Mindfulness Incorporates Psychological Flexibility Which Lessens Post-Traumatic Stress during Covid-19

January 31, 2023 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“The measure of intelligence is the ability to change.” ― Albert Einstein

Mindfulness training has been shown to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress. Mindfulness also decreases the individual’s tendency to use tried and true solutions to problems and thereby improves cognitive and psychological flexibility. Psychological flexibility includes:”(1) acceptance – openness to inner experiencing, (2) defusion – observing feelings and thoughts without attachment, (3) present moment awareness – mindful awareness of the present, (4) self-as-context – flexible self-awareness and perspective taking, (5) values – connection to personal values, (6) committed action – values-guided effective action.” It is clear that there is considerable overlap between the ideas of mindfulness and psychological flexibility. It is possible that many of the effects of mindfulness are actually due to flexibility. So, there is a need to investigate the relative effectiveness of mindfulness and flexibility on psychological distress.

In today’s Research News article “Post-traumatic growth in people experiencing high post-traumatic stress during the COVID-19 pandemic: The protective role of psychological flexibility.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9420208/ ) Landi and colleagues examined Italian survey responses before and after a Covid-19 lockdown measuring psychological flexibility, Post-Traumatic Stress symptoms, and post-traumatic growth.

They found that there were significant intercorrelations between the various components of psychological flexibility. They found that for participants who were high in Post-Traumatic Stress symptoms on the pre-lockdown survey, psychological flexibility in the first survey was significantly predictive of post-traumatic growth after the lockdown. Further, for the high traumatic stress participants, psychological flexibility components of present moment awareness, defusion, values, and committed action at the first survey were significantly predictive of post-traumatic growth after the lockdown.

So, for flexibility and also mindfulness (present moment awareness) to be beneficial the participants need to have high stress levels to begin with. Those with low stress levels may be capable of post-traumatic growth without additional characteristics. These findings suggest that flexibility and mindfulness mitigate the effects of a Covid-19 lockdown on psychological well-being of people who are experiencing high levels of post-traumatic stress.

“When the whole world is entrenched in the bunker of physical and often emotional isolation, only flexibility and ingenuity can revive us to remain grounded and imbibe the bolstering sunlight piercing through the canvas of chaos. (Because the world has corona)” ― Erik Pevernagie

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

Study Summary

Landi G, Pakenham KI, Mattioli E, Crocetti E, Agostini A, Grandi S, Tossani E. Post-traumatic growth in people experiencing high post-traumatic stress during the COVID-19 pandemic: The protective role of psychological flexibility. J Contextual Behav Sci. 2022 Oct;26:44-55. doi: 10.1016/j.jcbs.2022.08.008. Epub 2022 Aug 28. PMID: 36060527; PMCID: PMC9420208.

Abstract

The COVID-19 pandemic evokes high levels of post-traumatic stress (PTS) in some people as well as positive personal changes, a phenomenon known as post-traumatic growth (PTG). Experiencing an adverse event as traumatic is crucial for triggering PTG, therefore higher PTS is often associated with higher PTG. This longitudinal study examined the protective role of psychological flexibility in fostering PTG in a group of people reporting high PTS related to COVID-19 as compared to those with low PTS. We hypothesized that higher psychological flexibility will be associated with higher PTG in those with high PTS and that psychological flexibility would be unrelated to PTG in those with low PTS. Secondary data analysis was conducted on data from a larger project investigating the psychological impacts of COVID-19. Adult Italians (N = 382) completed online surveys at Time 1 (three months after the first national lockdown, July 2020) and Time 2 (three months later when the number of COVID-19 cases increased, October 2020). Based on the Impact of Event Scale–Revised cut-off score, two PTS groups were identified at Time 2: low PTS (below cut-off) and high PTS (above cut-off). As predicted, moderation analyses showed that after controlling for Time 1 PTS and PTG and confounding variables, Time 1 psychological flexibility was associated with higher Time 2 PTG in the high PTS group, whereas psychological flexibility was unrelated to PTG in the low PTS group. Four psychological flexibility sub-processes (present moment awareness, defusion, values, committed action) at Time 1 were related to higher Time 2 PTG in only the high PTS group. Findings advance understanding of the role of psychological flexibility in trauma reactions and pandemic mental health adjustment. Evidence-based approaches that target psychological flexibility, like Acceptance and Commitment Therapy, are likely to foster PTG and ultimately adjustment in people with high PTS during and after the pandemic.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9420208/

Mindfulness Taught in Person or Online Improves Psychological Well-Being

June 19, 2022 psyjdc Leave a comment

Mindfulness Taught in Person or Online Improves Psychological Well-Being

By John M. de Castro, Ph.D.

“The practice of a face-to-face or an online MBSR course reduces general psychological distress regardless of the course modality.” – Tomás Esteban Sard-Peck

Mindfulness training has been shown to improve health and well-being in healthy individuals. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. The vast majority of the mindfulness training techniques, however, require a trained teacher. The participants must be available to attend multiple sessions at scheduled times that may or may not be compatible with their schedules and at locations that may not be convenient.

