Improve the Psychological Well-Being of Patients with Irritable Bowel Syndrome with Acceptance and Commitment Therapy (ACT)

Improve the Psychological Well-Being of Patients with Irritable Bowel Syndrome with Acceptance and Commitment Therapy (ACT)

 

By John M. de Castro, Ph.D.

 

physical and psychological symptoms of IBS were more effectively managed by people practicing mindfulness meditation than in support group therapy.” – Bill Hendrick

 

Irritable bowel syndrome (IBS) is the most common functional gastrointestinal (GI) disorder with worldwide prevalence rates ranging from 9–23%. In the U.S. the rates generally in the area of 10–15% affecting between 25 and 45 million people. IBS is not life threatening but it is very uncomfortable producing changes in bowel movement patterns, bloating and excess gas, and pain in the lower belly. It is also a major source of absenteeism both at work and in school. IBS is also associated with a marked reduction in the individual’s health quality of life, with disruption of the physical, psychological and social routines of the individuals. At present, there are no known cures for IBS and treatments involve symptomatic relief, often with fairly radical dietary changes.

 

The cause(s) of IBS are not known. But emotion dysregulation is suspected to be involved. It is clear that psychological stress exacerbates the illnesses and anxiety amplifies the symptoms. This suggests that mindfulness training might be helpful as mindfulness is known to reduce the psychological and physical responses to stress and to improve emotion regulation. In addition, It has been shown that meditation and yoga can help relieve IBS symptoms.

 

A therapeutic technique that contains mindfulness training and Cognitive Behavioral Therapy (CBT) is Acceptance and Commitment Therapy (ACT). It is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT). ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. So, it would make sense to further investigate the effectiveness of ACT for Irritable Bowel Syndrome (IBS).

 

In today’s Research News article “The Efficacy of Acceptance and Commitment Therapy (ACT) Matrix on Depression and Psychological Capital of the Patients with Irritable Bowel Syndrome.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390158/), Mirsharifa and colleagues recruited adult patients with Irritable Bowel Syndrome (IBS) and randomly assigned them to either receive 6 sessions of Acceptance and Commitment Therapy (ACT) or to treatment as usual. They were measured before and after treatment for depression and psychological capital, including hope, tolerance, optimism and self-efficiency.

 

They found that in comparison to baseline and to the control group, the IBS patients who received Acceptance and Commitment Therapy (ACT) had significantly lower depression scores and significantly higher scores on psychological capital. The effect sizes were very large indicating that ACT was a potent therapy to improve the psychological well-being of patients with irritable bowel syndrome, improving their mood and making them more hopeful and optimistic and increasing their tolerance and belief in being able to improve their own well-being.

 

So, improve the psychological well-being of patients with irritable bowel syndrome with acceptance and commitment therapy (ACT).

 

A review of mind/body approaches to irritable bowel syndrome has therefore suggested that alternate strategies targeting mechanisms other than thought content change might be helpful, specifically mindfulness and acceptance-based approaches.” – Sebastián Sánchez

 

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

 

Mirsharifa, S. M., Mirzaian, B., & Dousti, Y. (2019). The Efficacy of Acceptance and Commitment Therapy (ACT) Matrix on Depression and Psychological Capital of the Patients with Irritable Bowel Syndrome. Open access Macedonian journal of medical sciences, 7(3), 421–427. doi:10.3889/oamjms.2019.076

 

Abstract

BACKGROUND:

Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders, worldwide. Psychological disorders are common among patients with IBS.

AIM:

This study aims to investigate the efficacy of acceptance and commitment therapy (ACT) matrix on depression and psychological capital of patients with IBS.

MATERIAL AND METHODS:

In a quasi-experimental study, a total number of 30 patients with IBS were selected using convenience sampling. Those patients who meet the inclusion criteria were randomly assigned to control and experimental groups (15 patients in each group). Data were collected using the Beck Depression Inventory (BDI) and the Psychological Capital Questionnaire (PCQ). The experimental group was subjected to the acceptance and commitment therapy (ACT) amtrix, but the control group do not receive this treatment. Questionnaires were completed before (pre-test) and after (post-test) the intervention by patients in two groups. All patients in two groups responded to the questionnaires and returned them to the researcher. Data were analyzed using chi-square test, independent t-test, analysis of covariance (ANCOVA) and multivariate analysis of covariance (MANCOVA).

