Emotions

Mindfulness Improves the Emotion Regulation in Patients with Schizophrenia

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Mindfulness Improves the Emotion Regulation in Patients with Schizophrenia

 

By John M. de Castro, Ph.D.

 

“Mindfulness treatments do not aim to decrease the occurrence or severity of the symptoms of psychosis, but by helping to reduce the distress people experience, many of these treatments help indirectly to alleviate psychotic symptoms as well.” – Tania Lecomte

 

Schizophrenia is the most common form of psychosis. It effects about 1% of the population worldwide. It appears to be highly heritable and involves changes in the brain. It is characterized by both positive and negative symptoms. Positive symptoms include hallucinations; seeing and, in some cases, feeling, smelling or tasting things that aren’t there, or delusions; unshakable beliefs that, when examined rationally, are obviously untrue. Negative symptoms include a reduced ability to function normally, neglect of personal hygiene, lack of emotion, blank facial expressions, speaking in a monotone, loss of interest in everyday activities, social withdrawal, an inability to experience pleasure, and a lack of insight into their symptoms. The symptoms of schizophrenia usually do not appear until late adolescence or early adulthood.

 

Schizophrenia is very difficult to treat with psychotherapy and is usually treated with antipsychotic drugs. These drugs, however, are not always effective, sometimes lose effectiveness, and can have some difficult side effects. Mindfulness training has been shown to be beneficial for a variety of mental health problems, including psychosis. Mindfulness has also been shown to associated with lower symptom severity of schizophrenia. Patients with schizophrenia have difficulty regulating emotions and mindfulness training improves emotion regulation. Hence, it makes sense to investigate the effectiveness of mindfulness training in improving emotion regulation in patients with schizophrenia.

 

In today’s Research News article “The Effectiveness of a Mindfulness-Based Psychoeducation Programme for Emotional Regulation in Individuals with Schizophrenia Spectrum Disorders: A Pilot Randomised Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075335/), Lam and colleagues recruited adult patients diagnosed with schizophrenia-spectrum disorders and randomly assigned them to a treatment as usual control condition or to receive a 90 minute once a week for 8 weeks Mindfulness-Based Psychoeducation Program (MBPP) including “engagement and empowerment, mindfulness in daily living and problem solving, mindfulness in illness management and equip and prepare for the future.” Patients also performed daily mindfulness practice. They were measured before and after training and 3 months later for the emotion regulation processes of reappraisal and suppression, rumination, psychotic symptoms, mindfulness, anxiety, and depression.

 

Engagement in the Mindfulness-Based Psychoeducation Program (MBPP) was high with 85% of participants attending 6 or more sessions with average attendance of 6.88 sessions. The average amount of home practice was 31 minutes per week. Hence the program can be successfully implemented and is acceptable to the patients.

 

They found that in comparison to baseline and the treatment as usual group after Mindfulness-Based Psychoeducation Program (MBPP) there was a significant improvement in mindfulness and the emotion regulation strategy of reappraisal. These improvements were maintained for 3 months after the end of training. The results suggest that mindfulness training improves the emotion regulation strategy of reappraisal in patients diagnosed with schizophrenia-spectrum disorders.

 

Reappraisal is a cognitive strategy to reinterpret the origin and meaning of an emotional event to reduce its impact. This is an effective emotion regulation strategy to help the individual cope with emotions. Since, problems with emotions are common in schizophrenia, improving emotion regulation may be of great assistance to them in dealing with the symptoms of the disease.

 

So, mindfulness improves the emotion regulation in patients with schizophrenia.

 

“mindfulness-based psycho-educational intervention expressly designed for patients with schizophrenia can be well tolerated and result in better illness outcomes than either standard treatment alone or standard treatment supplemented by a more typical psycho-educational approach. This is an important finding because of the widely held belief that psychotic patients can neither tolerate nor benefit from mindfulness-based interventions.” – American Mindfulness Research Association

 

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

 

Lam, A., Leung, S. F., Lin, J. J., & Chien, W. T. (2020). The Effectiveness of a Mindfulness-Based Psychoeducation Programme for Emotional Regulation in Individuals with Schizophrenia Spectrum Disorders: A Pilot Randomised Controlled Trial. Neuropsychiatric disease and treatment, 16, 729–747. https://doi.org/10.2147/NDT.S231877

 

Abstract

Background

Emotion dysregulation has emerged as a transdiagnostic factor that potentially exacerbates the risk of early-onset, maintenance, and relapse of psychosis. Mindfulness is described as the awareness that emerges from paying attention to the present moment without judgment. It gently pulls the mind out of the negative emotions induced by the disparity between expectation and reality by focusing on the present moment, instead of worrying about the future or regretting the past. However, only a few research has ever focused on the efficacy of using a mindfulness-based intervention to improve emotion regulation in schizophrenia spectrum disorders.

Purpose

The purpose of this study was to examine the effectiveness of a Mindfulness-Based Psychoeducation Programme (MBPP) on the emotion regulation of individuals with schizophrenia, in particular, to access emotion regulation strategies. The objective of this study was to find out whether MBPP is feasible for improving emotion regulation strategies, in terms of rumination, cognitive reappraisal, and expressive suppression, with a sustainable effect at a three-month follow-up.

Patients and Methods

A single-blinded pilot randomised controlled trial with repeated-measures designs was adopted. Forty-six participants diagnosed with schizophrenia and its subtypes were randomised in either the 8-week mindfulness-based psychoeducation programme or treatment-as-usual (control) group.

