Improve Chronic Conditions with Mindfulness Taught over the Internet

Improve Chronic Conditions with Mindfulness Taught over the Internet

 

By John M. de Castro, Ph.D.

 

“It’s important for people living with health conditions to recognize what they are feeling, instead of trying to push painful thoughts and emotions away, which can actually amplify them. For those living with serious medical conditions, mindfulness can help them accept and respond to difficult feelings, including fear, loneliness and sadness. By bringing mindfulness to emotions (and the thoughts that may underlie them), we can begin to see them more clearly and recognize that they are temporary.” – Shauna Shapiro

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress. The vast majority of the mindfulness training techniques, however, require a certified 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. This makes delivery to individuals in remote locations nearly impossible.

 

As an alternative, applications over the internet and on smartphones have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, eliminating the need to go repeatedly to specific locations, and being available to patients in remote areas. But, the question arises as to the level of compliance with the training and the effectiveness of these internet applications in inducing mindfulness and improving physical and psychological health in chronically ill patients.

 

In today’s Research News article “Digital Characteristics and Dissemination Indicators to Optimize Delivery of Internet-Supported Mindfulness-Based Interventions for People With a Chronic Condition: Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6107686/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6123540/  ), Russell and colleagues review and summarize the published research literature on the effectiveness of internet based mindfulness training programs for the treatment of patients with chronic diseases. They identified 10 randomized controlled studies that contained a control group where mindfulness training was performed over the internet. The patients were afflicted with chronic pain in 3 of the studies, and in single studies with fibromyalgia, heart disease, cancer post-treatment, anxiety disorder, major depressive disorder, residual depressive symptoms, and psychosis.

 

They found that internet-based mindfulness interventions in general had significant beneficial effects that improved patient functioning in comparison to the control groups. Half of the studies reported follow-up measurements that reflected persisting benefits. They noted that when measured participant adherence to the programs was in general low.

 

Hence, it appears that internet-based mindfulness interventions are safe and effective treatments for the well-being of patients with chronic diseases. This is potentially very important as these interventions can be administered inexpensively, conveniently, and to large numbers of patients regardless of their locations, greatly increasing the impact of the treatments.

 

There are some caveats. The majority of the participants by far were women and there was no study that compared the efficacy of the internet-based intervention to the comparable face-to-face intervention or another treatment. So, it was recommended that future studies include more males and a comparison to another treatment.

 

So, improve chronic conditions with mindfulness taught over the internet.

 

“MBSR programs might not reverse underlying chronic disease, but they can make it easier to cope with symptoms, improve overall well-being and quality of life and improve health outcomes.” – Monika Merkes

 

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

Russell, L., Ugalde, A., Milne, D., Austin, D., & Livingston, P. M. (2018). Digital Characteristics and Dissemination Indicators to Optimize Delivery of Internet-Supported Mindfulness-Based Interventions for People With a Chronic Condition: Systematic Review. JMIR Mental Health, 5(3), e53. http://doi.org/10.2196/mental.9645

 

Abstract

Background

Internet-supported mindfulness-based interventions (MBIs) are increasingly being used to support people with a chronic condition. Characteristics of MBIs vary greatly in their mode of delivery, communication patterns, level of facilitator involvement, intervention period, and resource intensity, making it difficult to compare how individual digital features may optimize intervention adherence and outcomes.

Objective

The aims of this review were to (1) provide a description of digital characteristics of internet-supported MBIs and examine how these relate to evidence for efficacy and adherence to the intervention and (2) gain insights into the type of information available to inform translation of internet-supported MBIs to applied settings.

Methods

MEDLINE Complete, PsycINFO, and CINAHL databases were searched for studies assessing an MBI delivered or accessed via the internet and engaging participants in daily mindfulness-based activities such as mindfulness meditations and informal mindfulness practices. Only studies using a comparison group of alternative interventions (active compactor), usual care, or wait-list were included. Given the broad definition of chronic conditions, specific conditions were not included in the original search to maximize results. The search resulted in 958 articles, from which 11 articles describing 10 interventions met the inclusion criteria.

Results

Internet-supported MBIs were more effective than usual care or wait-list groups, and self-guided interventions were as effective as facilitator-guided interventions. Findings were informed mainly by female participants. Adherence to interventions was inconsistently defined and prevented robust comparison between studies. Reporting of factors associated with intervention dissemination, such as population representativeness, program adoption and maintenance, and costs, was rare.

Conclusions

More comprehensive descriptions of digital characteristics need to be reported to further our understanding of features that may influence engagement and behavior change and to improve the reproducibility of MBIs. Gender differences in determinants and patterns of health behavior should be taken into account at the intervention design stage to accommodate male and female preferences. Future research could compare MBIs with established evidence-based therapies to identify the population groups that would benefit most from internet-supported programs.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6123540/

 

Improve Mental Illness with Yoga

Improve Mental Illness with Yoga

 

By John M. de Castro, Ph.D.

 

“for the general person, yoga greatly enhances mental health: mood, sense of self, motivation, sense of inner direction and purpose, as well as physical health—and physical health is so important for mental health.“– Eleanor Criswell

 

Yoga is a complex of practices including postures, movements, breathing practices and meditation. Although its benefits have been touted for centuries, it is only recently that scientific study was verified these benefits. Yoga practice has been repeatedly demonstrated in research studies to be beneficial for the psychological and physical health of the practitioners. It appears to be helpful for both healthy individuals and those suffering from physical and mental health issues.

 

In today’s Research News article “The Efficacy of Body-Oriented Yoga in Mental Disorders: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5400032/ ),

Klatte and colleagues review, summarize, and perform a meta-analysis of the published research literature on effects of yoga practice on a variety of mental health problems. They focused on randomized controlled studies with adults suffering from psychiatric problems. They identified 25 published studies that met their criteria, including treatment of depression, schizophrenia, dependency, post-traumatic Stress Disorder (PTSD), and other mental illnesses.

 

They found that yoga practice produced, on the whole, large and significant improvements in the symptoms of the mental illnesses even in comparison to active control groups such as attention training and exercise. The beneficial effects of yoga practice were comparable to those produced by psychotherapy. But, the combination of yoga practice with psychotherapy produced even greater effects.

 

These are exciting and compelling findings that yoga practice is an effective treatment for mental illness on a par with individual psychotherapy. But, yoga practice has the advantage of being relatively inexpensive, can be practiced at home or in groups, and after a few weeks of instruction can be carried on without a therapist present. In addition, it can supplement traditional psychotherapy potentiating its effectiveness.

