Reduce Dysfunctional Eating with Mindfulness

Reduce Dysfunctional Eating with Mindfulness

 

By John M. de Castro, Ph.D.

 

The more you eat, the less flavor; the less you eat, the more flavor.” ~Chinese Proverb

 

Around 30 million people in the United States of all ages and genders suffer from an eating disorder: either anorexia nervosa, bulimia, or binge eating disorder. 95% of those who have eating disorders are between the ages of 12 and 26. Eating disorders are not just troubling psychological problems, they can be deadly, having the highest mortality rate of any mental illness. Two example of eating disorders are binge eating disorder (BED) and bulimia nervosa (BN). BED involves eating a large amount of food within a short time-period while experiencing a sense of loss of control over eating. BN involves binge-eating and purging (e.g., self-induced vomiting, compensatory exercise).

 

Eating disorders can be difficult to treat because eating is necessary and cannot be simply stopped as in smoking cessation or abstaining from drugs or alcohol. One must learn to eat appropriately not stop. So, it is important to find methods that can help prevent and treat eating disorders. Contemplative practices, mindfulness, and mindful eating have shown promise for treating eating disorders. It is not known however, if mindfulness training can improve dysregulated eating and in turn reduce the likelihood of eating disorders.

 

In today’s Research News article “Delivering Mindfulness-Based Interventions for Insomnia, Pain, and Dysfunctional Eating Through a Text Messaging App: Three Randomized Controlled Trials Investigating the Effectiveness and Mediating Mechanisms.” (See summary below or view the full text of the study at:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9115660/ ) Li and colleagues recruited adults over the internet and provided mindfulness training through text messaging. They measured insomnia, pain, and dysregulated eating.

 

They found that mindfulness training compared to a wait-list control condition resulted in resulted in significant decreases in anxiety, depression, insomnia, pain, and dysregulated eating and these improvements were sustained 3 months after the end of training. They found a wide array of improvements from mindfulness training. Particularly important from the perspective of eating disorders were the findings of reductions in depression and dysregulated eating. This suggests that mindfulness training reduces the likelihood of the development of an eating disorder.

 

When walking, walk. When eating, eat.” rashaski · Zen Proverb

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Li AC, Wong KK, Chio FH, Mak WW, Poon LW. Delivering Mindfulness-Based Interventions for Insomnia, Pain, and Dysfunctional Eating Through a Text Messaging App: Three Randomized Controlled Trials Investigating the Effectiveness and Mediating Mechanisms. J Med Internet Res. 2022 May 3;24(5):e30073. doi: 10.2196/30073. PMID: 35503653; PMCID: PMC9115660.

 

Abstract

Background

Although text messaging has the potential to be the core intervention modality, it is often used as an adjunct only. To improve health and alleviate the distress related to insomnia, pain, and dysregulated eating of people living in urban areas, text messaging–based mindfulness-based interventions were designed and evaluated in 3 randomized controlled trials.

Objective

This study investigated the effectiveness and mediating mechanisms of text messaging–based mindfulness-based interventions for people with distress related to insomnia, pain, or dysregulated eating.

Methods

In these trials, 333, 235, and 351 participants were recruited online and randomized to intervention and wait-list control conditions for insomnia, pain, and dysregulated eating, respectively. Participants experienced 21 days of intervention through WhatsApp Messenger. Participants completed pre-, post-, 1-month follow-up, and 3-month follow-up self-report questionnaires online. The retention rates at postmeasurements were 83.2% (139/167), 77.1% (91/118), and 72.9% (129/177) for intervention groups of insomnia, pain, and dysregulated eating, respectively. Participants’ queries were answered by a study technician. Primary outcomes included insomnia severity, presleep arousal, pain intensity, pain acceptance, and eating behaviors. Secondary outcomes included mindfulness, depression, anxiety, mental well-being, and functional impairments. Mindfulness, dysfunctional beliefs and attitudes about sleep, pain catastrophizing, and reactivity to food cues were hypothesized to mediate the relationship between the intervention and outcomes.

Results

For all 3 studies, the intervention groups showed significant improvement on most outcomes at 1-month follow-up compared to their respective wait-list control groups; some primary outcomes (eg, insomnia, pain, dysregulated eating indicators) and secondary outcomes (eg, depression, anxiety symptoms) were sustained at 3-month follow-up. Medium-to-large effect sizes were found at postassessments in most outcomes in all studies. In the intervention for insomnia, mediation analyses showed that dysfunctional beliefs and attitudes about sleep mediated the effect of the intervention on all primary outcomes and most secondary outcomes at both 1-month and 3-month follow-ups, whereas mindfulness mediated the intervention effect on presleep arousal at 1-month and 3-month follow-ups. In the intervention for pain, pain catastrophizing mediated the effect of intervention on pain intensity and functioning at both 1-month and 3-month follow-ups, whereas mindfulness only mediated the effect of intervention on anxiety and depressive symptoms. In the intervention for dysregulated eating, power of food mediated the effect of intervention on both uncontrolled and emotional eating at both 1-month and 3-month follow-ups and mindfulness was found to mediate the effect on depressive symptoms at both 1-month and 3-month follow-ups.