Results

The results of the Generalised Estimating Equations test indicated that the MBPP group showed a significant improvement in reappraisal at a three-month follow-up (β = −6.59, Wald’s χ2=4.55, p=0.033), and a significant reduction in rumination across time. However, the Generalised Estimating Equations indicated no significant difference in rumination and expressive suppression in the MBPP group. Two participants reported having unwanted experiences, including feelings of terror and distress during the mindfulness practice.

Conclusion

The MBPP appeared to be effective for improving emotion regulation, which will contribute to future large-scale RCT to confirm the treatment effects in more diverse groups of schizophrenic patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075335/

 

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/

 

Reduce the Risk of Major Depression Relapse with Mindfulness

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Reduce the Risk of Major Depression Relapse with Mindfulness

 

By John M. de Castro, Ph.D.

 

“a growing body of research is pointing to an intervention that appears to help prevent relapse by altering thought patterns without side effects: mindfulness-based cognitive therapy, or MBCT.” – Stacy Lu

 

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

 

Relapsing into depression is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering. Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior.

 

There has been considerable research demonstrating that Mindfulness-Based Cognitive Therapy (MBCT) is effective in treating depression.  In today’s Research News article “The effects of mindfulness-based cognitive therapy on risk and protective factors of depressive relapse – a randomized wait-list controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275325/), Schanche and colleagues investigate the ability of  MBCT to reduce risk factors associated with relapse in patients with major depressive disorder.

 

They recruited adult patients diagnosed with major depressive disorder who had at least 3 depressive episodes and who were currently in remission. They were randomly assigned to be on a wait list or to receive 8 weekly 2-hour sessions of Mindfulness-Based Cognitive Therapy (MBCT). They were measured before and after training for rumination, emotion regulation, anxiety, self-compassion, mindfulness, and depression.

 

They found that in comparison to baseline and the wait-list group after Mindfulness-Based Cognitive Therapy (MBCT) there were significant reductions in rumination, anxiety, emotional reactivity to stress and depression and significant increases in emotion regulation, self-compassion and mindfulness. Hence, MBCT significantly improved the psychological well-being of these patients.

 

These are interesting results that suggest that Mindfulness-Based Cognitive Therapy (MBCT) produces a reduction in the types of negative emotional symptoms that could promote a depressive relapse and an increase in factors that could promote resistance to relapse especially the ability to effectively cope with their emotions and compassion for themselves. Mindfulness training has been repeatedly shown in the past to reduce rumination, anxiety, emotional reactivity to stress and depression and increase emotion regulation and self-compassion. The present study demonstrates that these benefits occur in patients in remission from major depressive disorder. This suggests that MBCT is effective in improving the major depressive disorder patients psychological state in a way that suggests that they would be resistant to relapse in the future.

 

So, reduce the risk of major depression relapse with mindfulness.

 

“MBCT and CT attempt to reduce the risk of relapse by promoting different skill sets. CT promotes challenging dysfunctional thinking and increasing physical activity level. MBCT promotes nonjudgmental monitoring of moment-by-moment experience, and decentering from thoughts or seeing thoughts as transient mental phenomena and not necessarily valid.” – American Mindfulness Research Association

 

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

 

Elisabeth Schanche, Jon Vøllestad, Endre Visted, Julie Lillebostad Svendsen, Berge Osnes, Per Einar Binder, Petter Franer, Lin Sørensen. The effects of mindfulness-based cognitive therapy on risk and protective factors of depressive relapse – a randomized wait-list controlled trial. BMC Psychol. 2020; 8: 57. Published online 2020 Jun 5. doi: 10.1186/s40359-020-00417-1

 

Abstract

Background

The aim of this randomized wait-list controlled trial was to explore the effects of Mindfulness–Based Cognitive Therapy (MBCT) on risk and protective factors for depressive relapse within the domains of cognition, emotion and self-relatedness.

Methods

Sixty-eight individuals with recurrent depressive disorder were randomized to MBCT or a wait-list control condition (WLC).

Results

Completers of MBCT (N = 26) improved significantly on measures assessing risk and protective factors of recurrent depression compared to WLC (N = 30) on measures of rumination (d = 0.59, p = .015), emotion regulation (d = 0.50, p = .028), emotional reactivity to stress (d = 0.32, p = .048), self-compassion (d = 1.02, p < .001), mindfulness (d = 0.59, p = .010), and depression (d = 0.40, p = .018). In the Intention To Treat sample, findings were attenuated, but there were still significant results on measures of rumination, self-compassion and depression.

Conclusions

Findings from the present trial contribute to evidence that MBCT can lead to reduction in risk factors of depressive relapse, and strengthening of factors known to be protective of depressive relapse. The largest changes were found in the domain of self-relatedness, in the form of large effects on the participants’ ability to be less self-judgmental and more self-compassionate.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275325/

 

Improve Smoking Abstinence with Mindfulness

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Improve Smoking Abstinence with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness training (MT) may decouple the association between craving and smoking, thus facilitating smoking cessation.” – J. Kim Pemberthy

 

“Tobacco use remains the single largest preventable cause of death and disease in the United States.” (Centers for Disease Control and Prevention). So, treating nicotine addiction and producing smoking cessation could greatly improve health. But smoking has proved devilishly difficult to treat. There are a wide variety of methods and strategies to quit smoking which are to only a very limited extent effective. According to the National Institutes of Health, about 40% of smokers who want to quit make a serious attempt to do so each year, but fewer than 5% actually succeed. Most people require three or four failed attempts before being successful.