As an alternative, training over the internet has been developed. This has 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 internet training versus live instruction in reducing stress and improving psychological well-being.

In today’s Research News article “Comparing the Effectiveness of Virtual and In-Person Delivery of Mindfulness-Based Skills Within Healthcare Curriculums.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9043883/ ) Hoover and colleagues recruited students studying to become physicians assistants. They received either no treatment or a 5 session mindfulness training delivered either in person or virtually. They were measured before and after training for mindfulness, decentering, flexibility, perceived stress, and satisfaction with life.

They found that in comparison to baseline and the not-treatment group both groups that received mindfulness training had significant increases in mindfulness, psychological flexibility, and satisfaction with life and significant decreases in perceived stress. Hence, mindfulness training, regardless of whether it is delivered in person or virtually, improves the psychological well-being of students. This is important as virtual delivery of mindfulness training is much more convenient for busy, stressed students.

In person and virtual mindfulness training produces equivalent improvement in psychological health.

“Mindfulness training programs were proven to be effective in improving well-being and reducing perceived stress in several populations (especially those prone to burnout) and conditions. These effects were also found in online training.” – Francesco Bossi

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

Study Summary

Hoover, E. B., Butaney, B., Bernard, K., Coplan, B., LeLacheur, S., Straker, H., Carr, C., Blesse-Hampton, L., Naidu, A., & LaRue, A. (2022). Comparing the Effectiveness of Virtual and In-Person Delivery of Mindfulness-Based Skills Within Healthcare Curriculums. Medical science educator, 1–14. Advance online publication. https://doi.org/10.1007/s40670-022-01554-5

Abstract

Purpose

To promote well-being, healthcare education programs have incorporated mindfulness-based skills and principles into existing curriculums. Pandemic-related restrictions have compelled programs to deliver content virtually. Study objectives were to determine (1) whether teaching mindfulness-based skills within physician assistant (PA) programs can promote well-being and (2) whether delivery type (virtual vs. in-person) can impact the effectiveness.

Methods

During this 2-year study, a brief mindfulness-based curriculum was delivered to incoming first-year students at six PA programs, while students at two programs served as controls. The curriculum was delivered in-person in year one and virtually in year two. Validated pre- and post-test survey items assessed mindfulness (decentering ability, present moment attention and awareness, and psychological flexibility) and well-being (perceived stress and life satisfaction).

Results

As expected, coping abilities and well-being were adversely impacted by educational demands. The mindfulness-based curriculum intervention was effective in increasing mindfulness and life satisfaction, while decreasing perceived stress when delivered in-person. Virtual curricular delivery was effective in decreasing perceived stress but not improving life satisfaction. Over half of the participants receiving the curriculum reported positive changes on mindfulness measures with approximately 14–38% reporting a change of greater than one standard deviation. Changes on mindfulness measures explained 30–38% of the reported changes in perceived stress and 22–26% of the changes in life satisfaction. Therefore, the mindfulness curriculum demonstrated statistically significant improvements in measures of mindfulness and mitigated declines in life satisfaction and perceived stress.

Conclusion

Mindfulness-based skills effectively taught in-person or virtually within PA programs successfully promote well-being.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9043883/

Improve the Psychological Well-Being of Patients with Breast Cancer with Mindfulness

April 4, 2022 psyjdc Leave a comment

Improve the Psychological Well-Being of Patients with Breast Cancer with Mindfulness

By John M. de Castro, Ph.D.

“Mindfulness based interventions hold a great deal of promise for helping people with cancer cope across a broad range of symptoms and issues, both during and after the completion of active treatment.” – Jessica Pieczynski

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 alleviate many of the residual physical and psychological symptoms, including stress, sleep disturbance, and anxiety and depression. A therapeutic technique that contains mindfulness training and Cognitive Behavioral Therapy (CBT) is Acceptance and Commitment Therapy (ACT). It focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. This suggests that ACT may be an effective treatment for women with breast cancer.

In today’s Research News article “Efficacy of acceptance and commitment therapy (ACT) on depression, pain acceptance, and psychological flexibility in married women with breast cancer: a pre- and post-test clinical trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8317551/ ) Ghorbani and colleagues recruited married women with breast cancer who exhibited moderate levels of anxiety and depression and randomly assigned them to receive 8 weekly 90 minute sessions of Acceptance and Commitment Therapy (ACT) or to a wait list control condition. They were measured before and after ACT and 2 months later for perceived stress, anxiety, depression, chronic pain, and acceptance and action.

They found that in comparison to baseline and the wait-list control group after Acceptance and Commitment Therapy (ACT) there were significant reductions in depression and significant increases in pain acceptance and flexibility. These improvements were maintained at the 2-month follow-up.