Conclusions

These 3 studies converged and provided empirical evidence that mindfulness-based interventions delivered through text messaging are effective in improving distress related to sleep, pain, and dysregulated eating. Text messaging has the potential to be a core intervention modality to improve various common health outcomes for people living a fast-paced lifestyle.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9115660/

 

Improve Shoulder Pain with Brief Meditation

Improve Shoulder Pain with Brief Meditation

 

By John M. de Castro, Ph.D.

 

“Mindfulness also helps deconstruct the pain: Rather than seeing it as a solid block that has taken over a part of your body, you go into the pain and see moments of pressure, moments of burning, moments of iciness, etc,” – Sharon Salzberg

 

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. Shoulder pain is a very common musculoskeletal complaint. The effects of meditation and acupressure on chronic shoulder pain have received little research attention.

 

In today’s Research News article “Reduced Pain by Mind-Body Intervention Correlates with Improvement of Shoulder Function in People with Shoulder Pain: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8970874/ ) Kang and colleagues recruited adults with chronic shoulder pain and randomly assigned them to a wait-list control condition or to receive a 5 minute meditation plus acupressure treatment. They were measured before and after treatment for pain, activities of daily living, range of motion, and strength.

 

They found that in comparison to the wait-list controls and the baseline after meditation and acupressure treatment there was a significant reduction in pain intensity and a significant improvement in range of motion. Thus, a brief meditation plus acupressure treatment appears to have a beneficial effect for chronic shoulder pain patients. Whether these effects are lasting has yet to be determined.

 

So, relieve shoulder pain with brief meditation.

 

Research shows that meditation uses neural pathways that make the brain less sensitive to pain and increases use of the brain’s own pain-reducing opioids.” – Deborah Weatherspoon

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Kang, H., An, S. C., Kim, B., Song, Y., Yoo, J., Koh, E., Lee, S., & Yang, H. J. (2022). Reduced Pain by Mind-Body Intervention Correlates with Improvement of Shoulder Function in People with Shoulder Pain: A Randomized Controlled Trial. Evidence-based complementary and alternative medicine : eCAM, 2022, 6149052. https://doi.org/10.1155/2022/6149052

 

Abstract

Meditation and acupressure-like stimulations have been shown to relieve pain. The aim of this study was to determine whether a short bout of mind-body intervention combined with meditation and acupressure-like stimulation was able to alleviate shoulder pain and improve its function in a short time window. Sixty-five adults with shoulder pain were recruited and randomly classified into two groups. One group participated in an intervention which consisted of acupressure-like stimulation and meditation over a 5 min period. The other group was instructed to rest during this time. A visual analog scale (VAS) pain score and objective constant scores were measured before and after intervention to determine shoulder pain and range of motion (ROM), respectively. A two-way repeated measures analysis of variance with Bonferroni correction and a regression analysis were performed. VAS pain, objective constant score, flexion, abduction, and external rotation score showed significant interactions between time and group. The pain intensity was significantly reduced, while flexion and abduction were significantly improved, in the experimental group compared to the control group, after the intervention. In addition, the change of flexion negatively correlated with the change of pain intensity in the experimental group, but not in the control group. These results show that a short-term application of mind-body intervention significantly alleviates shoulder pain and improves shoulder movement, suggesting its potential use as a therapy for people with shoulder pain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8970874/

Reduce Opioid Dependence in Chronic Pain Patients with Mindfulness

Reduce Opioid Dependence in Chronic Pain Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“meditation involves endogenous opioid pathways, mediating its analgesic effect and growing resilient with increasing practice to external suggestion.” – Haggai Sharon

 

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

 

Hence, it is important to find an effective method to treat substance abuse and prevent relapse, but an effective treatment has been elusive. Most programs and therapies to treat addictions have poor success rates. Recently, mindfulness training has been found to be effective in treating addictions and preventing relapses. Mindfulness-Oriented Recovery Enhancement (MORE) was developed to treat patients with opioid addictions. It involves mindful breathing and body scan meditations, cognitive reappraisal to decrease negative emotions and craving, and savoring to augment natural reward processing and positive emotion.

 

In today’s Research News article “Mindfulness-Oriented Recovery Enhancement vs Supportive Group Therapy for Co-occurring Opioid Misuse and Chronic Pain in Primary Care: A Randomized Clinical Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8886485/ ) Garland and colleagues recruited chronic pain patients being treated with opioid drugs who were misusing opioids. They were randomly assigned to receive 8 weekly 2-hour sessions of Mindfulness-Oriented Recovery Enhancement (MORE) or supportive psychotherapy. They were measured before and after treatment and 3, 6, and 9 months later for chronic pain, opioid misuse, daily opioid dose, opioid craving, anxiety, depression, perceived stress, and adverse events.