 

One problem is that nicotine is one of the most addictive substances known and withdrawal from nicotine is very stressful, producing many physical and psychological problems, including negative emotional states and depression. In essence, the addict feels miserable without the nicotine. This promotes relapse to relieve the discomfort. Better methods to quit which can not only promote quitting but also prevent relapse are badly needed. Mindfulness practices have been found to be helpful in treating addictions, including nicotine addiction, and reducing the risk of relapse.

 

In today’s Research News article “Mechanisms linking mindfulness and early smoking abstinence: An ecological momentary assessment study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483850/), Spears and colleagues recruited adult smokers desiring to quit and provided them with “six smoking cessation counseling sessions (10–20 minutes each).” They completed questionnaires on demographics and mindfulness. They were also asked to complete assessments at baseline and for 4 weeks after cessation of smoking on a smartphone of positive and negative emotions, smoking urges, and expectancy of regulating emotions whenever they had an urge to smoke, smoked a cigarette, and 4 randomly selected times per day prompted on their smartphone.

 

Of the participants 63% achieved smoking abstinence after treatment and 41% remained abstinent 7 days later. They found that on the day of smoking cessation and 7 days later, the higher the levels of mindfulness the lower the levels of negative emotions, stress, smoking urges, and expectancies that smoking would improve mood and the higher the levels of positive emotions. They also found that lower smoking urges were associated with higher levels of abstinence when the participants were low in mindfulness but not when they were high in mindfulness. In addition, the higher the levels of mindfulness, the higher the levels of positive emotions and the lower the levels of negative emotions which were in turn associated with higher levels of smoking abstinence.

 

Even though the smoking cessation therapy did not include a mindfulness component, the participant’s level of mindfulness was an important contributor to successful smoking abstinence. Mindfulness appeared to be associated with improved mood and lower stress levels and urges to smoke which were in turn associated with improved outcomes. Hence, mood and stress appear to mediate the association of mindfulness with successfully quitting smoking. Mindful people appear to have more positive moods which works to improve the likelihood of quitting smoking.

 

So, improve smoking abstinence with mindfulness.

 

“stress is caused by craving. If you can let go of that craving, then your stress will dissolve, and practicing mindfulness is the way to do that.” – Judson Brewer

 

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

 

Spears, C. A., Li, L., Wu, C., Vinci, C., Heppner, W. L., Hoover, D. S., Lam, C., & Wetter, D. W. (2019). Mechanisms linking mindfulness and early smoking abstinence: An ecological momentary assessment study. Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, 33(3), 197–207. https://doi.org/10.1037/adb0000451

 

Abstract

Research suggests that individuals with greater dispositional mindfulness (i.e., non-judgmental, present-focused attention) are more likely to quit smoking, but the underlying mechanisms are unclear. This study investigated mechanisms linking mindfulness and early smoking abstinence using ecological momentary assessment (EMA). Participants were 355 smokers (33% Caucasian, 33% African American, 32% Latino; 55% female) receiving smoking cessation treatment. Mindfulness was assessed at baseline and on the quit date. For 4 days pre-quit and 1 week post-quit, participants completed up to 4 EMAs per day indicating levels of negative affect (NA), positive affect (PA), smoking urges, and affect regulation expectancies. Mean, slope, and volatility were calculated for each pre-quit and post-quit EMA variable. Associations among mindfulness, EMA parameters, and abstinence on the quit day and 7 days post-quit, as well as indirect effects of mindfulness on abstinence through EMA parameters were examined. Mindfulness predicted higher odds of abstinence in unadjusted but not covariate-adjusted models. Mindfulness predicted lower NA, higher PA, and lower affective volatility. Lower stress mediated the association between mindfulness and quit-day abstinence. Higher ratings of happy and relaxed, and lower ratings of bored, sad and angry, mediated the association between mindfulness and post-quit abstinence. Mindfulness appeared to weaken the association between craving and post-quit abstinence. This study elucidates real-time, real-life mechanisms underlying dispositional mindfulness and smoking abstinence. During the early process of quitting smoking, more mindful individuals appear to have more favorable emotional profiles, which predicts higher likelihood of achieving abstinence 1 week after the quit date.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483850/

 

Improve Borderline Personality Disorder with Mindfulness

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Improve Borderline Personality Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness meditation training may help individuals with BPD be more effective in applying healthy coping skills in the midst of emotional pain. Mindfulness skills allow you to get just a little bit of space to be able to notice the emotion and be more strategic in terms of how you will act in the face of the emotion.” – Kristalyn Salters-Pedneault

 

Borderline Personality Disorder (BPD) is a very serious mental illness that is estimated to affect 1.6% of the U.S. population. It involves unstable moods, behavior, and relationships, problems with regulating emotions and thoughts, impulsive and reckless behavior, and unstable relationships. BPD is associated with high rates of co-occurring depression, anxiety disorders, substance abuse, eating disorders, self-harm, suicidal behaviors, and completed suicides. Needless to say, it is widespread and debilitating.

 

One of the few treatments that appears to be effective for Borderline Personality Disorder (BPD) is Dialectical Behavior Therapy (DBT). It is targeted at changing the problem behaviors characteristic of BPD 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 not known if Dialectical Behavior Therapy (DBT) is effective for a subset of patients with Borderline Personality Disorder (BPD) who are not suicidal or self-harming. In today’s Research News article “Dialectical behaviour therapy skills reconsidered: applying skills training to emotionally dysregulated individuals who do not engage in suicidal and self-harming behaviours.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6993331/), Kells and colleagues recruited patients with Borderline Personality Disorder (BPD) who had never attempted suicide or engaged in any self-harming and who had high levels of emotional dysregulation. They received a 24-week Dialectical Behavior Therapy (DBT) program that met once a week for 2.5 hours. They were measured before, during, and after treatment and 6 months later for emotion regulation, mindfulness, and DBT skills.

