Research News

Improve Treatment Resistant Obsessive-Compulsive Disorder with Compassion-Focused Therapy

psyjdc Leave a comment

Improve Treatment Resistant Obsessive-Compulsive Disorder with Compassion-Focused Therapy

 

By John M. de Castro, Ph.D.

 

“A big part of learning to live with OCD is to incorporate self-compassion. Instead of avoiding your anxiety, self-compassion invites you to look at it with understanding and gentle curiosity. This approach allows you to see your pain exactly how it is without self-judgment or self-criticism.” – Nancy Larsen

 

Obsessive-Compulsive Disorder (OCD) sufferers have repetitive anxiety producing intrusive thoughts (obsessions) that result in repetitive behaviors to reduce the anxiety (compulsions). In a typical example of OCD, the individual is concerned about germs and is unable to control the anxiety that these thoughts produce. Their solution is to engage in ritualized behaviors, such as repetitive cleaning or hand washing that for a short time relieves the anxiety. The obsessions and compulsions can become so frequent that they become a dominant theme in their lives. Hence OCD drastically reduces the quality of life and happiness of the sufferer and those around them. About 2% of the population, 3.3 million people in the U.S., are affected at some time in their life.

 

Fortunately, Obsessive-Compulsive Disorder (OCD) can be treated and many respond to Cognitive Behavioral Therapy (CBT). But some do not. Mindfulness training has been shown to be effective in treating OCD. One understudied meditation technique is Compassion -Focused Therapy. It is designed to develop kindness and compassion to oneself and others. On the face of it learning self-compassion would seem to be useful in dealing with OCD. But there is little empirical evidence.

 

In today’s Research News article “Compassion-Focused Group Therapy for Treatment-Resistant OCD: Initial Evaluation Using a Multiple Baseline Design.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7835278/ ) Petrocchi and colleagues recruited patients with Obsessive-Compulsive Disorder (OCD) who had received 6-months of Cognitive Behavioral Therapy (CBT) and still have significant residual OCD symptoms. They received 8 weekly 2-hour sessions of Compassion-Focused Therapy after varying periods of baseline (Multiple Baseline Research Design). The treatment consisted of training in meditation and visualization practices during sessions and at home. It is designed to replace self-criticism with self-compassion. Before and after training and 1 month later they were measured for OCD symptom severity, OCD symptom presence and distress, depression, fear of guilt, self-criticizing, self-attacking, self-reassuring, and self-compassion.

 

They found that the patients all had large improvements in Obsessive-Compulsive Disorder (OCD) symptoms that were maintained at the 1-month follow-up. They also found significant improvements in fear of guilt, self-criticism, and self-reassurance. In additions, there were less reliable improvements in depression and common humanity. Hence, Compassion-Focused Therapy improved the symptom of OCD in patients who didn’t respond to Cognitive Behavioral Therapy (CBT).

 

These are important preliminary findings that must be followed up with a large randomized controlled trial. But these results suggest that Compassion-Focused Therapy may be effective in treating Obsessive-Compulsive Disorder (OCD) symptoms in patients who do not respond to the gold standard treatment of Cognitive Behavioral Therapy (CBT). The results may suggest that CBT should incorporate Compassion-Focused training when being employed to treat OCD. This should be explored in future studies.

 

So, improve treatment resistant obsessive-compulsive disorder with compassion-focused therapy.

 

“people with OCD may feel better if they remind themselves that it is normal to worry, and that it is not their fault if their OCD symptoms get worse.” –  Jessica Caporuscio

 

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

 

Petrocchi, N., Cosentino, T., Pellegrini, V., Femia, G., D’Innocenzo, A., & Mancini, F. (2021). Compassion-Focused Group Therapy for Treatment-Resistant OCD: Initial Evaluation Using a Multiple Baseline Design. Frontiers in psychology, 11, 594277. https://doi.org/10.3389/fpsyg.2020.594277

 

Abstract

Obsessive–compulsive disorder (OCD) is a debilitating mental health disorder that can easily become a treatment-resistant condition. Although effective therapies exist, only about half of the patients seem to benefit from them when we consider treatment refusal, dropout rates, and residual symptoms. Thus, providing effective augmentation to standard therapies could improve existing treatments. Group compassion-focused interventions have shown promise for reducing depression, anxiety, and avoidance related to various clinical problems, but this approach has never been evaluated for OCD individuals. However, cultivating compassion for self and others seems crucial for OCD patients, given the accumulating research suggesting that fear of guilt, along with isolation and self-criticism, can strongly contribute to the development and maintenance of OCD. The primary aim of this pilot study was to evaluate the acceptability, tolerability, and effectiveness of an 8-week group compassion-focused intervention for reducing OCD symptoms, depression, fear of guilt and self-criticism, and increasing common humanity and compassionate self-reassuring skills in treatment-resistant OCD patients. Using a multiple baseline experimental design, the intervention was evaluated in a sample of OCD patients (N = 8) who had completed at least 6 months of CBT treatment for OCD, but who continued to suffer from significant symptoms. Participants were randomized to different baseline assessment lengths; they then received 8 weekly, 120-min group sessions of compassion-focused therapy for OCD (CFT-OCD), and then were tested again at post-treatment and at 1 month follow up. Despite the adverse external circumstances (post-treatment and follow-up data collection were carried out, respectively, at the beginning and in the middle of the Italian lockdown due to the COVID-19 pandemic), by the end of treatment, all participants demonstrated reliable decreases in OCD symptoms, and these improvements were maintained at 4-week follow-up for seven of eight participants. The intervention was also associated with improvements in fear of guilt, self-criticism, and self-reassurance, but less consistent improvements in depression and common humanity. Participants reported high levels of acceptability of and satisfaction with the intervention. Results suggest that the intervention may be beneficial as either a stand-alone treatment or as an augmentation to other treatments.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7835278/

