Fatigue

Mindful Eating is Related to Less Binge Eating and Fewer Mood Disorders

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Mindful Eating is Related to Less Binge Eating and Fewer Mood Disorders

 

By John M. de Castro, Ph.D.

 

“Paying attention to what you are eating is the most effective way to attain a positive relationship with food and therefore find your ideal healthy weight.” – UT Counseling

 

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

 

Eating disorders can be difficult to treat because eating is necessary and cannot be simply stopped as in smoking cessation or abstaining from drugs or alcohol. One must learn to eat appropriately not stop. So, it is important to find methods that can help prevent and treat eating disorders. Contemplative practices, mindfulness, and mindful eating have shown promise for treating eating disorders.

 

Mindful eating involves paying attention to eating while it is occurring, including attention to the sight, smell, flavors, and textures of food, to the process of chewing and may help reduce intake by affecting the individual’s response to non-homeostatic cues for eating. Indeed, high levels of mindfulness are associated with lower levels of obesity and mindful eating has been shown to improve eating behaviors. Hence, mindful eating may counter binge eating. So, it is important to investigate the relationship of mindful eating to mood and binge eating.

 

In today’s Research News article “Mindfulness in Eating Is Inversely Related to Binge Eating and Mood Disturbances in University Students in Health-Related Disciplines.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7071141/ ) Giannopoulou and colleagues recruited college students and had them complete online measures of mood, mindful eating, and binge eating. They then compared students with binge eating to non-binge eaters and the data were subjected to regression analysis.

 

They found that 41% of the students met the criterion for binge eating. In comparison to non-binge eating students, the binge eaters had significantly higher levels of tension, depression, anger, fatigue, and confusion and significantly lower levels of vigor and mindful eating. Similarly, female students had significantly higher levels of tension, depression, anger, fatigue, and confusion and significantly lower levels of vigor and mindful eating. In addition, the higher the level of mindful eating the higher the mood scores and the lower the binge eating score.

 

It should be noted that these results are correlational. So, conclusions about causation cannot be made directly. But prior research has demonstrated that training in mindfulness produces reductions in binge eating and improvements in mood. Including decreases in, depression, anger, and fatigue. So, the present results probably result from causal connections.

 

The results then suggest that binge eating is associated with negative mood states. College students are particularly vulnerable to negative moods and binge eating. The results also suggest that mindful eating may be an antidote to negative moods and binge eating. This suggests that training in mindful eating might work to lessen or prevent these problems so rampant in college students.

 

So, mindful eating is related to less binge eating and fewer mood disorders.

 

“Practicing mindfulness can help you recognize when you’re no longer hungry, which can improve your eating behaviors and reduce the incidence of binge eating.” – Rachel Link

 

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

 

Giannopoulou, I., Kotopoulea-Nikolaidi, M., Daskou, S., Martyn, K., & Patel, A. (2020). Mindfulness in Eating Is Inversely Related to Binge Eating and Mood Disturbances in University Students in Health-Related Disciplines. Nutrients, 12(2), 396. https://doi.org/10.3390/nu12020396

 

Abstract

The purpose of the study was to investigate the relationship between mindful eating, disordered eating and mood in university students in health-related disciplines. A total of 221 university students participated in the study; 102 students studied sport and exercise science (SS), 54 students pharmacy sciences (PS), and 65 students health sciences (HS). Participants completed the Binge Eating Scale (BES), the Mindful Eating Questionnaire (MEQ), and the Profile of Mood State questionnaire (POMS). 41% of the students were classified as binge eaters and 57% were above the POMS threshold of depression. Binge eaters were found to have significantly lower MEQ score and significantly higher total mood disturbance scores (TMD) compared to non-binge eaters (p < 0.01). Students with a high depression score exhibited no differences in the MEQ score but a significantly higher BES score compared to non-depressed students (p < 0.01). Gender differences were found in the MEQ with females exhibiting significantly higher scores in the MEQ score and in all MEQ subscales compared to males, with the exception of the emotional subscale that females were noted to have a lower score compared to males (p < 0.01). The MEQ score was inversely related to the BES score (r = −0.30, p < 0.01) and TMD (r = −0.21, p < 0.05). The MEQ score was a significant negative predictor of the variance of the binge eating behavior of the students (B = −3.17, p < 0.001). In conclusion, mindfulness in eating is inversely related to the binge eating behavior and mood state of university students studying health-related subjects and is a significant negative predictor of disordered eating behavior in this high risk population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7071141/

 

Improve Stress Responding, Health, and Well-Being with Qigong

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Improve Stress Responding, Health, and Well-Being with Qigong

 

By John M. de Castro, Ph.D.

 

“Qigong is an extraordinary tool for reducing the harmful effects of stress. The three pillars of qigong practice are body, breath, and mind. If your body is relaxed your breathing will slow down. When your breath is slow, you feel more centered, more calm, and more in touch with yourself” – Kenneth Cohen

 

Tai Chi and Qigong are ancient mindfulness practices involving slow prescribed movements. They are gentle and completely safe, can be used with the elderly and sickly, are inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, they can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice.

 

Tai Chi and Qigong are both mindfulness practices and gentle exercises. They have been shown to be beneficial for the health and well-being of individuals of a variety of ages, but particularly the elderly. They also improve the symptoms of a variety of diseases. One way that these practices may improve health and well-being is by reducing stress. The studies of the benefits for health of Tai Chi and Qigong are accumulating and so it makes sense to take a moment to summarize what has been learned about the benefits of Qigong practice.

