Diversity

Ethnicity Modulates Improvements in Sleep in Prehypertensive Patients with a Smartphone Meditation App

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Ethnicity Modulates Improvements in Sleep in Prehypertensive Patients with a Smartphone Meditation App

 

“Several practices that help calm the mind can also lower blood pressure. All are types of meditation.” – Harvard Health

 

By John M. de Castro, Ph.D.

 

High Blood Pressure (Hypertension) is an insidious disease because there are no overt symptoms. The individual feels fine. But it can be deadly as more than 360,000 American deaths, roughly 1,000 deaths each day, had high blood pressure as a primary or contributing cause. In addition, hypertension markedly increases the risk heart attack, stroke, heart failure, and kidney disease.  It is also a very common disorder with about 70 million American adults (29%) having high blood pressure and only about half (52%) of people with high blood pressure have their condition under control. Treatment frequently includes antihypertensive drugs. But these medications often have adverse side effects. So, patients feel lousy when taking the drugs, but fine when they’re not. So, compliance is a major issue with many patients not taking the drugs regularly or stopping entirely.

 

Obviously, there is a need for alternative to drug treatments for hypertension. Mindfulness practices have been shown to aid in controlling hypertension. The vast majority of the mindfulness training techniques, however, require a trained teacher. This results in costs that many patients 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, 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.

 

In today’s Research News article “Ethnicity Differences in Sleep Changes Among Prehypertensive Adults Using a Smartphone Meditation App: Dose-Response Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576537/ ) Sieverdes and colleagues recruited patients diagnosed with prehypertension. They had the participants use a smartphone app, “Tension Tamer” for 6 months. The app provided focused breath following meditation practice and also measured heart rate and blood pressure. The participants were randomized into 3 dosage groups, 5, 10, or 15 minutes of daily practice. They were measured before and after training and at 1 and 3-months during training for sleep with a self-reports and 7-days of wrist actigraphy which also measured activity levels.

 

They found that the 47% of the participants who were African American had significantly shorter sleep durations, poorer sleep quality, and greater sleep disturbance at baseline both in the self-report and actigraphy measures than non-Hispanic white participants. They also found that the effects of the meditation app on sleep varied according to ethnic group. For the Non-Hispanic White participants, the 5-minute per day dose of “Tension timer” use produced significantly greater improvements in sleep efficiency and quality, lower fragmentation, and longer sleep duration than the 10 or 15-minute doses. For the African American participants, the 5-minute dose produced significantly less sleep fragmentation and duration than the 10 or 15-minute doses. In comparing the ethnic groups, they found that the Non-Hispanic White participants had significantly greater improvements in sleep efficiency, reduced fragmentation, and longer sleep duration than the African American participants.

 

These results are interesting and suggest that smartphone app guided meditation practice improves sleep in patients diagnosed as prehypertensive. But the effects are less positive for African American participants than Non-Hispanic White participants. This is a bit surprising as African American participants appear to have more problematic sleep to start with and hence had greater room for improvement. It is also surprising that the lower amount of meditation practice, 5-minutes per day, was more beneficial that the longer daily meditations. It appears that the 5-minute practice participants tended to use the app more often and to use it more often just prior to going to bed than the other dose participants and this may have led to the differences.

 

Improving sleep is important in promoting relaxation and reducing the likelihood that prehypertension will progress to patent hypertension. So, the use of the app may be helpful in maintaining the health of prehypertensive patients. The ethnic differences, however, suggest that app usage may be more beneficial for white as opposed to black participant. The results also suggest that brief daily practice, 5-minutes, may promote more frequent use that improves effectiveness.

 

So, ethnicity modulates improvements in sleep in prehypertensive patients with a smartphone meditation app.

 

“If you struggle with “turning your brain off”, you may find yourself feeling restless and unable to sleep. Fortunately, meditation is one way to quiet your thoughts and fight insomnia. Meditation has been shown to help people who struggle with insomnia and other sleep disturbances.“ – Florida Medical Clinic

 

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

 

Sieverdes, J. C., Treiber, F. A., Kline, C. E., Mueller, M., Brunner-Jackson, B., Sox, L., Cain, M., Swem, M., Diaz, V., & Chandler, J. (2020). Ethnicity Differences in Sleep Changes Among Prehypertensive Adults Using a Smartphone Meditation App: Dose-Response Trial. JMIR formative research, 4(10), e20501. https://doi.org/10.2196/20501

 

Abstract

Background

African Americans (AAs) experience greater sleep quality problems than non-Hispanic Whites (NHWs). Meditation may aid in addressing this disparity, although the dosage levels needed to achieve such benefits have not been adequately studied. Smartphone apps present a novel modality for delivering, monitoring, and measuring adherence to meditation protocols.

Objective

This 6-month dose-response feasibility trial investigated the effects of a breathing awareness meditation (BAM) app, Tension Tamer, on the secondary outcomes of self-reported and actigraphy measures of sleep quality and the modulating effects of ethnicity of AAs and NHWs.

Methods

A total of 64 prehypertensive adults (systolic blood pressure <139 mm Hg; 31 AAs and 33 NHWs) were randomized into 3 different Tension Tamer dosage conditions (5,10, or 15 min twice daily). Sleep quality was assessed at baseline and at 1, 3, and 6 months using the Pittsburgh Sleep Quality Index (PSQI) and 1-week bouts of continuous wrist actigraphy monitoring. The study was conducted between August 2014 and October 2016 (IRB #Pro00020894).