 

There was a 49% drop-out rate. They found that for those that completed the program at each time point during and after treatment including the 6-month follow-up there were significant reductions in dysfunctional coping and increases in emotion regulation, mindfulness, and DBT skills. The effects were quite large with changes of 22% to 50% from baseline.

 

The study has a number of interpretive problems as there wasn’t a control condition. Previous controlled research, however, has demonstrated that Dialectical Behavior Therapy (DBT) is effective for the treatment of Borderline Personality Disorder (BPD). So. the present results were probably due to the treatment and not a confounding influence. The drop-out rate in this study was very high. BPD is a very difficult condition to treat and high drop-out rates are common. Hence it is reasonable to conclude that the present study successfully demonstrated that DBT is an effective treatment for BPD in patients without a history of suicide attempts or self-harming behaviors.

 

These findings suggest that Dialectical Behavior Therapy (DBT) affects a core symptom of Borderline Personality Disorder (BPD), an inability to cope with and regulate emotions. The patients improved markedly in their ability to regulate their emotions and cope with them. It is possible that the observed improvements in mindfulness may have been responsible for the improvements as mindfulness has been shown repeatedly to improve emotion regulation and coping behavior. It remains for future research to investigate this idea.

 

So, improve Borderline Personality Disorder with mindfulness.

 

“Strong emotions disrupt a person’s ability to think and to be mindful. This is true for all of us. An inability to think can lead to even stronger and more dysregulated emotions. This is of particular concern in people with BPD, who often experience strong and difficult to control emotions.” = Blaise Aguirre

 

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

 

Kells, M., Joyce, M., Flynn, D., Spillane, A., & Hayes, A. (2020). Dialectical behaviour therapy skills reconsidered: applying skills training to emotionally dysregulated individuals who do not engage in suicidal and self-harming behaviours. Borderline personality disorder and emotion dysregulation, 7, 3. https://doi.org/10.1186/s40479-020-0119-y

 

Abstract

Background

Dialectical behaviour therapy (DBT) is an evidence-based intervention for borderline personality disorder (BPD) but is an intensive treatment with significant health service costs. Access to DBT can sometimes be restricted due to limited resources. Positive results have been reported for the use of DBT skills training (DBT-ST), one of the four modes of standard DBT, in the treatment of individuals with BPD who self-harm. This study evaluates DBT-ST for a subgroup of individuals attending community mental health services who may have a diagnosis of BPD (or emerging BPD traits) but who are not actively self-harming.

Methods

Participants in this study were 100 adults attending community mental health services with a diagnosis of BPD, emerging BPD traits or emotion dysregulation who were not actively self-harming. The majority of participants were female (71%), aged 25–34 years (32%), single (48%) and unemployed (34%). Participants partook in a 24-week DBT-ST intervention delivered by DBT therapists. Outcome measures included the Difficulties in Emotion Regulation Scale (DERS), the DBT Ways of Coping Checklist (DBT-WCCL) and the Five Facet Mindfulness Questionnaire (FFMQ). Measures were administered at pre-intervention, at the end of each skills module, and at post-intervention.

Results

Significant reductions in emotion dysregulation (DERS) and dysfunctional coping (DBT-WCCL) scores were reported from pre- to post-intervention (p < .001). A significant increase in mindfulness scores (FFMQ) and DBT skill use (DBT-WCCL) was also observed (p < .001). However, the drop-out rate was high (49% at post-intervention).

Discussion

The results of this uncontrolled study suggest that a standalone 24-week DBT-ST intervention may have a beneficial impact in terms of a reduction in emotion dysregulation and dysfunctional coping, and an increase in mindfulness and DBT skills use in patients with BPD/ emerging BPD traits who are not currently engaging in self-harm. Adequately powered randomised controlled trials are required to determine treatment efficacy in comparison to standard DBT for this population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6993331/

 

Reduce Stress at Work with Mindfulness

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Reduce Stress at Work with Mindfulness

 

By John M. de Castro, Ph.D.

 

“I think of mindfulness as the ability not to be yanked around by your own emotions. That can have a big impact on how you are in the workplace.” – Dan Harris

 

Work is very important for our health and well-being. We spend approximately 25% of our adult lives at work. How we spend that time is immensely important for our psychological, social, and physical health. But, nearly 2/3 of employees worldwide are unhappy at work. This is partially due to work-related stress which is epidemic in the western workplace. Almost two thirds of workers reporting high levels of stress at work. This stress can result in impaired health and can result in burnout; producing fatigue, cynicism, and professional inefficacy.

 

To help overcome unhappiness, stress, and burnout, mindfulness practices have been implemented in the workplace. Indeed, mindfulness practices have been shown to markedly reduce the physiological and psychological responses to stress. As a result, it has become very trendy for business to incorporate meditation into the workday to help improve employee well-being, health, and productivity. These programs attempt to increase the employees’ mindfulness at work and thereby reduce stress. It is not known, however, the amount of mindfulness training that is needed to improve employee well-being or whether the training affects moment-to-moment stress levels and the individual’s ability to cope with the stress in the actual work environment.

 

In today’s Research News article “Mindfulness Training Reduces Stress At Work: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6433409/), Chin and colleagues recruited healthy adults at their workplace who had not received training in mindfulness or actively practiced mindfulness. They were provided a 4-hour mindfulness workshop and then randomly assigned to either a low- or high-dose mindfulness training. Low-dose participants received no further training while high-dose participants were provided 6 weekly instructions in mindfulness and also practiced at home for 25-minutes per day for 5 days per week with pre-recorded guided mindfulness instructions.

