Mental Health

Be Mindful for Improved Psychological Health

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Be Mindful for Improved Psychological Health

 

By John M. de Castro, Ph.D.

 

“We’ve seen this in the clinical domain for many years. People, in concert with their physicians… actually going off their medications for pain, for anxiety, for depression, as they begin to learn the self-regulatory elements of mindfulness. They discover that the things that used to be symptomatically problematic for them are no longer arising at the same level.” – Jon Kabat-Zinn

 

Mindfulness training has been shown through extensive research to be effective in improving the physical and psychological condition of otherwise healthy people and also treating the physical and psychological issues of people with illnesses and particularly with the physical and psychological reactions to stress. Techniques such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) as well as Yoga practice and Tai Chi or Qigong practice have been demonstrated to be particularly effective. This has led to an increasing adoption of these mindfulness techniques for the health and well-being of both healthy and ill individuals.

 

In fact, the degree of mindfulness, inherent in the individual, without training, known as dispositional mindfulness, has been shown to be associated with the degree of mental and physical health. In today’s Research News article “Dispositional Mindfulness and Psychological Health: a Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5770488/ ), Tomlinson and colleagues review and summarize the published scientific research regarding the relationship of dispositional mindfulness to psychological health. They identified 93 research studies that found three different areas of relationship.

 

They report that the published research found that dispositional mindfulness was associated with improved psychopathological symptoms. The published research report that the higher the individuals’ levels of dispositional mindfulness the lower the levels of depression, anxiety, disordered eating, Post-Traumatic Stress Disorder (PTSD) symptoms, and Borderline Personality Disorder (DPD) symptoms.

 

They report that the published research found that dispositional mindfulness was associated with improved cognitive performance. It was found that that the higher the individuals’ levels of dispositional mindfulness the lower the levels of avoidant coping strategies e.g. procrastination, rumination, impulsivity, catastrophizing and neuroticism, and the higher the levels of executive function (high level thinking).

 

Finally, they report that dispositional mindfulness was associated with improved emotional control. It was reported that the higher the individuals’ levels of dispositional mindfulness the lower the levels of perceived stress, emotional distress, and higher levels of emotion regulation, emotional stability, psychological well-being, and recovery following stressful conditions.

 

This review of the published research suggests that being generally mindful (dispositional mindfulness) is associated with psychological health and well-being. The problem with dispositional characteristics is that they cannot be manipulated as they are relatively stable characteristics of the individual. They can only be correlated with other characteristics. As such, it is impossible to conclude causal relationships between dispositional mindfulness and psychological health. It is equally likely that psychological health produces dispositional mindfulness, that dispositional mindfulness produces psychological health, or that a third factor causes both.

 

Manipulative research, producing changes in the short-term state of mindfulness, however, demonstrates that increases in mindfulness cause improvements in psychological well-being. So, it is likely that the observed relationships of dispositional mindfulness and psychological health are the result of dispositional mindfulness causing improved emotional and cognitive function and thereby reduced psychopathology and improved mental health.

 

So, be mindful for improved psychological health.

 

“A great deal of research has documented physical health benefits of mindfulness, such as an improved immune system, lower blood pressure, and better sleep. Mindfulness has also been linked to mental health benefits, such as reduced stress and anxiety, and improved concentration and focus, less emotional reactivity.” – American Psychiatric Association

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Eve R. Tomlinson, Omar Yousaf, Axel D. Vittersø, Lauraine Jones. Dispositional Mindfulness and Psychological Health: a Systematic Review. Mindfulness (N Y) 2018; 9(1): 23–43. Published online 2017 Jul 1. doi: 10.1007/s12671-017-0762-6

 

Abstract

Interest in the influence of dispositional mindfulness (DM) on psychological health has been gathering pace over recent years. Despite this, a systematic review of this topic has not been conducted. A systematic review can benefit the field by identifying the terminology and measures used by researchers and by highlighting methodological weaknesses and empirical gaps. We systematically reviewed non-interventional, quantitative papers on DM and psychological health in non-clinical samples published in English up to June 2016, following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A literature search was conducted using PsycINFO, PubMED, Medline and Embase, and 93 papers met the inclusion criteria. Within these, three main themes emerged, depicting the relationship between DM and psychological health: (1) DM appears to be inversely related to psychopathological symptoms such as depressive symptoms, (2) DM is positively linked to adaptive cognitive processes such as less rumination and pain catastrophizing and (3) DM appears to be associated with better emotional processing and regulation. These themes informed the creation of a taxonomy. We conclude that research has consistently shown a positive relationship between DM and psychological health. Suggestions for future research and conceptual and methodological limitations within the field are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5770488/

Retreat for Health

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Retreat for Health

 

By John M. de Castro, Ph.D.

 

“retreat confirmed the importance of taking time out of our busy lives to quietly reflect and connect with ourselves. I learned countless lessons that could have only happened through direct experience. Perhaps most importantly, I deeply accepted myself and vowed to continue leaning into my fears.” – Alyssa Siefert

 

Retreat can be a powerful experience. But, in some ways, is like being on vacation. Everything is taken care of, beds made, towels and linens provided, all meals prepared, and time is dictated by a detailed schedule of meditations, talks, question and answer periods, and reflective time. All the individual has to do is show up, meditate, relax, contemplate and listen. The retreatants are terribly spoiled! That seeming ease, however, is deceptive.

 

Retreat is actually quite difficult and challenging. It can be very tiring as it can run from early in the morning till late at night every day. It can also be physically challenging as engaging in sitting meditation repeatedly over the day is guaranteed to produce many aches and pains in the legs, back, and neck. But the real challenges are psychological, emotional, and spiritual. Retreat can be a real test. The darkness can descend. Deep emotional issues can emerge and may even overwhelm the individual. Many participants will spontaneously burst out in tears. Others may become overwhelmed with fear and anxiety and break out in cold sweats, and still others are sleepless and tormented. How can this be, that something so seemingly peaceful as silent retreat can be so emotionally wrenching? The secret is that the situation removes the minds ability to hide and distract.

 

Humans have done a tremendous job of providing distractions for the mind including books, movies, magazines, music, television, sports, amusement parks, surfing the internet, tweeting, texting, etc. Any time troubling thoughts or memories of traumatic experiences begin to emerge in everyday life, the subject can easily be changed by engaging in a distraction. So, the issues never have to truly be confronted. But, in silent retreat there is no escape. Difficult issues emerge and there is no place to hide. They must be confronted and experienced. With all these difficulties, why would anyone want to put themselves through such an ordeal and go on a meditation retreat? People go because they find that retreat produces many profound and sometimes life altering benefits.

