Pain

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

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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/

 

Improve Pain, Sleep, and the Mental Health of Chronic Pain Patients with Internet Mindfulness Training

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Improve Pain, Sleep, and the Mental Health of Chronic Pain Patients with Internet Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“In the context of chronic pain . . . meditation can help you to stop your mind wandering back to your pain when you are trying to focus on something else, therefore improving your ability to give your entire attention to the task at hand and in turn, improve your level of functioning. It gives you the power to take your mind off your pain and refocus it, therefore aiding you in replacing unhelpful, behaviours with healthy ones which can reduce your pain and allow you to take better care of your health.” – Ann-Marie D’arcy-Sharpe

 

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. 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.

 

Acceptance and Commitment Therapy (ACT) requires a scheduled program of sessions with a trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. As an alternative, mindfulness training over the internet have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. In addition, research has indicated that mindfulness training online can be effective for improving the health and well-being of the participants.

 

In today’s Research News article “Internet‐delivered acceptance and commitment therapy as microlearning for chronic pain: A randomized controlled trial with 1‐year follow‐up.” (See summary below or view the full text of the study at: https://onlinelibrary.wiley.com/doi/10.1002/ejp.1723 ) Rickardsson and colleagues recruited adult chronic pain patients and randomly assigned them to either a wait-list control condition or to receive an 8-week program of Acceptance and Commitment Therapy (ACT) delivered over the internet. ACT was delivered in daily microlearning short learning interactions. There was a 74% completion rate of the modules. The participants were measured before and after training and at 3-, 6-, and 12-month follow-ups for psychiatric problems, pain interference, pain intensity, anxiety, depression, psychological inflexibility, values, and health-related quality of life.

 

They found that compared to baseline and the wait-list control group, the group that received internet-delivered Acceptance and Commitment Therapy (ACT) had significant decreases in pain interference, pain intensity, anxiety, depression, psychological inflexibility, value obstruction, and insomnia. These improvements were long-lasting as they were maintained at the 12-month follow-up.

 

These are impressive improvements in the pain and psychological health of these diverse chronic pain patients. These results correspond with the frequent prior observations that mindfulness training produces reductions in pain, anxiety, depression, psychological inflexibility, and insomnia in a wide range of patient types and normal individuals. These results are particularly impressive as Acceptance and Commitment Therapy (ACT) was delivered over the internet. in daily microlearning short learning interactions. This was very convenient for the patients and required only 12.4 minutes per week of therapist time per week and was thus very inexpensive to deliver. Yet ACT was highly effective and lasting in relieving the suffering of these chronic pain patients.

 

So, improve pain, sleep, and the mental health of chronic pain patients with internet mindfulness training.

 

“What we want to do as best as we can is to engage with the pain just as it is. It’s not about achieving a certain goal – like minimizing pain – but learning to relate to your pain differently.” – Elisha Goldstein

 

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

 

Jenny Rickardsson, Charlotte Gentili, Linda Holmström, Vendela Zetterqvist, Erik Andersson, Jan Persson, Mats Lekander, Brjánn Ljótsson, Rikard K. Wicksell. Internet‐delivered acceptance and commitment therapy as microlearning for chronic pain: A randomized controlled trial with 1‐year follow‐up, European Journal of Pain, 2021;00:1–19, https://doi.org/10.1002/ejp.1723

 

Abstract

Background

Studies of Internet‐delivered acceptance and commitment therapy (ACT) for chronic pain have shown small to moderate positive effects for pain interference and pain acceptance. Effects on pain intensity, depression, anxiety and quality of life (QoL) have been less favourable, and improvements for values and sleep are lacking. In this randomized controlled trial iACT – a novel format of Internet‐ACT using daily microlearning exercises – was examined for efficacy compared to a waitlist condition.

Methods

Adult participants (mean age 49.5 years, pain duration 18.1 years) with diverse chronic pain conditions were recruited via self‐referral, and randomized to iACT (n = 57) or waitlist (n = 56). The primary outcome was pain interference. The secondary outcomes were QoL, depression, anxiety, insomnia and pain intensity. The process variables included psychological inflexibility and values. Post‐assessments were completed by 88% (n = 100) of participants. Twelve‐month follow‐up assessments were completed by 65% (iACT only, n = 37). Treatment efficacy was analysed using linear mixed models and an intention‐to‐treat‐approach.

