Mental Health

Improve Complex Post-Traumatic Stress Disorder (CPTSD) Symptoms with Online Mindfulness Training

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Improve Complex Post-Traumatic Stress Disorder (CPTSD) Symptoms with Online Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“Mindfulness can help people train themselves to get unstuck from a vicious cycle of negative thinking, often a cornerstone of trauma.” – Jennifer Wolkin

 

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime. But only a fraction will develop Post-Traumatic Stress Disorder (PTSD). But this still results in a frightening number of people with 7%-8% of the population developing PTSD at some point in their life.

 

PTSD involves a number of troubling symptoms including reliving the event with the same fear and horror in nightmares or with a flashback. PTSD sufferers avoid situations that remind them of the event this may include crowds, driving, movies, etc. and may avoid seeking help because it keeps them from having to think or talk about the event. They often experience negative changes in beliefs and feelings including difficulty experiencing positive or loving feelings toward other people, avoiding relationships, memory difficulties, or see the world as dangerous and no one can be trusted. Sufferers may feel hyperarousal, feeling keyed up and jittery, or always alert and on the lookout for danger. They may experience sudden anger or irritability, may have a hard time sleeping or concentrating, may be startled by a loud noise or surprise.

 

Recently, a new category has emerged of Complex Post-Traumatic Stress Disorder (CPTSD) that meets the criterion for PTSD but has the additional symptoms of disturbances in self-organization including affect dysregulation, negative self-concept, and disturbances in relationships. There are a number of therapies that have been developed to treat PTSD. Mindfulness-based therapies have been shown to be particularly effective. But it is not known if mindfulness-based therapies are also effective for CPTSD.

 

In today’s Research News article “Effects of Mindfulness-Based Internet Intervention on ICD-11 Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder Symptoms: a Pilot Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8435188/ ) Dumarkaite and colleagues recruited college students who had been exposed to trauma including natural disasters, accidents, physical or sexual abuse, or assault. They were randomly assigned to either a wait-list control condition or to receive 8 weekly online mindfulness trainings sessions. They were measured before and after training for traumatic experiences, symptoms of Post-Traumatic Stress Disorder (PTSD) or Complex Post-Traumatic Stress Disorder (CPTSD), anxiety, depression, positive mental health, and satisfaction and usability of the online program.

 

They found that in comparison to baseline and the wait-list control group, the participants who received online mindfulness training had significant decreases in disturbances in self-organization including negative self-concept, and disturbances in relationships and increases in positive mental health. In addition, satisfaction and usability of the online program was high. But they did not find significant changes in PTSD symptoms. Because of the improvements in self-concept, relationships, and mental health it is likely that online mindfulness training is effective for Complex Post-Traumatic Stress Disorder (CPTSD).

 

These results are disappointing in that Mindfulness training has been shown in multiple studies to be effective in improving the symptoms of Post-Traumatic Stress Disorder (PTSD). The difference here is that the mindfulness training was online. This raises the possibility that the interpersonal connections involved in the face-to-face delivery of mindfulness training which is usually delivered in groups is essential for the success of the therapy in treating PTSD.

 

So, improve Complex Post-Traumatic Stress Disorder (CPTSD) symptoms with online mindfulness training.

 

“Trauma and presence (or mindfulness) cannot coexist. Thus, mindfulness practices can help bring trauma victims back to the present and heal from disturbing past events.” – Jason Linder

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Dumarkaite, A., Truskauskaite-Kuneviciene, I., Andersson, G., Mingaudaite, J., & Kazlauskas, E. (2021). Effects of Mindfulness-Based Internet Intervention on ICD-11 Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder Symptoms: a Pilot Randomized Controlled Trial. Mindfulness, 1–13. Advance online publication. https://doi.org/10.1007/s12671-021-01739-w

 

Abstract

Objectives

A substantial proportion of trauma survivors with posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) continue to experience symptoms even after trauma-focused therapies. Internet-based interventions could facilitate access to treatment for PTSD and CPTSD. The current pilot study aimed to investigate the effects of mindfulness-based internet intervention on PTSD and CPTSD symptoms.

Methods

A randomized controlled trial (RCT) design with two measurement points (pre-test and post-test) was used to investigate the effects of a structured mindfulness-based internet intervention on PTSD and CPTSD symptoms as well as anxiety, depression, and positive mental health. In total, 70 university students with high levels of PTSD and CPTSD symptoms based on ICD-11 criteria participated in the study: 31 in the intervention group and 39 in the waiting list control group.

Results

We found that the mindfulness-based internet intervention reduced CPTSD disturbances in self-organization (DSO) symptoms (ES = − 0.48 [− 0.96; 0.00]), particularly negative self-concept (ES = − 0.72 [− 1.21; − 0.24]) and disturbances in relationships (ES = − 0.55 [− 1.03; − 0.07]). Moreover, the intervention reduced the symptoms of PTSD sense of threat (ES = − 0.48 [− 0.96; − 0.01]) and promoted positive mental health (ES = 0.51 [0.03; 0.99]). High user satisfaction and good usability of the intervention were reported.

Conclusions

Promising treatment effects were found, indicating that mindfulness-based internet intervention can reduce CPTSD symptoms and have a positive effect on mental health among youth in general. The findings of the current study contribute to the further development of trauma care using internet-delivered interventions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8435188/

 

Improve Cognitive and Socio-Emotional Skills in Children with Mindfulness

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Improve Cognitive and Socio-Emotional Skills in Children with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Teaching mindfulness to kids can also help shape three critical skills developed in early childhood: paying attention and remembering information, shifting back and forth between tasks, and behaving appropriately with others.” – Christopher Willard

 

Childhood is a miraculous period during which the child is dynamically absorbing information from every aspect of its environment. This is particularly evident during the elementary school years. Mindfulness training in school has been shown to have very positive effects. These include improvements in the cognitive, psychological, emotional and social domains. Importantly, mindfulness training in school appears to improve attentional ability which is fundamental to success in all aspects of academic performance. The research evidence has been accumulating. So, there is a need to summarize what has been learned.