 

They found that at the 9 month follow up 45% of the Mindfulness-Oriented Recovery Enhancement (MORE) were no longer misusing opioids while only 24% of the supportive psychotherapy were no longer misusing. The MORE group also had significantly greater reductions in pain severity, opioid dosage, depression, and pain-related functional interference.

 

The finding support the ability of Mindfulness-Oriented Recovery Enhancement (MORE) to improve opioid misuse and improve the psychological well-being of chronic pain patients.

 

That is not because pain is psychological. It’s because all pain is processed in the brain and mindfulness changes how the brain processes the signals of damage from the body,” – Eric Garland

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Garland, E. L., Hanley, A. W., Nakamura, Y., Barrett, J. W., Baker, A. K., Reese, S. E., Riquino, M. R., Froeliger, B., & Donaldson, G. W. (2022). Mindfulness-Oriented Recovery Enhancement vs Supportive Group Therapy for Co-occurring Opioid Misuse and Chronic Pain in Primary Care: A Randomized Clinical Trial. JAMA internal medicine, 182(4), 407–417. https://doi.org/10.1001/jamainternmed.2022.0033

 

Key Points

Question

Does a mindfulness-based intervention reduce comorbid chronic pain and opioid misuse in the primary care setting more than supportive psychotherapy?

Findings

In this randomized clinical trial that included 250 adults with both chronic pain and opioid misuse, 45.0% of participants receiving Mindfulness-Oriented Recovery Enhancement (MORE) were no longer misusing opioids after 9 months of follow-up compared with 24.4% of participants receiving supportive group psychotherapy. Participants receiving MORE also reported significant improvements in chronic pain symptoms compared with those receiving supportive psychotherapy.

Meaning

In this study, MORE appeared to be an efficacious treatment for opioid misuse among adults with chronic pain.

Go to:

Abstract

Importance

Successful treatment of opioid misuse among people with chronic pain has proven elusive. Guidelines recommend nonopioid therapies, but the efficacy of mindfulness-based interventions for opioid misuse is uncertain.

Objective

To evaluate the efficacy of Mindfulness-Oriented Recovery Enhancement (MORE) for the reduction of opioid misuse and chronic pain.

Design, Setting, and Participants

This interviewer-blinded randomized clinical trial enrolled patients from primary care clinics in Utah between January 4, 2016, and January 16, 2020. The study included 250 adults with chronic pain receiving long-term opioid therapy who were misusing opioid medications.

Interventions

Treatment with MORE (comprising training in mindfulness, reappraisal, and savoring positive experiences) or supportive group psychotherapy (control condition) across 8 weekly 2-hour group sessions.

Main Outcomes and Measures

Primary outcomes were (1) opioid misuse assessed by the Drug Misuse Index (self-report, interview, and urine screen) and (2) pain severity and pain-related functional interference, assessed by subscale scores on the Brief Pain Inventory through 9 months of follow-up. Secondary outcomes were opioid dose, emotional distress, and ecological momentary assessments of opioid craving. The minimum intervention dose was defined as 4 or more completed sessions of MORE or supportive group psychotherapy.

Results

Among 250 participants (159 women [63.6%]; mean [SD] age, 51.8 [11.9] years), 129 were randomized to the MORE group and 121 to the supportive psychotherapy group. Overall, 17 participants (6.8%) were Hispanic or Latino, 218 (87.2%) were White, and 15 (6.0%) were of other races and/or ethnicities (2 American Indian, 3 Asian, 1 Black, 2 Pacific Islander, and 7 did not specify). At baseline, the mean duration of pain was 14.7 years (range, 1-60 years), and the mean (SD) morphine-equivalent opioid dose was 101.0 (266.3) mg (IQR, 16.0-90.0 mg). A total of 203 participants (81.2%) received the minimum intervention dose (mean [SD], 5.7 [2.2] sessions); at 9 months, 92 of 250 participants (36.8%) discontinued the study. The overall odds ratio for reduction in opioid misuse through the 9-month follow-up period in the MORE group compared with the supportive psychotherapy group was 2.06 (95% CI, 1.17-3.61; P = .01). At 9 months, 36 of 80 participants (45.0%) in the MORE group were no longer misusing opioids compared with 19 of 78 participants (24.4%) in the supportive psychotherapy group. Mixed models demonstrated that MORE was superior to supportive psychotherapy through 9 months of follow-up for pain severity (between-group effect: 0.49; 95% CI, 0.17-0.81; P = .003) and pain-related functional interference (between-group effect: 1.07; 95% CI, 0.64-1.50; P < .001). Participants in the MORE group reduced their opioid dose to a greater extent than those in the supportive psychotherapy group. The MORE group also had lower emotional distress and opioid craving.