 

In today’s Research News article “The health impact of residential retreats: a systematic review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5761096/ ), Naidoo and colleagues review and summarize the effects on health of attending a retreat. They discovered 23 scientific studies of the health effects of retreat of which 8 were randomized controlled trials. These studies included a wide range of participants including healthy individuals and people with mental and physical disorders. The retreats lasted from 2.5 to 15 days with most around a week.

 

They found that without exception the studies reported statistically significant improvements following the retreat in some outcome measures of mental or physical health. These benefits included significant improvements in quality of life, perceived physical health and health symptoms, as well as psychological and spiritual well-being, and even genetic markers of longevity. These benefits appear to last long after the completion of the retreat. So, retreat appears to produce substantial and lasting health benefits.

 

It is very difficult to find appropriate comparison conditions for a retreat or have a retreat with blind participants or researchers. So, there is a considerable risk of bias in all of these studies. Nevertheless, the universal findings of the scientific studies that have investigated the effects of participating in a retreat find significant psychological, physical, and spiritual benefits for healthy or sick individuals.

 

So, retreat for health.

 

“A 1-month Vipassana meditation retreat may yield improvements in mindfulness, affect and personality, even in experienced meditators.” – Montero Marin

 

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

 

Dhevaksha Naidoo, Adrian Schembri, Marc Cohen, The health impact of residential retreats: a systematic review. BMC Complement Altern Med. 2018; 18: 8. Published online 2018 Jan 10. doi: 10.1186/s12906-017-2078-4

 

Abstract

Background

Unhealthy lifestyles are a major factor in the development and exacerbation of many chronic diseases. Improving lifestyles though immersive residential experiences that promote healthy behaviours is a focus of the health retreat industry. This systematic review aims to identify and explore published studies on the health, wellbeing and economic impact of retreat experiences.

Methods

MEDLINE, CINAHL and PsychINFO databases were searched for residential retreat studies in English published prior to February 2017. Studies were included if they were written in English, involved an intervention program in a residential setting of one or more nights, and included before-and-after data related to the health of participants. Studies that did not meet the above criteria or contained only descriptive data from interviews or case studies were excluded.

Results

A total of 23 studies including eight randomised controlled trials, six non-randomised controlled trials and nine longitudinal cohort studies met the inclusion criteria. These studies included a total of 2592 participants from diverse geographical and demographic populations and a great heterogeneity of outcome measures, with seven studies examining objective outcomes such as blood pressure or biological makers of disease, and 16 studies examining subjective outcomes that mostly involved self-reported questionnaires on psychological and spiritual measures. All studies reported post-retreat health benefits ranging from immediately after to five-years post-retreat. Study populations varied widely and most studies had small sample sizes, poorly described methodology and little follow-up data, and no studies reported on health economic outcomes or adverse effects, making it difficult to make definite conclusions about specific conditions, safety or return on investment.

Conclusions

Health retreat experiences appear to have health benefits that include benefits for people with chronic diseases such as multiple sclerosis, various cancers, HIV/AIDS, heart conditions and mental health. Future research with larger numbers of subjects and longer follow-up periods are needed to investigate the health impact of different retreat experiences and the clinical populations most likely to benefit. Further studies are also needed to determine the economic benefits of retreat experiences for individuals, as well as for businesses, health insurers and policy makers.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5761096/

Improve Mental Health During Pregnancy with Mindfulness

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Improve Mental Health During Pregnancy with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Not only does cultivating moment-to-moment awareness of thoughts and surroundings seem to help pregnant women keep their stress down and their spirits up—benefits that are well-documented among other groups of people—it may also lead to healthier newborns with fewer developmental problems down the line.” – Kira Newman

 

The period of pregnancy is a time of intense physiological and psychological change. Anxiety, depression, and fear are quite common during pregnancy. More than 20 percent of pregnant women have an anxiety disorder, depressive symptoms, or both during pregnancy. A debilitating childbirth fear has been estimated to affect about 6% or pregnant women and 13% are sufficiently afraid to postpone pregnancy. It is difficult to deal with these emotions under the best of conditions but in combinations with the stresses of pregnancy can turn what could be a joyous experience of creating a human life into a horrible worrisome, torment.

 

The psychological health of pregnant women has consequences for fetal development, birthing, and consequently, child outcomes. Depression during pregnancy is associated with premature delivery and low birth weight. Hence, it is clear that there is a need for methods to treat depression, and anxiety during pregnancy. Since the fetus can be negatively impacted by drugs, it would be preferable to find a treatment that did not require drugs. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy. So, it would make sense to review and summarize the studies of the effects of mindfulness training during pregnancy.

 

In today’s Research News article “Mindfulness-Based Interventions During Pregnancy: 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/PMC5693962/ ), Dhillon and colleagues review, summarize, and perform a meta-analysis of 14 published controlled research studies of the effects of mindfulness training on the psychological health of the mother.

 

They found that the published research reports that mindfulness training during pregnancy produces significant reductions in anxiety, depression, and perceived stress, and increases in mindfulness. Hence, mindfulness training was found to significantly improve the psychological health of the pregnant women. Some studies identified similar trends but not significant differences and so there is some question as to the robustness of the effects. Further research is needed to verify these benefits.

 

It is well established that mindfulness training reduces anxiety, depression, and perceived stress in a wide array of healthy and ill individuals of a variety of ages. So, it is not surprising that mindfulness training has similar effects on pregnant women. But, that it does, is particularly important during pregnancy due to the consequences for the child and its development.

 

So, improve mental health during pregnancy with mindfulness.