 

In today’s Research News article “Individual Stress Prevention through Qigong.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7579037/ )  van Dam reviews and summarizes the published research studies of the effects of Qigong practice on stress. She reports that the published studies found that Qigong practice improves the cardiovascular system including a significant reduction in blood pressure and an increase in heartrate variability, an indicator of parasympathetic relaxation. It improves the respiratory system including increased lung capacity, oxygen intake and breathing patterns. It improves immune function and reduces inflammatory responses. It improves both psychological and physiological responses to stress. It improves sleep quality and reduces fatigue. It reduces depression and both acute and chronic anxiety.

 

These findings are remarkable and suggest that this gentle safe practice markedly improves the physical and mental well-being and health of the practitioners. Many of these benefits may result from the ability of Qigong practice to improve stress responding. Stress impairs health and well-being and Qigong practice appears to counteract these effects.

 

So, improve stress responding, health, and well-being with Qigong.

 

“Qi Gong helps you develop a crystal clear mind as you connect with the present moment, letting go of the stress of daily life and relaxing deeply.”- Nick Jankel

 

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

 

van Dam K. (2020). Individual Stress Prevention through Qigong. International journal of environmental research and public health, 17(19), 7342. https://doi.org/10.3390/ijerph17197342

 

Abstract

Owing to work intensification and an accelerated pace of life in general, individuals in many Western countries are often overactivated and find it difficult to switch off. However, recovery from physiological and mental activation is critical to prevent stress symptoms and maintain one’s physiological and mental well-being. Extensive research evidence indicates that Qigong, a traditional Chinese movement practice for promoting health, provides an effective means to recover from work and off-work demands. The main objective of this paper is to offer a comprehensive, narrative review of the effects of Qigong and its core components. Attention is first paid to the outcomes of work and off-work demands and stress, and the role of recovery for individuals’ well-being. Then, Qigong and its components are explained, followed by the results of scientific research. Finally, limitations and implications for research and practiced are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7579037/

 

Improve the Psychological Health of Cancer Patients with Mindfulness Taught over the Internet

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Improve the Psychological Health of Cancer Patients with Mindfulness Taught over the Internet

 

By John M. de Castro, Ph.D.

 

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

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress,  sleep disturbance, fear, and anxiety and depression. The vast majority of the mindfulness training techniques, however, require a trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient.

 

As an alternative, mindfulness training over the internet 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 addition, research has indicated that mindfulness training online can be effective for improving the health and well-being of the participants. The research has been accumulating. So, it makes sense to step back and summarize what has been learned about the effectiveness of mindfulness training over the internet in treating the psychological symptoms of cancer patients.

 

In today’s Research News article “Mindfulness-Based Programs for Patients With Cancer via eHealth and Mobile Health: Systematic Review and Synthesis of Quantitative Research.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704284/ ) Matis and colleagues review, summarize, and perform a meta-analysis on the published research studies on the effectiveness of mindfulness training over the internet in treating the psychological symptoms of cancer patients. They identified 24 published research studies including at least 4 weeks of mindfulness training delivered over the internet.

 

They report that the published research studies found that mindfulness training delivered over the internet to cancer patients produced significant decreases in stress, anxiety, depression, pain, fatigue, and sleep problems, and significant increases in mindfulness, posttraumatic growth, and some parameters of general health. In the few studies where long-term follow-up measures were obtained the effects were maintained.

 

These are very promising results that suggest that mindfulness training over the internet is a safe and effective treatment for the psychological issues common in cancer survivors. Mindfulness training, in general, has been shown in a large number of previous studies o be effective in reducing stress, anxiety, depression, pain, fatigue, and sleep problems, and significant increases in mindfulness, posttraumatic growth, and some parameters of general health. So, the present study simply extends these findings to patients with cancer who receive mindfulness training over the internet.

 

These results are important as good mental health, particularly the ability to cope with stress, are predictors of good health outcomes. In addition, the fact that the interventions were provided over the internet allows for cost-effective and convenient delivery to patients. This makes participation and compliance more likely and effective. Hence, internet-based mindfulness training may help relieve the psychological suffering of patients diagnosed with cancer and should be included in their treatment plan.

 

So, improve the psychological health of cancer patients with mindfulness taught over the internet.

 

“Both MBCT and eMBCT significantly reduced fear of cancer recurrence and rumination and increased mental health–related quality of life, mindfulness skills, and positive mental health.” – Matthew Stenger

 

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

 

Matis, J., Svetlak, M., Slezackova, A., Svoboda, M., & Šumec, R. (2020). Mindfulness-Based Programs for Patients With Cancer via eHealth and Mobile Health: Systematic Review and Synthesis of Quantitative Research. Journal of medical Internet research, 22(11), e20709. https://doi.org/10.2196/20709

 

Abstract

Background

eHealth mindfulness-based programs (eMBPs) are on the rise in complex oncology and palliative care. However, we are still at the beginning of answering the questions of how effective eMBPs are and for whom, and what kinds of delivery modes are the most efficient.

Objective

This systematic review aims to examine the feasibility and efficacy of eMBPs in improving the mental health and well-being of patients with cancer, to describe intervention characteristics and delivery modes of these programs, and to summarize the results of the included studies in terms of moderators, mediators, and predictors of efficacy, adherence, and attrition.

Methods

In total, 4 databases (PubMed, PsycINFO, Scopus, and Web of Knowledge) were searched using relevant search terms (eg, mindfulness, program, eHealth, neoplasm) and their variations. No restrictions were imposed on language or publication type. The results of the efficacy of eMBPs were synthesized through the summarizing effect estimates method.