Conclusions and Relevance

In this randomized clinical trial, among adult participants in a primary care setting, the MORE intervention led to sustained improvements in opioid misuse and chronic pain symptoms and reductions in opioid dosing, emotional distress, and opioid craving compared with supportive group psychotherapy. Despite attrition caused by the COVID-19 pandemic and the vulnerability of the sample, MORE appeared to be efficacious for reducing opioid misuse among adults with chronic pain.

Improve the Psychological Well-Being of Patients with Cardiovascular Disease with Tai Chi

Improve the Psychological Well-Being of Patients with Cardiovascular Disease with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Tai Chi involves a series of graceful, gentle movements that can get your heart rate up while also relaxing your mind. It’s been called meditation in motion.” – Cleveland Heart Lab

 

Cardiovascular disease is the number one killer. A myriad of treatments has been developed including a variety of surgical procedures and medications. In addition, lifestyle changes have proved to be effective including quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Unfortunately, for a variety of reasons, 60% of cardiovascular disease patients decline engaging in these lifestyle changes, making these patients at high risk for another attack.

 

Contemplative practices have been shown to be safe and effective alternative treatments for cardiovascular disease. Practices such as meditation, tai chi, and yoga, have been shown to be helpful for heart health and to reduce the physiological and psychological responses to stress. They have also been shown to be effective in maintaining cardiovascular health and the treatment of cardiovascular disease. The research has been accumulating. So, it makes sense to pause and take a look at what has been learned.

 

In today’s Research News article “Does tai chi improve psychological well-being and quality of life in patients with cardiovascular disease and/or cardiovascular risk factors? A systematic review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8725570/ ) Yang and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials of the effectiveness of Tai Chi practice for patients with cardiovascular disease. They identified 37 published trials.

 

They report that the published research found that Tai Chi practiced improved the psychological well-being of the patients including decreases in perceived stress, anxiety, depression, bodily pain and increases in mental health, self-efficacy, and mood.

 

Hence practicing Tai Chi improves the mental health and quality of life of patients with cardiovascular disease.

 

practicing tai chi may help to modestly lower blood pressure. It’s also proved helpful for people with heart failure, who tend to be tired and weak as a result of the heart’s diminished pumping ability. The slow movements involve both the upper and lower body, which safely strengthens the heart and major muscle groups without undue strain.” – Harvard Health

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Yang, G., Li, W., Klupp, N., Cao, H., Liu, J., Bensoussan, A., Kiat, H., Karamacoska, D., & Chang, D. (2022). Does tai chi improve psychological well-being and quality of life in patients with cardiovascular disease and/or cardiovascular risk factors? A systematic review. BMC complementary medicine and therapies, 22(1), 3. https://doi.org/10.1186/s12906-021-03482-0

 

Abstract

Background

Psychological risk factors have been recognised as potential, modifiable risk factors in the development and progression of cardiovascular disease (CVD). Tai Chi, a mind-body exercise, has the potential to improve psychological well-being and quality of life. We aim to assess the effects and safety of Tai Chi on psychological well-being and quality of life in people with CVD and/or cardiovascular risk factors.

Methods

We searched for randomised controlled trials evaluating Tai Chi for psychological well-being and quality of life in people with CVD and cardiovascular risk factors, from major English and Chinese databases until 30 July 2021. Two authors independently conducted study selection and data extraction. Methodological quality was evaluated using the Cochrane Risk of Bias tool. Review Manager software was used for meta-analysis.

Results

We included 37 studies (38 reports) involving 3525 participants in this review. The methodological quality of the included studies was generally poor. Positive effects of Tai Chi on stress, self-efficacy, and mood were found in several individual studies. Meta-analyses demonstrated favourable effects of Tai Chi plus usual care in reducing anxiety (SMD − 2.13, 95% confidence interval (CI): − 2.55, − 1.70, 3 studies, I2 = 60%) and depression (SMD -0.86, 95% CI: − 1.35, − 0.37, 6 studies, I2 = 88%), and improving mental health (MD 7.86, 95% CI: 5.20, 10.52, 11 studies, I2 = 71%) and bodily pain (MD 6.76, 95% CI: 4.13, 9.39, 11 studies, I2 = 75%) domains of the 36-Item Short Form Survey (scale from 0 to 100), compared with usual care alone. Tai Chi did not increase adverse events (RR 0.50, 95% CI: 0.21, 1.20, 5 RCTs, I2 = 0%), compared with control group. However, less than 30% of included studies reported safety information.