 

Improve Psychological Well-Being and Happiness with Mindfulness

psyjdc Leave a comment

Improve Psychological Well-Being and Happiness with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness has been shown to help us be healthier, less affected by stress, more relaxed, more creative, more open to learning, sleep better, improve our relationships with others and feel happier and more satisfied with our lives.” – Action for Happiness

 

There has accumulated a large amount of research demonstrating that mindfulness practices have significant benefits for psychological, physical, and spiritual wellbeing. They have been shown to improve emotions and their regulation. They also increase happiness levels in practitioners. It is not known how mindfulness improves well-being and happiness, directly or through intermediaries. That is, does mindfulness produce these benefits directly or by altering a variable that in turn affects well-being and happiness.

 

In today’s Research News article “Relationships between Mindfulness, Purpose in Life, Happiness, Anxiety, and Depression: Testing a Mediation Model in a Sample of Women.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908241/ ) Crego and colleagues recruited online a transnational sample of adult women and had them complete online measures of mindfulness, purpose in life, behavioral activation, happiness, anxiety, and depression. These data were analyzed with regression analysis and structural equation modelling.

 

They found that the higher the levels of mindfulness, the higher the levels of purpose in life, behavioral activation, and happiness and the lower the levels of anxiety and depression. Similarly, the higher the levels of purpose in life, the higher the levels of mindfulness, behavioral activation, and happiness and the lower the levels of anxiety and depression. Finally, the higher the levels of behavioral activation, the higher the levels of mindfulness, purpose in life, and happiness and the lower the levels of anxiety and depression.

 

To untangle these similar associations, structural equation modelling was performed. It revealed that mindfulness was directly associated with higher levels of happiness and lower levels of anxiety and depression. But mindfulness was also indirectly associated with these variables through positive associations with purpose in life and behavioral activation which in turn were associated with higher levels of happiness and lower levels of anxiety and depression.

 

The findings are correlative, so caution must be exercised in making causal inferences. But previous research has shown that mindfulness training results in significant increases in purpose in life, behavioral activation, and happiness and significant decreases in anxiety and depression. So, the current findings likely represent causal connections between the variables. Hence, mindfulness improves psychological well-being directly and also indirectly by increasing purpose in live and behavioral activation which also improve psychological well-being. Clearly, being mindful leads to happiness.

 

So, improve psychological well-being and happiness with mindfulness.

 

“Happiness isn’t about being upbeat all the time. Instead, think of it as a trait—one that helps you to recognize even the tiniest moments of joy, to fully embrace the good stuff in life without pause, and to know that even when things aren’t going well, this hard time, too, shall pass.” Kelle Walsh

 

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

 

Crego, A., Yela, J. R., Gómez-Martínez, M. Á., Riesco-Matías, P., & Petisco-Rodríguez, C. (2021). Relationships between Mindfulness, Purpose in Life, Happiness, Anxiety, and Depression: Testing a Mediation Model in a Sample of Women. International journal of environmental research and public health, 18(3), 925. https://doi.org/10.3390/ijerph18030925

 

Abstract

Mindfulness is connected to positive outcomes related to mental health and well-being. However, the psychological mechanisms that account for these relationships are largely unknown. A multiple-step multiple mediator structural equation modeling (SEM) model was tested with mindfulness as the independent variable; purpose in life and behavioral activation as serial mediators; and happiness, anxiety, and depression as outcome measures. Data were obtained from 1267 women. Higher mindfulness was associated with higher levels of happiness and lower anxiety and depression symptoms. The association of mindfulness with the outcome variables could be partially accounted for by purpose in life and behavioral activation. The SEM model explained large proportions of variance in happiness (50%), anxiety (34%), and depression (44%) symptoms. Mindfulness is associated with both a sense of purpose in life and engagement in activities, which are also connected with positive outcomes. Moreover, having purposes in life is linked to higher levels of behavioral activation.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908241/

 

Have Better Sex with Mindfulness

psyjdc Leave a comment

Have Better Sex with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindful sex involves being able to observe and describe what’s happening inside your body and mind without sorting experiences into “bad” and “good” or trying to change your feelings. When we are able to do that, we can “turn off the autopilot.” – Gina Silverstein

 

Sex is a very important aspect of life. Problems with sex are very common and have negative consequences for relationships. While research suggests that sexual dysfunction is common, it is a topic that many people are hesitant or embarrassed to discuss. Women suffer from sexual dysfunction more than men with 43% of women and 31% of men reporting some degree of difficulty. Hence, sex has major impacts on people’s lives and relationships. Greater research attention to sexual activity and sexual satisfaction and the well-being of the individual is warranted.

 

Mindfulness trainings have been shown to improve a variety of psychological issues including emotion regulation, stress responses, trauma, fear and worry, anxiety, and depression, and self-esteem. Mindfulness training has also been found to improve relationships and to be useful in treating sexual problems. But there is little empirical research on the relationship of mindfulness with sexuality in normal, non-clinical, individuals.