RESULTS:

Analyzing the data showed that there were significant differences regarding depression and psychological capital between experimental and control group, before and after the study (p < 0.05).

CONCLUSION:

Using ACT matrix is a useful modality to improve the depression and psychological capital among patients with IBS.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390158/

 

Improve Workplace Wellness with Mindful Meditation

Improve Workplace Wellness with Mindful Meditation

 

By John M. de Castro, Ph.D.

 

If your workforce deals with stress, emotional health issues, or low morale, you’ll likely benefit from implementing a meditation program. Meditation programs have a lot of amazing health and wellness benefits that will have a positive impact on your employees.” – Robyn Whalen

 

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

 

To help overcome unhappiness, stress, and burnoutmindfulness practices have been implemented in the workplace. Indeed, mindfulness practices have been shown to markedly reduce the physiological and psychological responses to stress. As a result, it has become very trendy for business to incorporate meditation into the workday to help improve employee well-being, health, and productivity. These programs attempt to increase the employees’ mindfulness at work and thereby reduce stress and burnout. The research has been accumulating. So, it is important to step back and summarize what has been learned.

 

In today’s Research News article “Mindfulness meditation for workplace wellness: An evidence map.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6598008/), Hilton and colleagues reviewed and summarized published systematic reviews of the research on mindfulness training in the workplace and its effects on employee health and well-being. They identified 175 reviews that focused on health care workers, caregivers, educators, and general workplace workers.

 

They report that the reviews demonstrated that mindfulness-based interventions were effective in treating chronic conditions producing relief of psychological distress, anxiety, and depression symptoms. Mindfulness was found to produce small decreases in chronic pain but significant improvements in pain-related quality of life. Mindfulness training was found to reduce substance abuse and help prevent relapse, reduce negative emotions, anxiety, depression, somatization, irritable bowel syndrome, and stress effects. Mindfulness training also was effective in cancer care, including reducing stress, anxiety, depression, and fatigue, and improving sleep and quality of life. for support of caregivers.

 

These findings are remarkable. The wide range of positive benefits on physical and mental health are breathtaking. To this authors knowledge there is no other treatment that has such broad application and effectiveness. This suggests that workplace mindfulness training is safe and highly effective and should be implemented throughout the workplace.

 

So, improve workplace wellness with mindful meditation.

 

The ancient art of meditation has many benefits, especially in the workplace. Studies have shown that meditation practiced in the workplace has a direct impact on increased productivity, creativity, focus, and the overall happiness of employees.” – The Lotus

 

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

 

Hilton, L. G., Marshall, N. J., Motala, A., Taylor, S. L., Miake-Lye, I. M., Baxi, S., … Hempel, S. (2019). Mindfulness meditation for workplace wellness: An evidence map. Work (Reading, Mass.), 63(2), 205–218. doi:10.3233/WOR-192922

 

Abstract

BACKGROUND:

Mindfulness interventions aim to foster greater attention and awareness of present moment experiences. Uptake of mindfulness programs in the workplace has grown as organizations look to support employee health, wellbeing, and performance.

OBJECTIVE:

In support of evidence-based decision making in workplace contexts, we created an evidence map summarizing physical and mental health, cognitive, affective, and interpersonal outcomes from systematic reviews of randomized controlled trials (RCTs) of mindfulness interventions.

METHODS:

We searched nine electronic databases to July 2017, dually-screened all reviews, and consulted topic experts to identify systematic reviews on mindfulness interventions. The distribution of evidence is presented as an evidence map in a bubble plot.

RESULTS:

In total, 175 systematic reviews met inclusion criteria. Reviews included a variety of mindfulness-based interventions. The largest review included 109 randomized controlled trials. The majority of these addressed general health, psychological conditions, chronic illness, pain, and substance use. Twenty-six systematic reviews assessed studies conducted in workplace settings and with healthcare professionals, educators, and caregivers. The evidence map shows the prevalence of research by the primary area of focus. An outline of promising applications of mindfulness interventions is included.

CONCLUSIONS:

The evidence map provides an overview of existing mindfulness research. It shows the body of available evidence to inform policy and organizational decision-making supporting employee wellbeing in work contexts.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6598008/

 

Improve Irritable Bowel Syndrome (IBS) with Mindfulness

Improve Irritable Bowel Syndrome (IBS) with Mindfulness

 

By John M. de Castro, Ph.D.