Conclusions

Tai Chi seems to be beneficial in the management of anxiety, depression, and quality of life, and safe to practice in people with CVD and/or cardiovascular risk factors. Monitoring and reporting of safety information are highly recommended for future research. More well-designed studies are warranted to determine the effects and safety of Tai Chi on psychological well-being and quality of life in this population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8725570/

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

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

 

By John M. de Castro, Ph.D.

 

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

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.

 

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

 

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

 

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

 

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

 

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

 

mindfulness-based stress reduction can be effective in alleviating anxiety and depression, decreasing long-term emotional and physical side effects of treatments and improving the quality of sleep in breast cancer patients.” –  BCRF

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

Objective:

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

Methods:

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

Results:

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

Conclusion:

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

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

 

Improve Neuropsychological Disorders with Yoga

Improve Neuropsychological Disorders with Yoga

 

By John M. de Castro, Ph.D.

 

“yoga might be considered as an effective adjuvant for the patients with various neurological disorders including stroke, Parkinson’s disease, multiple sclerosis, epilepsy, Alzheimer’s disease, dementia, headache, myelopathy, neuropathies.” – A.Mooventhan

 

Mindfulness training and yoga practices have been shown to improve health and well-being in healthy individuals. They have also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. There has accumulated a large amount of research on the effectiveness of yoga practice for the treatment of a variety of physical and mental issues. Hence, it would be useful to summarize what has been learned.

 

In today’s Research News article “Therapeutic role of yoga in neuropsychological disorders.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8546763/ ) Nourollahimoghadam and colleagues review and summarize the published research regarding the effectiveness of yoga practice for the treatment of a variety of neuropsychological disorders.

 

They report that the published research found that yoga practice produced significant improvements in physical illnesses including migraine headaches, Alzheimer’s Disease, epilepsy, multiple sclerosis, Parkinson’s Disease, and neuropathy. Yoga practice also produced significant improvements in psychological well-being including anxiety, stress, depression, bipolar disorder, schizophrenia, somatoform disorders, obsessive-compulsive disorder, and burnout. They further report that yoga may produce its beneficial effects by altering the chemistry, electrical activity, structures, and connectivity within the brain.

 

Hence Yoga practice appears to have a myriad of positive physical and psychological benefits. The authors, however, point to weaknesses in the research including small sample sizes, short-term follow-up, confounding variables, and lack of appropriate controls. So, more and better controlled studies are needed to verify the benefits of yoga practice. Hence, the present state of knowledge supports the engagement in yoga practice to advance the physical and mental well-being of both ill and healthy individuals.

 

So, improve neuropsychological disorders with yoga.

 

Yoga can be a helpful practice of self-care for people with multiple sclerosis (MS) and other neurological conditions (such as stroke, traumatic brain injury, Parkinson’s disease, Lyme’s disease, Lou Gehrig’s disease).” – Mary Hilliker

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Nourollahimoghadam, E., Gorji, S., Gorji, A., & Khaleghi Ghadiri, M. (2021). Therapeutic role of yoga in neuropsychological disorders. World journal of psychiatry, 11(10), 754–773. https://doi.org/10.5498/wjp.v11.i10.754

 

Abstract

Yoga is considered a widely-used approach for health conservation and can be adopted as a treatment modality for a plethora of medical conditions, including neurological and psychological disorders. Hence, we reviewed relevant articles entailing various neurological and psychological disorders and gathered data on how yoga exerts positive impacts on patients with a diverse range of disorders, including its modulatory effects on brain bioelectrical activities, neurotransmitters, and synaptic plasticity. The role of yoga practice as an element of the treatment of several neuropsychological diseases was evaluated based on these findings.

Core Tip: A multitude of beneficial effects of yoga practice and the underlying mechanisms of action have been reported and point out its role as an influential element in the integrative therapy of various neuropsychological disorders. In the planning of further investigations, studies should be designed to achieve more accuracy and precision in the heterogeneous field of yoga practices and potential fields of application.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8546763/

 

Improve the Symptoms of Central Pain Sensitization Syndromes with Mindfulness

Improve the Symptoms of Central Pain Sensitization Syndromes with Mindfulness

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

MCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

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

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

Improve the Symptoms of Lupus with Mindfulness

Improve the Symptoms of Lupus with Mindfulness

 

By John M. de Castro, Ph.D.

 

“However it strikes, pain is a persistent part of daily life for many people living with lupus. . . mindfulness-based interventions decrease the intensity of pain for people dealing with chronic pain.” – Lupus Foundation

 

Autoimmune diseases occur when the body’s systems that are designed to ward off infection attack the individual’s own tissues. Lupus is an autoimmune disease that affects a variety of organ systems including kidneys, joints, skin, blood, brain, heart and lungs. Lupus can produce fever, joint pain, stiffness and swelling, butterfly-shaped rash on the face or rashes elsewhere on the body, skin lesions that appear or worsen with sun exposure, fingers and toes that turn white or blue when exposed to cold or during stressful periods, shortness of breath, chest pain, dry eyes, headaches, confusion and memory loss. Lupus strikes between 10 to 25 people per 100,000, or about 322,000 cases in the U.S.