Results

At baseline, PSQI and actigraphy data indicated that AAs had shorter sleep duration, greater sleep disturbance, poorer efficiency, and worse quality of sleep (range P=.03 to P<.001). Longitudinal generalized linear mixed modeling revealed a dose effect modulated by ethnicity (P=.01). Multimethod assessment showed a consistent pattern of NHWs exhibiting the most favorable responses to the 5-min dose; they reported greater improvements in sleep efficiency and quality as well as the PSQI global value than with the 10-min and 15-min doses (range P=.04 to P<.001). Actigraphy findings revealed a consistent, but not statistically significant, pattern in the 5-min group, showing lower fragmentation, longer sleep duration, and higher efficiency than the other 2 dosage conditions. Among AAs, actigraphy indicated lower sleep fragmentation with the 5-min dose compared with the 10-min and 15-min doses (P=.03 and P<.001, respectively). The 10-min dose showed longer sleep duration than the 5-min and 15-min doses (P=.02 and P<.001, respectively). The 5-min dose also exhibited significantly longer average sleep than the 15-min dose (P=.03).

Conclusions

These findings indicate the need for further study of the potential modulating influence of ethnicity on the impact of BAM on sleep indices and user-centered exploration to ascertain the potential merits of refining the Tension Tamer app with attention to cultural tailoring among AAs and NHWs with pre-existing sleep complaints.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576537/

 

Mindfulness Improves the Psychological Health of Arab Teachers

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Mindfulness Improves the Psychological Health of Arab Teachers

 

By John M. de Castro, Ph.D.

 

“thousands of schools across the country that is bringing mindfulness into the classroom. Growing numbers of teachers, parents, and children are reaping the benefits that learning mindfulness—can bring, including reduced levels of stress and anxiety, increased focus and self-regulation, and improved academic performance and sleep, among others.” – Caren Osten Gerszberg

 

Stress is epidemic in the western 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. Teachers experience burnout at high rates. Roughly a half a million teachers out of a workforce of three million, leave the profession each year and the rate is almost double in poor schools compared to affluent schools. Indeed, nearly half of new teachers leave in their first five years. Hence, methods of reducing stress and improving teacher psychological health needs to be studied.

 

Mindfulness techniques are gaining increasing attention for the treatment of the symptoms of stress and burnout. They have 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 including schools. But there are very few studies of the effects of mindfulness training for teachers cultures other than western and oriental and virtually none in Arab cultures.

 

In today’s Research News article “Effects of a Mindfulness Intervention Among Arab Teachers Are Mediated by Decentering: A Pilot Study.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2020.542986/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1456740_69_Psycho_20201013_arts_A ) Berkovich-Ohana and colleagues recruited Arab elementary school teachers from 2 different schools. The teachers in one school underwent a 30-hour 3-month mindfulness training program tailored for teachers while the teacher in the other underwent a 30-hour 6-month training program on teaching for understanding. The teachers were measured before and after the training programs for perceived stress, decentering, rumination, emotion regulation, including cognitive reappraisal and expressive suppression subscales, and mindfulness.

 

They found that the mindfulness group significantly increased in mindfulness and emotion regulation compared to baseline while the control group significantly decreased in mindfulness and emotion regulation. They also found that the mindfulness group had significant increases in decentering and decreases in perceived stress while the control group did not. In addition, while both groups significantly decreased in rumination, the mindfulness group had a significantly greater decrease.

 

Mindfulness training has been well established in western and oriental cultures to produces increased emotion regulation and decentering and decreased rumination and perceived stress. The present results extend these findings to Arab teachers. This leads to the conclusion that mindfulness training is beneficial for the psychological health of teachers regardless of culture. Mindfulness training appears to be helpful in lowering the stress levels of school teachers generally. Although not measured in the present study it would be expected that this would lead to decreased burnout and better classroom performance by the teachers.

 

So, mindfulness improves the psychological health of Arab teachers.

 

“Practicing mindfulness can help teachers to recognize our emotional patterns and proactively regulate how we behave, responding in the way we want to rather than reacting automatically. It can also help us to savor the positive moments in our job—when we feel the joy of true connection with our students or resonate with the joy and excitement our students feel when learning clicks for them.” – Patricia A. Jennings 

 

 

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

 

Berkovich-Ohana A, Lavy S and Shanboor K (2020) Effects of a Mindfulness Intervention Among Arab Teachers Are Mediated by Decentering: A Pilot Study. Front. Psychol. 11:542986. doi: 10.3389/fpsyg.2020.542986

 