 

“Practicing mindfulness during pregnancy and childbirth can bring great benefits, which will extend beyond the birth into the sometimes stressful, always profound and mostly joyful weeks and months of learning to care for our child. Mindfulness can be a source of strength and pleasure in our years as a family.“ – Daniel & Jannette

 

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

 

Dhillon, A., Sparkes, E., & Duarte, R. V. (2017). Mindfulness-Based Interventions During Pregnancy: a Systematic Review and Meta-analysis. Mindfulness, 8(6), 1421–1437. http://doi.org/10.1007/s12671-017-0726-x

 

Abstract

This systematic review aims to assess the effect of mindfulness-based interventions carried out during pregnancy exploring mindfulness and mental health outcomes. A systematic review was conducted to appraise the current literature on the subject area. Inclusion and exclusion criteria were agreed and after reviewing titles, abstracts and full papers, 14 articles met the inclusion criteria and were included in the review. The quality of included articles was checked using the Quality Assessment Tool for Quantitative Studies. Pooled results of the randomised controlled trials (RCTs) reporting outcomes on anxiety, depression and perceived stress indicated no differences between the mindfulness intervention group and the control group. Pooled results of the non-RCTs reporting anxiety, depression and perceived stress showed a significant benefit for the mindfulness group. Mindfulness as an outcome was assessed in four RCTs for which the pooled results show a significant difference in favour of the mindfulness intervention when compared to a control group. The pooled results of the four non-RCTs also indicate a significant difference following mindfulness intervention. Results suggest that mindfulness-based interventions can be beneficial for outcomes such as anxiety, depression, perceived stress and levels of mindfulness during the perinatal period. Further research would be useful to explore if such benefits are sustained during the post-natal period.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5693962/

Mindfulness is Associated with Reduced Inflexibility and Psychopathology in Adolescents

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Mindfulness is Associated with Reduced Inflexibility and Psychopathology in Adolescents

 

By John M. de Castro, Ph.D.

 

“As present-moment focused, mindfulness, acceptance, and defusion interventions alter the context, behavioral flexibility emerges and, with it, increased sensitivity to context, including that aspect of context we call consequences.” – Kelly Wilson

 

Adolescence should be a time of mental, physical, social, and emotional growth. It is during this time that higher levels of thinking, sometimes called executive function, develops. These executive functions are an important foundation for success in the complex modern world. But, adolescence can be a difficult time, fraught with challenges. During this time the child transitions to young adulthood; including the development of intellectual, psychological, physical, and social abilities and characteristics. There are so many changes occurring during this time that the child can feel overwhelmed and unable to cope with all that is required.

 

Making these profound changes successfully requires a good deal or flexibility, adapting and changing with the physical, psychological, and social changes of adolescence. In today’s Research News article “Inflexible Youngsters: Psychological and Psychopathological Correlates of the Avoidance and Fusion Questionnaire for Youths in Nonclinical Dutch Adolescents.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605724/, Muris and colleagues examined the relationships between mindfulness, inflexibility and mental health in adolescents. They recruited youths aged 12 to 16 years and had them complete measures of mindfulness, psychological inflexibility, thought suppression self-compassion, self-worth, self-efficacy, somatization, psychopathological symptoms, anxiety, depression, and aggression.

 

They found that the higher the levels of mindfulness the lower the levels of inflexibility, thought suppression, somatization, anxiety, depression, emotional problems, aggression, oppositional conduct, and the higher the levels of self-worth and self-efficacy. They also found that psychological inflexibility was inversely related to the same variables, with higher levels of inflexibility associated with higher levels of thought suppression, somatization, anxiety, depression, emotional problems, aggression, oppositional conduct, and the lower the levels of self-worth and self-efficacy. In other words, mindfulness was associated with positive mental health while inflexibility was associated with negative mental health in these youths.

 

They further investigated the effectiveness of psychological inflexibility to affect the mental health of the adolescents while holding mindfulness mathematically constant. They found that each had independent contributions to the levels of anxiety and depression, with mindfulness associated with lower values and inflexibility associated with higher values. So, mindfulness and psychological inflexibility appear to be independently associated with emotional health in adolescents.

 

It is important to keep in mind that this study was correlational and did not manipulate the levels of any variables. So, causal connections cannot be determined between the variables. The associations though suggest that both mindfulness and psychological flexibility are important contributors to the psychological development of adolescents. It will be interesting to investigate in future research whether training in mindfulness and flexibility will help to promote healthy mental health in youths.

 

“While psychological inflexibility was most strongly associated with Neuroticism , as expected, mindfulness demonstrated the strongest association with consciousness, a trait reflecting impulse control abilities and attention to detail.” – Robert Latzman

 

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

 

Muris, P., Meesters, C., Herings, A., Jansen, M., Vossen, C., & Kersten, P. (2017). Inflexible Youngsters: Psychological and Psychopathological Correlates of the Avoidance and Fusion Questionnaire for Youths in Nonclinical Dutch Adolescents. Mindfulness, 8(5), 1381–1392. http://doi.org/10.1007/s12671-017-0714-1

 

Abstract

The present study examined psychological and psychopathological correlates of psychological inflexibility as measured by the Avoidance and Fusion Questionnaire for Youth (AFQ-Y) in two independent samples of nonclinical Dutch adolescents aged between 12 and 18 years (Ns being 184 and 157). Participants completed a survey containing the AFQ-Y and scales assessing mindfulness, thought suppression, self-compassion, self-worth, self-efficacy, and internalizing/externalizing symptoms. In both samples, the AFQ-Y was found to be a reliable measure of psychological inflexibility that correlated in a theoretically meaningful way with other psychological constructs. Most importantly, AFQ-Y scores correlated positively with internalizing and externalizing symptoms, and in most cases, these associations remained significant when controlling for other measures. These findings suggest that psychological inflexibility is an important factor in youth psychopathology that needs to be further investigated in future research.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605724/

Improve Emotion Regulation, and in Turn, Anxiety, and Depression with Mindfulness

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Improve Emotion Regulation, and in Turn, Anxiety, and Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“With mindfulness meditation training or practice (even a little practice has been shown to make a difference), we become more able to allow disturbing emotions and thoughts to pass through awareness. We develop the ability to NOT act or react to every emotion or thought we have.” – Timothy Psychyl

 

Mindfulness practice has been shown to produce improved emotion regulation. Practitioners demonstrate the ability to fully sense and experience emotions, but respond to them in more appropriate and adaptive ways. In other words, mindful people are better able to experience yet control emotions. This is a very important consequence of mindfulness. Humans are very emotional creatures and these emotions can be very pleasant, providing the spice of life. But, when they get extreme they can produce misery and even mental illness. The ability of mindfulness training to improve emotion regulation is thought to be the basis for a wide variety of benefits that mindfulness provides to mental health and the treatment of mental illness especially depression and anxiety disorders.