 

In today’s Research News article “Mindfulness in Sexual Activity, Sexual Satisfaction and Erotic Fantasies in a Non-Clinical Sample.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908537/ )  Sánchez-Sánchez and colleagues recruited online adults who were meditation naïve or who practiced meditation for at least 5 months. They completed measures online of mindfulness, body awareness, sexual satisfaction, sexual activity, and sexual fantasies.

 

They found that the meditation practitioners were significantly higher in emotion regulation, family, academics, relationships, sociability, attention, health, sexuality, and leisure and significantly lower in perceived stress. They were also significantly higher in mindfulness, body awareness, sexual satisfaction, sexual activity, and sexual fantasies. They also found that the higher the levels of mindfulness and the amount of mindfulness practice, the higher the levels of body awareness sexual satisfaction and sexual activity. Also, they found that the higher the levels of mindfulness the lower the levels of body dissociation.

 

It should be kept in mind that there was no random assignment and so the groups may be quite different, People who meditate may be systematically different from those who don’t in many ways including the variables measured in this study. But previous research including randomized studies demonstrated that mindfulness produced higher levels of emotion regulation, family, academics, relationships, sociability, attention, health, and sexuality, and lower levels of stress. So, the present findings likely also represent causal connections.

 

These findings suggest that mindfulness is associated with better psychological and physical health and well-being. They also suggest that mindfulness is associated with better sexual function in terms of sexual activity, satisfaction with sex, and relationship quality and even a better sexual fantasy life. Sex is such an important aspect of life that many of the other psychological and physical benefits of mindfulness may emanate from the improved sex life of the individuals. Much more research is needed.

 

So, have better sex with mindfulness.

 

“Think of mindful sex as an invitation, as an opportunity to explore the mystery of sex. The reward is deeper intimacy, more meaningful connections, and (fingers crossed) greater physical pleasure.” – Kayti Christian

 

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

 

Sánchez-Sánchez, L. C., Rodríguez, M., García-Montes, J. M., Petisco-Rodríguez, C., & Fernández-García, R. (2021). Mindfulness in Sexual Activity, Sexual Satisfaction and Erotic Fantasies in a Non-Clinical Sample. International journal of environmental research and public health, 18(3), 1161. https://doi.org/10.3390/ijerph18031161

 

Abstract

The goal of this study is to better understand the relation between the practice of Mindfulness and the sexual activity, sexual satisfaction and erotic fantasies of Spanish-speaking participants. This research focuses on the comparison between people who practice Mindfulness versus naïve people, and explores the practice of Mindfulness and its relation with the following variables about sexuality: body awareness and bodily dissociation, personal sexual satisfaction, partner and relationship-related satisfaction, desire, subjective sexual arousal, genital arousal, orgasm, pain, attitudes towards sexual fantasies and types of sexual fantasies. The sample consisted of 106 selected adults, 32 men and 74 women, who completed six measures on an online survey platform: (a) Mindfulness Attention Awareness Scale (MAAS), (b) Scale of Body Connection (SBC), (c) New Sexual Satisfaction Scale (NSSS), (d) Scale of Sexual Activity in Women (SSA-W) and Men (SSA-M), (e) Hurlbert Index of Sexual Fantasy (HISF), (f) Wilson’s Sex Fantasy Questionnaire. In the MAAS, Body Awareness subscale (SBC), NSSS, SSA-W and SSA-M, HISF and intimate fantasies subscale (Wilson’s questionnaire), people in the Mindfulness condition showed higher scores and these differences were statistically significant. These results may have relevant implications in the sexuality of clinical and non-clinical samples.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908537/

 

Decrease Defensiveness and Increase Psychological Health with Meditation

psyjdc Leave a comment

Decrease Defensiveness and Increase Psychological Health with Meditation

 

By John M. de Castro, Ph.D.

 

“Meditation is the habitual process of training your mind to focus and redirect your thoughts. . . People also use the practice to develop other beneficial habits and feelings, such as a positive mood and outlook, self-discipline, healthy sleep patterns, and even increased pain tolerance.” – Matthew Thorpe

 

Over the last several decades, research and anecdotal experiences have accumulated an impressive evidential case that the development of mindfulness has positive benefits for the individual’s mental, physical, and spiritual life. Mindfulness appears to be beneficial both for healthy people and for people suffering from a myriad of illnesses. It appears to be beneficial across ages, from children to the elderly. And it appears to be beneficial across genders, personalities, race, and ethnicity. The breadth and depth of benefits is unprecedented.

 

Meditation practice has been shown to improve physical and psychological health and longevity. But people use defense mechanisms to cope with demanding emotional situations, including stress. It is not known if this defensiveness may interfere with the ability of meditation practice to improve the psychological health of the practitioners.

 

In today’s Research News article “Defensive Functioning Moderates the Effects of Nondirective Meditation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7876444/ )  Hersoug and colleagues recruited adult working professionals and had them attend a 2-hour seminar on stress management. Afterward they were assigned to either a no-treatment control condition or to receive 5 2-hour sessions over 8 weeks of open monitoring meditation training. They were measured before and after training and 1 and 4 months later for defense mechanisms, neuroticism, general health, insomnia, and musculoskeletal pain.

 

They found that in comparison to baseline and the control group, the group that received open monitoring meditation training had significant improvements in sleep, muscle pain, neuroticism, and general health. These improvements were maintained during the follow-up period. They also found that the levels of defense mechanisms moderated these improvements such that the greater the level of defensiveness, the smaller the impact of meditation training on the physical and psychological health of the participants.