 

“IBS causes a huge public health and economic burden in the U.S. The standard of care currently has been diet changes along with medications. A mind-based . . . has the potential to minimize both the public health and economic burden of this debilitating disease,” – Saurabh Sethi

 

Irritable bowel syndrome (IBS) is the most common functional gastrointestinal (GI) disorder with worldwide prevalence rates ranging from 9–23%. In the U.S. the rates generally in the area of 10–15% affecting between 25 and 45 million people. IBS is not life threatening but it is very uncomfortable producing changes in bowel movement patterns, bloating and excess gas, and pain in the lower belly. It is also a major source of absenteeism both at work and in school. IBS is also associated with a marked reduction in the individual’s health quality of life, with disruption of the physical, psychological and social routines of the individuals. At present, there are no known cures for IBS and treatments involve symptomatic relief, often with fairly radical dietary changes.

 

The cause(s) of IBS are not known. But emotion dysregulation is suspected to be involved. It is clear that psychological stress exacerbates the illnesses and anxiety amplifies the symptoms. This suggests that mindfulness or the lack thereof may be involved as mindfulness is known to be helpful in reducing the psychological and physical responses to stress and mindfulness is known to improve emotion regulation. In addition, It has been shown that meditation and yoga can help relieve IBS symptoms.  So, it would make sense to further investigate the effectiveness of mindfulness training and emotion regulation for Irritable Bowel Syndrome (IBS).

 

In today’s Research News article “Comparing the Efficacy of Mindfulness-Based Stress Reduction Therapy with Emotion Regulation Treatment on Quality of Life and Symptoms of Irritable Bowel Syndrome.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6178327/ ), Ghandi and colleagues recruited patients with Irritable Bowel Syndrome (IBS) and randomly assigned them to receive either an 8-week, once a week for 90 minutes program of Mindfulness Based Stress Reduction (MBSR), Emotion Regulation group training, or a wait-list. The MBSR treatment consisted of body scan, meditation, and yoga practices and group discussion with homework. Emotion Regulation training consisted in training on “emotional awareness” and “acceptance”. The patients were measured before and after training and 2 months later for IBS severity and quality of life with IBS.

 

They found that both Mindfulness Based Stress Reduction (MBSR) and Emotion Regulation training produced significant improvements in IBS severity and the quality of life with IBS and that this effectiveness was maintained 2 months later. There were no significant differences in the effectiveness of MBSR and emotion regulation training. Hence, both MBSR and emotion regulation training produce large and lasting improvements in the symptoms of IBS and the quality of life of the patients.

 

Since MBSR training is known to improve emotion regulation, the fact that MBSR and emotion regulation training produced equivalent benefits suggests that MBSR may be effective for IBS because of its ability to improve emotion regulation, particularly improving the emotional responses to stress. It will require further research to examine this possibility.

 

So, improve Irritable Bowel Syndrome (IBS) with mindfulness.

 

“For a person who has IBS, mindfulness-based therapies are thought to help to reduce anxiety related to digestive symptoms. Due to our body’s natural stress response, such anxiety can actually exacerbate the very digestive symptoms that a person with IBS is most concerned about. The theory behind mindfulness-based therapies for IBS is that when you experience less reactivity to physical sensations related to your digestive system, you will experience less unwanted symptoms.” – Barbara Bolen

 

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

Abstract

 

Ghandi, F., Sadeghi, A., Bakhtyari, M., Imani, S., Abdi, S., & Banihashem, S. S. (2018). Comparing the Efficacy of Mindfulness-Based Stress Reduction Therapy with Emotion Regulation Treatment on Quality of Life and Symptoms of Irritable Bowel Syndrome. Iranian journal of psychiatry, 13(3), 175-183.

 

Objective: Irritable bowel syndrome is a common gastrointestinal disorder. The perception of stress and GI-specific anxiety play a key role in irritable bowel syndrome (IBS). The present study aims at comparing the efficacy of mindfulness-based stress reduction therapy with emotion regulation on the quality of life and severity in patients IBS.