 

In today’s Research News article “Emotion Regulation Mediates the Associations of Mindfulness on Symptoms of Depression and Anxiety in the General Population.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605587/, Freudenthaler and colleagues examine whether mindfulness practice improves mental health by improving emotion regulation. They recruited a large sample of relatively normal adults from the German population and measured them for mindfulness, emotion regulation, and psychological symptoms, particularly anxiety and depression.

 

They found that the higher the levels of mindfulness the lower the levels of anxiety, depression, and difficulties with emotion regulation and the greater the difficulties with emotion regulation the higher the levels of anxiety and depression. So, mindfulness was associated with better mental health and emotion regulation while difficulties in regulating emotions was associated with poorer mental health.

 

They also conducted a mediation analysis to determine whether the association of mindfulness with anxiety and depression was mediated by emotion regulation. They found that mindfulness was primarily associated with mental health by being associated with reduced difficulties with emotion regulation. But, there were still small but significant direct effects of mindfulness on reducing anxiety and depression. So, it appears that mindfulness is associated with reduced anxiety and depression primarily by improving emotion regulation. The small remaining direct effect of mindfulness suggests that other intermediaries may also be present.

 

These results are a strong confirmation that mindfulness markedly improves the individual’s ability to experience emotions, but respond to them in more appropriate and adaptive ways. This allows them to feel anxiety and depression but cope with it effectively. Anxiety and Depression are self-reinforcing. That is, the presence of anxiety tends to produce greater anxiety and the same is true for depression. So, by being able to respond adaptively to the feelings of anxiety and depression, the individual prevents the escalation of the emotions. Hence, mindfulness reduces anxiety and depression.

 

It should be kept in mind that the participants were normally functioning individuals and not people with serious mental health problems. It remains to be seen if these relationships will still be present in clinical populations. Regardless, the ability of mindfulness to improve the mental health of normal individuals is important for allowing the individual to thrive and be happy in their lives. This suggests that promoting mindfulness will have positive mental health benefits for entire populations of humans.

 

So, improve emotion regulation, and in turn, anxiety, and depression with mindfulness.

 

“Individuals who are naturally mindful can effectively regulate their emotions even without meditation, but for those who are not naturally mindful, simply forcing oneself to be mindful “in the moment” is not enough — it is necessary to engage in mindfulness meditation in order to effectively regulate your emotions.” – Crystal Goh

 

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

 

Freudenthaler, L., Turba, J. D., & Tran, U. S. (2017). Emotion Regulation Mediates the Associations of Mindfulness on Symptoms of Depression and Anxiety in the General Population. Mindfulness, 8(5), 1339–1344. http://doi.org/10.1007/s12671-017-0709-y

 

Abstract

In the last decade, clinical research on mindfulness and its positive effects on depression and anxiety have gained increased interest. Emotion regulation mediates the effects of mindfulness on mental health in clinical samples and among meditators. The present study examined whether these associations also generalize to the general population. Multi-group structural equation models tested with a sample of 853 adults whether difficulties in emotion regulation mediated the associations between overall mindfulness in addition to the Observe facet with symptoms of depression and anxiety and whether associations were similar among men and women. Emotion regulation partially mediated the associations of overall mindfulness with symptoms of depression and anxiety; associations with Observe were fully mediated. The magnitude of associations was similar among men and women. Mindfulness exerts positive effects on mental health among the general population mostly via improving emotion regulation. The training of mindfulness and emotion regulation may thus benefit mental health not only in clinical populations but also in the general population. Venues for further research are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605587/

Improve Prisoner Mental Health with Mindfulness

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Improve Prisoner Mental Health with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Through meditation, prisoners come to recognize their conditioning as their own and take responsibility for it, and ultimately step outside of it so their thoughts and actions can come from a space of freedom. For some it’s like a light bulb going off, for others it takes time. But they all get it eventually. You see, most of them have been in and out of jail many times. They know through personal experience that just because the jail door opens, it doesn’t mean their life is going to change. They understand that this issue of real freedom is not about being locked up or not.” – Fleet Maull

 

Around 2 ¼ million people are incarcerated in the United States. Even though prisons are euphemistically labelled correctional facilities very little correction actually occurs. This is supported by the rates of recidivism. About three quarters of prisoners who are released commit crimes and are sent back to prison within 5-years. The lack of actual treatment for the prisoners leaves them ill equipped to engage positively in society either inside or outside of prison. Hence, there is a need for effective treatment programs that help the prisoners while in prison and prepares them for life outside the prison.

 

About half of the prison population have diagnosed mental health problems, most of which are untreated. Hence, there is a need for therapeutic programs to treat these problems in prisoners. Contemplative practices are well suited to this environment. Mindfulness training teaches skills that may be very important for prisoners. In particular, it puts the practitioner in touch with their own bodies and feelings. It improves present moment awareness and helps to overcome rumination about the past and negative thinking about the future. It’s been shown to be useful in the treatment of the effects of trauma and attention deficit disorder. It also relieves stress and improves overall health and well-being. Finally, mindfulness training has been shown to be effective in treating depression, anxiety, and anger. It has also been shown to help overcome trauma in male prisoners.

 

In today’s Research News article “Outcomes of Psychological Therapies for Prisoners With Mental Health Problems: 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/PMC5518650/, Yoon and colleagues review and summarize the published research literature on the effectiveness of various therapies for the treatment of mental health problems in prisoners. They included randomized controlled trials that employed a variety of different therapies, including “Cognitive behavioral therapy, dialectical behavior therapy, Mindfulness-based Therapy, and other group treatments such as Music Therapy and Art Therapy,” but excluded trials which solely used drug treatments. The trials examined depressed mood, anxiety, trauma symptoms, overall psychopathology, somatization, and hostility/anger.

 

They found 37 published reports of randomized controlled trials. These trials reported positive improvements in the prisoners’ mental health with moderate effect sizes. These included improvements in depression anxiety, trauma symptoms, overall psychopathology, and hostility/anger. Cognitive Behavioral Therapy (CBT) and Mindfulness-based Therapies were the most effective therapies. It did not matter if they were administered in a group or individual format. Unfortunately, the small number of studies, 6, that reported 3 and 6-month follow up data reported that the effects did not last and were no longer significant at follow-up.