Although mindfulness-based interventions (MBIs) in education are widely spreading in the world, examination of mindfulness effects in Arab schools is still scarce. This pilot study aimed to fill this gap by examining the effects of an MBI among Arab teachers in Israel. This examination was conducted within the framework of the mindful self in school relationships (MSSR) model, which suggests that the positive effects of MBI on teachers’ emotion regulation are mediated by decentering. The participants (N = 39) were teachers from two Arab elementary schools in Israel, who underwent an MBI course (the MBI condition, N = 20) and another cognitive intervention (the control condition, N = 19). In a pre–post design, participants completed mindfulness, decentering, emotion regulation, and stress questionnaires. We hypothesized that (1) only in the MBI group, teachers’ mindfulness, decentering, and emotional regulation will increase and stress will decrease, and (2) changes in teachers’ decentering would mediate the associations of changes in teachers’ mindfulness with changes in their emotion regulation. ANOVA analyses show that, only in the MBI condition, teachers showed an increase in three mindfulness subscales (acting with awareness, non-reactivity, and observance), in decentering, and in adaptive emotion regulation (reappraisal) and a decrease in stress. Furthermore, changes from pre-intervention to post-intervention in teachers’ decentering mediated the associations of their pre–post changes in mindfulness with changes in emotion regulation. This study provides initial support to the feasibility and efficacy of MBI among Israeli Arab teachers and suggests decentering as a potential mediator of its effects in initial support of the MSSR model.

https://www.frontiersin.org/articles/10.3389/fpsyg.2020.542986/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1456740_69_Psycho_20201013_arts_A

 

Lower Social Anxiety is Associated with Mindfulness in Nepalese Adolescents

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Lower Social Anxiety is Associated with Mindfulness in Nepalese Adolescents

 

By John M. de Castro, Ph.D.

 

“At the basic level, social anxiety refers to fear or worry related to interactions in social situations. It is normal for teens to get anxious about public speaking or going on a first date. However, for those with social anxiety, the fears and thoughts are too intense, cause high stress and make the person avoid activities of daily living that could bring joy into their life.” – Silvina Galperin

 

It is a common human phenomenon that being in a social situation can be stressful and anxiety producing. Most people can deal with the anxiety and can become quite comfortable. But many do not cope well and the anxiety is overwhelming, causing the individual to withdraw. Social Anxiety Disorder (SAD) is characterized by a persistent, intense, and chronic fear of being watched and judged by others and feeling embarrassed or humiliated by their actions. This fear may be so severe that it interferes with work, school, and other activities and may negatively affect the person’s ability to form relationships.

 

Anxiety disorders have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for anxiety. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders including Social Anxiety Disorder (SAD).

 

Mindfulness training was examined as a treatment for emotional disorders in affluent western populations which are not necessarily representative of the unique situations, cultures, and education levels of diverse populations. Hence, there is a need to investigate the effectiveness of mindfulness with diverse populations. There are indications that mindfulness therapies may be effective in diverse populations. But there is a need for further investigation the associations of mindfulness with emotional disorders in different populations.

 

In today’s Research News article “Social support, emotion regulation and mindfulness: A linkage towards social anxiety among adolescents attending secondary schools in Birgunj, Nepal.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7117668/), Singh and colleagues recruited adolescents from schools in Nepal and measured them for social anxiety, social support, emotion regulation, and mindfulness.

 

They found that the higher the levels of social anxiety the lower the levels of the mindfulness facets of describing and acting with awareness, the emotion regulation facets of awareness, clarity, and acceptance, and social support especially from friends, relatives, and teachers. They also found that social anxiety levels were higher in females and older adolescents. Taken together, mindfulness, emotion regulation, social support, age, and gender explained 41% of the variance in social anxiety in the adolescents.

 

These results are correlational and as such causation cannot be determined. The results also are similar to those observed in different ethnic groups with mindfulness associated with lower levels of social anxiety and greater levels of emotion regulation. This further suggests that mindfulness relationships with social anxiety in Nepal are similar to other cultures. This suggests that these association apply almost universally across cultures and ethnicities.

 

In many of the previous studies, mindfulness was trained and it was found to cause changes in social anxiety and emotion regulation. So, the current findings probably represent causal connections between these variables. They further imply that training in mindfulness may be helpful in lowering social anxiety and improving emotion regulation in Nepalese youth.

 

In the present study there was no attempt to determine mediation. Since mindfulness is associated with higher levels of emotion regulation and emotion regulation is associated with lower levels of social anxiety, it is possible that mindfulness decreases social anxiety directly and also indirectly by improving emotion regulation. In addition, social support is associated with higher mindfulness. So, it is possible that social support decreases social anxiety directly and also indirectly by improving mindfulness. It will remain for future research to explore these hypotheses.

 

So, lower social anxiety is associated with mindfulness in Nepalese adolescents.

 

“If you are suffering with the symptoms of social anxiety disorder (SAD), regular practice will eventually improve your self-concept and ability to handle negative emotions. You will also learn how to better respond to troubling thoughts and treat yourself with more compassion.” – Arlin Cuncic

 

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

 

Singh, R., Singh, B., Mahato, S., & Hambour, V. K. (2020). Social support, emotion regulation and mindfulness: A linkage towards social anxiety among adolescents attending secondary schools in Birgunj, Nepal. PloS one, 15(4), e0230991. https://doi.org/10.1371/journal.pone.0230991

 

Abstract

There has been a growing burden of anxiety among Nepalese adolescents. Social anxiety in particular is one of the commonly reported symptoms indicating mental health problem among adolescents. The purpose of this study was to assess social anxiety, and identify how social support, emotion regulation and mindfulness uniquely contribute to social anxiety among adolescents in Birgunj, Nepal. The study was conducted by using a self-administered questionnaire among 384 adolescents (65.4% boys; M = 16.05 years, SD = 1.39) studying at secondary schools of Birgunj. Results show that there was a positive correlation between social anxiety symptoms and age, and girls reported more symptoms. Traits such as non-acceptance of emotions, lack of clarity and lack of awareness of emotions were related to increased social anxiety; while acting with awareness, non-reactivity, and better ability to describe emotions was related to decreased social anxiety. Finally, more social support from close friends was related to lower social anxiety. These results suggest that improving emotion regulation, dispositional mindfulness, and social support may be helpful for adolescents who are at risk of, or are suffering from, social anxiety.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7117668/

 

Religious and Spiritual Coping Reduces the Risk of Hypertension.