 

It would appear that the exercise component of yoga practice is not essential for its effectiveness as exercise only control groups show benefits but significantly less than the yoga practice groups. This suggests that the improvement of mindfulness that occurs in yoga practice has an additional beneficial role to play in treating mental illness. The combination of exercise with mindfulness training that occur with yoga  practice appears to be particularly effective in treating mental illnesses. These results suggest that yoga practice is safe and effective and should applied either as a stand-alone treatment or be combined with more traditional treatments.

 

So, improve mental illness with yoga.

 

“It will come as no surprise that the various forms of yoga have long been acknowledged as allies in mastering the mind and coping with stress. Science is Increasingly validating those claims, especially for depression, schizophrenia, anxiety, PTSD (post-traumatic stress disorder), and ADHD (attention deficit hyperactivity disorder).” – Mental Health America

 

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

 

Klatte, R., Pabst, S., Beelmann, A., & Rosendahl, J. (2016). The Efficacy of Body-Oriented Yoga in Mental Disorders: A Systematic Review and Meta-Analysis. Deutsches Ärzteblatt International, 113(12), 195–202. http://doi.org/10.3238/arztebl.2016.0195

Abstract

Background

The efficacy of body-oriented yoga in the treatment of mental disorders has been investigated in numerous studies. This article is a systematic review and meta-analysis of the relevant publications.

Methods

All studies in which the efficacy of hatha-yoga, i.e., body-oriented yoga with asanas and pranayama, was studied in adult patients suffering from a mental disorder (as diagnosed by ICD or DSM criteria) were included in the analysis. The primary endpoint was disorder-specific symptom severity. The publications were identified by a systematic search in the PubMed, Web of Science, PsycINFO and ProQuest databases, supplemented by a search with the Google Scholar search engine and a manual search in the reference lists of meta-analyses and primary studies, as well as in specialized journals.

Results

25 studies with a total of 1339 patients were included in the analysis. A large and significant effect of yoga was seen with respect to the primary endpoint (symptom severity) (Hedges’ g = 0.91; 95% confidence interval [0.55; 1.28]; number needed to treat [NNT]: 2.03), with substantial heterogeneity (I2 = 69.8%) compared to untreated control groups. Small but significant effects of yoga were also seen in comparison with attention control (g = 0.39; [0.04; 0.73]; NNT: 4.55) and physical exercise (g = 0.30; [0.01; 0.59]; NNT: 5.75); no difference in efficacy was found between yoga and standard psychotherapy (g = 0.08; [-0.24; 0,40]; NNT: 21.89). In view of the relatively high risk of bias, these findings should be interpreted with caution.

Conclusion

Body-oriented yoga with asanas and pranayama as central components is a promising complementary treatment for mental disorders and should be investigated in further high-quality studies.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5400032/

Improve Bipolar Disorder with Mindfulness

Improve Bipolar Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness looks like a potentially effective way of managing bipolar disorder, especially the depressive pole, which may be the most difficult to treat with medication alone. Mindfulness exercises and meditations are useful for people with bipolar disorder (manic depression) because mindfulness decreases the relapse rate for depression, reduces stress and anxiety, which contribute significantly to the onset of both mania and depression and may worsen the course of the illness, and improves a person’s ability to manage thoughts and feelings and increases awareness of the way the person tends to internalize external stimuli.” Shamash Alidina

 

Bipolar Disorder, also known as Manic Depressive Disorder, is a mood disorder characterized by alternating states of extreme depression, relative normalcy, and extreme euphoria (mania). The symptoms of depression and mania are so severe that the individual is debilitated and unable to conduct their normal daily lives. The depression is so severe that suicide occurs in about 1% of cases of Bipolar Disorder. It is thought to result from imbalances in the monoamine neurotransmitter systems in the nervous system and appears to be highly linked to the genes. There are great individual differences in Bipolar Disorder. The extreme mood swings can last for a few days to months and can occur only once or reoccur frequently.

 

Bipolar Disorder affects about 1% of the population throughout the world at any time. But about 3% to 10% of the population may experience it sometime during their lives. It is usually treated with drugs. But, these medications are not always effective and can have difficult side effects. Hence, there is a great need for alternative treatments. Mindfulness practices and treatments have been shown to be effective for major mental disorders, including depression and anxiety disorders and to improve the regulation of emotions. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed for the treatment of depression and has been shown to be very effective. MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. So, MBCT may be a safe and effective treatment for Bipolar Disorder.

 

In today’s Research News article “Mindfulness-Based Treatment for Bipolar Disorder: A Systematic Review of the Literature.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5590538/, Bojic and Becerra reviewed and summarized the published research literature on the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for the treatment of Bipolar Disorder. They identified 13 published research studies.

 

They report that the published research finds that MBCT in conjunction with drug treatments produces significant improvements in most of the symptoms of Bipolar Disorder. MBCT  was found to produce significant improvements in mood, including decreased mania, anxiety, and depression. In addition, there were significant increases in the patients’ ability to regulate their emotions and their ability to think clearly (cognitive abilities). The studies report that MBCT remains effective one year after the conclusion of treatment.

 

Thus the current state of the research suggests that Mindfulness-Based Cognitive Therapy (MBCT) is a safe, effective, and lasting treatment for Bipolar Disorder when used in addition to the standard drug treatments. These are important and exciting findings. They suggest that MBCT can help to relieve the suffering and improve the patients ability to conduct their lives.

 

So, improve bipolar disorder with mindfulness.