Results

Significant improvements in favour of iACT were seen for pain interference, depression, anxiety, pain intensity and insomnia, as well as process variables psychological inflexibility and values. Between‐group effect sizes were large for pain interference (d = 0.99) and pain intensity (d = 1.2), moderate for anxiety and depressive symptoms and small for QoL and insomnia. For the process variables, the between‐group effect size was large for psychological inflexibility (d = 1.0) and moderate for values. All improvements were maintained at 1‐year follow‐up.

Conclusions

Internet‐ACT as microlearning may improve a broad range of outcomes in chronic pain.

Significance

The study evaluates a novel behavioral treatment with positive results on pain interference, mood as well as pain intensity for longtime chronic pain sufferers. The innovative format of a digital ACT intervention delivered in short and experiential daily learnings may be a promising way forward.

https://onlinelibrary.wiley.com/doi/10.1002/ejp.1723

 

Mindfulness Improves Physical and Mental Well-Being

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Mindfulness Improves Physical and Mental Well-Being

 

By John M. de Castro, Ph.D.

 

“scientists have found that practicing mindfulness is associated with changes in the structure and function of the brain as well as changes in our body’s response to stress, suggesting that this practice has important impacts on our physical and emotional health.” –  University of Minnesota

 

Over the last several decades, research and anecdotal experiences have accumulated an impressive evidential case that the development of mindfulness has positive benefits for the individual’s mental, physical, and spiritual life. Mindfulness appears to be beneficial both for healthy people and for people suffering from a myriad of mental and physical illnesses. It appears to be beneficial across ages, from children, to adolescents, to the elderly. And it appears to be beneficial across genders, personalities, race, and ethnicity. The breadth and depth of benefits is unprecedented. There is no other treatment or practice that has been shown to come anyway near the range of mindfulness’ positive benefits.

 

Research on mindfulness effects on mental and physical health has exploded over the last few decades. So, it makes sense to pause and examine what has been learned. In today’s Research News article “Mindfulness-based interventions: an overall review” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8083197/ )  Zhang and colleagues reviewed and summarized the randomized controlled trials and meta-analyses of the effects of mindfulness-based practices on mental and physical health.

 

They report that the published research studies and meta-analyses found that mindfulness-based practices produced significant improvements in mental health including anxiety, depression, anger, prosocial behavior, loneliness, physiological and psychological indicators of stress, insomnia, eating disorders, addictions, psychoses, Post-Traumatic Stress Disorder (PTSD), attention-deficit hyperactivity disorder (ADHD), and autism. They also report that mindfulness-based practices produced significant improvements in physical health including pain, hypertension, cardiovascular disease, obesity, diabetes, cancer, asthma, chronic obstructive pulmonary disease (COPD), aggression, and violence.

 

In addition, mindfulness-based practices produced safe, cost-effective improvements in professional and healthcare settings, in schools, and in the workplace. Further they report that mindfulness-based practices produced significant changes in the structure and activity of the nervous system, improvements in immune functioning and physiological markers of stress.

 

The review of the published research has provided a compelling case for the utilization of mindfulness-based practices for a myriad of psychological and physical problems in humans of all ages with and without disease. The range and depth of effects are unprecedented making a strong case for the routine training in mindfulness for the improvement of their well-being.

 

So, mindfulness improves physical and mental well-being.

 

“engaging in mindfulness meditation cultivates our ability to both focus and broaden our attention, which is a practical way to elicit psychological well-being.” – Jennifer Wolkin

 

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

 

Zhang, D., Lee, E., Mak, E., Ho, C. Y., & Wong, S. (2021). Mindfulness-based interventions: an overall review. British medical bulletin, ldab005. Advance online publication. https://doi.org/10.1093/bmb/ldab005

 

Abstract

Introduction

This is an overall review on mindfulness-based interventions (MBIs).

Sources of data

We identified studies in PubMed, EMBASE, CINAHL, PsycINFO, AMED, Web of Science and Google Scholar using keywords including ‘mindfulness’, ‘meditation’, and ‘review’, ‘meta-analysis’ or their variations.