 

The findings suggest that open monitoring meditation training is beneficial for the psychological and physical health of working professionals. This replicates previous findings that mindfulness training improves sleep, personality, health, and pain. The current study adds that these effects are negatively impacted by the level of defense mechanisms of the participants. In other words, using defense mechanisms when confronted by stress rather than seeing it for what it is interferes with the ability of open monitoring meditation to improve psychological functioning and health. This makes sense as open monitoring meditation practice is designed to improve the individual’s ability to see things as they are. Using defense mechanisms interferes with seeing things as they are.

 

So, decrease defensiveness and increase psychological health with meditation.

 

“mindfulness meditation . . .  practices focus on training attention and awareness in order to bring mental processes under greater voluntary control and thereby foster general mental well-being and development and/or specific capacities such as calmness, clarity and concentration.” – Daphne Davis

 

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

 

Hersoug, A. G., Wærsted, M., & Lau, B. (2021). Defensive Functioning Moderates the Effects of Nondirective Meditation. Frontiers in psychology, 12, 629784. https://doi.org/10.3389/fpsyg.2021.629784

 

Abstract

We have recently found that nondirective meditation facilitates stress reduction. This supplementary study investigated whether defensive functioning would moderate these beneficial effects. We explored the occurrence of defense mechanisms and the impact of defensive functioning on the outcome of companies’ stress management programs regarding worries nervousness, mental distress, sleep problems, and muscle pain. The sample was a population of active, working professionals recruited from Norwegian companies (n = 105). The intervention group obtained significant benefits on all outcome measures, but there were no effects in the control group. We analyzed defensive functioning with the self-report questionnaire, Life Style Index, at four time points. The healthy adults who participated had a low level of defense scores at the outset. There was a significant reduction in the level of defenses in both groups over the study period, 6 months. Defensive functioning significantly moderated the change of the outcome measures from baseline to follow-up in the intervention group, but not in the control group.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7876444/

 

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

psyjdc Leave a comment

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 Brain Function and Mental Health in Chronic Pain Patients with Mindfulness

psyjdc Leave a comment

Improve Brain Function and Mental Health in Chronic Pain Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“With the ACT approach, learning to let go of behaviors, memories, thoughts, and emotions creates space to explore new experiences, including acceptance of chronic pain sensations.” – Rosemary Black

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

 

Hence, it is important to find an effective method to treat Chronic pain. There is an accumulating volume of research findings to demonstrate that mindfulness practices, in general, are effective in treating pain. 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.

 

Pain experiences are processed in the nervous system. So, it’s likely that mindfulness practices somehow alter the brain’s processing of pain. So, it makes sense to study the how Acceptance and Commitment Therapy (ACT) may affect the brain to improve the mental health of chronic pain patients.

 

In today’s Research News article “Neural Mechanisms of Acceptance and Commitment Therapy for Chronic Pain: A Network-Based fMRI Approach.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7892587/ ) Aytur and colleagues recruited with musculoskeletal pain who did not abuse opioids. They completed 2 sessions per week for 4 weeks of Acceptance and Commitment Therapy (ACT). Before and after therapy they were measured for acceptance, chronic pain acceptance, quality of life, pain interference, and depression. Brain systems were measured before and after therapy with functional Magnetic Resonance Imaging (fMRI).

 

They found that in comparison to baseline after Acceptance and Commitment Therapy (ACT) the participants had significant increases in acceptance, chronic pain acceptance, quality of life and significant decreases in pain interference, and depression. In the fMRIs they also observed significant decreases in activation and connectivity in the Default Mode Network (DMN), Salience Network (SN), and Frontal-Parietal Network (FPN) networks of the brain. In addition, they observed that changes in the connectivity between these networks were correlated with decreases in depression and pain interference, and increases in quality of life.

 

These are interesting results that need to be interpreted with caution as there wasn’t a control, comparison condition present opening the findings up to alternative confounded interpretations. But the results replicate previous findings with controlled designs that Acceptance and Commitment Therapy (ACT) produces improvements in depression, pain, and quality of life. So, the improvements observed in the present study are likely due to causal effects of ACT.

 

These results also show that the psychological improvements produced by Acceptance and Commitment Therapy (ACT) are related to changes in the activity and connectivity within and between significant brain networks. This suggests that these neural alterations may underly the improvements in mental health of chronic pain patients produced by ACT. It remains for future studies to unravel the cause effect relationships.

 

So, improve brain function and mental health in chronic pain patients with mindfulness.

 

“ACT can help us to break out of that box that we have created for ourselves. To understand that the key to living with our condition is not to limit our lives and miss out on experiences, but instead to face things head on and be dedicated to working with our pain and doing things that bring us joy. ACT’s goal is not necessarily to reduce the pain but to help you to live your life with it, to feel more confident in engaging in activities that you might have otherwise swayed away from.” – Ann-Marie D’arcy-Sharpe

 

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

 

Aytur, S. A., Ray, K. L., Meier, S. K., Campbell, J., Gendron, B., Waller, N., & Robin, D. A. (2021). Neural Mechanisms of Acceptance and Commitment Therapy for Chronic Pain: A Network-Based fMRI Approach. Frontiers in human neuroscience, 15, 587018. https://doi.org/10.3389/fnhum.2021.587018

 