Results

A total of 29 published papers describing 24 original studies were included in this review. In general, the results indicate that eMBPs have the potential to reduce the levels of stress, anxiety, depression, fatigue, sleep problems, and pain, and improve the levels of mindfulness, posttraumatic growth, and some parameters of general health. The largest median of Cohen d effect sizes were observed in reducing anxiety and depression (within-subject: median −0.38, IQR −0.62 to −0.27; between-group: median −0.42, IQR −0.58 to −0.22) and facilitating posttraumatic growth (within-subject: median 0.42, IQR 0.35 to 0.48; between-group: median 0.32, IQR 0.22 to 0.39). The efficacy of eMBP may be comparable with that of parallel, face-to-face MBPs in some cases. All studies that evaluated the feasibility of eMBPs reported that they are feasible for patients with cancer. Potential moderators, mediators, and predictors of the efficacy, attrition, and adherence of eMBPs are discussed.

Conclusions

Although the effects of the reviewed studies were highly heterogeneous, the review provides evidence that eMBPs are an appropriate way for mindfulness practice to be delivered to patients with cancer. Thus far, existing eMBPs have mostly attempted to convert proven face-to-face mindfulness programs to the eHealth mode. They have not yet fully exploited the potential of eHealth technology.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704284/

 

Reduce Fatigue and Improve Quality of Life of Breast Cancer Survivors with Yoga

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Reduce Fatigue and Improve Quality of Life of Breast Cancer Survivors with Yoga

 

By John M. de Castro, Ph.D.

 

“For women with breast cancer, research shows those who practice yoga may also have less stress and fatigue, and better quality of life.” – Stacie Simon

 

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

 

Mindfulness training has been shown to help with general cancer recovery. Mindfulness practices have been shown to improve the residual symptoms in cancer survivors.  Yoga is both an exercise and a mindfulness practice that has also been shown to be helpful with the residual symptoms in cancer survivors, the psychological and physical ability to deal with cancer treatment and improves sleep. The research on yoga practice as a treatment for patients recovering from breast cancer has been accumulating. It is thus reasonable to take a step back and summarize what has been learned.

 

In today’s Research News article “The Effect of Yoga Interventions on Cancer-Related Fatigue and Quality of Life for Women with Breast Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7580184/ ) O’Neill and colleagues review, summarize, and perform a meta-analysis of published randomized controlled trials of the effects of yoga practice on the fatigue and quality of life of breast cancer survivors. They identified 24 published randomized controlled trials.

 

They report that the published trials revealed that yoga practice produced significant reductions in cancer related fatigue and increases in the women’s quality of life. This was true overall and for the 18 trials with a passive control group such as a wait-list control, but not for the 6 trials with an active control group, such as physical exercise or supportive therapy. Hence, yoga practice appears to be beneficial for breast cancer survivors reducing fatigue and improving quality of life. But the benefits are comparable to those produced by other exercises or therapies.

 

So, reduce fatigue and improve quality of life of breast cancer survivors with yoga.

 

“A targeted yoga intervention led to significant improvements in fatigue and vigor among breast cancer survivors with persistent fatigue symptoms.” – Julienne Bower

 

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

 

O’Neill, M., Samaroo, D., Lopez, C., Tomlinson, G., Santa Mina, D., Sabiston, C., Culos-Reed, N., & Alibhai, S. (2020). The Effect of Yoga Interventions on Cancer-Related Fatigue and Quality of Life for Women with Breast Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Integrative cancer therapies, 19, 1534735420959882. https://doi.org/10.1177/1534735420959882

 

Abstract

Background:

Women with breast cancer (BC) are living longer with debilitating side effects such as cancer-related fatigue (CRF) that affect overall well-being. Yoga promotes health, well-being and may be beneficial in reducing CRF. Although there have been previous systematic reviews and meta-analyses, the effects of yoga on CRF and quality of life (QOL) remain unclear, particularly in comparison with other types of physical activity (PA). Our objective is to carry out a systematic review and meta-analysis of the effects of yoga on CRF and QOL in women with BC.

Methods:

Electronic databases were searched (MEDLINE, Embase Classic+Embase and EMB Reviews, Cochrane Central CT) from inception to May 2018. Randomized controlled trials were included if they were full text, in English, included a yoga intervention, a comparator (including non-PA usual care or alternate PA intervention), and reported on CRF or QOL. Effects of yoga were pooled using standardized mean difference (SMD) via a random effects model.

Results:

Of the 2468 records retrieved, 24 trials were included; 18 studies compared yoga to a non-PA comparator and 6 to a PA comparator. Yoga demonstrated statistically significant improvements in CRF over non-PA (SMD −0.30 [−0.51; −0.08]) but not PA (SMD −0.17 [−0.50; 0.17]) comparators. Additionally, yoga demonstrated statistically significant improvements in QOL over non-PA (SMD −0.27 [−0.46; −0.07]) but not PA (SMD 0.04 [−0.22; +0.31]) comparators.

Discussion:

This meta-analysis found that yoga provides small to medium improvements in CRF and QOL compared to non-PA, but not in comparison to other PA interventions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7580184/

 

Manage Symptoms in Cancer Survivors with Yoga

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Manage Symptoms in Cancer Survivors with Yoga

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

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

 

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

 

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

 

So, manage symptoms in cancer survivors with yoga.