Areas of agreement

MBIs are effective for improving many biopsychosocial conditions, including depression, anxiety, stress, insomnia, addiction, psychosis, pain, hypertension, weight control, cancer-related symptoms and prosocial behaviours. It is found to be beneficial in the healthcare settings, in schools and workplace but further research is warranted to look into its efficacy on different problems. MBIs are relatively safe, but ethical aspects should be considered. Mechanisms are suggested in both empirical and neurophysiological findings. Cost-effectiveness is found in treating some health conditions.

Areas of controversy

Inconclusive or only preliminary evidence on the effects of MBIs on PTSD, ADHD, ASD, eating disorders, loneliness and physical symptoms of cardiovascular diseases, diabetes, and respiratory conditions. Furthermore, some beneficial effects are not confirmed in subgroup populations. Cost-effectiveness is yet to confirm for many health conditions and populations.

Growing points

Many mindfulness systematic reviews and meta-analyses indicate low quality of included studies, hence high-quality studies with adequate sample size and longer follow-up period are needed.

Areas timely for developing research

More research is needed on online mindfulness trainings and interventions to improve biopsychosocial health during the COVID-19 pandemic; Deeper understanding of the mechanisms of MBIs integrating both empirical and neurophysiological findings; Long-term compliance and effects of MBIs; and development of mindfulness plus (mindfulness+) or personalized mindfulness programs to elevate the effectiveness for different purposes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8083197/

Reduce Pain and Depression in Chronic Pain Patients with Mindful Dance

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Reduce Pain and Depression in Chronic Pain Patients with Mindful Dance

 

By John M. de Castro, Ph.D.

 

“Music is the mediator between the life of the senses and the life of the spirit”  – Ludwig van Beethoven

 

Headaches are the most common disorders of the nervous system. It has been estimated that 47% of the adult population have a headache at least once during the last year. Primary headaches do not result from other medical conditions and include migraine, tension, and cluster headaches. There are a wide variety of drugs that are prescribed for primary headache pain with varying success. Headaches are treated with pain relievers, ergotamine, blood pressure drugs such as propranolol, verapamil, antidepressants, antiseizure drugs, and muscle relaxants. Drugs, however, can have some problematic side effects particularly when used regularly and are ineffective for many sufferers.

 

Most practitioners consider lifestyle changes that help control stress and promote regular exercise to be an important part of headache treatment and prevention. Avoiding situations that trigger headaches is also vital. A number of research studies have reported that mindfulness training is an effective There is an accumulating volume of research findings that demonstrate that mindfulness practices, in general, are effective in treating chronic pain and particularly headache pain. But there have been very few studies of the effectiveness of mindful dance for reducing chronic pain.

 

In today’s Research News article “” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.587923/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1616048_69_Psycho_20210504_arts_A )  Majore-Dusele and colleagues recruited adult patients with chronic headaches and who were high in anxiety and depression. They were randomly assigned to either a wait-list control condition or to receive a twice a week for 90 minutes for 5 weeks program of Mindful-Based Dance Movement Therapy. They were measured before and after treatment and 2 month later for pain intensity, anxiety, depression, depressive symptom severity, and mindfulness.

 

They found that in comparison to baseline and the wait-list control group, the participants who received Mindful-Based Dance Movement Therapy had significant reductions in pain intensity and depression symptom severity that were maintained at the 2-month follow-up. It should be noted that there wasn’t an active control group such as another exercise. So, it isn’t clear if it was mindful dance or the exercise involved in the program that was the effective component. More tightly controlled studies with active controls are needed to clarify these issues.

 

This was a small pilot study that demonstrated feasibility, acceptability, and adherence to the Mindful-Based Dance Movement Therapy program. But it did more in suggesting that the treatment produces significant improvements in the mental health and headache pain of the patients. Mindfulness training has been previously shown to improve headache and depression. What is new here is the demonstration that Mindful-Based Dance Movement Therapy may also be effective.

 

So, reduce pain and depression in chronic pain patients with mindful dance.