Method : This randomized clinical trial was conducted in 3 phases: pretest, posttest, and follow-up. Follow-up was performed 2 months after the last intervention. The study population consisted of 24 IBS patients who were randomly selected according to Rome-IV Criteria and were then divided into 3 eight-member groups: (1) mindfulness-based stress reduction, (2) emotion regulation, and (3) control group. IBS-QOL34 and IBS-SSS were administered as assessment tools to all the 3 groups. The experimental groups were subjected to MBSR and ER psychotherapy, while the control group received no psychological intervention. After the 2-month follow-up, the 3 groups were evaluated again.

Results: The results revealed that MBSR improved the quality of life of IBS patients and dicreased severity of their condition. The findings of between and within subjects design revealed that the difference between MBSR and control groups was significant in IBS at follow-up (p = 0.01).

Conclusion: MBSR could be considered as a new, effective, and stable method in psychotherapy, in irritable bowel syndrome.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6178327/

 

Improve Irritable Bowel Syndrome (IBS) with Mindfulness

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Improve Irritable Bowel Syndrome (IBS) with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Dealing with irritable bowel syndrome (IBS) isn’t easy, but the stress (and the symptoms) involved may be lessened with mindfulness meditation.” – Andrew Weil

 

Irritable bowel syndrome (IBS) is the most common functional gastrointestinal (GI) disorder with worldwide prevalence rates ranging from 9–23%. In the U.S. the rates generally in the area of 10–15% affecting between 25 and 45 million people. IBS is not life threatening but it is very uncomfortable producing changes in bowel movement patterns, bloating and excess gas, and pain in the lower belly. It is also a major source of absenteeism both at work and in school. IBS is also associated with a marked reduction in the individual’s health quality of life, with disruption of the physical, psychological and social routines of the individuals. At present, there are no known cures for IBS and treatments involve symptomatic relief, often with fairly radical dietary changes.

 

It has been shown that meditation and yoga can help relieve IBS symptoms but there is a need for more research, particularly of the long-term effectiveness of mindfulness on the symptoms of IBS. In today’s Research News article “Long Term Effects of Mindfulness on Quality of life in Irritable Bowel Syndrome.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1457490580941530/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752522/

Zomorrodi and colleagues recruited adult (average age = 34) participants who had been diagnosed with irritable bowel syndrome (IBS). They randomly assigned them to either receive treatment as usual or treatment as usual combined with an 8-week, once a week for 2 hours, Mindfulness-Based Stress Reduction (MBSR) program. The participants were measured for health quality of life before, and after treatment and were followed-up 2 months later.

 

They found that the MBSR group had a clinically significant (25%) improvement in their health-related quality of life that was sustained at the 2-month follow-up whereas the treatment as usual group showed no improvement. Hence mindfulness training improves the physical, psychological and social impact of IBS on the lives of the patients. These results are important as they show a sustained, relatively long-term improvement produced by MBSR treatment.  Many studies only report improvements measured immediately after treatment. A treatment that is effective only as long as it is being actively administered is of limited usefulness, while one that lasts well beyond the actual time of treatment is much more valuable.

 

It is not known exactly how mindfulness training improve the health-related quality of life in IBS patients. It can be speculated, however, that the training, by focusing the patient on the present moment reduces the worry and catastrophizing about the future that usually accompanies disease. This would allow the patient to focus only on their current physical state and not amplify the symptoms with worry. In addition, mindfulness training is known to reduce the psychological and physiological responses to stress. Stress is well known to exacerbate disease states. So, stress reduction would tend to improve the symptoms of IBS and improve the health-related quality of life.

 

So, improve irritable bowel syndrome (IBS) with mindfulness.

 

“compared to the control group, participants in the mindfulness training group improved on IBS-related quality of life and gastrointestinal-specific anxiety, depression, and general functioning.” – Mindful

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Zomorrodi, S., Rasoulzadeh Tabatabaie, S. K., Azadfallah, P., Ebrahimidaryani, N., & Arbabi, M. (2015). Long Term Effects of Mindfulness on Quality of life in Irritable Bowel Syndrome. Iranian Journal of Psychiatry, 10(2), 100–105.

 

Abstract

Objectives: This study aimed to investigate the long-term effects of mindfulness-based therapy on improving life quality of patients with irritable bowel syndrome.