 

In today’s Research News article “Exploring the Effects of Meditation Techniques Used by Mindfulness-Based Programs on the Cognitive, Social-Emotional, and Academic Skills of Children: A Systematic Review.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.660650/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1778822_a0P58000000G0YfEAK_Psycho_20211123_arts_A ) Filipe and colleagues review and summarize the published controlled research studies on the effects of mindfulness training on 6-12 year old children. They found 29 published research articles.

 

They report that the published research found that mindfulness training produced significant improvements in the children’s cognitive skills, including overall executive functions, attention, concentration, inhibitory control, cognitive flexibility, and immediate auditory-verbal memory. They also found that there were significant improvements in socio-emotional skills, including stress, wellbeing, mindfulness, self-esteem, resilience, psychological happiness, empathy, perspective-taking, emotional control, optimism, depression, internalizing problems, peer aggression, prosocial behavior, peer acceptance, anxiety, self-control, self-regulation, mental health problems, quality of life, self-compassion, acceptance, relaxation, happiness, aggressive behaviors, and social competence. But only one of the 29 studies reported improvements in academic skills.

 

The published research makes a strong case for the effectiveness of mindfulness training to improve the cognitive and socio-emotional skills on children. But there is little evidence for improvement in academic performance. Unfortunately, only 9 of the 29 studies employed strong research designs (randomized controlled trails). So, there is a need for further research with high quality research designs. Nevertheless, the consistency and magnitude of the findings suggest robust positive effects of mindfulness trainings on a myriad of cognitive, social, and emotional skills in children. These are important benefits for these developing humans that may have important contributions to their growth and well-being, perhaps eventually making them better adults. As such, mindfulness training should be incorporated into the school curriculum.

 

So, improve cognitive and socio-emotional skills in children with mindfulness.

 

“For children, mindfulness can offer relief from whatever difficulties they might be encountering in life. It also gives them the beauty of being in the present moment.” – Annaka Harris

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Filipe MG, Magalhães S, Veloso AS, Costa AF, Ribeiro L, Araújo P, Castro SL and Limpo T (2021) Exploring the Effects of Meditation Techniques Used by Mindfulness-Based Programs on the Cognitive, Social-Emotional, and Academic Skills of Children: A Systematic Review. Front. Psychol. 12:660650. doi: 10.3389/fpsyg.2021.660650

 

There is evidence for the positive impact of mindfulness in children. However, little is known about the techniques through which mindfulness practice results in differential outcomes. Therefore, this study intended to systematically review the available evidence about the efficacy of meditation techniques used by mindfulness-based programs on cognitive, socio-emotional, and academic skills of children from 6 to 12 years of age. The review was registered on the PROSPERO database, and the literature search was conducted according to PICO criteria and PRISMA guidelines. The EBSCO databases were searched, and 29 studies were eligible: nine randomized controlled trials and 20 quasi-experimental studies. All the included randomized controlled trials were rated as having a high risk of bias. Overall, the evidence for mindfulness techniques improving cognitive and socio-emotional skills was reasonably strong. Specifically, for cognitive skills, results showed that all the interventions used “body-centered meditations” and “mindful observations.” Regarding socio-emotional skills, although all the studies applied “body-centered meditations” and “mindful observations,” “affect-centered meditations” were also frequent. For academic skills, just one quasi-experimental trial found improvements, thus making it difficult to draw conclusions. Further research is crucial to evaluate the unique effects of different meditation techniques on the cognitive, social-emotional, and academic skills of children.

https://www.frontiersin.org/articles/10.3389/fpsyg.2021.660650/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1778822_a0P58000000G0YfEAK_Psycho_20211123_arts_A

Improve Worker Well-Being in Spite of Work-Life Conflicts with Mindfulness

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Improve Worker Well-Being in Spite of Work-Life Conflicts with Mindfulness

 

By John M. de Castro, Ph.D.

 

“For many busy professionals, the phrase “work-life balance” can seem like an oxymoron. In today’s world of multi-tasking and 24/7 connectivity, work can seem omnipresent and overwhelming. How can you possibly maintain your competitive edge at work while also nurturing a healthy personal life? . . . Mindfulness can bring us back into balance by acting as a bridge between work and life.” – Dorsey Standish

 

Work is very important for our health and well-being. We spend approximately 25% of our adult lives at work. Indeed, the work environment has even become an important part of our social lives, with friendships and leisure time activities often attached to the people we work with. But work-related stress is epidemic in the western workplace. Almost two thirds of workers reporting high levels of stress at work. This stress can result in impaired health and can result in burnout; producing fatigue, cynicism, and professional inefficacy. To help overcome unhappiness, stress, and burnout, mindfulness practices have been implemented in the workplace. These mindfulness practices have been shown to markedly reduce the physiological and psychological responses to stress.

 

One of the stresses produced by the modern work environments results from work conflicting with the rest of the workers’ lives harming their well-being and mental health. But there is little understanding regarding how these conflicts affect the worker and what practices might help to mitigate the effects of work-life conflicts. Mindfulness helps to prevent the harmful effects of conflicts. So, it may help to blunt the effects of work-life conflict on the individual’s well-being.

 

In today’s Research News article “When Work Conflicts With Personal Projects: The Association of Work-Life Conflict With Worker Wellbeing and the Mediating Role of Mindfulness.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.539582/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1771688_a0P58000000G0YfEAK_Psycho_20211111_arts_A ) Pacheco and colleagues recruited adult workers and had them complete a questionnaire measuring mindfulness, positive mental health, well-being in the workplace, personality, and work-life conflict, including time-based conflict and strain-based conflict..

 

They report that the higher the levels of mindfulness the higher the levels of positive mental health and well-being in the workplace and the lower the levels of time-based conflict and strain-based conflict. They also found that the higher the levels of both time-based conflict and strain-based conflict the lower the levels of positive mental health and well-being in the workplace.