 

“The extreme highs and lows of bipolar disorder can be difficult to cope with, and difficult for those around you. The disorder causes anxiety at one end and depression at the other. Meditation is an easy and natural method for relaxing and reducing stress in anyone, and particularly in people with bipolar disorder.” – Anthony Watt

 

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

 

Bojic, S., & Becerra, R. (2017). Mindfulness-Based Treatment for Bipolar Disorder: A Systematic Review of the Literature. Europe’s Journal of Psychology, 13(3), 573–598. http://doi.org/10.5964/ejop.v13i3.1138

 

Abstract

Despite the increasing number of studies examining the effects of mindfulness interventions on symptoms associated with Bipolar Disorder (BD), the effectiveness of this type of interventions remains unclear. The aim of the present systematic review was to (i) critically review all available evidence on Mindfulness Based Cognitive Therapy (MBCT) as a form of intervention for BD; (ii) discuss clinical implications of MBCT in treating patients with BD; and (iii) provide a direction for future research. The review presents findings from 13 studies (N = 429) that fulfilled the following selection criteria: (i) included BD patients; (ii) presented results separately for BD patients and control groups (where a control group was available); (iii) implemented MBCT intervention; (iv) were published in English; (v) were published in a peer reviewed journal; and (vi) reported results for adult participants. Although derived from a relatively small number of studies, results from the present review suggest that MBCT is a promising treatment in BD in conjunction with pharmacotherapy. MBCT in BD is associated with improvements in cognitive functioning and emotional regulation, reduction in symptoms of anxiety depression and mania symptoms (when participants had residual manic symptoms prior to MBCT). These, treatment gains were maintained at 12 month follow up when mindfulness was practiced for at least 3 days per week or booster sessions were included. Additionally, the present review outlined some limitations of the current literature on MBCT interventions in BD, including small study sample sizes, lack of active control groups and idiosyncratic modifications to the MBCT intervention across studies. Suggestions for future research included focusing on factors underlying treatment adherence and understanding possible adverse effects of MBCT, which could be of crucial clinical importance.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5590538/

Improve Schizophrenia with Mindfulness

Improve Schizophrenia with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness treatments do not aim to decrease the occurrence or severity of the symptoms of psychosis, but by helping to reduce the distress people experience.” – Tania Lecomte

 

Schizophrenia is the most common form of psychosis. It effects about 1% of the population worldwide. It appears to be highly heritable and involves changes in the brain. It is characterized by both positive and negative symptoms. Positive symptoms include hallucinations; seeing and, in some cases, feeling, smelling or tasting things that aren’t there, or delusions; unshakable beliefs that, when examined rationally, are obviously untrue. Negative symptoms include a reduced ability to function normally, neglect of personal hygiene, lack of emotion, blank facial expressions, speaking in a monotone, loss of interest in everyday activities, social withdrawal, an inability to experience pleasure, and a lack of insight into their symptoms. The symptoms of schizophrenia usually do not appear until late adolescence or early adulthood.

 

Schizophrenia is very difficult to treat with psychotherapy and is usually treated with antipsychotic drugs. These drugs, however, are not always effective, sometimes lose effectiveness, and can have some difficult side effects. In addition, even when effective, antipsychotic drugs only treat the positive symptoms of schizophrenia, leaving the negative symptom intact including the loss of functionality and a lack of insight. Hence, there is a need for safe and effective alternative treatments for schizophrenia that can treat the negative symptoms.

 

Mindfulness training has been shown to be beneficial for a variety of mental health problems, including psychosis. Mindfulness has also been shown to associated with lower symptom severity of schizophrenia. Another treatment, psychoeducation specific for schizophrenia, has also been shown to reduces relapse rates and improve medication adherence. Psychoeducation consists of working with individual patients and their families to improve schizophrenia survival skills, focusing on stressful situation and coping strategies, and problem-solving. Since both mindfulness training and psychoeducation appear to be effective their combination may be particularly effective in treating schizophrenia.

 

In today’s Research News article “An international multi-site, randomized controlled trial of a mindfulness-based psychoeducation group programme for people with schizophrenia.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5551382/, Chien and colleagues recruited patients who were diagnosed with schizophrenia and randomly assigned them to receive either treatment as usual, 6-weeks of psychoeducation alone, or 6-weeks of psychoeducation in combination with mindfulness training. The participants were measured before and after the treatment programs, and 6 and 18 weeks later for average number and length of re-hospitalizations, level of functioning, insight into illness, and schizophrenia symptoms.

 

They found that whereas the treatment as usual group had significant deterioration in all measures both intervention groups had significant improvements specifically in average length of rehospitalizations; patient functioning, including improvements in social and community functioning and self-management; patient mental state, including reductions in both positive and negative symptoms; and insight into their illness. In addition, there was a significant increase in complete remissions in the intervention groups. Importantly, in every case the psychoeducation in combination with mindfulness training produced significantly superior results to the psychoeducation alone condition.

 

These results suggest that psychoeducation alone is an effective treatment for schizophrenia, but the addition of mindfulness training markedly improves the outcomes. In the treatment as usual condition only 7% of the patients achieved remission while in the psychoeducation condition 27% achieved remission and with added mindfulness training 39% remissions were achieved. These are remarkable improvements in a very difficult condition to treat. The results suggest that teaching schizophrenia patients the skills to cope with their disease is very useful but that making them more mindful greatly improves this coping. It would appear that being able to look at and experience the symptoms of their disease in the present moment non-judgmentally improves the patients’ ability to cope with and alter their symptoms.

 

So, improve schizophrenia with mindfulness.

 

“mindfulness-based psycho-educational intervention expressly designed for patients with schizophrenia can be well tolerated and result in better illness outcomes than either standard treatment alone or standard treatment supplemented by a more typical psycho-educational approach. This is an important finding because of the widely held belief that psychotic patients can neither tolerate nor benefit from mindfulness-based interventions.” – American Mindfulness Research Association

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Chien, W. T., Bressington, D., Yip, A., & Karatzias, T. (2017). An international multi-site, randomized controlled trial of a mindfulness-based psychoeducation group programme for people with schizophrenia. Psychological Medicine, 47(12), 2081–2096. http://doi.org/10.1017/S0033291717000526

 

Abstract

Background

We aimed to test a mindfulness-based psychoeducation group (MBPEG), v. a conventional psychoeducation group (CPEG) v. treatment as usual (TAU), in patients with schizophrenia-spectrum disorders over a 24-month follow-up.

Method

This single-blind, multi-site, pragmatic randomized controlled trial was conducted in six community treatment facilities across three countries (Hong Kong, mainland China and Taiwan). Patients were randomly allocated to one of the treatment conditions, and underwent 6 months of treatment. The primary outcomes were changes in duration of re-hospitalizations and mental state (Positive and Negative Syndrome Scale; PANSS) between baseline and 1 week, and 6, 12 and 18 months post-treatment.

Results

A total of 300 patients in each country were assessed for eligibility between October 2013 and 30 April 2014, 38 patients per country (n = 342) were assigned to each treatment group and included in the intention-to-treat analysis. There was a significant difference in the length of re-hospitalizations between the three groups over 24 months (F2,330 = 5.23, p = 0.005), with MBPEG participants having a shorter mean duration of re-hospitalizations than those in the other groups. The MBPEG and CPEG participants had significant differential changes in proportional odds ratios of complete remission (all individual PANSS items <3) over the 24-month follow-up (37 and 26%, respectively), as opposed to only 7.2% of the TAU group (χ2 = 8.9 and 8.0, p = 0.001 and 0.003, relative risk = 3.5 and 3.1, 95% confidence interval 2.0–7.2 and 1.6–6.3).