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Religious and Spiritual Coping Reduces the Risk of Hypertension.

 

By John M. de Castro, Ph.D.

 

“Scientific literature have recorded that spiritual well-being is associated with better physical and mental health, according to psycho-neuro-immune models of health. Spirituality and religion can help patients, their families and caregivers dealing with illness and other stressful life events.” – Marcelo Saad

 

High Blood Pressure (Hypertension) is an insidious disease because there are no overt symptoms. The individual feels fine. But it can be deadly as more than 360,000 American deaths, roughly 1,000 deaths each day, had high blood pressure as a primary or contributing cause. In addition, hypertension markedly increases the risk heart attack, stroke, heart failure, and kidney disease.  It is also a very common disorder with about 70 million American adults (29%) having high blood pressure and only about half (52%) of people with high blood pressure have their condition under control. Hypertension is more prevalent in African American populations.

 

High blood pressure, because it doesn’t have any primary symptoms, is usually only diagnosed by direct measurement of blood pressure usually by a health care professional. When hypertension is chronically present over three quarters of patients are treated with antihypertensive drugs. But these medications often have adverse side effects. So, patients feel lousy when taking the drugs, but fine when they’re not. So, compliance is a major issue with many patients not taking the drugs regularly or stopping entirely. Obviously, there is a need for alternative to drug treatments for hypertension.

 

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. Religiosity is also known to help with a wide range of physical and psychological problems. So, it would make sense to investigate the influence of spirituality and religiosity on hypertension in African Americans.

 

In today’s Research News article “). Religious and Spiritual Coping and Risk of Incident Hypertension in the Black Women’s Health Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6230974/), Cozier and colleagues performed a secondary analysis of the data provided by a large U.S. national sample of adult black women. The women had completed a large array of measures. But for the present study measures were extracted of religion/spirituality, positive religious coping, perceived stress, depression, and experiences of racism. They were also measured 8 years later for the incidence of hypertension.

 

They found that women who reported high levels of religion/spirituality were older, more educated, less likely to smoke or drink, lived in disadvantaged neighborhoods, and with lower levels of perceived stress. Significantly, they also found that women high in positive religious coping had a significantly lower risk of developing hypertension 8 years later. This association was strongest in women with the highest levels of perceived stress.

 

These results are interesting and suggest that the development of hypertension is associated with stress and that positive religious coping can mitigate the effects of stress on blood pressure. Positive religious coping involves using “religious and spiritual resources to cope with and adapt to stressful life circumstances.” Hence spiritualty and religiosity can promote better health in black women by providing them with methods to cope with the stresses in their lives.

 

So, reduce the risk of hypertension with religious/spiritual coping.

 

“Religious coping now represents a key variable of interest in research on health outcomes, not only because many individuals turn to their faith in times of illness, but also because studies have frequently found that religious coping is associated with desirable health outcomes.” – Jeremey Cummings

 

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

 

Cozier, Y. C., Yu, J., Wise, L. A., VanderWeele, T. J., Balboni, T. A., Argentieri, M. A., … Shields, A. E. (2018). Religious and Spiritual Coping and Risk of Incident Hypertension in the Black Women’s Health Study. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 52(12), 989–998. doi:10.1093/abm/kay001

 

Abstract

Background

The few studies of the relationship between religion and/or spirituality (R/S) and hypertension are conflicting. We hypothesized that R/S may reduce the risk of hypertension by buffering adverse physiological effects of stress.

Methods

We prospectively assessed the association of R/S with hypertension within the Black Women’s Health Study (BWHS), a cohort study initiated in 1995 that follows participants through biennial questionnaires. The 2005 questionnaire included four R/S questions: (i) extent to which one’s R/S is involved in coping with stressful situations, (ii) self-identification as a religious/spiritual person, (iii) frequency of attending religious services, and (iv) frequency of prayer. Incidence rate ratios (IRRs) and 95% confidence intervals were calculated for each R/S variable in relation to incident hypertension using Cox proportional hazards regression models, controlling for demographics, known hypertension risk factors, psychosocial factors, and other R/S variables.

Results

During 2005–2013, 5,194 incident cases of hypertension were identified. High involvement of R/S in coping with stressful events compared with no involvement was associated with reduced risk of hypertension (IRR: 0.87; 95% CI: 0.75, 1.00). The association was strongest among women reporting greater levels of perceived stress (IRR: 0.77; 95% CI: 0.61, 0.98; p interaction = .01). More frequent prayer was associated with increased risk of hypertension (IRR: 1.12; 95% CI: 0.99, 1.27). No association was observed for the other R/S measures.

Conclusion

R/S coping was associated with decreased risk of hypertension in African American women, especially among those reporting higher levels of stress. Further research is needed to understand the mechanistic pathways through which R/S coping may affect health.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6230974/

 

Spirituality is Associated with Better Mental and Physical Health and Cognitive Ability in African Americans

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Spirituality is Associated with Better Mental and Physical Health and Cognitive Ability in African Americans

 

By John M. de Castro, Ph.D.