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

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

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

 

Improve Autonomic Nervous System Function and Well-Being in Cancer Survivors with Mind-Body Practices.

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Improve Autonomic Nervous System Function and Well-Being in Cancer Survivors with Mind-Body Practices.

 

By John M. de Castro, Ph.D.

 

“Tai Chi and Qigong are ancient forms of exercise that fit the bill for helping patients with cancer get moving and improve their overall sense of well-being. Tai Chi practice can help with pain conditions, especially pain involving muscles and joints; it can also reduce stress and anxiety and improve the quality of sleep.” – Susan Yaguda

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress, sleep disturbance, fear, and anxiety and depression. Mind-body practices such as Tai Chi or Qigong, and yoga have been shown to be effective in improving the psychological symptoms occurring in breast cancer patients. These practices work to relieve the emotional distress of cancer survivors.

 

A potential mechanism by which mind-body practices may relieve emotional distress is by altering the balance in the autonomic nervous system. A measure of this balance is Heart Rate Variability (HRV). It refers to the change in the time intervals between consecutive heart beats. Higher levels of HRV are indicative of flexibility in the Autonomic Nervous System and are associated with adaptability to varying environments. Increased heart rate variability signals greater relaxation in the autonomic nervous system with a predominance of parasympathetic (relaxation) activity over sympathetic (activation) activity. This all signals greater physiological relaxation.

 

In today’s Research News article “Mind-Body and Psychosocial Interventions May Similarly Affect Heart Rate Variability Patterns in Cancer Recovery: Implications for a Mechanism of Symptom Improvement.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425257/ ) Larkey and colleagues recruited female breast cancer survivors and randomly assigned them to receive 12 weeks of either Tai Chi or Sham-Tai Chi practice. Sham-Tai Chi used the same movements but did not incorporate breath control or meditative states. They were measured before and after training for fatigue, sleep, and depression and the electrocardiogram was measured and analyzed for Heart Rate Variability (HRV).

 

They found that after Tai Chi Practice, but not Sham-Tai Chi, there were significant reductions in fatigue and depression and significant improvements in sleep. In addition, in the Tai Chi group there was a significant reduction in low coherence Heart Rate Variability (HRV). Also, the greater the change, over training, in high coherence HRV the greater the reduction in depression levels.

 

This study replicates previous findings that Tai Chi practice reduces fatigue, and depression, and improves sleep. And produces changes in Heart Rate Variability (HRV). But this study used a unique control, comparison, condition of Sham-Tai Chi that had the same movements but lacked the breath control and meditative state of true Tai Chi practice. This suggests that it is not the movements of Tai Chi that produces the benefits but the mindfulness components that are essential.

 

The study also presents some evidence as to the mechanism by which Tai Chi practice improves that physical and psychological state of cancer survivors. The observed changes in Heart Rate Variability (HRV) are indicative of greater relaxation in the autonomic nervous system with a predominance of parasympathetic (relaxation) activity over sympathetic (activation) activity. This suggests that Tai Chi practice results in a physiological relaxation that in turn may be responsible for the physical and psychological benefits of the practice.

 

Some advantages of Tai Chi practice include the facts that it is not strenuous, involves slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It can also be practiced without professional supervision and in groups making it inexpensive to deliver and fun to engage in. This makes Tai Chi practice an excellent means to improve the physical and psychological symptoms experienced by cancer survivors.

 

So, improve autonomic nervous system function and well-being in cancer survivors with mind-body practices.

 

“Research in breast cancer patients has shown that tai chi may help to increase strength, balance, flexibility, heart and lung function, [and] feelings of well-being.” – Breast Cancer.org

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

 

Larkey, L., Kim, W., James, D., Kishida, M., Vizcaino, M., Huberty, J., & Krishnamurthi, N. (2020). Mind-Body and Psychosocial Interventions May Similarly Affect Heart Rate Variability Patterns in Cancer Recovery: Implications for a Mechanism of Symptom Improvement. Integrative cancer therapies, 19, 1534735420949677. https://doi.org/10.1177/1534735420949677

 

Abstract

Background:

Advancements in early detection and treatment of cancer have led to increased survival rates and greater need to identify effective supportive care options for resolving symptoms of survivorship. Many non-pharmacological approaches to symptom management during and after cancer treatment involve emotional self-regulation as a central strategy for improving well-being. Identifying commonalities among these strategies’ mechanisms of action may facilitate understanding of what might be useful for optimizing intervention effects. Heart rate variability (HRV) parameters are indicative of improved autonomic nervous system (ANS) balance and resiliency and reduced emotional distress and are thus identified as a mechanism to discuss as a marker of potential for intervention efficacy and a target for optimization.

Methods:

HRV data from 2 studies, 1 examining a mind-body intervention and 1 examining a psychosocial intervention, are presented as a point of discussion about preliminary associations between the interventions, change in HRV, and emotional distress reduction.

Results:

HRV significantly decreased in sympathetic activity in response to a mind-body intervention (Qigong/Tai Chi), and increased vagal tone in response to a psychosocial (storytelling) intervention. In both, these changes in HRV parameters were associated with improved emotional states.

Conclusion:

Our preliminary data suggest that HRV may serve as an important marker of underlying changes that mediate emotional regulation; this observation deserves further investigation. If identified as a worthy target, focusing on interventions that improve HRV within the context of interventions for cancer patients may be important to key outcomes and clinical practice.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425257/

 

Spirituality is Associated with Better Psychological Health of Adolescents with Cancer

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Spirituality is Associated with Better Psychological Health of Adolescents with Cancer

 

By John M. de Castro, Ph.D.