 

Using linear structural modelling to assess the interrelationships between the variables they found that both time-based conflict and strain-based conflict were associated with lower well-being in the workplace directly and also indirectly by being associated with lower mindfulness which was associated with lower well-being in the workplace. They also found that both time-based conflict and strain-based conflict were associated with lower positive mental health only indirectly by being associated with lower mindfulness which was associated with lower positive mental health.

 

These findings are correlational. So, no conclusions regarding causation can be reached. But in previous controlled research mindfulness training has been shown to improve mental health and well-being. So, the relationships with mindfulness observed here are likely due to causal connections. The findings, then, suggest that the conflicts between work and life in general are factors in lowering workers’ mental health and well-being at work. The findings further suggest that mindfulness is an important intermediary where mindfulness is a promoter of positive mental health and well-being at work, but work-life conflicts reduce mindfulness. Future research should attempt to train mindfulness to observe whether it can mitigate the negative effects of work-life conflicts.

 

So, improve worker well-being in spite of work-life conflicts with mindfulness.

 

“[mindfulness] is effective for encouraging work–life balance and improve well-being.” – Sarah Elena Althammer

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Pacheco T, Coulombe S and Meunier S (2021) When Work Conflicts With Personal Projects: The Association of Work-Life Conflict With Worker Wellbeing and the Mediating Role of Mindfulness. Front. Psychol. 12:539582. doi: 10.3389/fpsyg.2021.539582

 

The negative emotional and health effects of work-life conflict (WLC) have been demonstrated in numerous studies regarding organizational psychology and occupational health. However, little is known about WLC’s relationship with positive wellbeing outcomes, including emotional, psychological, and social aspects of workers’ thriving. Furthermore, the mediating processes underlying the effects of WLC remain mostly unknown. The current study investigated the associations of perceived time- and strain-based WLC with positive mental health and thriving at work, as well as the mediating role of mindfulness in these associations. It is argued that WLC causes reduced mindfulness capacities among workers, which is in turn associated with lower positive wellbeing given the importance of mindfulness in emotion regulation. A sample of 330 workers based in Québec, Canada, completed an online survey including a measure of strain- and time-based interference with personal projects (i.e., the goals and activities that define the daily life of an individual) and validated scales of wellbeing outcomes and mindfulness. Results of structural equation modeling revealed negative associations between time- and strain-based WLC with positive mental health and thriving at work. Work-life conflict was related to lower mindfulness, which played a mediating role in the associations between time-based WLC with positive mental health and thriving at work, as well as strain-based WLC with positive mental health. The mediation was complete for the time-based WLC and positive mental health association, but partial for the other mediated pathways, highlighting the need for more research to identify additional mediators. These results highlight that beyond resulting in negative emotional/health outcomes often studied in previous research, WLC may be associated with workers’ reduced potential to live a fulfilling life, in general and in the workplace. Recommendations (e.g., mindfulness intervention to promote emotional regulation, personal project intervention) for workplace policymakers and practitioners are identified.

https://www.frontiersin.org/articles/10.3389/fpsyg.2021.539582/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1771688_a0P58000000G0YfEAK_Psycho_20211111_arts_A

 

Improve the Psychological Well-Being of University Students with Mindfulness

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Improve the Psychological Well-Being of University Students with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness apps offer modest but clear benefits to users in terms of improved mental health. They present a promising supplement to traditional mental health services.” – Oskari Lahtinen

 

There is a lot of pressure on university students to excel so that they can get the best jobs after graduation. This stress might in fact be counterproductive as the increased pressure can actually lead to stress and anxiety which can impede the student’s physical and mental health, well-being, and school performance. Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health. Indeed, these practices have been found to improve psychological health in college students.

 

In today’s Research News article “The Mental Health and Wellbeing of University Students: Acceptability, Effectiveness, and Mechanisms of a Mindfulness-Based Course.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8199969/ ) Medlicott and colleagues recruited university students who attended an 8-week mindfulness training. The program was based upon Mindfulness-Based Cognitive Therapy (MBCT) and was delivered in 8 weekly 90 minute sessions along with daily home practice. The participants were measured before and after the program and 6 weeks later for expected benefits from the program, wellbeing, mental health, mindfulness, self-compassion, resilience, and academic goals.

 

They found that following the course there were significant improvement in wellbeing. mental health, mindfulness, self-compassion, resilience, and orientation toward their academic goals that were maintained 6 weeks later. The effects were greater for participants who had mental health problems at the beginning of the program. In addition, the greater the amount of home practice, the greater the improvements observed. The amount of change in mindfulness and self-compassion produced by the course was related to the amount of improvement in wellbeing and mental health while the amount of change in resilience was related to the improvements in wellbeing.

 

It has to be recognized that the study did not contain a control, comparison, condition, so it is open to numerous alternative, confounding, explanations. But previous controlled research has demonstrated that mindfulness training produces improvements in wellbeing, mental health, mindfulness, self-compassion, and resilience. So, it is likely that the present findings are the result of the effects of the mindfulness training program rather than some alternative explanation.

 

These results suggest that participating in a mindfulness training program produces significant benefits for the psychological health and wellbeing of university students. The fact their orientation to academic goals was also improved suggests that the program may also improve their academic performance. Indeed, it would be expected that improvement in the students wellbeing and mental health would improve the likelihood of academic success.

 

So, improve the psychological well-being of university students with mindfulness.