 

The participants were measured before and after training for perceived stress. They also completed momentary ecological assessments of stress, coping, and emotions. For these assessments they were prompted on their smartphones 4 times throughout the day for 3 days before and 3 days after treatment and were asked to rate on their smartphones their levels of momentary perceived stress, their ability to cope with the momentary stress, and the levels of positive or negative emotions experienced at that moment.

 

They found that after training, the high-dose but nor the low-dose participants had significant reductions in overall perceived stress after training. This was also true for the momentary positive emotions and perceived stress experienced including perceived stress severity, coping efficacy, and coping success, with high-dose participants having significantly greater changes in than low-dose participants after training. In addition, low-dose participants increased in their levels of negative emotions from baseline, while the high-dose participants did not.

 

These results are interesting and demonstrate, as has previous research, that mindfulness training reduces overall perceived stress. It is significant that the comparison condition also contained mindfulness training but at a low dose. This suggests that a small amount of mindfulness training is not sufficient to alter perceived levels of stress.

 

The present study also demonstrated that the effects of mindfulness training are not only on overall levels of perceived stress but also on these levels in momentary real-time work situations. They also show that during actual workplace stress mindfulness training improves the individuals’ ability to cope with the stress and experience more positive emotions and less negative emotions. This all suggests that mindfulness training doesn’t just work overall but moment-to-moment in the work environment to reduce stress levels and their impact on the worker. This should promote the overall psychological and physical health and well-being of the worker.

 

So, reduce stress at work with mindfulness.

 

“Work is a very commonplace of stress, but with a few minutes of mindfulness each day, we can improve our feelings regarding these stressors, reduce their impact on our mental health, and improve our mood as well, leaving us ready for anything ahead.” – Paul Jozsef

 

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, B., Slutsky, J., Raye, J., & Creswell, J. D. (2019). Mindfulness Training Reduces Stress At Work: A Randomized Controlled Trial. Mindfulness, 10(4), 627–638. https://doi.org/10.1007/s12671-018-1022-0

 

Abstract

Mindfulness-based interventions have been suggested as one way to improve employee well-being in the workplace. Despite these purported benefits, there have been few well-controlled randomized controlled trials (RCTs) evaluating mindfulness training in the workplace. Here we conducted a two-arm RCT at work among employees of a digital marketing firm comparing the efficacy of a high dose six-week mindfulness training to a low dose single-day mindfulness training for improving multiple measures of employee well-being assessed using ecological momentary assessment. High dose mindfulness training reduced both perceived and momentary stress, and buffered employees against worsened affect and decreased coping efficacy compared to low dose mindfulness training. These results provide well-controlled evidence that mindfulness training programs can reduce momentary stress at work, suggesting that more intensive mindfulness training doses (i.e., 6-weeks) may be necessary for improving workplace well-being outcomes. This RCT utilizes a novel experience sampling approach to measure the effects of a mindfulness intervention on employee well-being and considers potential dose-response effects of mindfulness training at work.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6433409/

 

Virtual Reality Enhances Online Mindfulness Training

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Virtual Reality Enhances Online Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“I’ve done meditation before and I just zone out to what they are saying…because your mind’s working to picture something it then is working to daydream as well…Whereas, when it was just there in front of you, I think that it took a bit of pressure off of thinking, and you could be in the present.” – Study Participant

 

Over the last several decades, research and anecdotal experiences have accumulated an impressive evidential case that the development of mindfulness has positive benefits for the individual’s mental, physical, and spiritual life. Mindfulness appears to be beneficial both for healthy people and for people suffering from a myriad of illnesses. It appears to be beneficial across ages, from children to the elderly. And it appears to be beneficial across genders, personalities, race, and ethnicity. The breadth and depth of benefits is unprecedented.

 

There is no other treatment or practice that has been shown to come anyway near the range of mindfulness’ positive benefits. With impacts so great it is important to know how to promote the development of mindfulness even in individuals who dislike or avoid the discipline of practice. Technology has recently been applied to training in mindfulness. Indeed, mindfulness training carried out completely on-line has been shown to be effective for as number of conditions. There is evidence that virtual reality may be used to enhance the therapeutic effectiveness of mindfulness training. There is a need, however, to explore whether virtual reality enhances the development of mindfulness?

 

In today’s Research News article “Understanding How Virtual Reality Can Support Mindfulness Practice: Mixed Methods Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7113800/), Seabrook and colleagues recruited healthy adults online and trained them in mindfulness with a 15-minute virtual reality experience that included viewing forest scenes with a guided meditation voiceover. They were measured before and after training for mindfulness, anxiety, depression, perceived stress, and positive and negative emotions. They were also asked to evaluate the virtual reality with questionnaires on simulator sickness and general systems presence and were asked to engage in a semi-structured interview to assess the VR.

 

They found that after training there were significant increases in mindfulness and positive emotions. They also reported a strong sense of presence and very little simulator sickness during the VR. They rated it as very engaging and that it helped them focus on the present moment and practice mindfulness.

 

The study did not incorporate a comparison, control, condition. So, conclusions must be tempered with the knowledge that the results might reflect participant expectations or demand characteristics. It also had only a brief single session of training. So, it is unclear if virtual reality may be useful in sustained mindfulness training. Nevertheless, the results suggest that virtual reality may be a useful add on to mindfulness training to improve the development of mindfulness.