 

These are important findings that clearly support the application of cognitive and mindfulness-based therapies for the treatment of prisoner mental health problems. The lack of lasting effectiveness, though, is a problem. This may suggest that the practices learned in the treatments are not continued after the formal sessions end. There is clearly a need for more study and experimentation to develop more long-lasting protocols. Regardless, mindfulness training would appear to be a potentially safe and effective treatment for the mental health problems of prisoners. It has to be kept in mind that mindfulness training not only helps the prisoners while incarcerated, it also helps after release, and this reduces recidivism. This by itself means that mindfulness treatments are not only a humane use of prison resources, but are also cost-effective.

 

So, improve prisoner mental health with mindfulness.

 

“The data demonstrate a stark change in the prisoners themselves and their interactions with others. Before the training most prisoners felt hopeless. They engaged in aggressive behaviour and exhibited a strong sense of “us” versus “them”. Following the training, prisoners reported that they could lead their lives more mindfully, had found fresh purpose and that their lives now had meaning – even for those who expected to spend the rest of their days behind bars.” – Inmaculada Adarves-Yorno

 

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

 

Yoon, I. A., Slade, K., & Fazel, S. (2017). Outcomes of Psychological Therapies for Prisoners With Mental Health Problems: A Systematic Review and Meta-Analysis. Journal of Consulting and Clinical Psychology, 85(8), 783–802. http://doi.org/10.1037/ccp0000214

 

Abstract

Objective: Prisoners worldwide have substantial mental health needs, but the efficacy of psychological therapy in prisons is unknown. We aimed to systematically review psychological therapies with mental health outcomes in prisoners and qualitatively summarize difficulties in conducting randomized clinical trials (RCTs). Method: We systematically identified RCTs of psychological therapies with mental health outcomes in prisoners (37 studies). Effect sizes were calculated and meta-analyzed. Eligible studies were assessed for quality. Subgroup and metaregression analyses were conducted to examine sources of between-study heterogeneity. Thematic analysis reviewed difficulties in conducting prison RCTs. Results:In 37 identified studies, psychological therapies showed a medium effect size (0.50, 95% CI [0.34, 0.66]) with high levels of heterogeneity with the most evidence for CBT and mindfulness-based trials. Studies that used no treatment (0.77, 95% CI [0.50, 1.03]) or waitlist controls (0.71, 95% CI [0.43, 1.00]) had larger effect sizes than those that had treatment-as-usual or other psychological therapies as controls (0.21, 95% CI [0.01, 0.41]). Effects were not sustained on follow-up at 3 and 6 months. No differences were found between group and individual therapy, or different treatment types. The use of a fidelity measure was associated with lower effect sizes. Qualitative analysis identified difficulties with follow-up and institutional constraints on scheduling and implementation of trials. Conclusions: CBT and mindfulness-based therapies are modestly effective in prisoners for depression and anxiety outcomes. In prisons with existing psychological therapies, more evidence is required before additional therapies can be recommended.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5518650/

Improve Psychology and Physiology with a Meditation and Yoga Retreat

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Improve Psychology and Physiology with a Meditation and Yoga Retreat

 

By John M. de Castro, Ph.D.

 

“Yoga is fantastic for decreasing stress levels, and research has also shown that those who practice yoga regularly have higher levels of leptin and adiponectin in their bodies. Both of these natural chemicals work to alleviate inflammation in the body.” –  Julie Montagu

 

The immune system is designed to protect the body from threats like stress, infection, injury, and toxic chemicals. One of its tools is the Inflammatory response. This response works quite well for short-term infections and injuries. But when inflammation is protracted and becomes chronic, it can itself become a threat to health. It can produce autoimmune diseases such as colitis, Chron’s disease, arthritis, heart disease, increased cancer risk, lung disease, sleep disruption, gum disease, decreased bone health, psoriasis, and depression. Needless to say, chronic inflammation can create major health problems. Indeed, the presence of chronic inflammation is associated with reduced longevity. So, it is important for health to control the inflammatory response, allowing it to do its job in fighting off infection but reducing its activity when no external threat is apparent.

 

Of course, it is far better to prevent chronic inflammation in the first place than to treat it later. Mind-body techniques such as yoga, Tai Chi and meditation have been shown to adaptively reduce the inflammatory response. Most of these results were obtained from treating diseased individuals. It is important to establish if Mind-body techniques can be effective in preventing chronic inflammation also in healthy individuals. In today’s Research News article “Yoga, Meditation and Mind-Body Health: Increased BDNF, Cortisol Awakening Response, and Altered Inflammatory Marker Expression after a 3-Month Yoga and Meditation Retreat.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5483482/, Cahn and colleagues investigate the effects of a 3-month yoga and meditation retreat on the functioning of the immune and activation systems.

 

They recruited male and female experienced yoga and meditation practitioners (average of 2 hours practice per day for 4.5 years) who were participating in a 3-month yoga and meditation retreat. The retreat involved daily yoga (about 1.5 hours per day), meditation (about 2 hours), and chanting (about 1 hour) practices and a vegetarian diet. They were measured before and during the last week of the retreat for mindfulness, psychological symptoms, and absorption. They also provided a saliva sample for cortisol assay and a blood sample for markers of the inflammatory processes.

 

They found that although the participants had high psychological health before the retreat that following the retreat there were significant reductions in psychological symptoms including depression, anxiety, and bodily symptoms and an increase in mindfulness. There were also significant increases in the neurotrophic factor, BDNF, pro-inflammatory factors, and cortisol levels immediately after waking up in the morning. Hence participation in the retreat produced improved psychological health, brain protection and development factor, and increased inflammatory system activity, and morning activation. The study did not have a control condition. So, the results could be due simply to the passage of time or expectancy or attentional effects. Future studies should include a control condition.

 

The improved mental health is similar to prior research findings that mindfulness practices improve anxiety, depression, and somatic symptoms. They are, however, a bit surprising as the participants were very psychologically healthy at the beginning of the retreat. This underscores the power of mindfulness practices in improving mental health. The increase in BDNF levels also underscores the ability of mindfulness practices to improve brain processing as BDNF is a neurotrophic factor that promotes neuroplasticity and brain health. The biological results are quite surprising. They conflict with previous research that has shown that mindfulness practices decrease inflammatory factors and cortisol levels. It is possible that because the participants were experienced practitioners that the beneficial effects of mindfulness practices were already high and further improvements would be difficult to detect. In addition, the retreat was physically demanding. As such, increased inflammation would be adaptive.

 

So, improve the physiology to control inflammation and stress with a meditation and yoga retreat.