The study did not have an active control condition, rather employing a wait-list control. This leaves open the possibility of participant expectancy (placebo) effects or attentional (Hawthorne) effects explaining the results. In addition, Acceptance and Commitment Therapy (ACT) is a complex therapy with several therapeutic components. It is unclear what components or combination of components are critical for the benefits. Nevertheless, the results demonstrate that Acceptance and Commitment Therapy (ACT) is effective in improving the psychological well-being of breast cancer patients. This could well translate into better recovery and health in these women.

So, improve the psychological well-being of patients with breast cancer with mindfulness.

“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.” – BCRF

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are available on Twitter @MindfulResearch

Study Summary

Ghorbani, V., Zanjani, Z., Omidi, A., & Sarvizadeh, M. (2021). Efficacy of acceptance and commitment therapy (ACT) on depression, pain acceptance, and psychological flexibility in married women with breast cancer: a pre- and post-test clinical trial. Trends in psychiatry and psychotherapy, 43(2), 126–133. https://doi.org/10.47626/2237-6089-2020-0022

Abstract

Objective:

Breast cancer is the most common cancer in women worldwide. Many of these patients suffer from multiple psychological symptoms. The present study aimed to investigate the impact of acceptance and commitment therapy (ACT) on depression, pain acceptance, and psychological flexibility in married women with breast cancer.

Methods:

The present study was a pre- and post-test clinical trial with intervention and control groups. The research population consisted of women with breast cancer referred to the Ayatollah Yasrebi and Shahid Beheshti Hospitals in Kashan in 2018. Through a purposive sampling method, 40 women were selected and randomly divided into two groups, namely, intervention (n = 20) and control (n = 20). The applied tools included the Depression, Anxiety and Stress Scale (DASS-21), Chronic Pain Acceptance Questionnaire 8 (CPAQ-8), and Acceptance and Action Questionnaire – II (AAQ-II). Data were analyzed by SPSS 16 using descriptive statistics and analysis of variance (ANOVA).

Results:

The results showed that ACT treatment significantly reduced the mean scores of depression compared to the control group (F = 107.72, p < 0.001). The mean scores of pain acceptance (F = 9.58, p < 0.05) and psychological flexibility (F = 10.61, p < 0 .05) significantly increased in comparison with the control group.

Conclusion:

ACT can be considered as an effective therapeutic approach to reduce depression and increase pain acceptance and psychological flexibility in women with breast cancer. These changes appear to be due to improved acceptance of thoughts and feelings associated with cancer and increased psychological flexibility, which is the primary goal of ACT treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8317551/

Improve the Psychological Well-Being of Parents of Children with Autism Spectrum Disorder with Mindfulness

February 16, 2022 psyjdc Leave a comment

Improve the Psychological Well-Being of Parents of Children with Autism Spectrum Disorder with Mindfulness

By John M. de Castro, Ph.D.

“mindfulness instruction may help to ease the stress of parenting young children with autism.” – B. Grace Bullock

Providing care for children with autism spectrum disorder (ASD) can be particularly challenging. These children’s behavior is characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors. These make it difficult to relate to the child and receive the kind of positive feelings that often help to support caregiving. The challenges of caring for a child with ASD require that the parent be able to deal with stress, to regulate their own emotions, and to be sensitive and attentive to their child. These skills are exactly those that are developed in mindfulness training. It improves the psychological and physiological responses to stress. It improves emotion regulation. And it improves the ability to maintain attention and focus in the face of high levels of distraction.

A therapeutic technique that contains mindfulness training and Cognitive Behavioral Therapy (CBT) is Acceptance and Commitment Therapy (ACT). It focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. It is not known whether ACT can improve the psychological well-being of parents of children with autism spectrum disorder.

In today’s Research News article “The Effect of Acceptance and Commitment Therapy for Improving Psychological Well-Being in Parents of Individuals with Autism Spectrum Disorders: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7892587/ ) Marino and colleagues recruited families with children between the ages of 4-10 and diagnosed with autism spectrum disorder and randomly assigned them to receive 24 weekly 90-minute sessions of either Acceptance and Commitment Therapy (ACT) or positive parent training to teach behavioral management skills to the children. The parents were measured before and after training for psychological flexibility, their emotions, the severity of disruptive and non-compliant behaviors in the children, behavior congruent with values, mindfulness, parental distress, parent-child dysfunction, and difficult child measures.

They found that in comparison to baseline and the positive parent training group, the group that received either Acceptance and Commitment Therapy (ACT) had significantly greater improvements in psychological flexibility, their emotions, the severity of disruptive and non-compliant behaviors in the children, behavior congruent with values, mindfulness, and parental distress.

The results are exciting particularly because of the strength of the research design. The control condition was an alternative therapy that met similarly over a similar period of time. This controls for most sources of research confounding which greatly improves the strength of the conclusions. These results suggest that Acceptance and Commitment Therapy (ACT) is a safe and effective treatment for parents of children with autism spectrum disorder improving the parent’s psychological well-being and also the children’s’ behavior.. One of the key differences between ACT and positive parent training is the training in mindfulness. This suggests that mindfulness may be the key training for the benefits to the parents.