 

“Spirituality plays a significant role for adolescents with cancer as it contributes to increased comfort and calmness, and better coping mechanisms when confronted with the illness, which indirectly improves the adolescent’s quality of life.” – Sembiring Lina Mahayati

 

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

 

Religion and spirituality become much more important to people when they’re diagnosed with cancer or when living with cancer. It is thought that people take comfort in the spiritual when facing mortality. Hence, spirituality and mindfulness may be useful tools for the survivors of cancer to cope with their illness. Thus, there is a need to study the relationships of spirituality on the ability of adolescent cancer survivors to positively adjust to their situation.

 

In today’s Research News article “.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298609/ ) Grossoehme and colleagues recruited adolescents, aged 14 to 21 years, who were diagnosed with cancer. They had them complete measures of spirituality, feeling God’s presence; praying privately; attending religious services; identifying as religious; identifying as spiritual, emotional distress–anxiety; emotional distress–depressive symptoms; fatigue; and pain interference, health-related quality of life

 

They found that the higher the levels of feeling God’s presence and identifying as a very religious person the lower the levels of anxiety, depressive symptoms, and fatigue. Structural equation modelling revealed that the levels of feeling God’s presence and identifying as a very religious person also were indirectly associated with anxiety, depressive symptoms, and fatigue via a positive association with a sense of meaning and peace. That is, the greater the feelings God’s presence and religiosity the greater the feelings of peace and meaningfulness in life and these feelings were in turn negatively associated with negative emotional states.

 

These results are correlational and as such no conclusions about causation can be definitively made. But the results clearly show that there are relationships between being spiritual and religious and better emotional states in adolescent cancer victims. They also suggest that this relationship is mediated by feelings of meaningfulness and peace. It could be speculated that these relationships occur due to causal connections and interpreted that being spiritual produces a state of peacefulness and meaning in life that counteracts the negative emotions associated with cancer. It remains for future research to determine if increasing spirituality would lead to better emotional adjustments to a cancer diagnosis.

 

Hence, spirituality is associated with better psychological health of adolescents with cancer.

 

“As is true with older cancer survivors, spirituality is related to many aspects of well-being for AYA survivors, but relations are more consistent for meaning/peace and struggle.” – Crystal Park

 

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

 

Grossoehme, D. H., Friebert, S., Baker, J. N., Tweddle, M., Needle, J., Chrastek, J., Thompkins, J., Wang, J., Cheng, Y. I., & Lyon, M. E. (2020). Association of Religious and Spiritual Factors With Patient-Reported Outcomes of Anxiety, Depressive Symptoms, Fatigue, and Pain Interference Among Adolescents and Young Adults With Cancer. JAMA network open, 3(6), e206696. https://doi.org/10.1001/jamanetworkopen.2020.6696

 

Key Points

Question

Among adolescents and young adults with cancer, is there an association between spirituality and patient-reported outcomes, and are these outcomes associated with a sense of meaning, peace, and comfort provided by faith?

Findings

In this cross-sectional study of 126 adolescents and young adults with cancer, structural equation modeling revealed that meaning and peace were associated with aspects of spirituality and religiousness as well as anxiety, depressive, and fatigue symptoms.

Meaning

In this study, participants’ sense of meaning and peace was associated with religiousness and with anxiety and depression, possibly representing an underappreciated intervention target.

Question

Among adolescents and young adults with cancer, is there an association between spirituality and patient-reported outcomes, and are these outcomes associated with a sense of meaning, peace, and comfort provided by faith?

Findings

In this cross-sectional study of 126 adolescents and young adults with cancer, structural equation modeling revealed that meaning and peace were associated with aspects of spirituality and religiousness as well as anxiety, depressive, and fatigue symptoms.

Meaning

In this study, participants’ sense of meaning and peace was associated with religiousness and with anxiety and depression, possibly representing an underappreciated intervention target.

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Abstract

Importance

The associations of spiritual and religious factors with patient-reported outcomes among adolescents with cancer are unknown.

Objective

To model the association of spiritual and religious constructs with patient-reported outcomes of anxiety, depressive symptoms, fatigue, and pain interference.

Design, Setting, and Participants

This cross-sectional study used baseline data, collected from 2016 to 2019, from an ongoing 5-year randomized clinical trial being conducted at 4 tertiary-referral pediatric medical centers in the US. A total of 366 adolescents were eligible for the clinical trial, and 126 were randomized; participants had to be aged 14 to 21 years at enrollment and be diagnosed with any form of cancer. Exclusion criteria included developmental delay, scoring greater than 26 on the Beck Depression Inventory II, non-English speaking, or unaware of cancer diagnosis.

Exposures

Spiritual experiences, values, and beliefs; religious practices; and overall self-ranking of spirituality’s importance.

Main Outcomes and Measures

Variables were taken from the Brief Multidimensional Measurement of Religiousness/Spirituality (ie, feeling God’s presence, daily prayer, religious service attendance, being very religious, and being very spiritual) and the spiritual well-being subscales of the Functional Assessment of Chronic Illness Therapy (meaning/peace and faith). Predefined outcome variables were anxiety, depressive symptoms, fatigue, and pain interference from Patient-Reported Outcomes Measurement Information System pediatric measures.