 

“The more we learn about yoga, the more we realize the benefits aren’t all in the mind. . . Yoga helps people to relax, making the heart rate go down, which is great for those with high blood pressure. The poses help increase flexibility and strength, bringing relief to back pain sufferers. Now, . . . it seems that those meditative sun salutations and downward dog poses can reduce inflammation, the body’s way of reacting to injury or irritation.” – Susan Brink

 

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

 

Cahn, B. R., Goodman, M. S., Peterson, C. T., Maturi, R., & Mills, P. J. (2017). Yoga, Meditation and Mind-Body Health: Increased BDNF, Cortisol Awakening Response, and Altered Inflammatory Marker Expression after a 3-Month Yoga and Meditation Retreat. Frontiers in Human Neuroscience, 11, 315. http://doi.org/10.3389/fnhum.2017.00315

 

Abstract

Thirty-eight individuals (mean age: 34.8 years old) participating in a 3-month yoga and meditation retreat were assessed before and after the intervention for psychometric measures, brain derived neurotrophic factor (BDNF), circadian salivary cortisol levels, and pro- and anti-inflammatory cytokines. Participation in the retreat was found to be associated with decreases in self-reported anxiety and depression as well as increases in mindfulness. As hypothesized, increases in the plasma levels of BDNF and increases in the magnitude of the cortisol awakening response (CAR) were also observed. The normalized change in BDNF levels was inversely correlated with BSI-18 anxiety scores at both the pre-retreat (r = 0.40, p < 0.05) and post-retreat (r = 0.52, p < 0.005) such that those with greater anxiety scores tended to exhibit smaller pre- to post-retreat increases in plasma BDNF levels. In line with a hypothesized decrease in inflammatory processes resulting from the yoga and meditation practices, we found that the plasma level of the anti-inflammatory cytokine Interleukin-10 was increased and the pro-inflammatory cytokine Interleukin-12 was reduced after the retreat. Contrary to our initial hypotheses, plasma levels of other pro-inflammatory cytokines, including Interferon Gamma (IFN-γ), Tumor Necrosis Factor (TNF-α), Interleukin-1β (IL-1β), Interleukin-6 (IL-6), and Interleukin-8 (IL-8) were increased after the retreat. Given evidence from previous studies of the positive effects of meditative practices on mental fitness, autonomic homeostasis and inflammatory status, we hypothesize that these findings are related to the meditative practices throughout the retreat; however, some of the observed changes may also be related to other aspects of the retreat such as physical exercise-related components of the yoga practice and diet. We hypothesize that the patterns of change observed here reflect mind-body integration and well-being. The increased BDNF levels observed is a potential mediator between meditative practices and brain health, the increased CAR is likely a reflection of increased dynamic physiological arousal, and the relationship of the dual enhancement of pro- and anti-inflammatory cytokine changes to healthy immunologic functioning is discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5483482/

Improve Mental Health in the Elderly with Mindfulness

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Improve Mental Health in the Elderly with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The interconnectedness of mind and body lies at the heart of mindfulness and this makes it highly relevant to older people who are more likely to experience physical health problems with associated psychological issues ­ such as reduced mobility and depression. It is thought that mindfulness can be particularly empowering to older people as it focuses on abilities rather than difficulties which may help older people to feel more engaged in decisions about their care.” – MyAgingParent.com

 

Human life is one of constant change. We revel in our increases in physical and mental capacities during development, but regret their decline during aging. As we age, there are systematic progressive declines in every system in the body, the brain included. This includes our mental abilities and results in impairments in memory, attention, and problem solving ability. It is inevitable and cannot be avoided. Aging also results in changes in mental health. Depression is very common in the elderly. The elderly cope with increasing loss of friends and family, deteriorating health, as well as concerns regarding finances on fixed incomes. All of these are legitimate sources of worry. In addition, many elderly experience withdrawal and isolation from social interactions. But, no matter how reasonable, the increased loneliness, worry and anxiety add extra stress that can impact on the elderly’s already deteriorating physical and psychological health.

 

Mindfulness appears to be effective for an array of physical and psychological issues that occur with aging. It appears to strengthen the immune system and reduce inflammation. It has also been shown to be beneficial in slowing or delaying physical and mental decline with aging. and improve cognitive processes. It has also been shown to reduce anxiety, worry, and depression and improve overall mental health. Since the global population of the elderly is increasing at unprecedented rates, it is imperative to investigate safe and effective methods to slow physical and mental aging and improve mental health in the elderly.

 

In today’s Research News article “Meditation in Stressed Older Adults: Improvements in Self-Rated Mental Health Not Paralleled by Improvements in Cognitive Function or Physiological Measures.” (See summary below). Oken and colleagues recruited health elderly between the ages of 50-85 (average age = 60 years) who did not evidence cognitive decline and who were at least mildly stressed. They were randomly assigned to either receive 6 weeks of mindfulness meditation practice or to a wait-list control condition. Mindfulness meditation practice included one-on-one instruction in body scan, sitting meditation, and breathing exercises. The participants were measured before and after training for mindfulness, perceived stress, positive and negative emotions, neuroticism, fatigue, quality of life, self-efficacy, sleep, executive function, memory, attention, physiological vital signs, and salivary cortisol levels.

 

They found that the mindful meditation group in comparison to the wait-list group and the baseline measures showed significant reductions in negative emotions, neuroticism, and perceived stress following training and significant increases in mindfulness, vitality, self-efficacy, agreeableness and conscientiousness. Hence, mindfulness meditation produced significant improvements in the overall mental health of the participants, but did not alter physical health or cognitive abilities.

 

These are important results that suggest that mindfulness meditation practice produces major improvements in the mental health of the elderly. The participants, however, were relatively young elderly with an average age of 60 and only one participant over 75. They were all in good health and demonstrated no cognitive issues. Hence, the failure to demonstrate any effects of mindfulness meditation on the physical health or cognitive ability of this group may have been due to the fact that they were high functioning at the beginning making it difficult to produce further improvements. Regardless, the results clearly show large and important effects of mindfulness meditation on the overall mental health of these young elderly. This suggests that mindfulness meditation should be incorporated into the lives of the elderly to improve their psychological state during their declining years.

 

So, improve mental health in the elderly with mindfulness.