So, improve the psychological well-being of parents of children with autism spectrum disorder with mindfulness.

“mindfulness means that parents are developing more compassion for themselves instead of feeling like it’s the end of the world when they do yell. Instead, they can mindfully reflect, repair if needed, and try again.” Katy Oberle

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

Study Summary

Marino, F., Failla, C., Chilà, P., Minutoli, R., Puglisi, A., Arnao, A. A., Pignolo, L., Presti, G., Pergolizzi, F., Moderato, P., Tartarisco, G., Ruta, L., Vagni, D., Cerasa, A., & Pioggia, G. (2021). The Effect of Acceptance and Commitment Therapy for Improving Psychological Well-Being in Parents of Individuals with Autism Spectrum Disorders: A Randomized Controlled Trial. Brain sciences, 11(7), 880. https://doi.org/10.3390/brainsci11070880

Abstract

Background: Acceptance and Commitment Therapy (ACT) has been demonstrated as effective in improving psychological well-being in several clinical domains, but there is no evidence regarding the parents of children with Autism Spectrum Disorder (ASD). Methods: In this randomized controlled trial, we evaluated the efficacy of the ACT matrix behavioral protocol in comparison to the Parent Training (PT) program, measuring several primary and secondary outcomes prior to and following treatments. Twelve parents were randomly and equally assigned to two demographically matched groups wherein individuals underwent 24 weekly meetings of ACT protocol (experimental group) or conventional PT (control group). Results: Parents enrolled in the ACT protocol demonstrated significant improvement in psychological flexibility, awareness states, personal values in everyday life, and parental stress, whereas reduced scores were elicited in parents’ perceptions of their child’s disruptive behaviors. Conclusions: The results of this randomized controlled trial, if repeated with a large number of subjects, could open the way to include ACT protocols in daily practice to support the development of new parenting skills.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8301771/

Improve the Symptoms of Central Pain Sensitization Syndromes with Mindfulness

January 14, 2022 psyjdc Leave a comment

Improve the Symptoms of Central Pain Sensitization Syndromes with Mindfulness

By John M. de Castro, Ph.D.

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

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

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

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

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

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

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

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

MCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

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

Abstract

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

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

Increase Positive Psychological States with Mindfulness

November 22, 2021 psyjdc Leave a comment

Increase Positive Psychological States with Mindfulness

By John M. de Castro, Ph.D.

“state mindfulness was associated with positive experiences across the three outcomes: higher levels of autonomy, more intense and frequent pleasant affect, and less intense and less frequent unpleasant affect.” – Kirk Warren Brown

The primary focus of the majority of research on mindfulness has been on its ability to treat negative emotional states such as anxiety, depression, and perceived stress. As such, it has been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. But mindfulness training has also been shown to improve health and well-being in healthy individuals. Indeed, it is possible that the effectiveness of mindfulness training in relieving mental and physical illness may result from its ability to improve positive psychological states. There is accumulating research. So, it makes sense to review and summarize what has been learned

In today’s Research News article “Mindfulness-based positive psychology interventions: a systematic review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8344333/ ) Allen and colleagues review and summarize the published research studies of the effects of mindfulness-based interventions on positive psychological states. They identified 22 published research studies.

They report that the published research found that mindfulness-based interventions significantly increased eudaimonia, well-being, of children, adults, and couples. Mindfulness-based interventions were also found to significantly enhance hedonia, positive emotions (amusement, awe, contentment, joy, gratitude, hope, interest, love, and pride, collectively) and quality of life. They also report that mindfulness training produces significant increases in prosocial behavior, social competence, emotion regulation, flexibility, academic performance, delay of gratification, coping behavior, relaxation, self-compassion, and happiness.

Hence, the research published to date supports the conclusion that mindfulness-based interventions improve positive psychological states. So, these interventions are not only useful for the relief of negative psychological states in people who are suffering but can also enhance the psychological well-being of everyone.

So, increase positive psychological states with mindfulness.

“mindfulness is a fundamental part of a broad program of psycho-spiritual development, aiming to help people reach ‘enlightenment’. . . it may be conceived of as the superlative state of happiness, equanimity and freedom that a human being is capable of experiencing.” – Itai Ivtzan

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

Allen, J. G., Romate, J., & Rajkumar, E. (2021). Mindfulness-based positive psychology interventions: a systematic review. BMC psychology, 9(1), 116. https://doi.org/10.1186/s40359-021-00618-2

Abstract

Background

There are hundreds of mindfulness-based interventions in the form of structured and unstructured therapies, trainings, and meditation programs, mostly utilized in a clinical rather than a well-being perspective. The number of empirical studies on positive potentials of mindfulness is comparatively less, and their known status in academia is ambiguous. Hence, the current paper aimed to review the studies where mindfulness-based interventions had integrated positive psychology variables, in order to produce positive functioning.