Abstract

Over 100 million Americans suffer from chronic pain (CP), which causes more disability than any other medical condition in the United States at a cost of $560–$635 billion per year (Institute of Medicine, 2011). Opioid analgesics are frequently used to treat CP. However, long term use of opioids can cause brain changes such as opioid-induced hyperalgesia that, over time, increase pain sensation. Also, opioids fail to treat complex psychological factors that worsen pain-related disability, including beliefs about and emotional responses to pain. Cognitive behavioral therapy (CBT) can be efficacious for CP. However, CBT generally does not focus on important factors needed for long-term functional improvement, including attainment of personal goals and the psychological flexibility to choose responses to pain. Acceptance and Commitment Therapy (ACT) has been recognized as an effective, non-pharmacologic treatment for a variety of CP conditions (Gutierrez et al., 2004). However, little is known about the neurologic mechanisms underlying ACT. We conducted an ACT intervention in women (n = 9) with chronic musculoskeletal pain. Functional magnetic resonance imaging (fMRI) data were collected pre- and post-ACT, and changes in functional connectivity (FC) were measured using Network-Based Statistics (NBS). Behavioral outcomes were measured using validated assessments such as the Acceptance and Action Questionnaire (AAQ-II), the Chronic Pain Acceptance Questionnaire (CPAQ), the Center for Epidemiologic Studies Depression Scale (CES-D), and the NIH Toolbox Neuro-QoLTM (Quality of Life in Neurological Disorders) scales. Results suggest that, following the 4-week ACT intervention, participants exhibited reductions in brain activation within and between key networks including self-reflection (default mode, DMN), emotion (salience, SN), and cognitive control (frontal parietal, FPN). These changes in connectivity strength were correlated with changes in behavioral outcomes including decreased depression and pain interference, and increased participation in social roles. This study is one of the first to demonstrate that improved function across the DMN, SN, and FPN may drive the positive outcomes associated with ACT. This study contributes to the emerging evidence supporting the use of neurophysiological indices to characterize treatment effects of alternative and complementary mind-body therapies.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7892587/

 

Improve Psychological Well-Being in Cancer Survivors with Online Mindfulness-Based Cognitive Therapy (MBCT)

psyjdc Leave a comment

Improve Psychological Well-Being in Cancer Survivors with Online Mindfulness-Based Cognitive Therapy (MBCT)

 

By John M. de Castro, Ph.D.

 

“both MBCT and eMBCT interventions reduced fear of cancer recurrence and rumination, and increased mental health–related quality of life, mindfulness skills, and positive mental health.” – Félix Compen

 

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

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatigue, stress,  sleep disturbance, fear, and anxiety and depression. Mindfulness-Based Cognitive Therapy (MBCT) is a well-established therapy that involves mindfulness training and cognitive therapy to change maladaptive thought processes. MBCT has been found to be effective in reducing the residual psychological issues that are common in cancer survivors.

 

But the vast majority of the mindfulness training techniques require a trained therapist. This results in costs that many parents 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 parents’ busy schedules and at locations that may not be convenient. As an alternative, mindfulness trainings over the internet have been developed. These have tremendous advantages in making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. So, it makes sense to explore the effectiveness of internet-based Mindfulness-Based Cognitive Therapy (iMBCT) in treating the psychological symptoms of cancer survivors.

 

In today’s Research News article “Internet-delivered Mindfulness-Based Cognitive Therapy for anxiety and depression in cancer survivors: Predictors of treatment response.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7843453/ )  Nissen and colleagues recruited adult breast and prostrate cancer survivors and randomly assigned them to a wait-list control condition or to receive internet-based Mindfulness-Based Cognitive Therapy (iMBCT); consisting of 8 1-week modules. They were measured before and after training and 6 months later for mindfulness, self-compassion, anxiety, depression, and therapy related working reliance.

 

They found that at baseline the higher the levels of self-compassion and the mindfulness facets of describing, non-judging, and acting with awareness, the lower the levels of anxiety and depression. Mindfulness-Based Cognitive Therapy (iMBCT) resulted in significant decreases in anxiety and depression. The amount of decrease in anxiety was related to the baseline depression level with the most depressed participants having the greatest reductions, while the amount of decrease in depression was related to the baseline self-compassion level with the participants with the highest levels of self-compassion having the greatest reductions. Neither mindfulness, therapy related working reliance, nor were related to the improvements.

 

These are interesting results that replicate previous findings of mindfulness training producing improvements in depression and anxiety in cancer patients, and that mindfulness training over the internet is effective in improving cancer patients. The primary intent of the research, though, was to examine predictors of patient responsiveness to the therapy. The results here were disappointing as only baseline self-compassion was related to depression improvements and only baseline depression was related to improvements in anxiety. Regardless, it is clear that mindfulness training can be successfully implemented over the internet and it is effective in improving the levels of anxiety and depression in cancer survivors.

 

So, improve psychological well-being in cancer survivors with online Mindfulness-Based Cognitive Therapy (iMBCT).

 

“I love being more mindful. Instead of waiting for the flowers to come out, I go out in the garden and see what is happening now. I am happier. Things still get difficult at times and when they do, I do my practice.” – MBCT Patient

 

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

 

Nissen, E. R., Zachariae, R., O’Connor, M., Kaldo, V., Jørgensen, C. R., Højris, I., Borre, M., & Mehlsen, M. (2021). Internet-delivered Mindfulness-Based Cognitive Therapy for anxiety and depression in cancer survivors: Predictors of treatment response. Internet interventions, 23, 100365. https://doi.org/10.1016/j.invent.2021.100365

 

Abstract

Background

The present study investigates possible predictors of treatment response in an Internet-delivered Mindfulness-Based Cognitive Therapy (iMBCT) intervention with therapist support. This iMBCT program, a fully online delivered intervention with asynchronous therapist support, has previously been shown to be efficacious in reducing symptoms of anxiety and depression in women treated for breast cancer and men treated for prostate cancer.