Conclusions

Compared with TAU and CPEG, MBPEG improves remission and hospitalization rates of people with schizophrenia spectrum disorders over 24 months.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5551382/

Reduce Suspiciousness and Excessive Social Anxiety with Mindfulness

Reduce Suspiciousness and Excessive Social Anxiety with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Our nervous system is like the soundtrack for every scene in life that we encounter. It is all but impossible to experience a scene as safe and happy when the music tells us otherwise. With a mindful, body-based approach, clients can learn to change their music.” – Jeena Cho

 

Meditation began as a spiritual practice and as such involves thoughts of an ultimate reality that transcends the mundane reality of everyday life. The beginning of such realizations can produce thinking that appears magical, that is not based in physical reality. This can appear to be magical thinking which can be confused with the types of ungrounded thinking that appears in schizophrenia. In addition, meditation practice, especially at meditation retreats, can unleash troubling thoughts often related to past trauma or emotional upheaval. As a result, vulnerable individuals may have serious psychological symptoms arise as a result of meditation practice. There has been very little study of these phenomena. Yet, such study may be quite important as meditation is generally seen as a safe practice, yet, in fact, meditation may lead to a state that resembles mental illnesses, such as schizophrenia, and meditators may be misdiagnosed.

 

In today’s Research News article “Schizotypy and mindfulness: Magical thinking without suspiciousness characterizes mindfulness meditators.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5514306/, Antonova and colleagues study symptoms of schizotypy in meditators and its relationship to mindfulness. “Schizotypy is a psychological construct, encompassing a range of personality traits and cognitions that are similar to psychosis but less severe in nature . . . schizotypy is characterized by nine dimensions: ideas of reference, excessive social anxiety, magical thinking, unusual perceptual experiences, eccentric behavior or appearance, no close friends or confidants, odd speech, constricted affect and suspiciousness. Schizotypy clearly encompasses both psychosis-like symptoms and symptoms related to anxiety and depression.” They recruited male experienced meditators who had been practicing consistently for at least 2 years (average 7.5 years) and a group of male meditation naïve participants. Participants completed scales measuring mindfulness and symptoms of schizotypy.

 

They found that, although the two groups did not differ in total schizotypy symptoms, the meditation group scored significantly higher on the mindfulness facets of Observe, Non-judgment and Non-reactivity, and higher on the schizotypy symptom of magical thinking and significantly lower on suspiciousness and excessive social anxiety. They also found that the higher the levels of the mindfulness facets of Observe, Non-judgment and Non-reactivity the lower the levels of social anxiety and total schizotypy symptoms.

 

These are interesting results that support the contention that meditation training does not necessarily lead to the kinds of symptoms that reflect early stages of schizophrenia. To the contrary, meditation appears to be associated with stronger mental health as mindfulness was associated with lower levels of schizotypy, including suspiciousness and social anxiety. The increase in magical thinking is expected in that all of the meditators engaged in meditation as a spiritual practice in the Buddhist traditions. Hence, there were no indications of any meditation effects that would tend to precipitate psychosis.

 

It should be kept in mind that the results were correlational and as such causation cannot be concluded. In addition, only males were studied. It is also possible that meditators who would be susceptible to negative consequences of meditation practice would have dropped out from meditation practice and so not be represented in a sample of long-term meditators. So, more research is needed investigating the effects of meditation on schizotypy symptoms in beginning meditators and in females.

 

So, reduce suspiciousness and excessive social anxiety with mindfulness.

 

“mindfulness meditation improves somatic, psychological, and spiritual wellbeing. Thus, although poorly-practiced or poorly-taught meditation can actually be harmful to a person’s health, where mindfulness meditation is taught by an experienced and authentic teacher who is aware of all of the risks, then adverse side effects are unlikely.” – Edo Shonin

 

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

 

Antonova, E., Amaratunga, K., Wright, B., Ettinger, U., & Kumari, V. (2016). Schizotypy and mindfulness: Magical thinking without suspiciousness characterizes mindfulness meditators. Schizophrenia Research: Cognition, 5, 1–6. http://doi.org/10.1016/j.scog.2016.05.001

 

Abstract

Despite growing evidence for demonstrated efficacy of mindfulness in various disorders, there is a continuous concern about the relationship between mindfulness practice and psychosis. As schizotypy is part of the psychosis spectrum, we examined the relationship between long-term mindfulness practice and schizotypy in two independent studies. Study 1 included 24 experienced mindfulness practitioners (19 males) from the Buddhist tradition (meditators) and 24 meditation-naïve individuals (all males). Study 2 consisted of 28 meditators and 28 meditation-naïve individuals (all males). All participants completed the Schizotypal Personality Questionnaire (Raine, 1991), a self-report scale containing 9 subscales (ideas of reference, excessive social anxiety, magical thinking, unusual perceptual experiences, odd/eccentric behavior, no close friends, odd speech, constricted affect, suspiciousness). Participants of study 2 also completed the Five-Facet Mindfulness Questionnaire which assesses observing (Observe), describing (Describe), acting with awareness (Awareness), non-judging of (Non-judgment) and non-reactivity to inner experience (Non-reactivity) facets of trait mindfulness. In both studies, meditators scored significantly lower on suspiciousness and higher on magical thinking compared to meditation-naïve individuals and showed a trend towards lower scores on excessive social anxiety. Excessive social anxiety correlated negatively with Awareness and Non-judgment; and suspiciousness with Awareness, Non-judgment and Non-reactivity facets across both groups. The two groups did not differ in their total schizotypy score. We conclude that mindfulness practice is not associated with an overall increase in schizotypal traits. Instead, the pattern suggests that mindfulness meditation, particularly with an emphasis on the Awareness, Non-judgment and Non-reactivity aspects, may help to reduce suspiciousness and excessive social anxiety.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5514306/

Reduce Psychotic Symptoms with Meditation

Reduce Psychotic Symptoms with Meditation

 

By John M. de Castro, Ph.D.