Methods

Data were obtained from the databases of PubMed, Scopus, and PsycNet and manual search in Google Scholar. From the 3831 articles, irrelevant or inaccessible studies were eliminated, reducing the number of final articles chosen for review to 21. Interventions that contribute to enhancement of eudaimonia, hedonia, and other positive variables are discussed.

Results

Findings include the potential positive qualities of MBIs in producing specific positive outcomes within limited circumstances, and ascendancy of hedonia and other positive variables over eudaimonic enhancement.

Conclusion

In conclusion, exigency of modifications in the existing MBIs to bring about exclusively positive outcomes was identified, and observed the necessity of novel interventions for eudaimonic enhancement and elevation of hedonia in a comprehensive manner.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8344333/

Improve the Well-Being of Children with Special Health Care Needs and Their Parents with Mindfulness

October 29, 2021 psyjdc Leave a comment

Improve the Well-Being of Children with Special Health Care Needs and Their Parents with Mindfulness

By John M. de Castro, Ph.D.

“mindfulness-based parenting program can be an effective intervention for reducing the stress experienced by parents of children with special needs.” – Elizabeth J. Shaffer

There is a tremendous demand for caregiving in the US. It is estimated that over 65 million (29% of the adult population) provides care to someone who is ill, disabled, or aged, averaging 20 hours per week spent caring for their loved ones. Children with special health care needs include a variety of conditions from psychological such as anxiety disorders or depression to chronic conditions such as asthma or diabetes or chronic pain, to developmental issues such as autism. They place considerable burdens on their caregivers. Mindfulness practice for caregivers has been shown to help them cope with the physical and psychological demands of caregiving.

There has been accumulating research on the application of Acceptance and Commitment Therapy (ACT) for the treatment of children with special health care needs and their caregivers and there is a need to review and summarize the findings. In today’s Research News article “Acceptance and Commitment Therapy for Children with Special Health Care Needs and Their Parents: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8345967/ ) Parmar and colleagues review, summarize, and perform a meta-analysis of the published research studies on the effectiveness of Acceptance and Commitment Therapy (ACT) for the treatment of children with special health care needs and their caregivers.

They identified 10 published research studies. They report that the published research finds that Acceptance and Commitment Therapy (ACT) produces significant reductions in depression and perceived stress, and increases in psychological flexibility in the children. On the other hand, the parents did not show similar improvements except for a small improvement in psychological flexibility.

The published research, then, suggests that Acceptance and Commitment Therapy (ACT) is effective for children with special health care needs in reducing mental distress and increasing their flexibility in dealing with it. ACT also produce small improvements in their caregivers. This suggests that ACT should be recommended to increase mindfulness in children with special health care needs to improve their psychological well-being.

CMCS – Center for Mindfulness and Contemplative Studies

“cultivating a more mindful way of parenting is associated with reduced stress, anxiety, and depression. Parents experienced increased mindful awareness and improved psychological well-being, and they were more accepting of their children. Their children also had fewer behavior problems and enhanced positive interaction with their parents.” – Manika Petcharat

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

Study Summary

Parmar, A., Esser, K., Barreira, L., Miller, D., Morinis, L., Chong, Y. Y., Smith, W., Major, N., Church, P., Cohen, E., & Orkin, J. (2021). Acceptance and Commitment Therapy for Children with Special Health Care Needs and Their Parents: A Systematic Review and Meta-Analysis. International journal of environmental research and public health, 18(15), 8205. https://doi.org/10.3390/ijerph18158205

Abstract

Context: Acceptance and Commitment Therapy (ACT) is an emerging treatment for improving psychological well-being. Objective: To summarize research evaluating the effects of ACT on psychological well-being in children with special health care needs (SHCN) and their parents. Data Sources: An electronic literature search was conducted in PubMed, Web of Science, Ovid/EMBASE and PsycINFO (January 2000–April 2021). Study Selection: Included were studies that assessed ACT in children with SHCN (ages 0–17y) and/or parents of children with SHCN and had a comparator group. Data Extraction: Descriptive data were synthesized and presented in a tabular format, and data on relevant outcomes (e.g., depressive symptoms, stress, avoidance and fusion) were used in the meta-analyses to explore the effectiveness of ACT (administered independently with no other psychological therapy) compared to no treatment. Results: Ten studies were identified (child (7) and parent (3)). In children with SHCN, ACT was more effective than no treatment at helping depressive symptoms (standardized mean difference [SMD] = −4.27, 95% CI: −5.20, −3.34; p < 0.001) and avoidance and fusion (SMD = −1.64, 95% CI: −3.24, −0.03; p = 0.05), but not stress. In parents of children with SHCN, ACT may help psychological inflexibility (SMD = −0.77, 95% CI: −1.07, −0.47; p < 0.01). Limitations: There was considerable statistical heterogeneity in three of the six meta-analyses. Conclusions: There is some evidence that ACT may help with depressive symptoms in children with SHCN and psychological inflexibility in their parents. Research on the efficacy of ACT for a variety of children with SHCN and their parents is especially limited, and future research is needed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8345967/

Improve Pain, Sleep, and the Mental Health of Chronic Pain Patients with Internet Mindfulness Training

September 18, 2021 psyjdc Leave a comment

Improve Pain, Sleep, and the Mental Health of Chronic Pain Patients with Internet Mindfulness Training

By John M. de Castro, Ph.D.