Results

A total of 126 individuals participated (72 [57.1%] female participants; 100 [79.4%] white participants; mean [SD] age, 16.9 [1.9] years). Structural equation modeling showed that meaning and peace were inversely associated with anxiety (β = –7.94; 95% CI, –12.88 to –4.12), depressive symptoms (β = –10.49; 95% CI, –15.92 to –6.50), and fatigue (β = –8.90; 95% CI, –15.34 to –3.61). Feeling God’s presence daily was indirectly associated with anxiety (β = –3.37; 95% CI, –6.82 to –0.95), depressive symptoms (β = –4.50; 95% CI, –8.51 to –1.40), and fatigue (β = –3.73; 95% CI, –8.03 to –0.90) through meaning and peace. Considering oneself very religious was indirectly associated with anxiety (β = –2.81; 95% CI, –6.06 to –0.45), depressive symptoms (β = −3.787; 95% CI, –7.68 to –0.61), and fatigue (β = –3.11, 95% CI, –7.31 to –0.40) through meaning and peace. Considering oneself very spiritual was indirectly associated with anxiety (β = 2.11; 95% CI, 0.05 to 4.95) and depression (β = 2.8, 95% CI, 0.07 to 6.29) through meaning and peace. No associations were found between spiritual scales and pain interference.

Conclusions and Relevance

In this study, multiple facets of spirituality and religiousness were associated with anxiety, depression, and fatigue, all of which were indirectly associated with the participant’s sense of meaning and peace, which is a modifiable process. Although these results do not establish a causal direction, they do suggest palliative interventions addressing meaning-making, possibly including a spiritual or religious dimension, as a novel focus for intervention development.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298609/Importance

 

Improve Medically Unexplained Symptoms with Mindfulness

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Improve Medically Unexplained Symptoms with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindful people might have lower blood pressure, lower blood sugar, and better heart health. One study found that people who got a flu vaccine after 8 weeks of mindfulness training developed more antibodies against the flu than those who only got the vaccine. It may relieve symptoms of irritable bowel syndrome and cut down on migraines, too.” – WebMD

 

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.

 

A number of patients come to see a physician with long-lasting subjective symptoms that do not have a clear medical explanation. Examples are fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome. It is important to establish if mindfulness may also be effective for these medically unexplained symptoms. The evidence has been accumulating. It is important, then, to step back and summarize what has been learned.

 

In today’s Research News article “What Works in Mindfulness Interventions for Medically Unexplained Symptoms? A Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7373253/) Billones and Saligan review and summarize the published research studies on the effectiveness of mindfulness training for the treatment of patients with medically unexplained symptoms including fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome and post-traumatic stress disorder. They identified 24 controlled trials which included a total of 2126 participants who were primarily female (98%).

 

They report that the published studies found that in comparison to control conditions and baseline, mindfulness-based interventions produced significant reductions in symptom severity with moderate to large effect sizes. There were also significant improvements in pain, anxiety, and depression. The results suggest that mindfulness training is highly effective in reducing the symptoms of medically unexplained symptoms.

 

So, improve medically unexplained symptoms with mindfulness.

 

“it’s encouraging to know that something that can be taught and practiced can have an impact on our overall health—not just mental but also physical—more than 2,000 years after it was developed. That’s reason enough to give mindfulness meditation a try.” – Jill Suttie

 

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

 

Billones, R., & Saligan, L. (2020). What Works in Mindfulness Interventions for Medically Unexplained Symptoms? A Systematic Review. Asian/Pacific Island Nursing Journal, 5(1), 1–11. https://doi.org/10.31372/20200501.1082

 

Abstract

Background/Purpose: Mindfulness-based interventions (MBIs) have been used in medically unexplained symptoms (MUS). This systematic review describes the literature investigating the general effect of MBIs on MUS and identifies the effects of specific MBIs on specific MUS conditions. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Guidelines (PRISMA) and the modified Oxford Quality Scoring System (Jadad score) were applied to the review, yielding an initial 1,556 articles. The search engines included PubMed, ScienceDirect, Web of Science, Scopus, EMBASE, and PsychINFO using the search terms: mindfulness, or mediations, or mindful or MBCT or MBSR and medically unexplained symptoms or MUS or Fibromyalgia or FMS. A total of 24 articles were included in the final systematic review. Results/Conclusions: MBIs showed large effects on: symptom severity (d  = 0.82), pain intensity (d  = 0.79), depression (d  = 0.62), and anxiety (d  = 0.67). A manualized MBI that applies the four fundamental elements present in all types of interventions were critical to efficacy. These elements were psycho-education sessions specific to better understand the medical symptoms, the practice of awareness, the nonjudgmental observance of the experience in the moment, and the compassion to ones’ self. The effectiveness of different mindfulness interventions necessitates giving attention to improve the gaps that were identified related to home-based practice monitoring, competency training of mindfulness teachers, and sound psychometric properties to measure the mindfulness practice.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7373253/

 

Improve the Psychological Health in Breast Cancer Patients with Mindfulness

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Improve the Psychological Health in Breast Cancer Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is a state of mind which we can all acquire and use to support our wellbeing physically, emotionally and mentally.  . . Having cancer, or specifically breast cancer, is no exception. Our cancer experiences take up a lot of energies, mental focus and can drain us emotionally. It is important to have a few tools to help us create ‘down’ and ‘out’ times, and to replenish and reconnect with who we are. “ – Breast Cancer Now

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress,  sleep disturbance, fear, and anxiety and depression. There has been considerable research conducted on the effectiveness of mindfulness practices in treating the psychological issues associated with cancer. So, it makes sense to step back and summarize what has been learned.