 

“meditation used as a pain mediator . . allows us to see our thoughts & feelings in a non-reactive way. Sure it takes practice to get to this point, but so does everything. To be able to feel discomfort and watch your thoughts, decreases the chance of feeding the symptoms and inevitably increasing them. It allows us to practice being non-reactive to every sensation.” – Mehta Physiotherapy

 

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

 

Majore-Dusele I, Karkou V and Millere I (2021) The Development of Mindful-Based Dance Movement Therapy Intervention for Chronic Pain: A Pilot Study With Chronic Headache Patients. Front. Psychol. 12:587923. doi: 10.3389/fpsyg.2021.587923

 

Chronic pain is of significant global concern. There is growing evidence that body–mind therapies and psychological approaches can contribute toward changing chronic pain perceptions. This is the first model described in the literature that combines a mindfulness-based approach with dance movement therapy and explores the potential psychological and pain-related changes for this client population. In this paper, the results from the pilot study are presented involving patients with chronic headache recruited in an outpatient rehabilitation setting.

Methods: In this pilot study, 29 patients (n = 29) with chronic headache were randomized to either the Mindful-Based Dance Movement Therapy (MBDMT) group or the waiting list control group (treatment as usual, TAU). The MBDMT group was offered 10 sessions in a clinical outpatient rehabilitation setting for 5 weeks. Data were collected pre- and post-intervention and 16 weeks after the intervention was finished. The Hospital Anxiety and Depression Scale (HADS), Patient Health Questionnaire−9 (PHQ-9), Five Facet Mindfulness Questionnaire (FFMQ), and Numeric Rating Scale (NRS) were used as outcome measures.

Results: The working model of MBDMT identifies nine therapeutic mechanisms (safe therapeutic environment, mindfulness skills, body awareness, relaxation/releasing, distancing and staying with discomfort, meaning making, self-regulation, acceptance and integration, creative process). Per-protocol analysis reveals statistically significant reduction of pain intensity and depression scores in favor of the MBDMT group, and these improvements were maintained in the follow-up assessment.

Conclusions: The results suggest that MBDMT is a feasible and promising therapy approach for chronic pain patients. The pilot study offered sufficient information and preliminary results in the desirable direction to enable the researchers to move to a randomized controlled trial (RCT) stage in order to establish the efficacy of the intervention.

https://www.frontiersin.org/articles/10.3389/fpsyg.2021.587923/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1616048_69_Psycho_20210504_arts_A

 

Reduce Pain and Relax the Autonomic Nervous System with Mindfulness

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Reduce Pain and Relax the Autonomic Nervous System with Mindfulness

 

By John M. de Castro, Ph.D.

 

“When we impose a litany of negativity upon our pain, it only becomes worse, and potentially elicits other difficulties including depression and anxiety. When we become more aware of what we are actually experiencing, without the overlay of our judgment, the overall perception of pain is reduced.” – Jennifer Wolkin

 

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. Mindfulness appears to work by changing how the patient relates to pain rather than actually reducing or eliminating the pain. What is not known is the mechanism by which mindfulness affects chronic pain.

 

In today’s Research News article “The Role of Heart Rate Variability in Mindfulness-Based Pain Relief.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6994350/ ) Adler-Neal and colleagues recruited healthy adult non-meditators and randomly assigned them to either a meditation or sham-meditation group. The group met for 4 25-minute sessions over 7 days and practiced focused breath meditation or sham-meditation. In the sham-meditation sessions the participants were told every 2 to 3 minutes to close their eyes and take a deep breath. They were measured before and after training for respiration and heart rate variability. In addition, the participants underwent noxious non-damaging thermal stimulation on the calf of the leg and rated their pain levels.

 

They found that after both meditation and sham-meditation training there was a significant reduction in pain intensity. pain unpleasantness, and respiration rate and increase in heart rate variability, with no group differences. They also found for the meditation group only that the greater the heart rate variability the lower the pain unpleasantness ratings.

 

Heart rate variability refers to the change in the time intervals between consecutive heart beats. Higher levels of HRV are indicative of flexibility in the Autonomic Nervous System and are associated with adaptability to varying environments and lower stress levels. Higher heart rate variability is an indicator of physiological relaxation. This relaxation may well underlie the reduced pain unpleasantness. Since contemplative practices such as meditation increases heart rate variability it makes sense that these practices would also lower the perception of pain.

 

It is interesting that sham-meditation had similar effects as real meditation on pain and heart rate variability. This suggests that mindfulness reduction in pain may be due to a placebo effect where the participants’ belief that the intervention would reduce pain produced reduced perception of pain. But it could also be that the sham-meditation was actually a mindfulness practice. By focusing the participant’s attention on the breath, it might have increased mindfulness. It remains for future research to investigate this possibility.