Methods

Eighty-two breast- and prostate cancer survivors experiencing psychological distress received 8 weeks of therapist-guided iMBCT. Primary outcomes were improvement in anxiety and depression scores from baseline to post-treatment and from baseline to six-months follow-up. Clinical predictors included levels of depression and anxiety at the time of screening and at baseline, as well as time since diagnosis. Demographic predictors included age and educational level. Therapy-related predictors included working alliance, self-compassion, and five facets of mindfulness. Mixed Linear Models were employed to test the prediction effects over time.

Results

Higher levels of baseline depression were associated with increased treatment response in anxiety at post-treatment, and lower levels of self-compassion were associated with increased treatment response in depression at post-treatment. None of the proposed predictors significantly predicted treatment response at six-months follow-up.

Conclusion

The findings suggest that iMBCT can be provided for cancer survivors regardless of their age, educational level, and time since diagnosis (up to five years) and that therapeutic alliance is not crucial for treatment response. We did not identify characteristics predicting treatment response, although many factors were tested. Still, other characteristics may be predictors, and given the relatively small sample size and a large number of statistical tests, the results should be interpreted with caution.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7843453/

 

Mindfulness-Based Therapies Benefits are Greatly Affected by Social Factors in Therapy

psyjdc Leave a comment

Mindfulness-Based Therapies Benefits are Greatly Affected by Social Factors in Therapy

 

By John M. de Castro, Ph.D.

 

“Designed to deliberately focus a person’s attention on the present experience in a way that is non-judgmental, mindfulness-based interventions, whether offered individually or in a group setting, may offer benefit to people seeking therapy for any number of concerns.” – Manuel A. Manotas

 

Psychotherapy is an interpersonal transaction. Its effectiveness in treating the ills of the client is to some extent dependent upon the chemistry between the therapist and the client, termed the therapeutic alliance. Research has demonstrated that there is a positive relationship with moderate effect sizes between treatment outcomes and the depth of the therapeutic alliance.

 

There are also other factors that may be important for successful therapy. The client’s engagement in the process as well as the therapists interpersonal skills may also be important ingredients in producing successful therapeutic outcomes. There are also important social factors present particularly when the therapy is provided in groups. In addition, formal and informal practice effects are involved. There is little known, however, of the role of these components of therapy on the effectiveness of treatment for mental health issues such as depression.

 

In today’s Research News article “The Contribution of Common and Specific Therapeutic Factors to Mindfulness-Based Intervention Outcomes.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874060/ )  Canby and colleagues recruited patients diagnosed with mild to severe depression and randomly assigned them to receive once a week for 8 weeks, 3 hour sessions of either focused meditation, open monitoring meditation or Mindfulness-Based Cognitive Therapy (MBCT) which contains both focused and open monitoring meditation practices. Before and after the 8-weeks of practice and 3 months later they were measured for empathy, therapeutic alliance, formal and informal mindfulness practices, depression, anxiety, stress, mindfulness, and group therapeutic factors in group therapy: instillation of hope, secure emotional expression, awareness of relational impact, and social learning. Finally, they received structured interviews exploring mindfulness practices and impact of treatment.

 

They found that the over treatment and follow-up the groups had significantly increased mindfulness and significantly decreased anxiety, depression and stress. They found that the higher the ratings of the instructors. the ratings of the groups and the amounts of formal meditation practice the greater the changes. In general, the instructor and group factors had stronger relationships to the psychological improvements than the amount of formal meditation and the amount of informal meditation practice had no relationship with the improvements. The analysis of the structured interviews indicated that the participants found the instructor and group factors including bonding, instilling hope, and expressing feelings were important to their improvements.

 

These results are interesting replicate previous findings of mindfulness-based therapies produce improvements in anxiety, depression, and stress. The results suggest that mindfulness-based therapies have complex effects and changes in mindfulness may be less important than the social environment produced by the instructor and the group. These social factors may account for a large proportion of the benefits to the participants. These results are important as they suggest that empathizing the social interactions involved in therapy may improve the impact of the therapy on the patients’ psychological well-being.

 

So, mindfulness-based therapies benefits are greatly affected by social factors in therapy.

 

“Mindfulness’ strength is in helping us to see more clearly, by giving us the room to not be so quickly reactive. And over time the event does not have to jump to emotional distress, like a grasshopper leaping over a stream.” – Barry Boyce

 

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

 

Canby, N. K., Eichel, K., Lindahl, J., Chau, S., Cordova, J., & Britton, W. B. (2021). The Contribution of Common and Specific Therapeutic Factors to Mindfulness-Based Intervention Outcomes. Frontiers in psychology, 11, 603394. https://doi.org/10.3389/fpsyg.2020.603394

 