 

“Mindfulness practice has a definite positive impact on issues such as recurrent depression, stress, anxiety, chronic physical pain and loneliness. For elderly people, loneliness is a major risk factor for health problems-such as cardiovascular disease and Alzheimer’s. Mindfulness meditation training can be used as a novel approach for reducing loneliness and the risk of disease. Research suggests that mindfulness meditation training is a promising intervention for improving the health of older adults.” – Bláthnait Ní Mhurchú

 

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

 

Oken, B.S., Wahbeh, H., Goodrich, E. et al. Meditation in Stressed Older Adults: Improvements in Self-Rated Mental Health Not Paralleled by Improvements in Cognitive Function or Physiological Measures. Mindfulness (2017) 8: 627. doi:10.1007/s12671-016-0640-7

 

Abstract

To determine if mindfulness meditation (MM) in older adults improves cognition and, secondarily, if MM improves mental health and physiology, 134 at least mildly stressed 50–85-year olds were randomized to a 6-week MM intervention or a waitlist control. Outcome measures were assessed at baseline and 2 months later at visit 2. The primary outcome measure was an executive function/attentional measure (flanker task). Other outcome measures included additional cognitive assessments, salivary cortisol, respiratory rate, heart rate variability, Positive and Negative Affect Schedule (PANAS), Center for Epidemiologic Studies Depression (CESD), Perceived Stress Scale (PSS), Neuroticism-Extraversion-Openness (NEO) personality traits, and SF-36 health-related quality of life. One hundred twenty-eight participants completed the study though visit 2 assessments. There was no significant change in the primary or other cognitive outcome measures. Even after statistical adjustment for multiple outcomes, self-rated measures related to negative affect and stress were all significantly improved in the MM intervention compared to waitlist group (PANAS-negative, CESD, PSS, and SF-36 health-related quality of life Vitality and Mental Health Component). The SF-36 Mental Health Component score improved more than the minimum clinically important difference. There were also significant changes in personality traits such as Neuroticism. Changes in positive affect were not observed. There were no group differences in salivary cortisol or heart rate variability. These moderate-sized improvements in self-rated measures were not paralleled by improvements in cognitive function or physiological measures. Potential explanations for this discrepancy in stress-related outcomes are discussed to help improve future studies.

Improve Veteran Health with In-Person and Telehealth Yoga

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Improve Veteran Health with In-Person and Telehealth Yoga

 

By John M. de Castro, Ph.D.

 

“The fact that veterans are embracing yoga and realizing its benefits speaks directly to the stigmas attached to both yoga and PTSD. Veterans practicing yoga illuminate the value of the practice for any person, from any walk of life, not just “new-age hippies.” It also demonstrates that suffering trauma that affects our mental health does not break us or make us any less human.” – Dana Santas

 

Mindfulness training has been shown through extensive research to be effective in improving the physical and psychological condition of otherwise healthy people and also treating the physical and psychological issues of people with illnesses and particularly with the physical and psychological reactions to stress. Techniques such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) as well as Yoga practice and Tai Chi or Qigong practice have been demonstrated to be particularly effective. This has led to an increasing adoption of these mindfulness techniques for the health and well-being of both healthy and ill individuals.

 

The vast majority of the mindfulness training techniques, adopted so far, however, require a certified trained therapist. This produces costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules. As a result, there has been attempts to develop alternative distance education approaches such as on-line mindfulness training programs and videoconferencing. These have tremendous advantages in decreasing costs and making training schedules much more flexible. But, the question arises as to whether these programs are as effective as their traditional counterparts. Many believe that the presence of a therapist is a crucial component to the success of the programs and the lack of an active therapist physically present in on-line or videoconferencing programs may greatly reduce their effectiveness. It is not known if yoga practice can be successfully delivered through distance videoconferencing programs.

 

In today’s Research News article “Results from a clinical yoga program for veterans: yoga via telehealth provides comparable satisfaction and health improvements to in-person yoga.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5381127/

Schulz-Heik and colleagues compared the effectiveness of yoga classes provided to veterans with a wide variety of physical and mental health problems. The classes were either in-person or the same class delivered via videoconferencing to a remote site. The classes were offered 13 times per week. The participants were free to attend whichever classes and how many they wanted on their own schedules. All participants who attended any classes during a two-week period were asked to complete a questionnaire on their satisfaction with the classes, global health, and 16 different health symptoms. Satisfaction with classes was demonstrated as 82% rated them excellent and 98% stated that they enjoyed the classes and 98% would recommend them to a friend.

 

They found that the veterans reported significant improvement in a wide range of physical and mental health symptoms, including overall pain, back pain, headache, upset stomach, sleep problems, energy level, irritability, concentration, anger, depression, anxiety, jumpiness, disturbing memories, and other symptoms. Importantly, the in-person and videoconferencing programs demonstrated equal improvements with no significant differences found between them.

 

These are very interesting results but must be interpreted with caution. There was no active control condition. So, the reported benefits might be due to placebo effects, experimenter bias, demand characteristics, etc. The results though are similar to those reported for yoga practice in randomized controlled trials and it is reasonable to conclude that the current yoga program produced similar benefits. Regardless, it is striking that the videoconferencing program was equally effective as the in-person program. This is important as it suggests that inexpensive mindfulness training can be offered to widespread audiences. In addition, videoconferencing training is convenient for the participants, as they do not have to go to a practitioners site on a particular schedule. This, in turn, allows for the application of yoga training for the prevention and treatment of psychological and physical disorders with busy people, low income people, and even people in remote locations, thus greatly expanding the numbers of people who can benefit.

 

“yoga is being increasingly embraced by Veterans Affairs and the military looking to move veterans off addictive painkillers and offer them alternative treatments for pain.” – Emily Wax-Thibodeaux

 

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

Schulz-Heik, R. J., Meyer, H., Mahoney, L., Stanton, M. V., Cho, R. H., Moore-Downing, D. P., … Bayley, P. J. (2017). Results from a clinical yoga program for veterans: yoga via telehealth provides comparable satisfaction and health improvements to in-person yoga. BMC Complementary and Alternative Medicine, 17, 198. http://doi.org/10.1186/s12906-017-1705-4

 

Abstract

Background

Yoga is increasingly popular, though little data regarding its implementation in healthcare settings is available. Similarly, telehealth is being utilized more frequently to increase access to healthcare; however we know of no research on the acceptability or effectiveness of yoga delivered through telehealth. Therefore, we evaluated the feasibility, acceptability, and patient-reported effectiveness of a clinical yoga program at a Veterans Affairs Medical Center and assessed whether these outcomes differed between those participating in-person and those participating via telehealth.