 

“all black religious expression has most of the following attributes: It is animistic, or spirit-filled; anthropocentric, or human-centered; dynamic; expressionistic; shamanistic (believing in communicating with spirits); and thaumaturgic (belief in miracle working).” – Diana Hayes

 

The immune system is designed to protect the body from threats like stress, infection, injury, and toxic chemicals. One of its tools is the Inflammatory response. This response works quite well for short-term infections and injuries. But when inflammation is protracted and becomes chronic, it can itself become a threat to health. It can produce autoimmune diseases such as colitis, Chron’s disease, arthritis, heart disease, increased cancer risk, lung disease, sleep disruption, gum disease, decreased bone health, psoriasis, and depression. Needless to say, chronic inflammation can create major health problems. Indeed, the presence of chronic inflammation is associated with reduced longevity. So, it is important for health to control the inflammatory response, allowing it to do its job in fighting off infection but reducing its activity when no external threat is apparent.

 

Depression is linked with increase inflammatory responses. Mind-body techniques such as yoga, Tai Chi and meditation have been shown to adaptively reduce the inflammatory response.  In addition, spirituality has been shown to be associated with reduced depression. African Americans have significantly greater incidences of disease. So, it is reasonable to investigate the relationships of spirituality, depression, inflammation and health in African Americans.

 

In today’s Research News article “Influence of Spirituality on Depression-Induced Inflammation and Executive Functioning in a Community Sample of African Americans.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6478044/), Herren and colleagues recruited healthy adult African Americans and measured them for depression, daily spiritual experiences, cognitive ability, and response inhibition. Blood was drawn and measured for inflammatory cytokines; IL-1a, TNF-a and IL-6.

 

They found that the higher the levels of depression the lower the levels of cognitive ability (executive function). This relationship was in part mediated by the levels of the inflammatory cytokine, IL-6, such that depression was associated with higher levels of IL-6 which in turn were associated with lower cognitive ability. Interestingly, they also found that the higher the frequency of daily spiritual experiences the lower the levels of depression and the higher the levels of cognitive ability and response inhibition. In addition, spirituality moderated the relationships of IL-6 with cognitive ability, such that the greater the frequency of spiritual experiences the smaller the negative relationship of IL-6 with cognitive ability.

 

These findings are interesting but they are correlational and causation cannot be determined. But they suggest that spirituality is associated with better physical and psychological health in African Americans. It is associated with lower depression levels and better cognitive performance. Additionally, it was associated with a lessened negative relationship between the inflammatory response and cognitive ability.

 

African Americans are generally more religious and spiritual than other groups. The present findings may help to explain why. Their spirituality is associated with better mental and physical health and cognitive ability. It remains for future research to determine if these relationships are causal and spirituality produces these benefits. It also remains to be seen if these relationships are present in other ethnic and racial groups.

 

Spirituality is associated with better mental and physical health and cognitive ability in African Americans.

 

“Changing our thoughts, feelings and behaviour to positivity, optimism, hope, acceptance and love boosts immunity at the physical, cognitive, emotional and spiritual levels.” – Sunnyside

 

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

 

Herren, O. M., Burris, S. E., Levy, S. A., Kirk, K., Banks, K. S., Jones, V. L., … Campbell, A. L. (2019). Influence of Spirituality on Depression-Induced Inflammation and Executive Functioning in a Community Sample of African Americans. Ethnicity & disease, 29(2), 267–276. doi:10.18865/ed.29.2.267

 

Abstract

African Americans (AAs) are disproportionately affected by cerebrovascular pathology and more likely to suffer from premature cognitive decline. Depression is a risk factor for poorer cognitive functioning, and research is needed to identify factors that serve to mitigate its negative effects. Studies have demonstrated positive influences of spirituality within the AA community. Determining whether spirituality attenuates the effects of depressive symptoms on cognitive functioning and the pathophysiological mechanisms that explain these relationships in AAs is paramount. This study examines the influence of daily spiritual experiences on the relationship between depressive symptoms and cognitive functioning, and how inflammatory markers may partially explain these associations. A sample of 212 (mean age= 45.6) participants completed the Daily Spiritual Experience Scale (DSES), Beck Depression Inventory-II (BDI-II), Trail Making Test A and B (TMT) and Stroop Color and Word Test (Stroop). Blood samples were collected to measure inflammatory mediators (IL-6, IL-1a, TNF-a). Linear regression analyses were used to evaluate associations. Higher BDI-II scores were associated with poorer psychomotor speed and visual scanning, measured by TMT A (B=1.49, P=.01). IL-6 explained a significant amount of variance in this relationship (B=.24, CI 95% [.00, .64]). IL-6 also significantly mediated the relationship between depressive symptoms and psychomotor speed and mental flexibility, measured by TMT B performance (B=.03, CI 95% [.003, .095]). Frequent spiritual experiences among AAs may ameliorate the negative influence of depressive symptoms on cognitive functioning.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6478044/

 

Mindfulness Training Improves Anxiety and Depression in Japanese Patients

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Mindfulness Training Improves Anxiety and Depression in Japanese Patients

 

By John M. de Castro, Ph.D.