 

So, reduce pain and relax the autonomic nervous system with mindfulness.

 

“The ancient Buddhist text called the Sullatta Sutta states that mindfulness practitioners have the ability to experience pain but then let go of it.” – Brain Tap

 

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

 

Adler-Neal, A. L., Waugh, C. E., Garland, E. L., Shaltout, H. A., Diz, D. I., & Zeidan, F. (2020). The Role of Heart Rate Variability in Mindfulness-Based Pain Relief. The journal of pain, 21(3-4), 306–323. https://doi.org/10.1016/j.jpain.2019.07.003

 

HIGHLIGHTS

  • Mindfulness and sham mindfulness meditation reduced pain during noxious heat
  • Mindfulness and sham mindfulness meditation increased heart rate variability (HRV)
  • Mindfulness-based pain relief was associated with higher HRV
  • Higher HRV during sham mindfulness meditation was associated with higher pain

Abstract

Mindfulness meditation is a self-regulatory practice premised on sustaining non-reactive awareness of arising sensory events that reliably reduces pain. Yet, the specific analgesic mechanisms supporting mindfulness have not been comprehensively disentangled from the potential non-specific factors supporting this technique. Increased parasympathetic nervous system (PNS) activity is associated with pain relief corresponding to a number of cognitive manipulations. However, the relationship between the PNS and mindfulness-based pain attenuation remains unknown. The primary objective of the present study was to determine the role of high frequency heart rate variability (HF HRV), a marker of PNS activity, during mindfulness-based pain relief as compared to a validated, sham-mindfulness meditation technique that served as a breathing-based control. Sixty-two healthy volunteers (31 females; 31 males) were randomized to a four-session (25 minutes/session) mindfulness or sham-mindfulness training regimen. Before and after each group’s respective training, participants were administered noxious (49°C) and innocuous (35°C) heat to the right calf. HF HRV and respiration rate were recorded during thermal stimulation and pain intensity and unpleasantness ratings were collected after each stimulation series. The primary analysis revealed that during mindfulness meditation, higher HF HRV was more strongly associated with lower pain unpleasantness ratings when compared to sham-mindfulness meditation (B = −0.82, p = 0.04). This finding is in line with the prediction that mindfulness-based meditation engages distinct mechanisms from sham-mindfulness meditation to reduce pain. However, the same prediction was not confirmed for pain intensity ratings (B = −0.41). Secondary analyses determined that mindfulness and sham-mindfulness meditation similarly reduced pain ratings, decreased respiration rate, and increased HF HRV (between group ps < 0.05). More mechanistic work is needed to reliably determine the role of parasympathetic activation in mindfulness-based pain relief as compared to other meditative techniques.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6994350/

 

Improve Migraine Headache with Mindfulness

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Improve Migraine Headache with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Stress is a migraine trigger for nearly 70% of people living with migraine and disorders that cause severe head pain. Simple mindfulness exercises and relaxation techniques can help alleviate stress, increase calmness and, in some cases, prevent a migraine attack.” – Shirley Kessel

 

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 are actually a collection of neurological symptoms. Migraines often include: 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. The research is accumulating. So, it makes sense to summarize what has been learned.

 

In today’s Research News article “Mindfulness in migraine: A narrative review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213534/ ) Wells and colleagues review and summarize the published research on the effectiveness of mindfulness-based interventions for the relief of migraine headaches. They identified 8 published studies.

 

They report that the published studies found that mindfulness-based interventions produced significant improvements in patients with migraine headaches in regards to their overall quality of life and disability, self-efficacy and psychological symptoms over headache frequency. They also found that these mindfulness-based interventions work well in combination with pharmacologic treatments.

 

It is not known exactly how mindfulness produces these benefits for the patients with migraine headaches. The authors suggest that mindfulness may work as a result of decreasing pain perception, better coping mechanisms, greater body awareness, lowering reactivity, decreasing inflammation, improving stress coping, and modulating the autonomic nervous system. Regardless it is clear that mindfulness-based interventions do not cure migraines but rather improve the quality of life and reduce the disability of the patients. In combination with pharmacologic treatments mindfulness-based interventions work even better. Migraine headache is a torment. So, the relief produced by mindfulness-based interventions is very important for relieving the suffering of the patients.