Methods

Veterans who attended a yoga class at the VA Palo Alto Health Care System were invited to complete an anonymous program evaluation survey.

Results

64 Veterans completed the survey. Participants reported high satisfaction with the classes and the instructors. More than 80% of participants who endorsed a problem with pain, energy level, depression, or anxiety reported improvement in these symptoms. Those who participated via telehealth did not differ from those who participated in-person in any measure of satisfaction, overall improvement (p = .40), or improvement in any of 16 specific health problems.

Conclusions

Delivering yoga to a wide range of patients within a healthcare setting appears to be feasible and acceptable, both when delivered in-person and via telehealth. Patients in this clinical yoga program reported high levels of satisfaction and improvement in multiple problem areas. This preliminary evidence for the effectiveness of a clinical yoga program complements prior evidence for the efficacy of yoga and supports the use of yoga in healthcare settings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5381127/

Improve Mental Health with On-line Mindfulness Training

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Improve Mental Health with On-line Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“Mindfulness meditation is known to improve symptoms of many physical and mental health conditions. However, the group settings in which mindfulness meditation typically is taught can be problematic for many participants, either because of inconvenient scheduling or because people are averse to sharing in public.” – eMindful

 

Mindfulness training has been shown through extensive research to be effective in improving the physical and psychological condition of otherwise healthy people and also treating the physical and psychological issues of people with illnesses and particularly with the physical and psychological reactions to stress. Techniques such as Mindfulness Training, Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) as well as Yoga practice and Tai Chi or Qigong practice have been demonstrated to be effective. This has led to an increasing adoption of these mindfulness techniques for the health and well-being of both healthy and ill individuals.

 

The vast majority of the mindfulness training techniques, however, require a certified trained therapist. This produces costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules. As a result, there has been attempts to develop on-line mindfulness training programs. These have tremendous advantages in decreasing costs and making training schedules much more flexible. But, the question arises as to whether these programs are as effective as their traditional counterparts. Many believe that the presence of a therapist is a crucial component to the success of the programs and the lack of an active therapist in on-line programs may greatly reduce their effectiveness.

 

In today’s Research News article “The Efficacy of Internet-Based Mindfulness Training and Cognitive-Behavioral Training With Telephone Support in the Enhancement of Mental Health Among College Students and Young Working Adults: Randomized Controlled Trial.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5382258/

Mak and colleagues recruited college students and young working adults and randomly assigned them to receive an 8-week on-line therapy program of either mindfulness training or Cognitive Behavioral Therapy aimed at improving physical and psychological health. Treatments were delivered in 8, 30-45 minute, on-line modules and included home practice. To help insurance compliance, all participants were phoned weekly by a trained treatment support specialist to answer questions and encourage compliance. They completed measurements before and after training and 3 months later of mental well-being, psychological distress, satisfaction with life, energy, sleep, pain, and their expectancies regarding the treatments.

 

They found that both the on-line mindfulness training and Cognitive Behavioral Therapy groups showed significant improvements in mental well-being, psychological distress, satisfaction with life, energy, sleep, and pain after training that was maintained at the 3-month follow-up. Hence, they did not find a difference between the therapies with participants in both groups showing significant improvements in mental and physical health.

 

The weakness of the study is that regardless of treatment all participants improved and there was not a no-treatment control condition. So, it is impossible to determine if the results were due to the therapy or to a placebo effect, the passage of time, experimenter bias, etc. In other words, it is clear that the participants improved but it is not clear that the therapies were responsible.

 

On the other hand, the strength of the study is that it involved therapies implemented on-line. This allows for widespread, inexpensive, and convenient distribution of the treatment programs thereby opening up treatment to individuals who live in remote areas, cannot afford traditional therapist led treatment, or do not have the time to come repeatedly to a clinic during the workday. In addition, the study found benefits to the physical and mental health of otherwise healthy young adults. So, the treatment is not just for the sick, but also produces benefits for the healthy.

 

So, improve mental health with on-line mindfulness training.

 

“there is emerging evidence that online MBIs have the potential to improve mental health outcomes, most notably stress.” – M.P.J. Spijkerman

 

 

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

Winnie WS Mak, Floria HN Chio, Amy TY Chan, Wacy WS Lui, Ellery KY Wu. The Efficacy of Internet-Based Mindfulness Training and Cognitive-Behavioral Training With Telephone Support in the Enhancement of Mental Health Among College Students and Young Working Adults: Randomized Controlled Trial. J Med Internet Res. 2017 Mar; 19(3): e84. Published online 2017 Mar 22. doi: 10.2196/jmir.6737

 

Abstract

Background

College students and working adults are particularly vulnerable to stress and other mental health problems, and mental health promotion and prevention are needed to promote their mental health. In recent decades, mindfulness-based training has demonstrated to be efficacious in treating physical and psychological conditions.

Objective

The aim of our study was to examine the efficacy of an Internet-based mindfulness training program (iMIND) in comparison with the well-established Internet-based cognitive-behavioral training program (iCBT) in promoting mental health among college students and young working adults.

Methods

This study was a 2-arm, unblinded, randomized controlled trial comparing iMIND with iCBT. Participants were recruited online and offline via mass emails, advertisements in newspapers and magazines, announcement and leaflets in primary care clinics, and social networking sites. Eligible participants were randomized into either the iMIND (n=604) or the iCBT (n=651) condition. Participants received 8 Web-based sessions with information and exercises related to mindfulness or cognitive-behavioral principles. Telephone or email support was provided by trained first tier supporters who were supervised by the study’s research team. Primary outcomes included mental and physical health-related measures, which were self-assessed online at preprogram, postprogram, and 3-month follow-up.

Results

Among the 1255 study participants, 213 and 127 completed the post- and 3-month follow-up assessment, respectively. Missing data were treated using restricted maximum likelihood estimation. Both iMIND (n=604) and iCBT (n=651) were efficacious in improving mental health, psychological distress, life satisfaction, sleep disturbance, and energy level.

Conclusions

Both Internet-based mental health programs showed potential in improving the mental health from pre- to postassessment, and such improvement was sustained at the 3-month follow-up. The high attrition rate in this study suggests the need for refinement in future technology-based psychological programs. Mental health professionals need to team up with experts in information technology to increase personalization of Web-based interventions to enhance adherence.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5382258/