 

“meditation was never conceived of as a treatment for any health problem. Rather, it is a path one travels on to increase our awareness and gain insight into our lives.” – Madhav Goyal

 

Many of the symptoms of psychological distress have been shown to be related to a lack of mindfulness, a focus on the present moment. Anxiety is often rooted in a persistent dread of future negative events while depression and rumination are 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. Indeed, mindfulness has been shown to reduce psychological distress, including anxiety and depression.

 

Most psychotherapies were developed to treat disorders in affluent western populations and may not be sensitive to the unique situations, cultures, and education levels of diverse populations. Hence, there is a need to investigate the effectiveness of psychological treatments with diverse populations. One increasingly popular treatment is mindfulness training. These include meditation, tai chi, qigong, yoga, guided imagery, prayer, etc. There are indications that mindfulness therapies may be effective in diverse populations. But there is a need for further investigation with different populations.

 

In today’s Research News article “Changes in depression and anxiety through mindfulness group therapy in Japan: the role of mindfulness and self-compassion as possible mediators.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378713/), Takahashi and colleagues recruited Japanese patients who suffered from anxiety or depression and provided them with an 8-week,  once a week for 2 hours, group mindfulness training that was a combination of Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT). They also practiced at home daily. They were measured before and after training and 2 months later for mindfulness, depression, anxiety, mind wandering, self-compassion, and behavioral activation.

 

They found that after mindfulness training there were significant reductions in anxiety and depression and significant increases in mindfulness and self-compassion that were maintained 2 months later. They also found that the greater the changes in the levels of mindfulness and self-compassion produced by the training, the greater the reductions in anxiety and depression. Hence, the mindfulness training produced lasting improvements in the mental health of Japanese patients suffering from anxiety or depression.

 

This study lacked a control group and is thus open to alternative confounding interpretations. But mindfulness training has been shown over a large number of well-controlled studies to improve self-compassion and to reduce anxiety and depression. So, the current improvements in mental health were also likely to be due to the mindfulness training. The major contribution of this research, however, is to add to the generalizability of mindfulness training’s ability to improve mental health by demonstrating that it is effective with Japanese patients with anxiety or depression.

 

So, mindfulness training improves anxiety and depression in Japanese patients.

 

“Mindfulness has been shown to help with people living with depression and anxiety. Americans often think a pill is the only way to fix things, but . . .  it doesn’t require any money to meditate so it seems like a purer way for people to live with these disorders.” – Katie Lindsley

 

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

 

Takahashi, T., Sugiyama, F., Kikai, T., Kawashima, I., Guan, S., Oguchi, M., … Kumano, H. (2019). Changes in depression and anxiety through mindfulness group therapy in Japan: the role of mindfulness and self-compassion as possible mediators. BioPsychoSocial medicine, 13, 4. doi:10.1186/s13030-019-0145-4

 

Abstract

Background

Mindfulness-based interventions are increasingly being implemented worldwide for problems with depression and anxiety, and they have shown evidence of efficacy. However, few studies have examined the effects of a mindfulness-based group therapy based on standard programs for depression and anxiety until follow-up in Japan. This study addresses that gap. Furthermore, this study explored the mechanisms of action, focusing on mindfulness, mind wandering, self-compassion, and the behavioral inhibition and behavioral activation systems (BIS/BAS) as possible mediators.

Methods

We examined 16 people who suffered from depression and/or anxiety in an 8-week mindfulness group therapy. Measurements were conducted using questionnaires on depression and trait-anxiety (outcome variables), mindfulness, mind wandering, self-compassion, and the BIS/BAS (process variables) at pre- and post-intervention and 2-month follow-up. Changes in the outcome and process variables were tested, and the correlations among the changes in those variables were explored.

Results

Depression and anxiety decreased significantly, with moderate to large effect sizes, from pre- to post-intervention and follow-up. In process variables, the observing and nonreactivity facets of mindfulness significantly increased from pre- to post-intervention and follow-up. The nonjudging facet of mindfulness and self-compassion significantly increased from pre-intervention to follow-up. Other facets of mindfulness, mind wandering, and the BIS/BAS did not significantly change. Improvements in some facets of mindfulness and self-compassion and reductions in BIS were significantly correlated with decreases in depression and anxiety.

Conclusions

An 8-week mindfulness group therapy program may be effective for people suffering from depression and anxiety in Japan. Mindfulness and self-compassion may be important mediators of the effects of the mindfulness group therapy. Future studies should confirm these findings by using a control group.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378713/

 

Adolescent Characteristics that Predict Success of Mindfulness Therapy to Reduce Self-Harm and Suicidality

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Adolescent Characteristics that Predict Success of Mindfulness Therapy to Reduce Self-Harm and Suicidality

 

By John M. de Castro, Ph.D.

 

“The pain of depression is quite unimaginable to those who have not suffered it,  and it kills in many instances because its anguish can no longer be borne.
The prevention of many suicides will continue to be hindered until there is a general awareness of the nature of this pain.” – William Styron

 

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. (Suicide Awareness Voices of Education). It is much more prevalent with males who account for 79% of suicides. 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. It is important to identify the characteristics of adolescents who are most likely to benefit from DBT for the reduction of suicide.