 

So, virtual reality enhances online mindfulness training.

 

“If I were sitting in that same environment in reality I would be thinking…are there other people there… is the car there. But knowing that this environment was virtual, I was able to simply enjoy it.” -– Study Participant

 

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

 

Seabrook, E., Kelly, R., Foley, F., Theiler, S., Thomas, N., Wadley, G., & Nedeljkovic, M. (2020). Understanding How Virtual Reality Can Support Mindfulness Practice: Mixed Methods Study. Journal of medical Internet research, 22(3), e16106. https://doi.org/10.2196/16106

 

Abstract

Background

Regular mindfulness practice has been demonstrated to be beneficial for mental health, but mindfulness can be challenging to adopt, with environmental and personal distractors often cited as challenges. Virtual reality (VR) may address these challenges by providing an immersive environment for practicing mindfulness and by supporting the user to orient attention to the present moment within a tailored virtual setting. However, there is currently a limited understanding of the ways in which VR can support or hinder mindfulness practice. Such an understanding is required to design effective VR apps while ensuring that VR-supported mindfulness is acceptable to end users.

Objective

This study aimed to explore how VR can support mindfulness practice and to understand user experience issues that may affect the acceptability and efficacy of VR mindfulness for users in the general population.

Methods

A sample of 37 participants from the general population trialed a VR mindfulness app in a controlled laboratory setting. The VR app presented users with an omnidirectional video of a peaceful forest environment with a guided mindfulness voiceover that was delivered by a male narrator. Scores on the State Mindfulness Scale, Simulator Sickness Questionnaire, and single-item measures of positive and negative emotion and arousal were measured pre- and post-VR for all participants. Qualitative feedback was collected through interviews with a subset of 19 participants. The interviews sought to understand the user experience of mindfulness practice in VR.

Results

State mindfulness (P<.001; Cohen d=1.80) and positive affect (P=.006; r=.45) significantly increased after using the VR mindfulness app. No notable changes in negative emotion, subjective arousal, or symptoms of simulator sickness were observed across the sample. Participants described the user experience as relaxing, calming, and peaceful. Participants suggested that the use of VR helped them to focus on the present moment by using visual and auditory elements of VR as attentional anchors. The sense of presence in the virtual environment (VE) was identified by participants as being helpful to practicing mindfulness. Interruptions to presence acted as distractors. Some uncomfortable experiences were discussed, primarily in relation to video fidelity and the weight of the VR headset, although these were infrequent and minor.

Conclusions

This study suggests that an appropriately designed VR app can support mindfulness practice by enhancing state mindfulness and inducing positive affect. VR may help address the challenges of practicing mindfulness by creating a sense of presence in a tailored VE; by allowing users to attend to visual and auditory anchors of their choice; and by reducing the scope of the content in users’ mind-wandering. VR has the unique capability to combine guided mindfulness practice with tailored VEs that lend themselves to support individuals to focus attention on the present moment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7113800/

 

Mindfulness is Associated with Greater Resilience and Less Emotional and Behavioral Problems in Adolescents

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Mindfulness is Associated with Greater Resilience and Less Emotional and Behavioral Problems in Adolescents

 

By John M. de Castro, Ph.D.

 

“mindfulness practice could be beneficial to teens, helping them cultivate empathy, as well as skills for concentration and impulse control. In short, mindfulness can help adolescents navigate the challenges of adolescence.” – Sarah Rundell Beach

 

Adolescence is a time of mental, physical, social, and emotional growth. It is during this time that higher levels of thinking, sometimes called executive function, develops. But adolescence can be a difficult time, fraught with challenges. During this time the child transitions to young adulthood; including the development of intellectual, psychological, physical, and social abilities and characteristics. There are so many changes occurring during this time that the child can feel overwhelmed and unable to cope with all that is required. This can lead to emotional and behavioral problems.

 

Indeed, up to a quarter of adolescents suffer from depression or anxiety disorders, and an even larger proportion struggle with subclinical symptoms. Mindfulness training in adults has been shown to reduce anxiety and depression levels and improve resilience and emotional regulation. In addition, in adolescents it has been shown to improve emotion regulation and to benefit the psychological and emotional health.

 

In today’s Research News article “Mindfulness, Life Skills, Resilience, and Emotional and Behavioral Problems for Gifted Low-Income Adolescents in China.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2020.00594/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1293822_69_Psycho_20200407_arts_A), Huang and colleagues recruited low-income gifted high school students and measured them for emotional and behavioral problems, including both internalizing and externalizing behaviors, resilience, life skills, including  self-control, assertiveness, refusal and relaxation, and mindfulness.

 

They found that the higher the levels of mindfulness the higher the levels of resilience and life skills and the lower the levels of emotional and behavioral problems. They also found that the higher the levels of life skills the higher the levels of mindfulness and resilience and the lower the levels of emotional and behavioral problems. Structural modelling revealed that mindfulness and life skills were associated with reduced emotional and behavioral problems both directly and indirectly by being associated with higher levels of resilience that was in turn associated with lower levels of emotional and behavioral problems.

 

These results are interesting but correlational and as such causation cannot be determined. Nevertheless, they suggest that the emotional and behavioral problems of gifted adolescents from low-income families are to some extent reduced by having strong mindfulness, resilience, and life skills. Additionally, the findings suggest that mindfulness and life skills are not only directly related to less emotional and behavioral problems but also indirectly by being related to higher levels of resilience. It remains for future research to determine if these connections are causal by training adolescents in mindfulness and life skills and observing if there are increases in resilience and decreases in emotional and behavioral problems.