 

 While meditating the last day I finally could see love as an underlying force in the universe, and I had a waking dream of some fractal patterns realigning, it is hard to describe with words. It is still embarrassing to remember all the details of this, but it can be summarized with one word: delirium. I was totally out of myself, and what is worse, I was acting in inappropriate ways with other people. For instance, I was being hosted by a girl, and I acted violently smashing a cup against a wall, and throwing a chair to the floor. I still remember how my mind was watching in horror how my body was acting. It was stuff for nightmares…” – TLDR

 

There have been a number of reports that mindfulness meditation can lead to psychotic like symptoms in a few individuals. This appears to be amplified by participation in meditation retreats. It has been reported that around 60% of participants in intensive meditation retreats experienced at least one negative side effect, including panic, depression and confusion and about 7% experienced psychotic-like symptoms. Hence, meditation, although highly beneficial, does have some potential negative effects for many people and extreme negative consequences for a few.

 

There has, unfortunately been very little research on these negative effects of meditation. In today’s Research News article “Schizotypy and mindfulness: Magical thinking without suspiciousness characterizes mindfulness meditators.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5514306/, Antonova and colleagues, to address this issue, examine whether psychotic like symptoms are present in experienced meditators. They recruited male meditators who have been consistently practicing over at least 2 years, meditating at least 6 days per week for at least 45 minutes per day and males who had never practiced meditation and any other mindfulness practice. The participants were measured for five facets of mindfulness, including describing, observing, acting with awareness, non-judging, and non-reacting, and schizotypal personality characteristics, including ideas of reference, excessive social anxiety, magical thinking, unusual perceptual experiences, odd/eccentric behavior, no close friends, odd speech, constricted affect and suspiciousness.

 

They found that meditators had significantly lower scores on suspiciousness and excessive social anxiety, and higher scores on magical thinking. They were also higher in mindfulness, including observing, non-judging, and non-reacting. In addition, the higher the scores on acting with awareness and non-judging, the lower the levels of schizotypal personality characteristics including suspiciousness, excessive social anxiety, and constricted affect (blunted emotions). Hence, experienced meditators tend to have fewer psychotic-like symptoms and higher mindfulness and high levels of mindfulness were associated with lower psychotic-like symptoms.

 

These results are interesting and tend to counter the notion that meditation is associated with increased negative psychotic-like symptoms. This may be due, though, to the fact that people who meditate consistently over a long period of time are generally psychological healthy individuals to begin with. It is also possible that those individuals who are sensitive of the negative effects of meditation simply drop out and don’t continue meditating as the negative consequences present themselves. The higher levels of magical thinking in the meditators may result from the fact that the meditators all practiced in the Buddhist tradition where metaphysical ideas are taught.

 

This is an important line of research and could be best addressed with longitudinal research investigating beginning meditators and following their progress over an extended period of time. Unfortunately, the present results do not provide a clearer understanding of the potential hazards of meditation practice, particularly while engaging in meditation retreats. Perhaps research that closely follows meditators while participating in a retreat may help to elucidate the factors responsible for the reported negative consequences.

 

So, reduce psychotic symptoms with meditation.

 

“60 per cent of people who had been on a meditation retreat had suffered at least one negative side effect, including panic, depression and confusion, a study in the US found.” – Harriett Crawford

 

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

 

Antonova, E., Amaratunga, K., Wright, B., Ettinger, U., & Kumari, V. (2016). Schizotypy and mindfulness: Magical thinking without suspiciousness characterizes mindfulness meditators. Schizophrenia Research: Cognition, 5, 1–6. http://doi.org/10.1016/j.scog.2016.05.001

 

 

Abstract

Despite growing evidence for demonstrated efficacy of mindfulness in various disorders, there is a continuous concern about the relationship between mindfulness practice and psychosis. As schizotypy is part of the psychosis spectrum, we examined the relationship between long-term mindfulness practice and schizotypy in two independent studies. Study 1 included 24 experienced mindfulness practitioners (19 males) from the Buddhist tradition (meditators) and 24 meditation-naïve individuals (all males). Study 2 consisted of 28 meditators and 28 meditation-naïve individuals (all males). All participants completed the Schizotypal Personality Questionnaire (Raine, 1991), a self-report scale containing 9 subscales (ideas of reference, excessive social anxiety, magical thinking, unusual perceptual experiences, odd/eccentric behavior, no close friends, odd speech, constricted affect, suspiciousness). Participants of study 2 also completed the Five-Facet Mindfulness Questionnaire which assesses observing (Observe), describing (Describe), acting with awareness (Awareness), non-judging of (Non-judgment) and non-reactivity to inner experience (Non-reactivity) facets of trait mindfulness. In both studies, meditators scored significantly lower on suspiciousness and higher on magical thinking compared to meditation-naïve individuals and showed a trend towards lower scores on excessive social anxiety. Excessive social anxiety correlated negatively with Awareness and Non-judgment; and suspiciousness with Awareness, Non-judgment and Non-reactivity facets across both groups. The two groups did not differ in their total schizotypy score. We conclude that mindfulness practice is not associated with an overall increase in schizotypal traits. Instead, the pattern suggests that mindfulness meditation, particularly with an emphasis on the Awareness, Non-judgment and Non-reactivity aspects, may help to reduce suspiciousness and excessive social anxiety.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5514306/

Improve the Negative Symptoms of Schizophrenia with Tai Chi.

Improve the Negative Symptoms of Schizophrenia with Tai Chi.

 

By John M. de Castro, Ph.D.

 

“Tai Chi, can potentially reduce psychopathological and negative symptoms, decrease aggressive behaviors, and improve quality of life. It is an ideal rehabilitation intervention for patients with schizophrenia.” – Supreme Chi Living

 

Schizophrenia is the most common form of psychosis. It effects about 1% of the population worldwide. It appears to be highly heritable and involves changes in the brain. It is characterized by positive symptoms such as hallucinations; seeing and, in some cases, feeling, smelling or tasting things that aren’t there, or delusions; unshakable beliefs that, when examined rationally, are obviously untrue. It is also characterized by negative symptoms involving a reduced ability to function normally, neglect of personal hygiene, lack of emotion, blank facial expressions, speaking in a monotone, loss of interest in everyday activities, social withdrawal, an inability to experience pleasure, and a lack of insight into their symptoms. The symptoms of schizophrenia usually do not appear until late adolescence or early adulthood.

 

Schizophrenia is very difficult to treat with psychotherapy and is usually treated with antipsychotic drugs. These drugs, however, are not always effective, sometimes lose effectiveness, and can have some difficult side effects. In addition, even when effective, antipsychotic drugs only treat the positive symptoms of schizophrenia, leaving the negative symptom intact including the loss of functionality and a lack of insight. Hence, there is a need for safe and effective alternative treatments for schizophrenia that can treat the negative symptoms.