 

“In college, it’s easy to compile all of the problems we’re facing and place it in to one big feeling of paranoia or stress. Headspace helps sort that out and filter what I should be worried about.” – Ryan Coughlin

 

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

 

Medlicott, E., Phillips, A., Crane, C., Hinze, V., Taylor, L., Tickell, A., Montero-Marin, J., & Kuyken, W. (2021). The Mental Health and Wellbeing of University Students: Acceptability, Effectiveness, and Mechanisms of a Mindfulness-Based Course. International journal of environmental research and public health, 18(11), 6023. https://doi.org/10.3390/ijerph18116023

 

Abstract

Mental health problems are relatively common during university and adversely affect academic outcomes. Evidence suggests that mindfulness can support the mental health and wellbeing of university students. We explored the acceptability and effectiveness of an 8-week instructor-led mindfulness-based course (“Mindfulness: Finding Peace in a Frantic World”; Williams and Penman, 2011) on improving wellbeing and mental health (self-reported distress), orientation and motivation towards academic goals, and the mechanisms driving these changes. Eighty-six undergraduate and post-graduate students (>18 years) participated. Students engaged well with the course, with 36 (48.0%) completing the whole programme, 52 (69.3%) attending 7 out of 8 sessions, and 71 (94.7%) completing at least half. Significant improvements in wellbeing and mental health were found post-intervention and at 6-week follow-up. Improvements in wellbeing were mediated by mindfulness, self-compassion, and resilience. Improvements in mental health were mediated by improvements in mindfulness and resilience but not self-compassion. Significant improvements in students’ orientation to their academic goal, measured by “commitment” to, “likelihood” of achieving, and feeling more equipped with the “skills and resources” needed, were found at post-intervention and at 6-week follow-up. Whilst exploratory, the results suggest that this mindfulness intervention is acceptable and effective for university students and can support academic study.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8199969/

 

Improve the Psychological Well-Being of Medical Students with Mindfulness

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Improve the Psychological Well-Being of Medical Students with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Medical students are being trained to have 100 things on their mind at all times. It’s harder and harder to focus on one thing explicitly. [Mindfulness] gives you that skill to know that you can focus on everything at once, but when you need to focus on one thing, you can be present with it.” – Chloe Zimmerman

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It is estimated that over 45% of healthcare workers experience burnout. Currently, over a third of healthcare workers report that they are looking for a new job. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout, in fact, it is a threat to the entire healthcare system as it contributes to the shortage of doctors and nurses.

 

Preventing burnout has to be a priority. Contemplative practices have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, and improving sleep. It would be best to provide techniques to combat burnout early in a medical career. Studying medicine can be extremely stressful and many students show distress and express burnout symptoms. The undergraduate medical student level may be an ideal time to intervene.

 

In today’s Research News article “Mindfulness-based stress reduction for medical students: a narrative review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8105581/ )  Polle and colleagues review and summarize the published research on the effectiveness of the Mindfulness-Based Stress Reduction (MBSR) program to improve the psychological well-being of undergraduate medical students. MBSR includes training in meditation, body scan, and yoga, and group discussions normally over an 8-week period. They identified 9 published studies.

 

They report that the published research found that Mindfulness-Based Stress Reduction (MBSR) produced significant increases in undergraduate medical students mood, mental health, satisfaction with life, and self-compassion and significant reductions in psychological distress, perceived stress, and depression. One study followed up these students 6 years later and found persisting effects of MBSR.

 

The published research paints a clear picture that participating in a Mindfulness-Based Stress Reduction (MBSR) program produces lasting benefits for the psychological health of undergraduate medical students. This is important as stress and burnout is prevalent in the medical professions and intervening early may prevent or ameliorate future problems. Incorporation of MBSR into the undergraduate medical curriculum should be considered.

 

So, improve the psychological well-being of medical students with mindfulness.

 

“in medical students, higher empathy, lower anxiety, and fewer depression symptoms have been reported by students after participating in MSBR. In summary, mindfulness meditation may be used to elicit positive emotions, minimize negative affect and rumination, and enable effective emotion regulation.”- Michael Minichiello

 

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

 

Polle, E., & Gair, J. (2021). Mindfulness-based stress reduction for medical students: a narrative review. Canadian medical education journal, 12(2), e74–e80. https://doi.org/10.36834/cmej.68406

 

Abstract

Background

Medical students are at high risk of depression, distress and burnout, which may adversely affect patient safety. There has been growing interest in mindfulness in medical education to improve medical student well-being. Mindfulness-based stress reduction (MBSR) is a commonly used, standardized format for teaching mindfulness skills. Previous research has suggested that MBSR may be of particular benefit for medical students. This narrative review aims to further investigate the benefits of MBSR for undergraduate medical students.

Methods

A search of the literature was performed using MedLine, Embase, ERIC, PSYCInfo, and CINAHL to identify relevant studies. A total of 102 papers were identified with this search. After review and application of inclusion and exclusion criteria, nine papers were included in the study.

Results

MBSR training for medical students was associated with increased measures of psychological well-being and self-compassion, as well as improvements in stress, psychological distress and mood. Evidence for effect on empathy was mixed, and the single paper measuring burnout showed no effect. Two studies identified qualitative themes which provided context for the quantitative results.

Conclusions

MBSR benefits medical student well-being and decreases medical student psychological distress and depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8105581/

 

Improve Physical and Mental Well-Being with Mindfulness Meditation-Based Interventions

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Improve Physical and Mental Well-Being with Mindfulness Meditation-Based Interventions

 

By John M. de Castro, Ph.D.

 

“mindfulness meditation is related to improved mental health across a variety of disorders, including different anxiety disorders, depression, eating disorders, substance abuse, and chronic pain symptom reduction.” – Jennifer Wolkin

 

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 mental and physical 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.

 

Over the last few decades, a vast amount of research has been published on the benefits of mindfulness practices on the mental and physical health of the practitioners. Many reviews, summarizations, and meta-analyses have been performed of these studies. So, it makes sense to step back and summarize what these meta-analyses have found.

 

In today’s Research News article “The empirical status of mindfulness-based interventions: A systematic review of 44 meta-analyses of randomized controlled trials.” (See summary below or view the full text of the study at: https://centerhealthyminds.org/assets/files-publications/Goldberg-the-empirical-status.pdf ) Goldberg and colleagues review, summarize, and perform a meta-analysis of previous meta-analyses of published randomized controlled studies on benefits of sustained meditation practices on mental and physical well-being. They identified 44 published meta-analyses, representing 336 randomized controlled trials, which included a total of 30,483 participants.