“In the context of chronic pain . . . meditation can help you to stop your mind wandering back to your pain when you are trying to focus on something else, therefore improving your ability to give your entire attention to the task at hand and in turn, improve your level of functioning. It gives you the power to take your mind off your pain and refocus it, therefore aiding you in replacing unhelpful, behaviours with healthy ones which can reduce your pain and allow you to take better care of your health.” – Ann-Marie D’arcy-Sharpe

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain.

There is an accumulating volume of research findings that demonstrate that mindfulness practices, in general, are effective in treating pain. A therapeutic technique that contains mindfulness training and Cognitive Behavioral Therapy (CBT) is Acceptance and Commitment Therapy (ACT). It focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

Acceptance and Commitment Therapy (ACT) requires a scheduled program of sessions with 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.

In today’s Research News article “Internet‐delivered acceptance and commitment therapy as microlearning for chronic pain: A randomized controlled trial with 1‐year follow‐up.” (See summary below or view the full text of the study at: https://onlinelibrary.wiley.com/doi/10.1002/ejp.1723 ) Rickardsson and colleagues recruited adult chronic pain patients and randomly assigned them to either a wait-list control condition or to receive an 8-week program of Acceptance and Commitment Therapy (ACT) delivered over the internet. ACT was delivered in daily microlearning short learning interactions. There was a 74% completion rate of the modules. The participants were measured before and after training and at 3-, 6-, and 12-month follow-ups for psychiatric problems, pain interference, pain intensity, anxiety, depression, psychological inflexibility, values, and health-related quality of life.

They found that compared to baseline and the wait-list control group, the group that received internet-delivered Acceptance and Commitment Therapy (ACT) had significant decreases in pain interference, pain intensity, anxiety, depression, psychological inflexibility, value obstruction, and insomnia. These improvements were long-lasting as they were maintained at the 12-month follow-up.

These are impressive improvements in the pain and psychological health of these diverse chronic pain patients. These results correspond with the frequent prior observations that mindfulness training produces reductions in pain, anxiety, depression, psychological inflexibility, and insomnia in a wide range of patient types and normal individuals. These results are particularly impressive as Acceptance and Commitment Therapy (ACT) was delivered over the internet. in daily microlearning short learning interactions. This was very convenient for the patients and required only 12.4 minutes per week of therapist time per week and was thus very inexpensive to deliver. Yet ACT was highly effective and lasting in relieving the suffering of these chronic pain patients.

So, improve pain, sleep, and the mental health of chronic pain patients with internet mindfulness training.

“What we want to do as best as we can is to engage with the pain just as it is. It’s not about achieving a certain goal – like minimizing pain – but learning to relate to your pain differently.” – Elisha Goldstein

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

Jenny Rickardsson, Charlotte Gentili, Linda Holmström, Vendela Zetterqvist, Erik Andersson, Jan Persson, Mats Lekander, Brjánn Ljótsson, Rikard K. Wicksell. Internet‐delivered acceptance and commitment therapy as microlearning for chronic pain: A randomized controlled trial with 1‐year follow‐up, European Journal of Pain, 2021;00:1–19, https://doi.org/10.1002/ejp.1723

Abstract

Background

Studies of Internet‐delivered acceptance and commitment therapy (ACT) for chronic pain have shown small to moderate positive effects for pain interference and pain acceptance. Effects on pain intensity, depression, anxiety and quality of life (QoL) have been less favourable, and improvements for values and sleep are lacking. In this randomized controlled trial iACT – a novel format of Internet‐ACT using daily microlearning exercises – was examined for efficacy compared to a waitlist condition.

Methods

Adult participants (mean age 49.5 years, pain duration 18.1 years) with diverse chronic pain conditions were recruited via self‐referral, and randomized to iACT (n = 57) or waitlist (n = 56). The primary outcome was pain interference. The secondary outcomes were QoL, depression, anxiety, insomnia and pain intensity. The process variables included psychological inflexibility and values. Post‐assessments were completed by 88% (n = 100) of participants. Twelve‐month follow‐up assessments were completed by 65% (iACT only, n = 37). Treatment efficacy was analysed using linear mixed models and an intention‐to‐treat‐approach.

Results

Significant improvements in favour of iACT were seen for pain interference, depression, anxiety, pain intensity and insomnia, as well as process variables psychological inflexibility and values. Between‐group effect sizes were large for pain interference (d = 0.99) and pain intensity (d = 1.2), moderate for anxiety and depressive symptoms and small for QoL and insomnia. For the process variables, the between‐group effect size was large for psychological inflexibility (d = 1.0) and moderate for values. All improvements were maintained at 1‐year follow‐up.