 

So, improve migraine headache with mindfulness.

 

“Many people with migraine have brains that are more sensitive to change, whether it be changes inside us such as hydration or hormone levels or outside changes such as stress or even weather conditions. Daily mindfulness practice may help to settle these fluctuations and calm the mind which could have a beneficial effect on migraine. It can also be useful during a migraine attack to reduce the impact of the pain.” – David Kernick

 

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

 

Wells, R. E., Seng, E. K., Edwards, R. R., Victorson, D. E., Pierce, C. R., Rosenberg, L., Napadow, V., & Schuman-Olivier, Z. (2020). Mindfulness in migraine: A narrative review. Expert review of neurotherapeutics, 20(3), 207–225. https://doi.org/10.1080/14737175.2020.1715212

 

Abstract

Introduction:

Migraine is the second leading cause of disability worldwide, yet many patients are unable to tolerate, benefit from, or afford pharmacological treatment options. Non-pharmacological migraine therapies exist, especially to reduce opioid use, which represents a significant unmet need. Mindfulness-based interventions (MBI) have potential as a non-pharmacological treatment for migraine, primarily through the development of flexible attentional capacity across sensory, cognitive, and emotional experiences.

Areas Covered:

We review efficacy and potential mechanisms of MBIs for migraine, including mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT).

Expert Opinion:

While most mindfulness research studies for migraine to date have been pilot trials, which are small and/or lacked rigor, initial evidence suggests there, may be improvements in overall headache-related disability and psychological well-being. Many research questions remain to help target the treatment to patients most likely to benefit, including the ideal dosage, duration, delivery method, responder characteristics, and potential mechanisms and biomarkers. A realistic understanding of these factors is important for patients, providers, and the media. Mindfulness will not “cure” migraine; however, mindfulness may be an important tool as part of a comprehensive treatment approach to help patients “mindfully” engage in valued life activities.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213534/

 

Tai Chi Practice Improves the Symptoms of Multiple Diseases

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Tai Chi Practice Improves the Symptoms of Multiple Diseases

 

By John M. de Castro, Ph.D.

 

“In addition to easing balance problems, and possibly other symptoms, tai chi can help ease stress and anxiety and strengthen all parts of the body, with few if any harmful side effects.” Peter Wayne

 

Tai Chi is an ancient mindfulness practice involving slow prescribed movements. It is gentle and completely safe, can be used with the elderly and sickly, is inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, it can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Indeed, studies have shown that Tai Chi practice is effective in improving the symptoms of many different diseases. The evidence is accumulating. So, it makes sense to step back and summarize what has been learned about the effectiveness of different Tai Chi practices for different disease conditions.

 

In today’s Research News article “.Clinical Evidence of Tai Chi Exercise Prescriptions: A Systematic Review” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972853/ ) Huang and colleagues review and summarize the published randomized controlled trials on the effectiveness of different Tai Chi practices for different disease conditions. They identified 139 published randomized controlled trials utilizing a number of different Tai Chi styles and numbers of forms. Yang style was by far the most frequent style and 24 forms was the most frequent number of forms employed.

 

They report that the published research found that Tai Chi practice produced significant improvement in the symptoms of musculoskeletal system or connective tissue diseases such as osteoarthritis, fibromyalgia, and chronic low back pain.; on circulatory system diseases such as hypertension, stroke, coronary heart disease, and chronic heart failure; on mental and behavioral disorders such as depression, cognitive impairment, and intellectual disabilities; on nervous system diseases such as Parkinson’s disease, dementia, and sleep disorders; on chronic obstructive pulmonary disease (COPD); on endocrine, nutritional, or metabolic diseases such as type 2 diabetes and metabolic syndrome; on the physical and mental state of cancer patients, and on traumatic brain injury and urinary tract disorders; on balance control and flexibility and falls in older adults.

 

These are remarkable findings. Tai Chi practice appears to be a safe and effective treatment for the symptoms of a wide variety of diseases. It doesn’t cure the disease. Rather if alleviates the symptoms. It is not known the mechanisms by which Tai Chi has these benefits. Future research needs to further explore what facets or effects of Tai Chi practice are responsible for the disease symptom improvements.