 

They report that the meta-analyses of published randomized controlled trials found that sustained mindfulness meditation practices in comparison to passive, no treatment, controls had a very wide range of beneficial effects across a wide range of participants from children to the elderly, over a variety of programs from Mindfulness-Based Stress Reduction (MBSR) to mobile health, over a variety of psychological issues from anxiety to psychoses, and over a wide range of diseases from chronic pain to cancer. These effects were present immediately post treatment and at later follow-ups (an average of 7 months after treatment).

 

Comparison of these mindfulness meditation practices to active control conditions such as attentional controls to evidence-based treatments, resulted in reduced effect sizes and many were non-significant. Mindfulness meditation practices had significantly superior effects than active controls for adults, children, employees, and health care professionals/trainees but not for students. They were superior for psychiatric disorders, substance use, smoking, and depression but not for physical health conditions, pain, weight/eating-related conditions, cancer, or anxiety. They were superior for stress, and psychiatric symptoms but not for sleep, physical health symptoms, objective measures, or physiological measures.

 

These findings are essentially summaries of summaries and are based upon a wide variety of different researchers, methodologies, cultures, and time frames. Yet, the results are fairly consistent. In comparison to doing nothing, passive controls, mindfulness meditation practices are very beneficial for a wide range of physical and psychological issues over a wide range of ages. But these practices when compared to other types of treatments, are less effective and at times not superior. Nevertheless, this meta-analysis of meta-analyses paints a clear picture of the wide-ranging efficacy of mindfulness meditation practices for the relief of physical and psychological issues. These results verify the unprecedented depth and breadth of benefits of mindfulness meditation practices.

 

So, improve physical and mental well-being with mindfulness meditation-based interventions.

 

“Practicing mindfulness exercises can have many possible benefits, including: reduced stress, anxiety and depression, less negative thinking and distraction, and improved mood,” -Mayo Clinic

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Goldberg, S. B., Riordan, K., Sun, S., & Davidson, R. J. (2021). The empirical status of mindfulness-based interventions: A systematic review of 44 meta-analyses of randomized controlled trials. Perspectives on Psychological Science 1–23, DOI: 10.1177/1745691620968771

 

Abstract

In response to questions regarding the scientific basis for mindfulness-based interventions (MBIs), we evaluated their empirical status by systematically reviewing meta-analyses of randomized controlled trials (RCTs). We searched six databases for effect sizes based on ≥4 trials that did not combine passive and active controls. Heterogeneity, moderators, tests of publication bias, risk of bias, and adverse effects were also extracted. Representative effect sizes based on the largest number of studies were identified across a wide range of populations, problems, interventions, comparisons, and outcomes (PICOS). A total of 160 effect sizes were reported in 44 meta-analyses (k=336 RCTs, N=30,483 participants). MBIs showed superiority to passive controls across most PICOS (ds=0.10-0.89). Effects were typically smaller and less often statistically significant when compared to active controls. MBIs were similar or superior to specific active controls and evidence-based treatments. Heterogeneity was typically moderate. Few consistent moderators were found. Results were generally robust to publication bias, although other important sources of bias were identified. Reporting of adverse effects was inconsistent. Statistical power may be lacking in meta-analyses, particularly for comparisons with active controls. As MBIs show promise across some PICOS, future RCTs and meta-analyses should build upon identified strengths and limitations of this literature.

https://centerhealthyminds.org/assets/files-publications/Goldberg-the-empirical-status.pdf

 

Increase Quality of Life and Decrease Weight of Patients with Diabetes with Tai Chi

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Increase Quality of Life and Decrease Weight of Patients with Diabetes with Tai Chi

 

By John M. de Castro, Ph.D.

 

“a regular tai chi exercise program may help lower blood glucose levels, allowing people with diabetes to better control their disease.” – Lindsey Getz

 

Diabetes is a major health issue. It is estimated that 30 million people in the United States have diabetes and the numbers are growing. Type 2 Diabetes results from a resistance of tissues, especially fat tissues, to the ability of insulin to promote the uptake of glucose from the blood. As a result, blood sugar levels rise producing hyperglycemia. Diabetes is the 7th leading cause of death in the United States. In addition, diabetes is heavily associated with other diseases such as cardiovascular disease, heart attacks, stroke, blindness, kidney disease, and circulatory problems leading to amputations. As a result, diabetes doubles the risk of death of any cause compared to individuals of the same age without diabetes.

 

Type 2 diabetes is largely preventable. One of the reasons for the increasing incidence of Type 2 Diabetes is its association with overweight and obesity which is becoming epidemic in the industrialized world. A leading cause of this is a sedentary life style. Current treatments for Type 2 Diabetes focus on diet, exercise, and weight control. Recently, mindfulness practices have been shown to be helpful in managing diabetes. Tai Chi is mindfulness practice and a gentle exercise that has been found to improve the symptoms of Type 2 Diabetes. The research is accumulating. So, it is reasonable to examine what has been learned.

 

In today’s Research News article “Effect of Tai Chi on Quality of Life, Body Mass Index, and Waist-Hip Ratio in Patients With Type 2 Diabetes Mellitus: 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/PMC7851054/ ) Qin and colleagues review, summarize, and perform a meta-analysis of the published research studies of the effectiveness of Tai Chi practice in the treatment of Type 2 Diabetes. They found 18 published research studies, 15 of which were randomized controlled studies.

 

They report that the published research found that patients with Type 2 Diabetes who practiced Tai Chi had significant improvements in their quality of life including physical function, pain, overall health, vitality, social function, emotional function, and mental health dimensions. The research also found that Tai Chi practice produced significant reductions in body size as reflected in the waist-hip ration and the body mass index (BMI), but the improvements were equivalent to that produced by other aerobic exercises.

 

These are important findings as Type 2 Diabetes is so impactful on the health and longevity of large numbers of patients. The results suggest that Tai Chi practice reduces body size which is very important in improving metabolic and glucose control. As a consequence, it greatly improves the quality of life of the patients. It appears from the research that the exercise component of Tai Chi practice is important for the improvements as other aerobic exercises produce similar effects.

 

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 patients with Type 2 Diabetes.

 

So, increase quality of life and decrease weight of patients with diabetes with Tai Chi.