Method: This was an experimental study including 24 patients (12 from each group) with IBS syndrome were selected based on the ROMEIII criteria and were randomly placed in the test and control groups. In both groups, the scales of the IBS-QOL34 Questionnaire were applied as assessment tool. Experiment group was subjected to the MFT (mindfulness-based therapy), while the control group received no intervention. After the two-month follow up, both groups were once again evaluated through the IBS-QOL34 scales.

Results: There is not significant difference between trial and control group in starting of the study in demographic and quality of life status. The findings of covariance analysis revealed that the difference between the experiment and the control groups at follow-up was significant (p = 0.01). The results showed that the MFT has long-term effects on the life quality of patients suffering from IBS.

Conclusion: The MFT could be considered as a new, effective and stable method in psychotherapy, particularly in psychosomatic disorders such as Irritable Bowel Syndrome.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752522/

 

Make Irritable Bowel Syndrome Less Irritating with Yoga

 

“The word yoga comes from Sanskrit, the language of ancient India. It means union, integration, or wholeness. It is an approach to health that promotes the harmonious collaboration of the human being’s three components: body, mind, and spirit.” – Stella Weller

 

Irritable bowel syndrome (IBS) is the most common functional gastrointestinal (GI) disorder with worldwide prevalence rates ranging from 9–23% and U.S. rates generally in the area of 10–15% affecting between 25 and 45 million people. IBS is not life threatening but it is very uncomfortable producing changes in bowel movement patterns, bloating and excess gas, and pain in the lower belly. It is also a major source of absenteeism both at work and in school. At present there are no known cures for IBS and treatments involve symptomatic relief, often with fairly radical dietary changes.

 

It has been shown that meditation can help relieve IBS symptoms but there is a need to find more and better treatments. Yoga practice can involve particular postures that are directed at affecting the GI tract. It is also a meditative practice. So, it would seem reasonable to investigate whether yoga practice may be useful in treating IBS. In today’s Research News article “Iyengar Yoga for Adolescents and Young Adults with Irritable Bowel Syndrome”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1109123002444958/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4146428/

Evans and colleagues compared 6-weeks of yoga practice to care as usual for Irritable bowel syndrome (IBS) in adolescents (14-17 yrs.) and young adults (18-26 yrs.).

 

They found that the yoga practice had a much greater impact in the young adults than in the adolescents. Yoga practice produced significant improvement in physical functioning in the adolescents but the young adults who practiced yoga showed significant improvements in IBS symptoms, global improvement, psychological distress, functional disability, fatigue, and sleep quality. These improvements were still significant 2 months after the end of yoga practice.

 

IBS is usually not diagnosed until adulthood. But there are a group of adolescents who also suffer from IBS. It is interesting that yoga practice for the most part did not significantly help them. This may indicate that early onset IBS may in some ways be different or more difficult to treat than adult onset IBS. It could also indicate that adolescents are not particularly good patients and due to non-compliance do not respond to otherwise effective treatments.

 

The effectiveness for the young adults is striking and potentially very significant. This raises the question, however, of how yoga practice might be affective with IBS symptoms. As mentioned above, there are yoga postures that target and manipulate the GI tract and these were emphasized in the yoga taught in the study. It is possible that these manipulations of the GI tract have a positive effect on regularizing GI transit. It was also mentioned above that meditation has been shown to be helpful for IBS and meditation is a component of yoga practice.

 

In addition, research has demonstrated that yoga decreases the inflammatory response (see http://contemplative-studies.org/wp/index.php/2015/09/11/reduce-inflammation-with-yoga/ and http://contemplative-studies.org/wp/index.php/2015/08/27/control-inflammation-with-mind-body-practices/). Since IBS involves inflammation of the GI tract it is possible that yoga is effective for IBS by reducing bowel inflammation. Future research is needed to clarify and test these ideas.

 

Regardless, it is clear that practicing yoga can be very beneficial for the treatment of IBS in adults. Since, yoga practice is generally safe, with few if any side effects, is generally a healthful practice for both the body and mind, and can be implemented at low cost, it would appear to be an excellent choice for the treatment of IBS.

 

So, practice yoga to make Irritable Bowel Syndrome less irritating.

 

“You cannot always control what goes on outside. But you can always control what goes on inside.” – Mr. Yoga

 

CMCS – Center for Mindfulness and Contemplative Studies