 

Mindfulness training has been shown to be beneficial for a variety of mental health problems, including anxietydepressionAntisocial Personality DisorderBorderline personality disorderimpulsivityobsessive compulsive disorderphobiaspost-traumatic stress disorder, sexual dysfunction, and suicidality. It also appears to be helpful with psychosis. Mindfulness has also been shown to associated with lower symptom severity of schizophrenia. This suggests that mindfulness training may be an effective treatment for schizophrenia, including negative symptoms.  Tai Chi practice includes mindfulness training and also gentle physical exercise which may also be beneficial. Hence, it would seem reasonable to examine the ability of Tai Chi practice in treating the symptoms of schizophrenia.

 

In today’s Research News article “Tai Chi for Schizophrenia: A Systematic Review.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5434269/ Zheng and colleagues review and perform a meta-analysis of published research studies examining the effectiveness of Tai Chi practice in treating schizophrenia. They found 6 published randomized controlled trials. They found that compared to controls Tai Chi practice produced significant reductions in the negative symptoms of schizophrenia but not the positive symptoms. In addition, they report that there is a significant improvement in social function.

 

These are important findings as antipsychotic drugs only improve the positive symptoms of schizophrenia and not the negative symptoms. Since, Tai Chi practice appears to improve the negative symptoms and not the positive symptoms, it would seem to be acting in a completely different way and by a different mechanism. Tai Chi is most frequently practiced socially and this may account for the improved social function. In addition, Tai Chi practice might be the perfect adjunctive treatment. The combination of Tai Chi practice and antipsychotic drugs should improve all of the symptoms of schizophrenia.

 

So, improve the negative symptoms of schizophrenia with Tai Chi.

 

“The usual method for treating schizophrenic patients focuses on self-care, symptom management, and dealing with daily functions. Unfortunately, physical and psychological well-being fall by the wayside, since simply dealing with day-to-day functions is enough of a struggle for most schizophrenic individuals. The mind-body connection provided by Tai-chi is believed to make it the optimal type of exercise for individuals with mental illnesses.”Katie Dabrowski

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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Study Summary

 

Wei Zheng, Qiang Li, Jingxia Lin, Yingqiang Xiang, Tong Guo, Qiong Chen, Dongbin Cai, Yutao Xiang. (2016). Tai Chi for Schizophrenia: A Systematic Review. Shanghai Archives of Psychiatry, 28(4), 185–194. http://doi.org/10.11919/j.issn.1002-0829.216051

 

Abstract

Background

Tai Chi as a form of moderate aerobic exercise originating in China, could promote balance and healing of the mind-body. Furthermore, Tai Chi has been used as an adjunctive treatment for patients with schizophrenia. However, no meta-analysis or systematic review on adjunctive Tai Chi for patients with schizophrenia has yet been reported.

Aim

A systematic review and meta-analysis was conducted to examine the efficacy of Tai Chi as an adjunctive treatment for schizophrenia using randomized controlled trial (RCT) data.

Method

Two evaluators independently and systematically searched both English- and Chinese-language databases for RCTs of Tai Chi for schizophrenia patients, selected studies, extracted data, conducted quality assessment and data synthesis. Statistical analyses were performed using the Review Manager (version 5.3). The Cochrane Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) was used to assess the strength of the evidence.

Results

In 6 RCTs conducted in mainland China and Hong Kong, there were 483 participants including 215 subjects in the intervention group and 268 subjects in the control group. The trials lasted 16.0 (6.2) weeks. Compared to control group, we found significant differences regarding improvement of negative symptoms assessed by the Positive and Negative Syndrome Scale (PANSS) negative symptom sub-score (2 trials) and Scale for the Assessment of Negative Symptoms (SANS) (3 trials) over the study period in the intervention group (5 trials with 6 treatment arms, n=451, SMD: -0.87 (95%CI: -1.51, -0.24), p=0.007; I2=90%). Furthermore, there is no significant difference regarding improvement of positive symptoms assessed by the PANSS positive symptom sub-score (2 trials) and Scale for the Assessment of Positive Symptoms (SAPS) (2 trials) over the study period (4 trials with 5 treatment arms, n=391, SMD: -0.09 (95%CI: -0.44, 0.26), p=0.60; I2=65%). All included RCTs did not report side effects. Based on the GRADE, the strength of the evidence for primary outcome was ‘very low’.

Conclusions

The data available on the effectiveness of adjunctive Tai Chi in patients with schizophrenia who are receiving antipsychotic is insufficient to arrive at a definitive conclusion about its efficacy. Furthermore, follow-up time in the available studies was relatively short, and all studies did not use blinded assessment of outcome measures. High-quality randomized trials are needed to inform clinical recommendations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5434269/

Improve Psychotic Symptoms with Mindfulness

Improve Psychotic Symptoms with Mindfulness

 

By John M. de Castro, Ph.D.

 

“there is now sufficient published research, backed up by considerable clinical experience, to encourage careful clinical practice and research exploring the efficacy and effectiveness of adapted mindfulness interventions for people struggling to cope with psychotic experience.” – Paul Chadwick

 

Psychoses are mental health problems that cause people to perceive or interpret things differently from those around them. This might involve hallucinations; seeing and, in some cases, feeling, smelling or tasting things that aren’t objectively there, or delusions; unshakable beliefs that, when examined rationally, are obviously untrue. The combination of hallucinations and delusional thinking can often severely disrupt perception, thinking, emotion, and behavior, making it difficult if not impossible to function in society without treatment. Psychoses appear to be highly heritable and involves changes in the brain.

 

The symptoms of psychoses usually do not appear until late adolescence or early adulthood. There are, however, usually early signs of the onset of psychoses which present as cognitive impairments. Psychoses are very difficult to treat with psychotherapy and are usually treated with antipsychotic drugs. These drugs, however, are not always effective, sometimes lose effectiveness, and can have some difficult side effects. Hence, there is a need for safe and effective alternative treatments for psychosis.

 

Mindfulness training has been shown to be beneficial with patients with psychosis. In today’s Research News article “Mindfulness- and acceptance-based interventions for psychosis: Our current understanding and a meta-analysis.” (See summary below). Louise and colleagues summarize and perform a meta-analysis on the published research literature on the effectiveness of mindfulness based therapies for the symptoms of psychosis and compare their effectiveness when performed in group vs individual therapies. They identified and included 10 published randomized controlled research studies. About half of the studies used group based mindfulness training while half used individual training. Only 4 studies used and active control group while most used treatment as usual or wait-list control conditions.