 

“Tai Chi exercises can improve blood glucose levels and improve the control of type 2 diabetes and immune system response.” – Anna Sophia McKenney

 

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

 

Qin, J., Chen, Y., Guo, S., You, Y., Xu, Y., Wu, J., Liu, Z., Huang, J., Chen, L., & Tao, J. (2021). Effect of Tai Chi on Quality of Life, Body Mass Index, and Waist-Hip Ratio in Patients With Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. Frontiers in endocrinology, 11, 543627. https://doi.org/10.3389/fendo.2020.543627

 

Abstract

Background

Type 2 diabetes mellitus (T2DM) is a worldwide public health concern with high morbidity and various progressive diabetes complications that result in serious economic expenditure and social burden. This systematic review aims to evaluate the effect of Tai Chi on improving quality of life (QoL), body mass index (BMI) and waist-hip ratio (WHR) in patients with T2DM.

Method

A systematic review and meta-analysis was performed following PRISMA recommendation. Four English databases and three Chinese databases were searched. The PEDro scale was used to assess the methodological quality of including studies. Study inclusion criteria: randomized controlled trials (RCTs) and quasi-experimental studies were included, patients with T2DM that adopted Tai Chi as intervention and QoL, BMI and/or WHR as outcome measurements.

Results

Eighteen trials were included. The aggregated results of seven trials showed that Tai Chi statistically significantly improved QoL measured by the SF-36 on every domains (physical function: MD = 7.73, 95% confidence interval (CI) = 1.76 to 13.71, p = 0.01; role-physical function: MD = 9.76, 95% CI = 6.05 to 13.47, p < 0.001; body pain: MD = 8.49, 95% CI = 1.18 to 15.8, p = 0.02; general health: MD = 9.80, 95% CI = 5.77 to 13.82, p < 0.001; vitality: MD = 6.70, 95% CI = 0.45 to 12.94, p = 0.04; social function: MD = 9.1, 95% CI = 4.75 to 13.45, p < 0.001; role-emotional function: MD = 7.88, 95% CI = 4.03 to 11.72, p < 0.001; mental health: MD = 5.62, 95% CI = 1.57 to 9.67, p = 0.006) and BMI (MD = −1.53, 95% CI = −2.71 to −0.36, p < 0.001) compared with control group (wait list; no intervention; usual care; sham exercise).

Conclusion

Tai Chi could improve QoL and decrease BMI for patients with T2DM, more studies are needed to be conducted in accordance with suggestions mentioned in this review.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7851054/

 

Improve Mental Health with Mindfulness

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Improve Mental Health with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is recommended as a treatment for people with mental ill-health as well as those who want to improve their mental health and wellbeing.” – Mental Health Foundation

 

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 mental and physical 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. Mindfulness appears to work well in clinical settings. But does it work well when mindfulness is trained in groups in community settings. It makes sense to step back and summarize what has been learned.

 

In today’s Research News article “Mindfulness-based programmes for mental health promotion in adults in nonclinical settings: A systematic review and meta-analysis of randomised controlled trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7799763/ ) Galante and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials of the effectiveness of mindfulness-based programs to improve mental health. They identified 136 trials including a total of 11,605 participants of the effectiveness of community-based group mindfulness programs.

 

They report that in comparison to no treatment controls, mindfulness-based programs produced significant improvements in anxiety, depression, psychological distress, and mental well-being. In comparison to non-therapeutic active controls mindfulness-based programs produced significant improvements in depression, and mental well-being. Finally, mindfulness-based programs did not appear to improve mental health to a greater extent that other therapeutic treatments. They further found that mindfulness-based programs appeared to work best for high-risk participants or those with subclinical levels of mental disorders.

 

There appears to be extensive research findings that suggest that group mindfulness-based programs in non-clinical, community, are as effective in improving mental health as other therapies. In particular they appear to decrease symptoms of anxiety, depression, and psychological distress and increase mental well-being. But, these programs do not appear to further improve mental health in people who already have excellent mental health. This suggests that mindfulness-based community programs should be implemented to improve the mental health of at-risk individuals or those who have metal health issues.

 

So, improve mental health with mindfulness.

 

“simple changes in lifestyle can lead to improved mental health and wellbeing.  Mindfulness is one such practice—with strong research supporting its usefulness for those suffering from anxiety, depression, or even just daily stress.” – U Minnesota

 

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

 

Galante, J., Friedrich, C., Dawson, A. F., Modrego-Alarcón, M., Gebbing, P., Delgado-Suárez, I., Gupta, R., Dean, L., Dalgleish, T., White, I. R., & Jones, P. B. (2021). Mindfulness-based programmes for mental health promotion in adults in nonclinical settings: A systematic review and meta-analysis of randomised controlled trials. PLoS medicine, 18(1), e1003481. https://doi.org/10.1371/journal.pmed.1003481

 

Abstract

Background

There is an urgent need for mental health promotion in nonclinical settings. Mindfulness–based programmes (MBPs) are being widely implemented to reduce stress, but a comprehensive evidence synthesis is lacking. We reviewed trials to assess whether MBPs promote mental health relative to no intervention or comparator interventions.

Methods and findings

Following a detailed preregistered protocol (PROSPERO CRD42018105213) developed with public and professional stakeholders, 13 databases were searched to August 2020 for randomised controlled trials (RCTs) examining in–person, expert–defined MBPs in nonclinical settings. Two researchers independently selected, extracted, and appraised trials using the Cochrane Risk–of–Bias Tool 2.0. Primary outcomes were psychometrically validated anxiety, depression, psychological distress, and mental well–being questionnaires at 1 to 6 months after programme completion. Multiple testing was performed using p < 0.0125 (Bonferroni) for statistical significance. Secondary outcomes, meta–regression and sensitivity analyses were prespecified. Pairwise random–effects multivariate meta–analyses and prediction intervals (PIs) were calculated.