 

So, mindfulness is associated with greater resilience and less emotional and behavioral problems in adolescents.

 

“Mindfulness processes and practices can help young people develop emotional resilience, self-awareness and regulation skills that assist them in taking greater responsibility for their behaviors, decisions and relationships.” – Jennifer Frank

 

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

 

Huang C-C, Chen Y, Jin H, Stringham M, Liu C and Oliver C (2020) Mindfulness, Life Skills, Resilience, and Emotional and Behavioral Problems for Gifted Low-Income Adolescents in China. Front. Psychol. 11:594. doi: 10.3389/fpsyg.2020.00594

 

In contrast to emotional and behavioral problems (EBPs), which can disrupt normal adolescent development, resilience can buffer the effects of stress and adverse childhood experiences and can help youth overcome adversity. While research has looked at the relationship between adolescent resilience and EBPs, current literature relatively lack a discussion of a strengths-based approach of resilience framework, nor discuss non-western sociocultural contexts. In this study, we utilized the resilience theory to examine the effects of individual mindfulness and life skills on resilience and consequently on EBPs in a group of low-income and gifted adolescents in China. A secondary data of 152 adolescents from a specialized school for low-income and gifted students in Guangzhou, China was used for the analysis. The findings from structural equation modeling indicated that mindfulness and life skills were associated with heightened resilience and reduced EBPs. In addition, resilience reduced EBPs for this group of adolescents. These findings underscore the promise of mindfulness and life skills training on increasing resilience and reducing EBPs in gifted adolescents.

https://www.frontiersin.org/articles/10.3389/fpsyg.2020.00594/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1293822_69_Psycho_20200407_arts_A

 

Improve Psychological Well-Being at Work with a Mindfulness App

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Improve Psychological Well-Being at Work with a Mindfulness App

By John M. de Castro, Ph.D.

“Mindfulness is not about living life in slow motion. It’s about enhancing focus and awareness both in work and in life. It’s about stripping away distractions and staying on track with individual, as well as organizational, goals.” Jacqueline Carter

 

Work is very important for our health and well-being. We spend approximately 25% of our adult lives at work. Indeed, the work environment has even become an important part of our social lives, with friendships and leisure time activities often attached to the people we work with. But, more than half of employees in the U.S. and nearly 2/3 worldwide are unhappy at work. This is partially due to work-related stress which is epidemic in the western workplace. Almost two thirds of workers reporting high levels of stress at work. This stress can result in impaired health and can result in burnout; producing fatigue, cynicism, and professional inefficacy.

 

To help overcome unhappiness, stress, and burnout, mindfulness practices have been implemented in the workplace. These mindfulness practices have been shown to markedly reduce the physiological and psychological responses to stress. As a result, it has become very trendy for business to incorporate meditation into the workday to help improve employee well-being, health, and productivity.

 

The vast majority of the mindfulness training techniques, however, require a trained teacher. The participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with busy employee 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. But the question arises as to the effectiveness of these apps in inducing mindfulness and reducing stress and improving psychological well-being in employees in real-world work settings.

 

In today’s Research News article “Mindfulness on-the-go: Effects of a mindfulness meditation app on work stress and well-being.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6215525/), Bostock and colleagues recruited healthy adults in the workplace and randomly assigned them to either a wait-list control condition or to 45 days of daily mindfulness training with the “Headspace” app for their smartphones. They were measured before and after the intervention and 8 weeks later for blood pressure and daily well-being at 5 different times during the day, psychological well-being, anxiety, depression, job strain, job status, workplace social support, and mindfulness.

 

They found that in comparison to baseline and the wait-list controls the participants who used the mindfulness training app had significantly higher levels of psychological well-being, daily positive emotions, and workplace social support and significantly lower levels of blood pressure, anxiety, depression, and job strain. They found that these benefits only occurred in participants who completed 10 or more practice sessions. Most of these improvements were maintained at the 8-week follow-up.

 

The research design contained a control condition but the condition was not active. This leaves open the possibility of placebo effects, demand characteristics, and experimenter bias. Employees that used the app less than 10 times, however, could be seen as an active control and they did not show improvements. Nevertheless, the results suggest that using a mindfulness training smartphone app can improve the psychological well-being of employees in the workplace. Since they can receive the training at their own convenience and schedule, it is especially applicable to busy real-world work environments. The low cost of this training suggests that it can be used over large numbers of employees, at diverse locations.

 

So, improve psychological well-being at work with a mindfulness app.

 

“mindfulness and mindfulness-based practices improve self-regulation of thoughts, emotions, and behaviors, linking them to both performance and employee well-being in the workplace.” Theresa Glomb

 

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

 

Bostock, S., Crosswell, A. D., Prather, A. A., & Steptoe, A. (2019). Mindfulness on-the-go: Effects of a mindfulness meditation app on work stress and well-being. Journal of occupational health psychology, 24(1), 127–138. https://doi.org/10.1037/ocp0000118

 

Abstract

We investigated whether a mindfulness meditation program delivered via a smartphone application (app) could improve psychological well-being, reduce job strain, and reduce ambulatory blood pressure during the workday. Participants were 238 healthy employees from two large UK companies that were randomized to a mindfulness meditation practice app or a wait-list control condition. The app offered 45 pre-recorded 10–20 minute guided audio meditations. Participants were asked to complete one meditation per day. Psychosocial measures, and blood pressure throughout one working day, were measured at baseline and 8 weeks later; a follow-up survey was also emailed to participants 16 weeks after the intervention start. Usage data showed that during the 8-week intervention period, participants randomized to the intervention completed an average of 17 meditation sessions (range 0 to 45 sessions). The intervention group reported significant improvement in well-being, distress, job strain, and perceptions of workplace social support compared to the control group. In addition, the intervention group had a marginally significant decrease in self-measured workday systolic blood pressure from pre to post intervention. Sustained positive effects in the intervention group were found for well-being and job strain at the 16-week follow-up assessment. This trial suggests that short guided mindfulness meditations delivered via smartphone and practiced multiple times per week can improve outcomes related to work stress and well-being, with potentially lasting effects.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6215525/

 

Improve Emotion Regulation and Reduce Pain with Mindful Acceptance

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Improve Emotion Regulation and Reduce Pain with Mindful Acceptance

 

By John M. de Castro, Ph.D.