 

In today’s Research News article “Predictors and moderators of recurring self‐harm in adolescents participating in a comparative treatment trial of psychological interventions.” (See summary below or view the full text of the study at: https://onlinelibrary.wiley.com/doi/full/10.1111/jcpp.13099), Adrian and colleagues recruited adolescents with previous lifetime suicide attempt, repetitive self‐harm in the past 12 weeks, borderline personality disorder (BPD) characteristics, and clinically significant suicidal ideation. They were randomly assigned to receive 6-months of either Dialectical Behavior Therapy (DBT) or individual/group supportive therapy. They were measured before and after treatment and at the midpoint of treatment for suicide attempts, non-suicidal self-injuries, self-harm, prior self-harm severity, externalizing symptoms, other psychiatric disorders, substance abuse, PTSD symptoms, borderline personality disorder (BPD) symptoms, adolescent-parent conflict, and emotional dysregulation. In addition, their parents were measured for emotional distress and adolescent-parent conflict.

 

They found that non-white adolescents had a greater response to treatment than white adolescents in the reduction in suicide ideation. The adolescent’s pre-treatment history also affected the response to treatment with adolescents with greater levels of family conflict, more extensive self‐harm histories, and more externalizing problems having a greater reduction in self-harm. They also found that Dialectical Behavior Therapy (DBT) was more effective for adolescents who were high in emotional dysregulation and whose parents had greater psychopathology and emotional dysregulation.

 

These results are interesting and suggest that certain adolescents are more responsive to treatment than others. Non-white (particularly Latino) youths, adolescents with greater levels of family conflict, more extensive self‐harm histories, more externalizing problems, higher in emotional dysregulation and whose parents had greater psychopathology and emotional dysregulation had more positive changes produced by therapy. These factors may be used to triage which youths would be most likely to benefit from different therapies and thus may potentiate therapeutic benefits.

 

Suicide is a major problem for adolescents and self-harm, self-injury, suicide ideation, and suicide attempts are all indicators of potential lethal outcomes. So, treatment is extremely important. Dialectical Behavior Therapy (DBT) appears to be effective but it is particularly effective for certain youths. Knowing this can help target and refine therapy to improve therapeutic effectiveness in reducing suicides in adolescents.

 

So, reduce suicidality in certain adolescents with mindfulness.

 

“Being curious about your suicidal thoughts is another part of mindful observation. If you have the thought, “I should kill myself,” how does it affect the thought’s meaning to then tell yourself, “Hmm, I wonder why I just had the thought that I should kill myself?” – Stacey Freedenthal

 

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

 

Molly Adrian, Elizabeth McCauley, Michele S. Berk, Joan R. Asarnow, Kathryn Korslund, Claudia Avina, Robert Gallop, Marsha M. Linehan. Predictors and moderators of recurring self‐harm in adolescents participating in a comparative treatment trial of psychological interventions. Journal of Child Psychology and Psychiatry, 30 July 2019, 60(10), 1123-1132, https://doi.org/10.1111/jcpp.13099

 

Key points

  • Adolescent prior self‐harm, externalizing problems, and reported family conflict were significant predictors of change in self‐harm, NSSI, and suicidal ideation, where adolescents with higher family conflict and less severe self‐harm history produced on average more reduction in SH from baseline to post‐treatment.
  • DBT produced better rate of improvement compared to IGST for adolescents who were emotionally dysregulation and whose parents had higher baseline emotion dysregulation and psychopathology.
  • Clinicians could consider either IGST or DBT for adolescents with self‐harm histories whose parents are well regulated and do not have impairing psychopathology. Adolescents with emotional dysregulation and parents with psychopathology and emotion dysregulation may benefit more from DBT than IGST.

Abstract

Background

In primary analyses, dialectical behavior therapy (DBT) was associated with greater reduction in self‐harm during treatment than individual/group supportive therapy (IGST). The objective of this paper was to examine predictors and moderators of treatment outcomes for suicidal adolescents who participated in a randomized controlled trial evaluating DBT and IGST.

Methods

Adolescents (N = 173) were included in the intent‐to‐treat sample and randomized to receive 6 months of DBT or IGST. Potential baseline predictors and moderators were identified within four categories: demographics, severity markers, parental psychopathology, and psychosocial variables. Primary outcomes were suicide attempts (SA) and nonsuicidal self‐injury evaluated at baseline, midtreatment (3 months), and end of treatment (6 months) via the Suicide Attempt and Self‐Injury Interview (Psychological Assessment, 18, 2006, 303). For each moderator or predictor, a generalized linear mixed model was conducted to examine main and interactive effects of treatment and the candidate variable on outcomes.

Results

Adolescents with higher family conflict, more extensive self‐harm histories, and more externalizing problems produced on average more reduction on SH frequency from baseline to post‐treatment. Adolescents meeting BPD diagnosis were more likely to have high SH frequency at post‐treatment. Analyses indicated significant moderation effects for emotion dysregulation on NSSI and SH. DBT was associated with better rates of improvement compared to IGST for adolescents with higher baseline emotion dysregulation and those whose parents reported greater psychopathology and emotion dysregulation. A significant moderation effect for ethnicity on SA over the treatment period was observed, where DBT produced better rate of improvement compared to IGST for Hispanic/Latino individuals.

Conclusions

These findings may help to inform salient treatment targets and guide treatment planning. Adolescents that have high levels of family conflict, externalizing problems, and increased level of severity markers demonstrated the most change in self‐harm behaviors over the course of treatment and benefitted from both treatment interventions. Those with higher levels of emotion dysregulation and parent psychopathology may benefit more from the DBT.

https://onlinelibrary.wiley.com/doi/full/10.1111/jcpp.13099

 

Mindfulness Training is Effective with Widely Diverse Populations

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Mindfulness Training is Effective with Widely Diverse Populations

 

By John M. de Castro, Ph.D.