A total of 11,605 participants in 136 trials were included (29 countries, 77% women, age range 18 to 73 years). Compared with no intervention, in most but not all scenarios MBPs improved average anxiety (8 trials; standardised mean difference (SMD) = −0.56; 95% confidence interval (CI) −0.80 to −0.33; p–value < 0.001; 95% PI −1.19 to 0.06), depression (14 trials; SMD = −0.53; 95% CI −0.72 to −0.34; p–value < 0.001; 95% PI −1.14 to 0.07), distress (27 trials; SMD = −0.45; 95% CI −0.58 to −0.31; p–value < 0.001; 95% PI −1.04 to 0.14), and well–being (9 trials; SMD = 0.33; 95% CI 0.11 to 0.54; p–value = 0.003; 95% PI −0.29 to 0.94). Compared with nonspecific active control conditions, in most but not all scenarios MBPs improved average depression (6 trials; SMD = −0.46; 95% CI −0.81 to −0.10; p–value = 0.012, 95% PI −1.57 to 0.66), with no statistically significant evidence for improving anxiety or distress and no reliable data on well–being. Compared with specific active control conditions, there is no statistically significant evidence of MBPs’ superiority. Only effects on distress remained when higher–risk trials were excluded. USA–based trials reported smaller effects. MBPs targeted at higher–risk populations had larger effects than universal MBPs. The main limitation of this review is that confidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach is moderate to very low, mainly due to inconsistency and high risk of bias in many trials.

Conclusions

Compared with taking no action, MBPs of the included studies promote mental health in nonclinical settings, but given the heterogeneity between studies, the findings do not support generalisation of MBP effects across every setting. MBPs may have specific effects on some common mental health symptoms. Other preventative interventions may be equally effective. Implementation of MBPs in nonclinical settings should be partnered with thorough research to confirm findings and learn which settings are most likely to benefit.

Author summary

Why was this study done?

Mindfulness courses to increase well–being and reduce stress have become very popular; most are in community settings.

Many randomised controlled trials (RCTs) tested whether mindfulness courses show benefit, but results are varied and, to our knowledge, there are no reviews combining the data from these studies to show an overall effect.

What did the researchers do and find?

Worldwide, we identified 136 RCTs on mindfulness training for mental health promotion in community settings. We reviewed them all, assessed their quality, and calculated their combined effects.

We showed that, compared with doing nothing, mindfulness reduces anxiety, depression, and stress, and increases well–being, but we cannot be sure that this will happen in every community setting.

In these RCTs, mindfulness is neither better nor worse than other feel–good practices such as physical exercise, and RCTs in this field tend to be of poor quality, so we cannot be sure that our combined results represent the true effects.

What do these findings mean?

Mindfulness courses in the community need to be implemented with care, because we cannot assume that they work for everyone, everywhere.

We need good quality collaborative research to find out which types of communities benefit from the different types of mindfulness courses available.

The courses that work best may be those aimed at people who are most stressed or in stressful situations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7799763/

 

Improve Recovery from Substance Abuse with Rolling Mindfulness Training

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Improve Recovery from Substance Abuse with Rolling Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“By facilitating conscious awareness with a nonjudgmental perspective, mindfulness can decrease the vicious circles of anxiety, fear, anger, sadness, depression, guilt, regret, and shame that make so many recovering people vulnerable to relapse.” – Dan Mager

 

Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use which includes unintentional overdoses, suicides, HIV and AIDS, and trauma. Obviously, there is a need to find effective methods to prevent and treat substance abuse. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers’ relapse and return to substance abuse. Hence, it is important to find an effective method to treat substance abuse and prevent relapse.

 

Mindfulness practices have been shown to improve recovery from various addictions. Mindfulness-based Relapse Prevention (MBRP) has been developed to specifically assist in relapse prevention and has been shown to be effective. “MBRP integrates mindfulness practices with cognitive-behavioral Relapse Prevention therapy and aims to help participants increase awareness and acceptance of difficult thoughts, feelings, and sensations to create changes in patterns of reactive behavior that commonly lead to relapse. Mindfulness training in MBRP provides clients with a new way of processing situational cues and monitoring internal reactions to contingencies, and this awareness supports proactive behavioral choices in the face of high-risk relapse situation.” – Grow et al. 2015

 

Typically, Mindfulness-based Relapse Prevention (MBRP) is administered with a group together from start to end. In practice in residential treatment programs, however, individuals enter treatment at different times. It would be important to examine whether MBRP with rolling admissions, where participants enter the therapy program at different times, is effective in treating substance abuse patients.

 

In today’s Research News article “An open trial of rolling admission mindfulness-based relapse prevention (Rolling MBRP): feasibility, acceptability, dose-response relations, and mechanisms.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6660179/) Roos and colleagues recruited residents in a short-term residential substance abuse disorders treatment program. They were provided 50 minute, twice per week, for 8 weeks group Mindfulness-based Relapse Prevention (MBRP) program. Participants could enter the program at any time during a 10-month period. They were measured before and after treatment for abstinent days, dependence severity, self-compassion, mindfulness, mental health, craving, and self-efficacy.

 

They found that the participants completed, on average, 3.69 sessions and the participants rated the sessions as very helpful. They found that in comparison to baseline and patients who did not participate, the rolling Mindfulness-based Relapse Prevention (MBRP) group had significantly decreased cravings, and increased mental health, mindfulness, and self-compassion. In addition, for attendees, the greater the amounts of formal and informal mindfulness practice, the greater the improvements in cravings, mental health, mindfulness, and self-compassion.

 

Prior studies demonstrated that mindfulness training improves mental health and self-compassion and is effective in improving the mental health of patients with a variety of addictions and in preventing substance abuse relapse. The present study is important in demonstrating that Mindfulness-based Relapse Prevention (MBRP) offered on a rolling basis is also effective. Such a rolling entry treatment program is better suited to the intake of patients in residential substance abuse treatment programs and makes MBRP more useable in these programs.

 

So, improve recovery from substance abuse with rolling mindfulness training.