 

The symptoms of Lupus can look like a number of other diseases, so it is hard to diagnose lupus. It is tipped off in many patients by the distinctive facial rash. There are no known cures for lupus and treatment is targeted at symptom relief. Drug treatments include pain relievers, corticosteroids, immunosuppressants, and even antimalarial drugs. Mindfulness practices have been shown to be effective for a wide variety of illnesses and to improve the immune system. So, it is not surprising that mindfulness training can improve Lupus and its symptoms.

 

In today’s Research News article “Mindfulness-Based Stress Reduction for Systemic Lupus Erythematosus: A Mixed-Methods Pilot Randomized Controlled Trial of an Adapted Protocol.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509215/ ) Taub and colleagues recruited adult patients with Systemic Lupus Erythematosus and randomly assigned them to either a wait-list control or to receive 10 weekly 2-hour sessions and a full day retreat of Mindfulness-Based Stress Reduction (MBSR) adapted for Lupus. MBSR consists of practice with meditation, body scan, and yoga, and with group discussions and home practice. They were measured before and after training and 6 months later for lupus activity, health, depression, quality of life, psychological inflexibility to pain, shame, and illness identity. In addition, a sub-sample of patients underwent semi-structured qualitative interviews.

 

They found that in comparison to baseline and the wait-list control group, immediately after training the group that received Mindfulness-Based Stress Reduction (MBSR) had significantly reduced depression, fusion with pain, shame and illness identity and increases quality of life. At the 6-month follow-up, depression, fusion with pain, shame and illness identity remained significantly reduced. The qualitative interviews revealed 6 distinct themes; changes related to mindfulness; stress reduction; improvement in general physical functioning; changes in illness identity and illness perception; and the group as a mechanism of psychological change.

 

The interpretation of the findings is limited by the fact that there was a passive (wait-list) control condition. This leaves open a number of potential confounding explanations such as placebo effects, attention effects, experimenter bias, etc. Future research should have an active control condition such as aerobic exercise. Nevertheless, the results are suggestive that Mindfulness-Based Stress Reduction (MBSR) training is effective in producing enduring improvements in the psychological symptoms produced by Systemic Lupus Erythematosus, helping to relieve the patient’s suffering.

 

So, improve the symptoms of Lupus with mindfulness.

 

If you have lupus and you feel stressed, or you would like to boost your pain tolerance while reducing sensitivity to pain itself, speak to your doctor about the desirability of meditation. Because this activity has no side effects and is easy and affordable to carry out, your family can join you in sessions, as a way to battle stress.” – Jess Walter

 

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

 

Taub, R., Horesh, D., Rubin, N., Glick, I., Reem, O., Shriqui, G., & Agmon-Levin, N. (2021). Mindfulness-Based Stress Reduction for Systemic Lupus Erythematosus: A Mixed-Methods Pilot Randomized Controlled Trial of an Adapted Protocol. Journal of Clinical Medicine, 10(19), 4450. https://doi.org/10.3390/jcm10194450

 

Abstract

Background: The psychological effects of systemic lupus erythematosus (SLE) are tremendous. This pilot mixed-methods randomized controlled trial aimed to evaluate the effects of a mindfulness-based stress reduction (MBSR) adapted protocol on psychological distress among SLE patients. Methods: 26 SLE patients were randomly assigned to MBSR group therapy (n = 15) or a waitlist (WL) group (n = 11). An adapted MBSR protocol for SLE was employed. Three measurements were conducted: pre-intervention, post-intervention and 6-months follow up. A sub-sample (n = 12) also underwent qualitative interviews to assess their subjective experience of MBSR. Results: Compared to the WL, the MBSR group showed greater improvements in quality of life, psychological inflexibility in pain and SLE-related shame. Analysis among MBSR participants showed additional improvements in SLE symptoms and illness perception. Improvements in psychological inflexibility in pain and SLE-related shame remained stable over six months, and depression levels declined steadily from pre-treatment to follow-up. Qualitative analysis showed improvements in mindfulness components (e.g., less impulsivity, higher acceptance), as well as reduced stress following MBSR. Conclusions: These results reveal the significant therapeutic potential of MBSR for SLE patients. With its emphasis on acceptance of negative physical and emotional states, mindfulness practice is a promising treatment option for SLE, which needs to be further applied and studied.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509215/

 

Improvements in Migraine Headaches Require Active Meditation and not Cognitive Distraction

Improvements in Migraine Headaches Require Active Meditation and not Cognitive Distraction

 

By John M. de Castro, Ph.D.