 

In today’s Research News article “Mindfulness-based stress reduction for women diagnosed with breast cancer.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436161/), Schell and colleagues review, summarize, and perform a meta-analysis of the published research studies investigating the effectiveness of the Mindfulness-Based Stress Reduction (MBSR) program for the treatment of the psychological problems that occur in women who survive breast cancer. MBSR includes meditation, body scan, yoga practices, and discussion along with daily home practice. They identified 14 randomized controlled trials.

 

They report that the published research studies provide evidence that the Mindfulness-Based Stress Reduction (MBSR) program improves the quality of life and sleep and reduces anxiety, depression, and fatigue in breast cancer patients. The effect sizes are small and the effects were no longer present at long-term follow-up a year after the end of treatment. MBSR is a complex of practices and the research to date cannot differentiate which components or which combination of components are responsible for the benefits.

 

There is substantial evidence that mindfulness training improves quality of life and sleep and reduces anxiety, depression, and fatigue in a wide variety of healthy and ill individuals. The present results suggest that it also has these benefits for women suffering with breast cancer. Hence, MBSR may be recommended to improve the psychological health of breast cancer patients.

 

So, improve the psychological health in breast cancer patients with mindfulness.

 

“Studies have shown mindfulness-based stress reduction can be effective in alleviating anxiety and depression, decreasing long-term emotional and physical side effects of treatments and improving the quality of sleep in breast cancer patients.” – Breast Cancer Research Foundation

 

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

 

Schell, L. K., Monsef, I., Wöckel, A., & Skoetz, N. (2019). Mindfulness-based stress reduction for women diagnosed with breast cancer. The Cochrane database of systematic reviews, 3(3), CD011518. https://doi.org/10.1002/14651858.CD011518.pub2

 

Abstract

Background

Breast cancer is the most common cancer in women. Diagnosis and treatment may drastically affect quality of life, causing symptoms such as sleep disorders, depression and anxiety. Mindfulness‐based stress reduction (MBSR) is a programme that aims to reduce stress by developing mindfulness, meaning a non‐judgmental, accepting moment‐by‐moment awareness. MBSR seems to benefit patients with mood disorders and chronic pain, and it may also benefit women with breast cancer.

Objectives

To assess the effects of mindfulness‐based stress reduction (MBSR) in women diagnosed with breast cancer.

Search methods

In April 2018, we conducted a comprehensive electronic search for studies of MBSR in women with breast cancer, in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and two trial registries (World Health Organization’s International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov). We also handsearched relevant conference proceedings.

Selection criteria

Randomised clinical trials (RCTs) comparing MBSR versus no intervention in women with breast cancer.

Data collection and analysis

We used standard methodological procedures expected by Cochrane. Using a standardised data form, the review authors extracted data in duplicate on methodological quality, participants, interventions and outcomes of interest (quality of life, fatigue, depression, anxiety, quality of sleep, overall survival and adverse events). For outcomes assessed with the same instrument, we used the mean difference (MD) as a summary statistic for meta‐analysis; for those assessed with different instruments, we used the standardised mean difference (SMD). The effect of MBSR was assessed in the short term (end of intervention), medium term (up to 6 months after intervention) and long term (up to 24 months after intervention).

Main results

Fourteen RCTs fulfilled our inclusion criteria, with most studies reporting that they included women with early breast cancer. Ten RCTs involving 1571 participants were eligible for meta‐analysis, while four studies involving 185 participants did not report usable results. Queries to the authors of these four studies were unsuccessful. All studies were at high risk of performance and detection bias since participants could not be blinded, and only 3 of 14 studies were at low risk of selection bias. Eight of 10 studies included in the meta‐analysis recruited participants with early breast cancer (the remaining 2 trials did not restrict inclusion to a certain cancer type). Most trials considered only women who had completed cancer treatment.

MBSR may improve quality of life slightly at the end of the intervention (based on low‐certainty evidence from three studies with a total of 339 participants) but may result in little to no difference up to 6 months (based on low‐certainty evidence from three studies involving 428 participants). Long‐term data on quality of life (up to two years after completing MBSR) were available for one study in 97 participants (MD 0.00 on questionnaire FACT‐B, 95% CI −5.82 to 5.82; low‐certainty evidence).

In the short term, MBSR probably reduces fatigue (SMD −0.50, 95% CI −0.86 to −0.14; moderate‐certainty evidence; 5 studies; 693 participants). It also probably slightly reduces anxiety (SMD −0.29, 95% CI −0.50 to −0.08; moderate‐certainty evidence; 6 studies; 749 participants), and it reduces depression (SMD −0.54, 95% CI −0.86 to −0.22; high‐certainty evidence; 6 studies; 745 participants). It probably slightly improves quality of sleep (SMD −0.38, 95% CI −0.79 to 0.04; moderate‐certainty evidence; 4 studies; 475 participants). However, these confidence intervals (except for short‐term depression) are compatible with both an improvement and little to no difference.

In the medium term, MBSR probably results in little to no difference in medium‐term fatigue (SMD −0.31, 95% CI −0.84 to 0.23; moderate‐certainty evidence; 4 studies; 607 participants). The intervention probably slightly reduces anxiety (SMD −0.28, 95% CI −0.49 to −0.07; moderate‐certainty evidence; 7 studies; 1094 participants), depression (SMD −0.32, 95% CI −0.58 to −0.06; moderate‐certainty evidence; 7 studies; 1097 participants) and slightly improves quality of sleep (SMD −0.27, 95% CI −0.63 to 0.08; moderate‐certainty evidence; 4 studies; 654 participants). However, these confidence intervals are compatible with both an improvement and little to no difference.