 

“Learning about your personal triggers, developing the ability to breathe through discomfort, and creating a mindfulness based lifestyle in recovery can be lifesavers in both early sobriety and throughout the rest of your life.” -Clear Mind Treatment

 

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

 

Roos, C., Kirouac, M., Stein, E., Wilson, A., Bowen, S., & Witkiewitz, K. (2019). An open trial of rolling admission mindfulness-based relapse prevention (Rolling MBRP): feasibility, acceptability, dose-response relations, and mechanisms. Mindfulness, 10(6), 1062–1073. https://doi.org/10.1007/s12671-018-1054-5

 

Abstract

Mindfulness-based relapse prevention (MBRP) is an effective treatment for substance use disorders (SUD). However, evidence is primarily based on studies of closed groups, and few studies support flexible formats of MBRP, such as rolling groups. This nonrandomized, open trial evaluated feasibility, acceptability, dose-response relations, and mechanisms of rolling admission MBRP (“Rolling MBRP”) offered as part of short-term residential treatment for SUD. Rolling MBRP was developed prior to the trial through an iterative process over several years. Participants included 109 adults (46% female, 74.3% racial/ethnic minorities, mean age=36.40). Rolling MBRP was offered to all patients in the program 2x/week and attendance was tracked. Outcomes were craving, self-efficacy, mental health, mindfulness, and self-compassion at discharge. Self-reported out-of-session mindfulness practice was examined as a mediator of attendance-outcome relations. Analyses involved multiple regression and mediation models. Feasibility was demonstrated by good attendance rates. Acceptability was demonstrated by high engagement in mindfulness practice and high satisfaction ratings. Total sessions attended did not predict outcomes at discharge. However, attending 2+ sessions (versus 1 or none) significantly predicted better mental health and higher mindfulness at discharge, and these effects were mediated by informal and formal mindfulness practice. Total sessions attended had significant indirect effects on craving, self-compassion, mindfulness, and mental health, via mindfulness practice. Results support the feasibility and acceptability of Rolling MBRP and suggest mindfulness practice may be a key mechanism driving effects of MBRP on other key mechanisms during the recovery process, such as decreased craving and improved mental health.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6660179/

 

Mindfulness Improves Flexibility Which Improves Residual Symptoms of Depression

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Mindfulness Improves Flexibility Which Improves Residual Symptoms of Depression

 

By John M. de Castro, Ph.D.

 

“Living resiliently represents a whole new way of being and doing. It isn’t just for the hard times — it’s for all times. Empowering us to live, love, and work adventurously in the face of change, it builds a well from which we can draw for the rest of our lives.” – Lynda Klau

 

Depression affects over 6% of the population. Depression can be difficult to treat. It is usually treated with antidepressant medication. But, of patients treated initially with drugs only about a third attained remission of the depression. Even after remission there are a number of symptoms that remain. These include lingering dysphoria, impaired psychosocial functioning, fatigue, and decreased ability to work. These residual symptoms can lead to relapse.

 

Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail. Acceptance and Commitment Therapy (ACT) 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.

 

It is not known how Acceptance and Commitment Therapy (ACT) might affect the residual symptoms in individuals in remission from depression. In today’s Research News article “Psychological Flexibility in Depression Relapse Prevention: Processes of Change and Positive Mental Health in Group-Based ACT for Residual Symptoms.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7119364/), Østergaard and colleagues recruited patients in remission from major depressive disorder and provided them with 8 weekly sessions of group based Acceptance and Commitment Therapy (ACT). They were measured before and after ACT and 6 months and 1 year later for psychiatric symptoms, mental health depression, cognitive defusion, flexibility, values, engaged living and mindfulness.

 

They found that after treatment and for the year following there were significant reductions in depression and increases in positive mental health. Mediation analysis revealed that Acceptance and Commitment Therapy (ACT) decreased depression and increased positive mental health directly and indirectly by increasing psychological flexibility. That is ACT not only directly decreased depression and increased positive mental health but also increased psychological flexibility which in turn decreased depression and increased positive mental health. They also showed that ACT had these effects by changing acceptance, cognitive defusion, values, and committed action, all of which increased psychological flexibility.

 

Psychological flexibility is the ability to make changes in behavior in order to produce positive effects. It’s the individual’s ability to avoid rumination and brooding over negative emotions that contribute to depression. In this way psychological flexibility contributes to maintaining positive mental health. The study shows that ACT directly reduces residual symptoms and also increases psychological flexibility which in turn reduces residual symptoms in patients in remission from major depressive disorder. It is important to note that these benefits produced by ACT were enduring lasting over the year of testing. Hence, treatment with ACT  should reduce the likelihood of future depressive episodes.

 

So, mindfulness improves flexibility which improves residual symptoms of depression.

 

“Mindfulness is a shallow description of a much larger process that makes us resilient when bad things happen.” – Michael Unger

 

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

 

Østergaard, T., Lundgren, T., Zettle, R. D., Landrø, N. I., & Haaland, V. Ø. (2020). Psychological Flexibility in Depression Relapse Prevention: Processes of Change and Positive Mental Health in Group-Based ACT for Residual Symptoms. Frontiers in psychology, 11, 528. https://doi.org/10.3389/fpsyg.2020.00528

 

Abstract

Relapse rates following a depressive episode are high, with limited treatments available aimed at reducing such risk. Acceptance and commitment therapy (ACT) is a cognitive-behavioral approach that has gained increased empirical support in treatment of depression, and thus represents an alternative in relapse prevention. Psychological flexibility (PF) plays an important role in mental health according to the model on which ACT is based. This study aimed to investigate the role of PF and its subprocesses in reducing residual symptoms of depression and in improving positive mental health following an 8-week group-based ACT treatment. Adult participants (75.7% female) with a history of depression, but currently exhibiting residual symptoms (N = 106) completed measures before and after intervention, and at 6 and 12-month follow-up. A growth curve model showed that positive mental health increased over 12-months. Multilevel mediation modeling revealed that PF significantly mediated these changes as well as the reduction of depressive symptoms, and that processes of acceptance, cognitive defusion, values and committed action, in turn, mediated increased PF.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7119364/