 

They report that the published research indicates that mindfulness based training results in a significant reduction in psychotic symptoms and depression and a significant increase in mindfulness. Group based mindfulness training appeared to be more effective than individual based training. This is confounded, however, as most of the individual based trainings involved a different therapeutic protocol which included mindfulness training, Acceptance and Commitments Therapy.

 

The published research suggests that mindfulness based training is an effective treatment for the symptoms of psychosis. Mindfulness training has been repeatedly shown to be effective for depression. The current analysis, though, extends this effectiveness to depression in patients with psychosis. There were no specific reported differences between the effects on positive and negative symptoms of psychosis. Hence, mindfulness training was effective for overall psychotic symptoms. It is clear, however, that there is a need for more randomized clinical trials that employ better active control conditions so that placebo, attention, and bias effects can be better eliminated as alternative explanations for the results.

 

These are exciting findings, however, as psychosis has been found to be difficult to treat with standard psychotherapies. The results suggest that mindfulness techniques may be, at least in part, a solution to the treatment of psychoses.

 

So, improve psychotic symptoms with mindfulness.

 

“The decentered awareness in mindfulness facilitates the experience of cognitions as mental events in a broader context, and thereby facilitates a more metacognitive stance of decentering or defusing rather than getting “caught” in or reacting to thoughts or delusions, images, and hallucinated voices. The awareness and acceptance of thoughts, images, sounds, and/or hallucinated voices (positive or negative) diminishes the processes of judgment and self-criticism, including the internalized self-stigma that is so often present in those who experience psychosis.” – NewHarbinger

 

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

 

Louise, S., et al., Mindfulness- and acceptance-based interventions for psychosis: Our current understanding and a metaanalysis, Schizophr. Res. (2017), http://dx.doi.org/10.1016/j.schres.2017.05.023

 

Abstract

In promoting optimal recovery in persons with psychosis, psychological interventions have become a key element of treatment, with cognitive behavioural therapy being widely recommended in clinical practice guidelines. One key area of development has been the trialling of “third wave” cognitive behavioural interventions, which promote mindfulness, acceptance and compassion as means of change. Trials to date have demonstrated encouraging findings, with beneficial effects observed on measures of psychotic symptoms. This meta-analysis evaluated the efficacy of third wave interventions for the treatment of psychosis in randomised controlled trials, with psychotic symptoms as the primary outcome. Overall, 10 studies were included. The primary outcome demonstrated a small but significant effect (g=0.29) for third wave interventions compared with control post-treatment. Trials of group format mindfulness-based interventions showed larger effects (g=0.46) than individual acceptance and commitment therapy based interventions (g=0.08), although methodological differences between trials were noted. Among secondary outcomes, a moderate, significant treatment effect (g=0.39) was found for depressive symptoms, but no significant effects were found on specific measures of positive and negative symptoms, hallucination distress, or functioning/disability. A moderate effect on mindfulness (g=0.56) was observed, but not on acceptance. Overall, findings indicate that third wave interventions show beneficial effects on symptoms in persons with psychotic disorders. However, further research is required to determine the efficacy of specific models of treatment.

Improve Schizophrenia with Mindfulness

Improve Schizophrenia with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Meditation, along with utilizing the painful energy of hardship as fuel for the meditative fire, has made me feel differently about life. I now look at my experience of life, despite it being the only thing I am aware of, as being a small part of a bigger picture.” – Jack Bragen

 

Schizophrenia is the most common form of psychosis. It effects about 1% of the population worldwide. It appears to be highly heritable and involves changes in the brain. It is characterized by positive symptoms such as hallucinations; seeing and, in some cases, feeling, smelling or tasting things that aren’t there, or delusions; unshakable beliefs that, when examined rationally, are obviously untrue. It is also characterized by negative symptoms involving a reduced ability to function normally, neglect of personal hygiene, lack of emotion, blank facial expressions, speaking in a monotone, loss of interest in everyday activities, social withdrawal, an inability to experience pleasure, and a lack of insight into their symptoms. The symptoms of schizophrenia usually do not appear until late adolescence or early adulthood.

 

Schizophrenia is very difficult to treat with psychotherapy and is usually treated with antipsychotic drugs. These drugs, however, are not always effective, sometimes lose effectiveness, and can have some difficult side effects. In addition, even when effective, antipsychotic drugs only treat the positive symptoms of schizophrenia, leaving the negative symptom intact including the loss of functionality and a lack of insight. Hence, there is a need for safe and effective alternative treatments for schizophrenia that can treat the negative symptoms.

 

Mindfulness training has been shown to be beneficial for a variety of mental health problems, including anxietydepressionAntisocial Personality DisorderBorderline personality disorderimpulsivityobsessive compulsive disorderphobiaspost-traumatic stress disorder, sexual dysfunction, and suicidality. It also appears to be helpful with psychosis. Mindfulness has also been shown to associated with lower symptom severity of schizophrenia. This suggests that mindfulness training may be an effective treatment for schizophrenia, including negative symptoms.

 

In today’s Research News article “Test of Mindfulness-Based Psychosocial Skills Training to İmprove Insight and Functional Recovery in Schizophrenia.” See summary below or view the full text of the study at:

http://journals.sagepub.com.ezproxy.shsu.edu/doi/full/10.1177/0193945917697222

Ylimaz and Okanlı recruited patients with schizophrenia and assigned them to either receive an 8-week, 45-minute sessions, twice per week, mindfulness based psychosocial skills training program or to a no treatment control condition. Patients continued taking antipsychotic medication throughout. The program consisted of mindfulness training, including “breathing exercise, body scan meditation, mindfulness in daily living, etc.”, and psychosocial skills training, including “communication skills, problem-solving skills, psychosis and antipsychotic drug therapy, recognizing and coping with stimulants, avoiding alcohol and drugs, learning and applying hygiene rules, and methods to cope with stress.” Before and after training and 2 months later the participants were measured for cognitive insight and for functional recovery, including social functioning, health care and treatment, daily life skills, and occupational functioning.

 

They found that following training and two months later, the mindfulness based psychosocial skills training group was significantly better than the no-treatment control group on all measures, cognitive insight and functional recovery, including social functioning, health care and treatment, daily life skills, and occupational functioning. Hence, the mindfulness based psychosocial skills training produced significant improvement in the negative symptoms of schizophrenia. It should be noted that the no-treatment control condition did not contain an active alternative treatment. So, many confounding factors such as placebo effects and experimenter bias could account for the results. In addition, since the treatment program contained both mindfulness training and also psychosocial skills training, it is unclear which component or their combination is necessary for effectiveness.