 

So, Tai Chi practice improves the symptoms of multiple diseases.

 

“Tai Chi and Qigong are evidence-based approaches to improve health-related quality of life, and they may be effective for a range of physical health conditions.” – Ryan Abbott

 

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

 

Huang, J., Wang, D., & Wang, J. (2021). Clinical Evidence of Tai Chi Exercise Prescriptions: A Systematic Review. Evidence-based Complementary and Alternative Medicine : eCAM, 2021, 5558805. https://doi.org/10.1155/2021/5558805

 

Abstract

Objectives

This systematic review aims to summarize the existing literature on Tai Chi randomized controlled trials (RCTs) and recommend Tai Chi exercise prescriptions for different diseases and populations.

Methods

A systematic search for Tai Chi RCTs was conducted in five electronic databases (PubMed, Cochrane Library, EMBASE, EBSCO, and Web of Science) from their inception to December 2019. SPSS 20.0 software and Microsoft Excel 2019 were used to analyze the data, and the risk of bias tool in the RevMan 5.3.5 software was used to evaluate the methodological quality of RCTs.

Results

A total of 139 articles were identified, including diseased populations (95, 68.3%) and healthy populations (44, 31.7%). The diseased populations included the following 10 disease types: musculoskeletal system or connective tissue diseases (34.7%), circulatory system diseases (23.2%), mental and behavioral disorders (12.6%), nervous system diseases (11.6%), respiratory system diseases (6.3%), endocrine, nutritional or metabolic diseases (5.3%), neoplasms (3.2%), injury, poisoning and certain other consequences of external causes (1.1%), genitourinary system diseases (1.1%), and diseases of the eye and adnexa (1.1%). Tai Chi exercise prescription was generally classified as moderate intensity. The most commonly applied Tai Chi style was Yang style (92, 66.2%), and the most frequently specified Tai Chi form was simplified 24-form Tai Chi (43, 30.9%). 12 weeks and 24 weeks, 2-3 times a week, and 60 min each time was the most commonly used cycle, frequency, and time of exercise in Tai Chi exercise prescriptions.

Conclusions

We recommend the more commonly used Tai Chi exercise prescriptions for different diseases and populations based on clinical evidence of Tai Chi. Further clinical research on Tai Chi should be combined with principles of exercise prescription to conduct large-sample epidemiological studies and long-term prospective follow-up studies to provide more substantive clinical evidence for Tai Chi exercise prescriptions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972853/

 

Improve Pain, Sleep, and the Mental Health of Chronic Pain Patients with Internet Mindfulness Training

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Improve Pain, Sleep, and the Mental Health of Chronic Pain Patients with Internet Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“In the context of chronic pain . . . meditation can help you to stop your mind wandering back to your pain when you are trying to focus on something else, therefore improving your ability to give your entire attention to the task at hand and in turn, improve your level of functioning. It gives you the power to take your mind off your pain and refocus it, therefore aiding you in replacing unhelpful, behaviours with healthy ones which can reduce your pain and allow you to take better care of your health.” – Ann-Marie D’arcy-Sharpe

 

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. 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.

 

Acceptance and Commitment Therapy (ACT) requires a scheduled program of sessions with a trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. As an alternative, mindfulness training over the internet have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. In addition, research has indicated that mindfulness training online can be effective for improving the health and well-being of the participants.

 

In today’s Research News article “Internet‐delivered acceptance and commitment therapy as microlearning for chronic pain: A randomized controlled trial with 1‐year follow‐up.” (See summary below or view the full text of the study at: https://onlinelibrary.wiley.com/doi/10.1002/ejp.1723 ) Rickardsson and colleagues recruited adult chronic pain patients and randomly assigned them to either a wait-list control condition or to receive an 8-week program of Acceptance and Commitment Therapy (ACT) delivered over the internet. ACT was delivered in daily microlearning short learning interactions. There was a 74% completion rate of the modules. The participants were measured before and after training and at 3-, 6-, and 12-month follow-ups for psychiatric problems, pain interference, pain intensity, anxiety, depression, psychological inflexibility, values, and health-related quality of life.