 

“In the last two decades, references to mindfulness-based treatments have proliferated. Its benefits are touted for many medical conditions and seem to be universally accepted as a technique to improve mental health across diverse populations.” – Sara Davin

 

Disadvantaged populations have a disproportionate share of mental health issues. Indeed, the lower the socioeconomic status of an individual the greater the likelihood of a mental disorder. It is estimated that major mental illnesses are almost 3 times more likely in the disadvantaged, including almost double the incidence of depression, triple the incidence of anxiety disorders, alcohol abuse, and eating disorders. These higher incidences of mental health issues occur, in part, due to mental health problems leading to unemployment and poverty, but also to the stresses of life in poverty.

 

Most psychotherapies were developed to treat disorders in affluent western populations and are not affordable or sensitive to the unique situations and education levels of the diverse populations. Hence, there is a great need for alternative treatments for diverse populations. One increasingly popular alternative is mindfulness practices. These include meditation, tai chi, qigong, yoga, guided imagery, prayer, etc. The research on the effectiveness of mindfulness practices with diverse populations is accumulating, so it makes sense to stop and summarize what has been learned.

 

In today’s Research News article “Addressing Diversity In Mindfulness Research On Health: A Narrative Review Using The Addressing Framework.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746558/),Chin and colleagues review and summarize the published research studies on the effectiveness of mindfulness practice for various populations.

 

They report that the published studies found that mindfulness practice was beneficial regardless of age, being effective in children, adolescents, adults, and the elderly, regardless of ethnicity, including black, Hispanic, native American, and Asian populations, and regardless of sexual orientation, including lesbian, gay, bisexual, and transgender participants. Mindfulness training was also found to improve the well-being of patients with acquired disabilities including Alzheimer’s disease, diabetic peripheral neuropathy, traumatic brain injury, and multiple sclerosis. Mindfulness appears to be effective regardless of socioeconomic status, being beneficial in both affluent and poor participants and regardless of nationality, being beneficial for European Americans, Taiwanese, South Africans, British and Swedes. Finally, there’s only a small number of studies that compare the effectiveness of mindfulness practice for males versus females. In general, mindfulness practice appears to be beneficial for both genders, but possibly more beneficial for women than men.

 

These findings are quite striking and suggest that mindfulness training is beneficial for a wide variety of people with a wide variety of conditions. It is no wonder that mindfulness practice appears to be spreading rapidly, with meditation practice increasing from 4% to 14% of the US population over the last 5 years.

 

Hus, mindfulness training is effective with widely diverse populations.

 

“The application of mindfulness to diversity and inclusion is about opening and appreciating rather than rejecting difference.” – Joshua Ehrlich

 

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

 

Chin, G., Anyanso, V., & Greeson, J. (2019). Addressing Diversity In Mindfulness Research On Health: A Narrative Review Using The Addressing Framework. Cooper Rowan medical journal, 1(1), 2.

 

INTRODUCTION

Over the past 5 years, the number of Americans practicing meditation has more than tripled, rising from 4% of adults in 2010 to 14% in 2017.1 This rise is likely related to the increasing focus on preventive and integrative approaches to healthcare in the United States, such as meditation, which is often used to reduce stress, anxiety, depression, and pain in conjunction with improving health and well-being.2 While many different meditative practices exist, mindfulness meditation emphasizes nonjudgmental awareness of the present moment. Although substantial research supports mindfulness-related improvements in patient-reported mental and physical health,3 the replication crisis in social science and medicine, alongside numerous methodological concerns about extant mindfulness studies,4 invites questions regarding the generalizability of research on the reported health-promoting effects of mindfulness meditation and mindfulness as an innate, dispositional quality (trait mindfulness). Moreover, as much of mindfulness research over-samples middle-to-upper class, Caucasian, women,5 the extent to which results generalize to a broader, more diverse population is unclear. One possible reason for this overrepresentation could be that this population has the time and/or finances to participate in mindfulness-based interventions (MBIs) from which researchers draw samples.

In 2001, Dr. Pamela Hays published Addressing Cultural Complexities in Practice,6 introducing the ADDRESSING framework as a guide to help clinicians better identify and understand the relevant cultural identities of their clients. According to Dr. Hays, the facets of identity include: Age, Developmental and acquired Disabilities, Religion, Ethnicity, Socioeconomic status, Sexual orientation, Indigenous heritage, National origin, and Gender. This framework allows room for intersectionality between identity facets and does not inherently exclude non-minority individuals. As such, the ADDRESSING framework, with its attention to multiple aspects of identity, provides an effective structure for organizing research published on different populations and identifying 1) which populations are represented and underrepresented in various categories and 2) what is known about underrepresented groups in research. The main purpose of this review, therefore, was to use the ADDRESSING framework to highlight mindfulness research conducted on historically underrepresented groups as both a method to summarize what has been done and to point out gaps for future research.

Overall, mindfulness can reduce stress and improve mental health in diverse populations. Given the unique stressors and mental health disparities individuals in diverse groups experience, mindfulness-related changes in mental health likely support improvements in health-related behavior, QoL and well-being.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746558/