Abstract

While Mindfulness-Based Interventions (MBIs) have been shown to be effective for a range of patient populations and outcomes, a question remains as to the role of common therapeutic factors, as opposed to the specific effects of mindfulness practice, in contributing to patient improvements. This project used a mixed-method design to investigate the contribution of specific (mindfulness practice-related) and common (instructor and group related) therapeutic factors to client improvements within an MBI. Participants with mild-severe depression (N = 104; 73% female, M age = 40.28) participated in an 8-week MBI. Specific therapeutic factors (formal out-of-class meditation minutes and informal mindfulness practice frequency) and social common factors (instructor and group ratings) were entered into multilevel growth curve models to predict changes in depression, anxiety, stress, and mindfulness at six timepoints from baseline to 3-month follow-up. Qualitative interviews with participants provided rich descriptions of how instructor and group related factors played a role in therapeutic trajectories. Findings indicated that instructor ratings predicted changes in depression and stress, group ratings predicted changes in stress and self-reported mindfulness, and formal meditation predicted changes in anxiety and stress, while informal mindfulness practice did not predict client improvements. Social common factors were stronger predictors of improvements in depression, stress, and self-reported mindfulness than specific mindfulness practice-related factors. Qualitative data supported the importance of relationships with instructor and group members, involving bonding, expressing feelings, and instilling hope. Our findings dispel the myth that MBI outcomes are exclusively the result of mindfulness meditation practice, and suggest that social common factors may account for much of the effects of these interventions. Further research on meditation should take into consideration the effects of social context and other common therapeutic factors.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874060/

 

Improve Physiological Responses to Stress in Schools with Mind-Body Practices

psyjdc Leave a comment

Improve Physiological Responses to Stress in Schools with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

“Mindfulness exercises have been shown to help students reduce stress and anxiety, gain conscious control over behaviors and attitudes, and improve focus.” – Robin L. Flanigan

 

In the modern world education is a key for success. Where a high school education was sufficient in previous generations, a college degree is now required to succeed in the new knowledge-based economies. There is a lot of pressure on students to excel so that they can get into the best schools and ultimately the best jobs. As a result, parents and students are constantly looking for ways to improve student performance in school. The primary tactic has been to pressure the student and clear away routine tasks and chores so that the student can focus on their studies. But, this might in fact be counterproductive as the increased pressure can actually lead to stress, depression, and anxiety which can impede the student’s mental health, well-being, and school performance.

 

It is, for the most part, beyond the ability of the individual to change the environment to reduce stress, so it is important that methods be found to reduce the students’ responses to stress; to make them more resilient when high levels of stress occur. Mind-body practices including meditation, mindfulness training, and yoga practice have been shown to reduce the psychological and physiological responses to stress. There is accumulating evidence of the effectiveness of mind-body practices on the students’ stress levels. So, it makes sense to summarize what has been learned.

 

In today’s Research News article “Mind-Body Physical Activity Interventions and Stress-Related Physiological Markers in Educational Settings: 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/PMC7795448/ ) Strehli and colleagues review, summarize, and perform a meta-analysis of the published research studies on the ability of mind-body practices to lower physiological indicators of stress in schools. They included studies involving elementary school, high school, and college students.

 

They identified 26 published studies, 80% of which were yoga based. They report that the published research found that the mind-body practices resulted in significant decreases in heart rate, systolic and diastolic blood pressure, and stress hormone (cortisol) levels. These effects were stronger for the college students and less so for high school and elementary school children.

 

The results suggest that mind-body practices reduce the physiological indicators of stress in school children and adolescents. This fits with previous findings with a variety of groups that mindfulness practices reduce the physiological responses to stress. This is thought to result from increases in balance in the autonomic nervous system. Regardless the published research literature suggests that mind-body practices are beneficial for school students, particularly college students, reducing their levels of stress.

 

So, improve physiological responses to stress in schools with mind-body practices.

 

“Students who engage in mindful movement activities can see a multitude of benefits, including increased strength and energy, better posture, reduced stress and improved attentiveness, self-confidence, self-awareness and self-care habits. Mind-body exercises also provide ways to build and strengthen relationships with others.” – Accredited Schools Online

 

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

 

Strehli, I., Burns, R. D., Bai, Y., Ziegenfuss, D. H., Block, M. E., & Brusseau, T. A. (2020). Mind-Body Physical Activity Interventions and Stress-Related Physiological Markers in Educational Settings: A Systematic Review and Meta-Analysis. International journal of environmental research and public health, 18(1), 224. https://doi.org/10.3390/ijerph18010224

 

Abstract

Mind–Body Physical Activity (MBPA) in educational settings is one possible preventive strategy for ameliorating stress-related physiological health parameters. The objectives of this study were to conduct a systematic review of the literature with meta-analyses on the effects of MBPA on stress-related physiological health markers in primary, secondary, and higher education students. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the search for peer-reviewed articles published in English was conducted in PubMed, EBSCOhost, PsychInfo, Scopus, and Cochrane Library databases. Criteria for inclusion consisted of empirical studies targeting the student population (primary, secondary, higher education), studies examining the effectiveness of an MBPA intervention, studies including a control or comparison group (pre-test/post-test studies excluded), studies targeting physiological marker outcomes such as heart rate, blood glucose, cortisol, and blood pressure, and finally, studies examining interventions implemented within educational settings. Twenty-six interventions were eligible for the review and quantitative synthesis, which comprised a total of 1625 participants, with 783 students serving within the control/comparison group. There were statistically significant and large pooled effects for MBPA effectiveness for lowering heart rate (Hedges’ g = −1.71, 95% Confidence Interval (CI): −2.43, −0.98), cortisol (Hedges’ g = −1.32, 95% CI: −2.50, −0.16), and systolic and diastolic blood pressure (Hedges’ g = −1.04, 95% CI: −1.53, −0.58). These effects tended to be stronger in older students compared to younger students. Most analyses were characterized as having high heterogeneity and only 10 of the 26 studies were characterized as good quality (38.4%). MBPA interventions may have a positive impact on specific physiological health markers in students, especially in students within higher education. However, higher-quality research is needed in this area.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7795448/

 

Self-centeredness Moderates the Effect of Mindfulness on Psychological Health

psyjdc Leave a comment

 

Improve Physical Function in Chronic Pain Patients with Mind-Body Practice

 

By John M. de Castro, Ph.D.

