what has been learned.

 

In today’s Research News article “Mindfulness-based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta-analysis of randomized controlled trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6916350/), Cillessen and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials (RCTs) on the effectiveness of mindfulness training in treating the symptoms of cancer and its treatment. They found 29 RCTs that included a total of 3224 participants.

 

The summary of the published research reflected that mindfulness training produced significant reductions in psychological distress in the cancer patients including reductions in anxiety, depression, fatigue, and fear of cancer reoccurrence with small to moderate effects sizes. These improvements were found both immediately after treatment and also at follow-up from 3 to 24 months later. Further they found that mindfulness trainings that adhered to the protocols for Mindfulness-Based Stress Reduction (MBSR) or Mindfulness-Based Cognitive Therapy (MBCT) had the greatest effect sizes.

 

It has been repeatedly demonstrated that mindfulness training is effective in reducing psychological distress including reductions in anxiety, depression, fatigue, and fear in a wide variety of individuals with and without disease states. The present meta-analysis demonstrates the effectiveness of mindfulness training for the relief of psychological and physical suffering of cancer patients. It does not affect the disease process. Rather, it reduces the patients psychological suffering and does so for a prolonged period of time.

 

So, improve the physical and psychological health of cancer patients with mindfulness.

 

“patients who practice mindfulness begin to feel better despite their medical problems. Physical symptoms don’t necessarily go away, but that’s not the aim of mindfulness. Rather, the goal is to help you find a different perspective and a new way of coping with your illness.” – Eric Tidline

 

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

 

Cillessen, L., Johannsen, M., Speckens, A., & Zachariae, R. (2019). Mindfulness-based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta-analysis of randomized controlled trials. Psycho-oncology, 28(12), 2257–2269. doi:10.1002/pon.5214

 

Abstract

Objective

Mindfulness‐based interventions (MBIs) are increasingly used within psycho‐oncology. Since the publication of the most recent comprehensive meta‐analysis on MBIs in cancer in 2012, the number of published trials has more than doubled. We therefore conducted a systematic review and meta‐analysis of randomized controlled trials (RCTs), testing the efficacy of MBIs on measures of psychological distress (primary outcome) and other health outcomes in cancer patients and survivors.

Methods

Two authors conducted independent literature searches in electronic databases from first available date to 10 October 2018, selected eligible studies, extracted data for meta‐analysis, and evaluated risk of bias.

Results

Twenty‐nine independent RCTs (reported in 38 papers) with 3274 participants were included. Small and statistically significant pooled effects of MBIs on combined measures of psychological distress were found at post‐intervention (Hedges’s g = 0.32; 95%CI: 0.22‐0.41; P < .001) and follow‐up (g = 0.19; 95%CI: 0.07‐0.30; P < .002). Statistically significant effects were also found at either post‐intervention or follow‐up for a range of self‐reported secondary outcomes, including anxiety, depression, fear of cancer recurrence, fatigue, sleep disturbances, and pain (g: 0.20 to 0.51; p: <.001 to.047). Larger effects of MBIs on psychological distress were found in studies (a) adhering to the original MBI manuals, (b) with younger patients, (c) with passive control conditions, and (d) shorter time to follow‐up. Improvements in mindfulness skills were associated with greater reductions in psychological distress at post‐intervention.

Conclusions

MBIs appear efficacious in reducing psychological distress and other symptoms in cancer patients and survivors. However, many of the effects were of small magnitude, suggesting a need for intervention optimization research.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6916350/