Conclusions

Internet‐ACT as microlearning may improve a broad range of outcomes in chronic pain.

Significance

The study evaluates a novel behavioral treatment with positive results on pain interference, mood as well as pain intensity for longtime chronic pain sufferers. The innovative format of a digital ACT intervention delivered in short and experiential daily learnings may be a promising way forward.

https://onlinelibrary.wiley.com/doi/10.1002/ejp.1723

Increase Psychological Flexibility and Thereby Relieve Anxiety and Depression with Psychedelic Drugs

July 10, 2021July 10, 2021 psyjdc Leave a comment

Increase Psychological Flexibility and Thereby Relieve Anxiety and Depression with Psychedelic Drugs

By John M. de Castro, Ph.D.

“psilocybin may be effective in the much wider population of patients who suffer from major depression than previously appreciated. The magnitude of the effect we saw was about four times larger than what clinical trials have shown for traditional antidepressants on the market,” – Alan Davis

Psychedelic substances have been used almost since the beginning of recorded history to alter consciousness and produce spiritually meaningful experiences. People find these experiences very pleasant and eye opening. They often report that the experiences changed them forever. But only very recently have these effects of psychedelic substances come under rigorous scientific scrutiny.

When studied in the laboratory under double blind conditions psychedelic substances have been shown to “reliably occasion deeply personally meaningful and often spiritually significant experiences (e.g. mystical-type experiences).” Psychedelic substances have also been shown to improve clinical depression. The case seems clear, but it’s important to look at the mechanism by which psychedelic substances improve depression.

In today’s Research News article “Psychological flexibility mediates the relations between acute psychedelic effects and subjective decreases in depression and anxiety.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7451132/ ) Davis and colleagues recruited adults who have had an experience with a single psychedelic drug. LSD was used by 42% of the respondents and psilocybin was used by 38%. The respondents completed a questionnaire measuring the drug used, when and how much; mystical experiences, acute insight, anxiety, depression, stress, and psychological flexibility.

They found that the greater the level of mystical experiences the greater the levels of acute insights and psychological flexibility. They also found that the greater the level of levels of acute insights and psychological flexibility the greater the decrease in anxiety and depression. A path analysis revealed that the effects of mystical experiences and acute insights on anxiety and depression were indirect by way of psychological flexibility. They increased psychological flexibility which reduced anxiety and depression.

These are interesting results but caution must be exercised in reaching conclusions as there was no control condition and the results are completely correlational and based upon subjective recall by the individuals. In addition, the participants volunteered by responding to recruitment materials and those who respond are likely those that benefited from the psychedelic experiences.

Regardless, the results replicate previous findings that psychedelic drugs increase mystical experiences and acute insights and these are associated with improved mental health. But the results suggest that these effects are completely mediated by increased psychological flexibility. In other words, mystical experiences and acute insights increase flexibility which improves anxiety and depression. “Psychological flexibility is described as an essential set of processes that help people manage stressors and engage in adaptive behaviors that promote values-driven action.” Hence, this flexibility allows the individual to adaptively respond to events in the environment rather than internalizing them producing anxiety and depression. Psychedelic drugs appear to enhance this flexibility and thereby improve mental health.

So, increase psychological flexibility and thereby relieve anxiety and depression with psychedelic drugs.

“The idea behind psychedelic therapy is that the receptive state that the drug confers opens the door to fresh ideas about how to think about the past and future, which the therapist can reinforce.” – Paul Tullis

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

Davis, A. K., Barrett, F. S., & Griffiths, R. R. (2020). Psychological flexibility mediates the relations between acute psychedelic effects and subjective decreases in depression and anxiety. Journal of contextual behavioral science, 15, 39–45. https://doi.org/10.1016/j.jcbs.2019.11.004

Abstract

Prior research has shown that acute subjective psychedelic effects are associated with both spontaneous and intended changes in depression and anxiety. Psychedelics are also theorized to produce increases in psychological flexibility, which could explain decreases in depression and anxiety following a psychedelic experience. Therefore, the present cross-sectional survey study sought to examine whether psychological flexibility mediated the relationship between acute psychedelic experiences and spontaneous or intended changes in depression and anxiety among a large international sample of people who reported having used a psychedelic (n=985; male=71.6%; Caucasian/white=84.1%; Mage=32.2, SD=12.6). A regression analysis showed that acute effects (i.e., mystical and insightful effects) were significantly associated with decreases in depression/anxiety following a psychedelic experience. A path analysis revealed that, while controlling for age and sex, increases in psychological flexibility fully mediated the effect of mystical and insightful experiences on decreases in depression and anxiety following a psychedelic experience. This suggests that psychological flexibility may be an important mediator of the therapeutic effects of psychedelic drugs. Future prospective experimental studies should examine the effect of psychedelic drug administration on psychological flexibility in order to gain a better understanding of the psychological processes that predict therapeutic effects of psychedelics.