 

“Individuals with minimal mindfulness meditation experience can quickly learn how to moderate their brains’ responses to painful experiences and negative images using a technique called mindful acceptance’” – Christopher Berglund

 

There is an accumulating volume of research findings to demonstrate that mind-body therapies have highly beneficial effects on the health and well-being of humans. Mindfulness practices have been shown to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. In other words, mindful people are better able to experience yet control their responses to emotions. The ability of mindfulness training to improve emotion regulation is thought to be the basis for a wide variety of benefits that mindfulness provides to mental health

Indeed, mindfulness practices are effective in treating pain in adults.

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. Pain involves both physical and psychological issues. The stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. So, reducing the emotional reactions to pain may be helpful in pain management. Emotional and pain experiences are processed in the nervous system. So, it’s likely that mindfulness practices somehow alters the brain’s processing of emotions and pain.

 

In today’s Research News article “Let it be: mindful acceptance down-regulates pain and negative emotion.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7057281/), Kober and colleagues recruited healthy adults and instructed them to on cue to “react naturally, whatever your response might be” and on another cue to accept. They were instructed for the accept condition to be mindful in the present moment and not judge what is happening but to accept it as it is. They then underwent brain scanning with functional Magnetic Resonance Imaging (fMRI). While in the scanner they were presented with a cue to either react or accept their experience. They were then presented with either neutral or emotionally negative images or a warm or hot thermal stimulus on their forearm. Afterward they rated how negatively they felt.

 

They found that the participants rated the emotionally negative picture and the hot stimulus as more negative than the neutral pictures or warm stimulus. But after the accept cue they reported lower negative ratings to both the negative images and hot stimulus. Hence, expressing an attitude of mindful acceptance produced lesser negative reactions to negative emotional and thermal stimuli.

 

The brain activity to the stimuli revealed that during the accept condition there was less activity in the amygdala than during the react condition. The painful, hot, thermal stimulus produced increased brain activity in widespread regions but during the mindful acceptance condition, the activations were significantly lower. Hence, expressing an attitude of mindful acceptance produced less brain activation to negative stimuli.

 

It should be pointed out that the study design contains considerable demand characteristics. Instructing a participant to take on an attitude of non-judging acceptance cues the participant that less reaction is expected. This demand characteristic may account for the ratings. It is less likely, though, that it could account for differential brain activations. Of course, demand characteristics probably have their effects by altering brain processing of the conditions.

 

Regardless, these findings are interesting and demonstrate that a brief mindfulness instruction is sufficient to alter the participants’ experiences of and the responses of their brains to neutral and negative experiences. In addition, the instruction appears to be sufficient to alter the experience of and brain activity to painful stimuli. This suggest that the mindful acceptance instruction produced an improved ability to regulate emotional reactions and experiences of pain and the brains responses to these conditions.

 

It has been repeatedly demonstrated in prior research that mindfulness improves emotion regulation and reduces pain perception. So, the present findings are compatible with prior findings. The contribution of the present study is the demonstration that a brief instruction and training in taking on an attitude of mindful acceptance is sufficient to produce these effects. It remains for future research to determine if this instruction is sufficient to alter real world reactions.

 

So, improve emotion regulation and reduce pain with mindful acceptance.

 

“The ability to stay in the moment when experiencing pain or negative emotions suggests there may be clinical benefits to mindfulness practice in chronic conditions as well — even without long meditation practice.” – Hedy Kober

 

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

 

Kober, H., Buhle, J., Weber, J., Ochsner, K. N., & Wager, T. D. (2019). Let it be: mindful acceptance down-regulates pain and negative emotion. Social cognitive and affective neuroscience, 14(11), 1147–1158. https://doi.org/10.1093/scan/nsz104

 

Abstract

Mindfulness training ameliorates clinical and self-report measures of depression and chronic pain, but its use as an emotion regulation strategy—in individuals who do not meditate—remains understudied. As such, whether it (i) down-regulates early affective brain processes or (ii) depends on cognitive control systems remains unclear. We exposed meditation-naïve participants to two kinds of stimuli: negative vs. neutral images and painful vs. warm temperatures. On alternating blocks, we asked participants to either react naturally or exercise mindful acceptance. Emotion regulation using mindful acceptance was associated with reductions in reported pain and negative affect, reduced amygdala responses to negative images and reduced heat-evoked responses in medial and lateral pain systems. Critically, mindful acceptance significantly reduced activity in a distributed, a priori neurologic signature that is sensitive and specific to experimentally induced pain. In addition, these changes occurred in the absence of detectable increases in prefrontal control systems. The findings support the idea that momentary mindful acceptance regulates emotional intensity by changing initial appraisals of the affective significance of stimuli, which has consequences for clinical treatment of pain and emotion.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7057281/