In the long term, moderate‐certainty evidence shows that MBSR probably results in little to no difference in anxiety (SMD −0.09, 95% CI −0.35 to 0.16; 2 studies; 360 participants) or depression (SMD −0.17, 95% CI −0.40 to 0.05; 2 studies; 352 participants). No long‐term data were available for fatigue or quality of sleep.

No study reported data on survival or adverse events.

Authors’ conclusions

MBSR may improve quality of life slightly at the end of the intervention but may result in little to no difference later on. MBSR probably slightly reduces anxiety, depression and slightly improves quality of sleep at both the end of the intervention and up to six months later. A beneficial effect on fatigue was apparent at the end of the intervention but not up to six months later. Up to two years after the intervention, MBSR probably results in little to no difference in anxiety and depression; there were no data available for fatigue or quality of sleep.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436161/

 

Mindfulness Reduces Fatigue with Breast Cancer Patients Directly and Indirectly by Improving Psychological Health

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Mindfulness Reduces Fatigue with Breast Cancer Patients Directly and Indirectly by Improving Psychological Health

 

By John M. de Castro, Ph.D.

 

“Women who were more mindful tended to have lower symptoms of metastatic breast cancer, including pain severity and interference, fatigue, psychological distress, and sleep disturbance.” – Lauren Zimmaro

 

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

 

Mindfulness training has been shown to help with general cancer recovery . Mindfulness practice have been shown to improve the residual symptoms in cancer survivors. So, it’s reasonable to further explore the potential benefits of mindfulness practice to relieve fatigue in patients who have survived breast cancer.

 

In today’s Research News article “The relation between mindfulness and the fatigue of women with breast cancer: path analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7011601/), Ikeuchi and colleagues recruited adult women who had undergone surgery for breast cancer and 6 or more months had passed since their last cancer treatment. They completed self-report measures of fatigue, mindfulness, anxiety, depression, pain, loneliness, and sleep disturbance.

 

They found that the higher the levels of mindfulness the lower the levels of fatigue, anxiety, depression, pain, loneliness, and sleep disturbance and the higher the levels of anxiety, depression, pain, loneliness, and sleep disturbance the higher the levels of fatigue. They then applied path modelling to examine the relationships of the variables. They found that high levels of mindfulness were not only directly associated with low levels of fatigue but also indirectly associated by way of high mindfulness being associated with low levels of anxiety, depression, pain, loneliness, and sleep disturbance. These variables that were, in turn, associated with fatigue levels.

 

These results are correlational and as such caution must be exercised in inferring causation. Previous research, though, has demonstrated that mindfulness is causally related to lower levels of fatigue, anxiety, depression, pain, loneliness, and sleep. So, the present correlative results probably are due to these causal connections. Given this inference, then, the results suggest that mindfulness lowers fatigue in breast cancer patients by directly lowering fatigue and also by improving the psychological and physical health of the patients which also improves fatigue levels.

 

These results are important. After cancer treatment there are substantial and troubling residual physical and psychological symptoms. The findings suggest that mindfulness may be an important means to improve these symptoms and markedly improve the quality of life of patients who have been treated for breast cancer.

 

So, mindfulness reduces fatigue with breast cancer patients directly and indirectly by improving psychological health.

 

“mindfulness meditation can reduce stress and anxiety in the general population as well as in breast cancer survivors.” – Kathleen Doheny

 

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

 

Ikeuchi, K., Ishiguro, H., Nakamura, Y., Izawa, T., Shinkura, N., & Nin, K. (2020). The relation between mindfulness and the fatigue of women with breast cancer: path analysis. BioPsychoSocial medicine, 14, 1. https://doi.org/10.1186/s13030-020-0175-y

 

Abstract

Background

Although fatigue is a common and distressing symptom in cancer survivors, the mechanism of fatigue is not fully understood. Therefore, this study aims to investigate the relation between the fatigue and mindfulness of breast cancer survivors using anxiety, depression, pain, loneliness, and sleep disturbance as mediators.

Methods

Path analysis was performed to examine direct and indirect associations between mindfulness and fatigue. Participants were breast cancer survivors who visited a breast surgery department at a university hospital in Japan for hormonal therapy or regular check-ups after treatment. The questionnaire measured cancer-related-fatigue, mindfulness, anxiety, depression, pain, loneliness, and sleep disturbance. Demographic and clinical characteristics were collected from medical records.

Results

Two-hundred and seventy-nine breast cancer survivors were registered, of which 259 answered the questionnaire. Ten respondents with incomplete questionnaire data were excluded, resulting in 249 participants for the analyses. Our final model fit the data well (goodness of fit index = .993; adjusted goodness of fit index = .966; comparative fit index = .999; root mean square error of approximation = .016). Mindfulness, anxiety, depression, pain, loneliness, and sleep disturbance were related to fatigue, and mindfulness had the most influence on fatigue (β = − .52). Mindfulness affected fatigue not only directly but also indirectly through anxiety, depression, pain, loneliness, and sleep disturbance.

Conclusions

The study model helps to explain the process by which mindfulness affects fatigue. Our results suggest that mindfulness has both direct and indirect effects on the fatigue of breast cancer survivors and that mindfulness can be used to more effectively reduce their fatigue. It also suggests that health care professionals should be aware of factors such as anxiety, depression, pain, loneliness, and sleep disturbance in their care for fatigue of breast cancer survivors.

Trial registration

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7011601/