Highlights

Acute psychedelic effects are related to changes in depression/anxiety
Changes in psychological flexibility fully mediate this relationship
Psychological flexibility should be examined in clinical trials with psychedelics

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7451132/

Tai Chi Practice Improves the Symptoms of Multiple Diseases

July 2, 2021July 2, 2021 psyjdc Leave a comment

Tai Chi Practice Improves the Symptoms of Multiple Diseases

By John M. de Castro, Ph.D.

“In addition to easing balance problems, and possibly other symptoms, tai chi can help ease stress and anxiety and strengthen all parts of the body, with few if any harmful side effects.” Peter Wayne

Tai Chi is an ancient mindfulness practice involving slow prescribed movements. It is gentle and completely safe, can be used with the elderly and sickly, is 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, it 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. Indeed, studies have shown that Tai Chi practice is effective in improving the symptoms of many different diseases. The evidence is accumulating. So, it makes sense to step back and summarize what has been learned about the effectiveness of different Tai Chi practices for different disease conditions.

In today’s Research News article “.Clinical Evidence of Tai Chi Exercise Prescriptions: A Systematic Review” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972853/ ) Huang and colleagues review and summarize the published randomized controlled trials on the effectiveness of different Tai Chi practices for different disease conditions. They identified 139 published randomized controlled trials utilizing a number of different Tai Chi styles and numbers of forms. Yang style was by far the most frequent style and 24 forms was the most frequent number of forms employed.

They report that the published research found that Tai Chi practice produced significant improvement in the symptoms of musculoskeletal system or connective tissue diseases such as osteoarthritis, fibromyalgia, and chronic low back pain.; on circulatory system diseases such as hypertension, stroke, coronary heart disease, and chronic heart failure; on mental and behavioral disorders such as depression, cognitive impairment, and intellectual disabilities; on nervous system diseases such as Parkinson’s disease, dementia, and sleep disorders; on chronic obstructive pulmonary disease (COPD); on endocrine, nutritional, or metabolic diseases such as type 2 diabetes and metabolic syndrome; on the physical and mental state of cancer patients, and on traumatic brain injury and urinary tract disorders; on balance control and flexibility and falls in older adults.

These are remarkable findings. Tai Chi practice appears to be a safe and effective treatment for the symptoms of a wide variety of diseases. It doesn’t cure the disease. Rather if alleviates the symptoms. It is not known the mechanisms by which Tai Chi has these benefits. Future research needs to further explore what facets or effects of Tai Chi practice are responsible for the disease symptom improvements.

So, Tai Chi practice improves the symptoms of multiple diseases.

“Tai Chi and Qigong are evidence-based approaches to improve health-related quality of life, and they may be effective for a range of physical health conditions.” – Ryan Abbott

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, J., Wang, D., & Wang, J. (2021). Clinical Evidence of Tai Chi Exercise Prescriptions: A Systematic Review. Evidence-based Complementary and Alternative Medicine : eCAM, 2021, 5558805. https://doi.org/10.1155/2021/5558805

Abstract

Objectives

This systematic review aims to summarize the existing literature on Tai Chi randomized controlled trials (RCTs) and recommend Tai Chi exercise prescriptions for different diseases and populations.

Methods

A systematic search for Tai Chi RCTs was conducted in five electronic databases (PubMed, Cochrane Library, EMBASE, EBSCO, and Web of Science) from their inception to December 2019. SPSS 20.0 software and Microsoft Excel 2019 were used to analyze the data, and the risk of bias tool in the RevMan 5.3.5 software was used to evaluate the methodological quality of RCTs.

Results

A total of 139 articles were identified, including diseased populations (95, 68.3%) and healthy populations (44, 31.7%). The diseased populations included the following 10 disease types: musculoskeletal system or connective tissue diseases (34.7%), circulatory system diseases (23.2%), mental and behavioral disorders (12.6%), nervous system diseases (11.6%), respiratory system diseases (6.3%), endocrine, nutritional or metabolic diseases (5.3%), neoplasms (3.2%), injury, poisoning and certain other consequences of external causes (1.1%), genitourinary system diseases (1.1%), and diseases of the eye and adnexa (1.1%). Tai Chi exercise prescription was generally classified as moderate intensity. The most commonly applied Tai Chi style was Yang style (92, 66.2%), and the most frequently specified Tai Chi form was simplified 24-form Tai Chi (43, 30.9%). 12 weeks and 24 weeks, 2-3 times a week, and 60 min each time was the most commonly used cycle, frequency, and time of exercise in Tai Chi exercise prescriptions.

Conclusions

We recommend the more commonly used Tai Chi exercise prescriptions for different diseases and populations based on clinical evidence of Tai Chi. Further clinical research on Tai Chi should be combined with principles of exercise prescription to conduct large-sample epidemiological studies and long-term prospective follow-up studies to provide more substantive clinical evidence for Tai Chi exercise prescriptions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972853/