 

“Mindfulness is a simple, effective method for managing migraines and reducing potential triggers.” – American Migraine Foundation

 

Migraine headaches are a torment far beyond the suffering of a common headache. It is an intense throbbing pain usually unilateral, focused on only one side of the head and lasts from 4 hours to 3 days. They involve a collection of neurological symptoms, including visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch and smell, and tingling or numbness in the extremities or face. Migraines are the 8th most disabling illness in the world. While most sufferers experience attacks once or twice a month, about 4% have chronic daily headaches. Migraines are very disruptive to the sufferer’s personal and work lives as most people are unable to work or function normally when experiencing a migraine.

 

There is no known cure for migraine headaches. Treatments are targeted at managing the symptoms. Prescription and over-the-counter pain relievers are frequently used. There are a number of drug and drug combinations that appear to reduce the frequency of migraine attacks. These vary in effectiveness but unfortunately can have troubling side effects and some are addictive. Behaviorally, relaxation and sleep appear to help lower the frequency of migraines. Mindfulness practices have been shown to reduce stress and improve relaxation. So, they may be useful in preventing migraines. Indeed, it has been shown that mindfulness practice can reduce headache pain. It is not known how the pain relief develops over time and whether meditation benefits simply occur due to distraction from the pain.

 

In today’s Research News article “A reanalysis of a randomized trial on meditation for migraine headaches: Distraction is not enough but meditation takes time.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8091992/ ) Wachholtz and colleagues recruited otherwise healthy adults who experience at least 2 migraine headaches a month. They were randomly assigned to meditate for 30 minutes per day for 30 days with 1 of 3 specific phrases that was to form their meditation focus. The phrases were spiritual (e.g. God is Peace), positive self-reinforcement (e.g. I am joyful), or cognitive distraction (e.g. Grass is Green). A fourth group practiced systematic muscle relaxation over the same period. They maintained daily logs of headaches and emotions for the 30 days.

 

They found that over the 30-day practice period participants happiness significantly increased, while pain ratings and anger significantly decreased for all groups except the cognitive distraction group. The spiritual meditation, positive self-reinforcement meditation, and relaxation groups did not show significant improvements in headache pain over the first 20 days of practice. Significant reductions in pain occurred only during the last 10 days.

 

These are interesting results that replicate previous findings that mindfulness practices produce improvements in emotions , including happiness and anger, and decreases in headache pain. What is new here is the finding that these benefits require over 20 days of practice to develop. The fact that the cognitive distraction group did not decrease in anger or headache pain is important. It suggests that improvements require specific meditation focuses and that a focus on an external characteristic (e.g. Sand is Soft) is not sufficient. So, the process of meditation, sitting down and focusing for 30 minutes per day, isn’t sufficient to produce benefits. The focus during the meditation must be on spiritual, self-reinforcement, or muscle relaxation targets. The benefits are not the result of distraction from the headache pain.

 

So, improvements in migraine headaches require active meditation and not cognitive distraction.

 

Mindfulness may be something that specifically helps people with migraines because it can teach new ways to respond to stress, which is the most commonly reported migraine trigger.” – Judy George

 

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

 

Wachholtz, A., Vohra, R., & Metzger, A. (2019). A reanalysis of a randomized trial on meditation for migraine headaches: Distraction is not enough but meditation takes time. Complementary therapies in medicine, 46, 136–143. https://doi.org/10.1016/j.ctim.2019.08.011

 

Highlights

  • There are many studies examining a single form of meditation, but few examine multiple meditation techniques to compare key ingredients that make a technique “successful” for patient’s pain management
  • In a longitudinal assessment, we found that meditative techniques integrating active cognitive controls work better to reduce migraine frequency, severity, and negative mood compared to passive or distraction techniques
  • Across active engagement meditation types, 30 minutes of daily practice for 20 days appeared necessary to reach efficacy

Abstract

OBJECTIVE:

Migraine headaches affect about approximately 15% of the population and some notable efforts have been made to develop meditation interventions to address pain and mood among this population. However, key active ingredients and the necessary duration of meditation interventions to produce an effect are still unknown. The purpose of this study is to assess key meditation ingredients that positively impact mood and headache factors across different meditation techniques and to establish an initial time or ”dose” needed to reach proactive treatment efficacy.

METHOD:

In this longitudinal study, three active management forms of meditation were compared to a cognitive distraction meditation to assess the effects on migraine headaches and emotions over a 30 day period when practiced 20 minutes per day.

RESULTS:

The active group showed significant decreases in anger (p=.005) and migraine pain (p=.002) over time. Further analysis showed that the bulk of the change for the active management group occurred in the final 10 days, after 20 days of practice of the technique (p<.05).