 

These are potentially important findings. The positive symptoms of schizophrenia were controlled by drugs in these patients. But, the drugs do not affect the negative symptoms. The results of this study suggest that adding a mindfulness based psychosocial skills training program to antipsychotic drug treatment can help to improve the negative symptoms of lack of insight and lack of functional recovery. Thus, the combination program may be able to treat the entire spectrum of symptoms with schizophrenia.

 

So, improve schizophrenia with mindfulness.

 

 

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

Emine Yılmaz, Ayşe Okanlı, Test of Mindfulness-Based Psychosocial Skills Training to İmprove Insight and Functional Recovery in Schizophrenia. West J Nurs Res. 2017 Mar 1:193945917697222. doi: 10.1177/0193945917697222.

 

Abstract

This study was conducted with two groups (training and control) using a pretest/posttest design to determine the effect of mindfulness-based psychosocial skills training for improving insight and functional recovery levels in patients with schizophrenia. The study sample included 45 patients with schizophrenia (21 were in the training group/mindfulness-based psychosocial skills training and 24 were in the control group/standard drug medication). The data were collected using a Personal Information Form, Functional Remission of General Schizophrenia (FROGS) scale, and Beck Cognitive Insight Scale (BCIS). The training group was divided into two groups of 10 to 12 persons on average. Training was given as a group training for a total of 16 sessions, two sessions a week for 8 weeks. The training group scored significantly higher in functional recovery and insight levels than the control group after training ( p < .05). The study determined training has an effect on increasing the levels of insight and functional recovery in schizophrenia.

http://journals.sagepub.com.ezproxy.shsu.edu/doi/full/10.1177/0193945917697222

 

Decrease Distress from Hearing Voices with Mindfulness

Image may contain: 1 person, closeup

 

By John M. de Castro, Ph.D.

 

The mindfulness-based psychoeducation group reported significantly greater improvements in psychiatric symptoms, psychosocial functioning, insight into illness/treatment and duration of readmissions to hospital.” – Wai Chien

 

Hearing voices (auditory hallucinations) is seen as a prime symptom of psychosis and is considered a first rank symptom of schizophrenia. Neuroimaging has demonstrated that the voices that people hear are experienced as if there were a real person talking to them with the same brain areas becoming active during voice hearing as during listening to actual speech. So, it would appear that voice hearers are actually experiencing voices.

 

Hearing voices, however, is not always indicative of psychosis. Around 2% – 4% of the population reports hearing voices. But, only about a third of voice hearers are considered psychotic. On the other hand, about two thirds of voice hearers are quite healthy and function well. They cope effectively with the voices they’re hearing, do not receive the diagnosis of psychosis, and do not require psychiatric care. The differences between people with psychoses and healthy people who hear voices, is not in the form but the content of the heard speech. Non-psychotic individuals hear voices both inside and outside their head just like the psychotic patients but either the content is positive or the individual feels positive about the voice or that they are in control of it. By contrast the psychotic patients are frightened of the voices, the voices are more malevolent, and they feel less control over them.

 

Mindfulness has been shown to be negatively related to the distress felt by the individual about hearing voices, such that the higher the level of mindfulness, the lower the level of distress. But, it has not been demonstrated that increasing mindfulness with training can produce decreases in distress. Cognitive Behavioral Therapy (CBT) has been shown repeatedly to help relieve the symptoms of psychosis. So, it would seem reasonable to test the ability of a mindfulness based form of CBT to relieve the distress produced by hearing voices.

 

In today’s Research News article “Group mindfulness-based intervention for distressing voices: A pragmatic randomised controlled trial.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1443292212361367/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4967452/

Chadwick and colleagues recruited participants who had reported hearing voices at least over the last year. The participants were randomly assigned to receive either treatment as usual or a Mindfulness-Based Cognitive Therapy (MBCT) program administered in a group format, weekly for 1.5 hours over 12 weeks. Before and after therapy and 6 months later the participants were measured for auditory hallucinations, anxiety, depression, and psychological distress. They found that the participants who received MBCT had significantly lower depression levels after treatment and 6 months later. In addition, the therapy produced a significant decrease in the distress felt about hearing voices and the participants perceived ability to control the voices.

 

These are interesting results that replicate the frequent finding that MBCT is effective in reducing depression. In addition, MBCT did not affect the severity of the voices heard. Rather it changed how people felt about the voices reducing how distressful they were to the individual and how well they felt that they could control them. So, MBCT doesn’t cause the voices to be heard differently, rather it simply helps the individuals to suffer less from the voices they hear. Being in the present moment may allow the voice hearer to feel more in control and to simply hear the voices without associating them with past or future problems making them much less distressful.

 

So, decrease distress from hearing voices with mindfulness.

 

mindfulness with individuals with psychosis can facilitate a decrease in overall symptoms, and can promote a reduction in subjective distress and the believability of symptoms. Mindfulness has also been shown to provide participants with a sense of calm and relaxation, while also instilling a sense of power over their experience. Thus, mindfulness-based treatment interventions may be an effective adjunctive treatment approach for individuals with psychotic illnesses.” – Kolina Delgado

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Chadwick, P., Strauss, C., Jones, A.-M., Kingdon, D., Ellett, L., Dannahy, L., & Hayward, M. (2016). Group mindfulness-based intervention for distressing voices: A pragmatic randomised controlled trial. Schizophrenia Research, 175(1-3), 168–173. http://doi.org/10.1016/j.schres.2016.04.001

 

Abstract

Group Person-Based Cognitive Therapy (PBCT) integrates cognitive therapy and mindfulness to target distinct sources of distress in psychosis. The present study presents data from the first randomised controlled trial investigating group PBCT in people distressed by hearing voices. One-hundred and eight participants were randomised to receive either group PBCT and Treatment As Usual (TAU) or TAU only. While there was no significant effect on the primary outcome, a measure of general psychological distress, results showed significant between-group post-intervention benefits in voice-related distress, perceived controllability of voices and recovery. Participants in the PBCT group reported significantly lower post-treatment levels of depression, with this effect maintained at six-month follow-up. Findings suggest PBCT delivered over 12 weeks effectively impacts key dimensions of the voice hearing experience, supports meaningful behaviour change, and has lasting effects on mood.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4967452/