 

“mind-body practices like tai chi, yoga, mindfulness and cognitive-behavioral therapy can all relieve lower back pain effectively.” – Wayne Jonas

 

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

 

There is an accumulating volume of research findings that demonstrate that mindfulness practices, in general, are effective in treating pain. Yoga practice has been shown to have a myriad of health benefits. These include relief of chronic pain. Yoga practice has also been shown to be effective for the relief of chronic pain.  Other mind-body  practices such as Tai Chi  improves spinal health and reduces pain. Since mind body practices involve exercise, it would seem reasonable to look at the effectiveness of mind-body practices in improving physical function and relieving pain in chronic pain patients.

 

In today’s Research News article “Mind-Body Activity Program for Chronic Pain: Exploring Mechanisms of Improvement in Patient-Reported, Performance-Based and Ambulatory Physical Function.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7872894/ )  Greenberg and colleagues recruited patients with chronic musculoskeletal pain and randomly assigned them to 10-week mind-body physical activity programs either with or without a Fitbit activity monitor. The programs consisted of 10 weekly 90-minute sessions teaching mindfulness, deep breathing, pain-specific cognitive behavioral skills, physical restoration skills, and education on the disability spiral. They were measured before and after training for physical function, disability, walking distance, and accelerometer-based steps, kinesiophobia (fear of movement due to pain), pain resilience, mindfulness, and pain catastrophizing.

 

Using multilevel linear modelling, they found that compared to baseline, after treatment, there were significant increases in walking distance, step count, pain resilience and mindfulness, and a significant decrease in kinesiophobia and disability. Mediation analysis revealed that the improvement in disability was due to increases in pain resilience and mindfulness and decreases in kinesiophobia. For the walk test, only decreases in kinesiophobia mediated the improvement.

 

It should be noted that there wasn’t a control condition as both groups received the mind-body physical activity program. So, it is possible that confounds such as placebo effects and time-based healing may be operative. So, conclusions must be reached with caution. That being said, the results suggest that mind-body physical activity program improves physical function in chronic pain patients. The improvements are associated with increases in mindfulness, and pain resilience and decreases in kinesiophobia. But these variables only appear to mediate the effects of the training with regard to disability.

 

Mindfulness has been well documented to improve the disability of chronic pain patients. It is not surprising that the ability to be resilient in the face of pain and the lowering the fear of moving with pain are also helpful. Chronic pain makes life miserable for the patients and the effectiveness of the mind-body physical activity program in improving physical ability is helpful to some extent in decreasing the disability resulting from the pain and reducing the patient’s suffering.

 

So, improve physical function in chronic pain patients with mind-body practice.

 

“The mind, emotions and attention play an important role in the experience of pain. In patients with chronic pain, stress, fear and depression can amplify the perception of pain. Mind-body approaches act to change a person’s mental or emotional state or utilise physical movement to train attention or produce mental relaxation.” – Craig Hassed

 

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

 

Greenberg, J., Mace, R. A., Bannon, S. M., Kulich, R. J., & Vranceanu, A. M. (2021). Mind-Body Activity Program for Chronic Pain: Exploring Mechanisms of Improvement in Patient-Reported, Performance-Based and Ambulatory Physical Function. Journal of pain research, 14, 359–368. https://doi.org/10.2147/JPR.S298212

 

Abstract

Background

Improving physical function among patients with chronic pain is critical for reducing disability and healthcare costs. However, mechanisms underlying improvement in patient-reported, performance-based, and ambulatory physical function in chronic pain remain poorly understood.

Purpose

To explore psychosocial mediators of improvement in patient-reported, performance-based, and objective/accelerometer-measured physical function among participants in a mind-body activity program.

Methods

Individuals with chronic pain were randomized to one of two identical 10-week mind-body activity interventions aimed at improving physical function with (GetActive-Fitbit; N=41) or without (GetActive; N=41) a Fitbit device. They completed self-reported (WHODAS 2.0), performance-based (6-minute walk test), and objective (accelerometer-measured step-count) measures of physical function, as well as measures of kinesiophobia (Tampa Kinesiophobia Scale), mindfulness (CAMS-R), and pain resilience (Pain Resilience Scale) before and after the intervention. We conducted secondary data analyses to test mediation via mixed-effects modeline.

Results

Improvements in patient-reported physical function were fully and uniquely mediated by kinesiophobia (Completely Standardized Indirect Effect (CSIE)=.18; CI=0.08, 0.30; medium-large effect size), mindfulness (CSIE=−.14; CI=−25, −.05; medium effect size) and pain resilience (CSIE=−.07; CI=−.16, −.005; small-medium effect size). Improvements in performance-based physical function were mediated only by kinesiophobia (CSIE=−.11; CI=−23, −.008; medium effect size). No measures mediated improvements in objective (accelerometer measured) physical function.

Conclusion

Interventions aiming to improve patient-reported physical function in patients with chronic pain may benefit from skills that target kinesiophobia, mindfulness, and pain resilience, while those focused on improving performance-based physical function should target primarily kinesiophobia. More research is needed to understand mechanisms of improvement in objective, accelerometer-measured physical function.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7872894/