CONCLUSION:

This suggests that cognitively active forms of meditation are more effective in reducing migraine headache pain and negative mood than distraction techniques. However, individuals engaging in these strategies need to consistently practice these techniques for approximately 20 days to proactively reduce migraine headache pain and negative mood.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8091992/

 

Improve Health Outcomes in Women on Long-Term Sick Leave with Mindfulness

Improve Health Outcomes in Women on Long-Term Sick Leave with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Since stress compromises our immune system, becoming caught up in this way can slow down our recovery. Instead, aim to approach your illness with care, seeing things as they are, with acceptance and compassion.” — Mark Bertin

 

Chronic Pain and mental health issues are the most common causes of long-term sick leave. 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. 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.

 

Depression affects over 6% of the population. Depression can be difficult to treat. It is usually treated with antidepressant medication. But, of patients treated initially with drugs only about a third attained remission of the depression. Even after remission there are a number of symptoms that remain. These include lingering dysphoria, impaired psychosocial functioning, fatigue, and decreased ability to work. These residual symptoms can lead to relapse. Mindfulness training is also an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail.

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. A characterizing feature of anxiety disorders is that the suffer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Anxiety disorders have generally been treated with drugs. But there are considerable side effects, and these drugs are often abused. Recently, it has been found that mindfulness training can be effective for anxiety disorders.

 

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

 

In today’s Research News article “Comparing the Efficacy of Multidisciplinary Assessment and Treatment, or Acceptance and Commitment Therapy, with Treatment as Usual on Health Outcomes in Women on Long-Term Sick Leave-A Randomised Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916944/ ) Finnes and colleagues recruited working age women who were on long-term sick leave and randomly assigned them to receive either treatment as usual, Acceptance and Commitment Therapy (ACT), or ACT in combination with a multidisciplinary team consisting of a physician, a psychologist, an occupational therapist and a social worker. They were measured before and after treatment and at 6 and 12 months after treatment for sick leave, satisfaction with treatment, pain, anxiety, depression, satisfaction with life, and general health well-being.

 

They found that there were no significant differences between Acceptance and Commitment Therapy (ACT), or ACT plus team with the women’s satisfaction with treatment. But in comparison to baseline and the treatment as usual group, both treatments produced significant reductions in anxiety, depression, pain intensity and significant increases in satisfaction with life, and general health well-being. At one year after treatment the ACT plus team group had significantly more patients classified as recovered than the ACT alone group.

 

These results demonstrate that Acceptance and Commitment Therapy (ACT) is effective in treating the physical and psychological symptoms of women who were on long-term sick leave. Women on long-term sick leave are very difficult to treat as their issues have resisted improvement for a substantial period of time. So, the ability of ACT to improve these symptoms is impressive. Adding the team produced slightly better outcomes at 12 months but the additional cost of the team is quite significant. So, from a cost effectiveness standpoint, ACT alone is superior.

 

So, improve health outcomes in women on long-term sick leave with mindfulness.

 

Musculoskeletal pain, depression, and anxiety cause the majority of all sick leave. . . Interestingly enough, mindfulness has become an important construct in return-to-work rehabilitation.” – Emily Lipinski

 

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

 

Finnes, A., Anderzén, I., Pingel, R., Dahl, J., Molin, L., & Lytsy, P. (2021). Comparing the Efficacy of Multidisciplinary Assessment and Treatment, or Acceptance and Commitment Therapy, with Treatment as Usual on Health Outcomes in Women on Long-Term Sick Leave-A Randomised Controlled Trial. International journal of environmental research and public health, 18(4), 1754. https://doi.org/10.3390/ijerph18041754

 

Abstract

Background: Chronic pain and mental disorders are common reasons for long term sick leave. The study objective was to evaluate the efficacy of a multidisciplinary assessment and treatment program including acceptance and commitment therapy (TEAM) and stand-alone acceptance and commitment therapy (ACT), compared with treatment as usual (Control) on health outcomes in women on long-term sick leave. Method: Participants (n = 308), women of working age on long term sick leave due to musculoskeletal pain and/or common mental disorders, were randomized to TEAM (n = 102), ACT (n = 102) or Control (n = 104). Participants in the multidisciplinary assessment treatment program received ACT, but also medical assessment, occupational therapy and social counselling. The second intervention included ACT only. Health outcomes were assessed over 12 months using adjusted linear mixed models. The results showed significant interaction effects for both ACT and TEAM compared with Control in anxiety (ACT [p < 0.05]; TEAM [p < 0.001]), depression (ACT [p < 0.001]; TEAM [p < 0.001]) and general well-being (ACT [p < 0.05]; TEAM [p < 0.001]). For self-rated pain, there was a significant interaction effect in favour of ACT (p < 0.05), and for satisfaction with life in favour of TEAM (p < 0.001). Conclusion: Both ACT alone and multidisciplinary assessment and treatment including ACT were superior to treatment as usual in clinical outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916944/