 

They found that compared to baseline and the wait-list control group, the group that received internet-delivered Acceptance and Commitment Therapy (ACT) had significant decreases in pain interference, pain intensity, anxiety, depression, psychological inflexibility, value obstruction, and insomnia. These improvements were long-lasting as they were maintained at the 12-month follow-up.

 

These are impressive improvements in the pain and psychological health of these diverse chronic pain patients. These results correspond with the frequent prior observations that mindfulness training produces reductions in pain, anxiety, depression, psychological inflexibility, and insomnia in a wide range of patient types and normal individuals. These results are particularly impressive as Acceptance and Commitment Therapy (ACT) was delivered over the internet. in daily microlearning short learning interactions. This was very convenient for the patients and required only 12.4 minutes per week of therapist time per week and was thus very inexpensive to deliver. Yet ACT was highly effective and lasting in relieving the suffering of these chronic pain patients.

 

So, improve pain, sleep, and the mental health of chronic pain patients with internet mindfulness training.

 

“What we want to do as best as we can is to engage with the pain just as it is. It’s not about achieving a certain goal – like minimizing pain – but learning to relate to your pain differently.” – Elisha Goldstein

 

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

 

Jenny Rickardsson, Charlotte Gentili, Linda Holmström, Vendela Zetterqvist, Erik Andersson, Jan Persson, Mats Lekander, Brjánn Ljótsson, Rikard K. Wicksell. Internet‐delivered acceptance and commitment therapy as microlearning for chronic pain: A randomized controlled trial with 1‐year follow‐up, European Journal of Pain, 2021;00:1–19, https://doi.org/10.1002/ejp.1723

 

Abstract

Background

Studies of Internet‐delivered acceptance and commitment therapy (ACT) for chronic pain have shown small to moderate positive effects for pain interference and pain acceptance. Effects on pain intensity, depression, anxiety and quality of life (QoL) have been less favourable, and improvements for values and sleep are lacking. In this randomized controlled trial iACT – a novel format of Internet‐ACT using daily microlearning exercises – was examined for efficacy compared to a waitlist condition.

Methods

Adult participants (mean age 49.5 years, pain duration 18.1 years) with diverse chronic pain conditions were recruited via self‐referral, and randomized to iACT (n = 57) or waitlist (n = 56). The primary outcome was pain interference. The secondary outcomes were QoL, depression, anxiety, insomnia and pain intensity. The process variables included psychological inflexibility and values. Post‐assessments were completed by 88% (n = 100) of participants. Twelve‐month follow‐up assessments were completed by 65% (iACT only, n = 37). Treatment efficacy was analysed using linear mixed models and an intention‐to‐treat‐approach.

Results

Significant improvements in favour of iACT were seen for pain interference, depression, anxiety, pain intensity and insomnia, as well as process variables psychological inflexibility and values. Between‐group effect sizes were large for pain interference (d = 0.99) and pain intensity (d = 1.2), moderate for anxiety and depressive symptoms and small for QoL and insomnia. For the process variables, the between‐group effect size was large for psychological inflexibility (d = 1.0) and moderate for values. All improvements were maintained at 1‐year follow‐up.

Conclusions

Internet‐ACT as microlearning may improve a broad range of outcomes in chronic pain.

Significance

The study evaluates a novel behavioral treatment with positive results on pain interference, mood as well as pain intensity for longtime chronic pain sufferers. The innovative format of a digital ACT intervention delivered in short and experiential daily learnings may be a promising way forward.

https://onlinelibrary.wiley.com/doi/10.1002/ejp.1723

 

jenny.rickardsson@ki.se

 

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

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

 

By John M. de Castro, Ph.D.

 

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

 

Over the last several decades, research and anecdotal experiences have accumulated an impressive evidential case that the development of mindfulness has positive benefits for the individual’s mental, physical, and spiritual life. Mindfulness appears to be beneficial both for healthy people and for people suffering from a myriad of mental and physical illnesses. It appears to be beneficial across ages, from children to the elderly. And it appears to be beneficial across genders, personalities, race, and ethnicity. The breadth and depth of benefits is unprecedented. There is no other treatment or practice that has been shown to come anyway near the range of mindfulness’ positive benefits.

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

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

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

 

Decrease Defensiveness and Increase Psychological Health with Meditation

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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/