Spirituality is Associated with Improved Psychological Well-Being in Patients with Persistent Mental Illness

May 20, 2021 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“No cure that fails to engage our spirit can make us well.” – Victor Frankl

Religion and spirituality have been promulgated as solutions to the challenges of life both in a transcendent sense and in a practical sense. What evidence is there that these claims are in fact true? The transcendent claims are untestable with the scientific method. But the practical claims are amenable to scientific analysis. There have been a number of studies of the influence of religiosity and spirituality on the physical and psychological well-being of practitioners mostly showing positive benefits, with spirituality encouraging personal growth and mental health. But there is still a need to investigate the relationships of spirituality with psychological well-being in patients with persistent mental illness.

In today’s Research News article “Spirituality and Employment in Recovery from Severe and Persistent Mental Illness and Psychological Well-Being.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7827133/ ) Saiz and colleagues recruited adult patients with persistent mental illness who were in a program to prepare them for employment. The disorders included psychoses, schizophrenia, personality disorders, and mood disorders. The patients completed questionnaires measuring stage of recovery, hope, self-determination, psychological well-being, including self-acceptance, positive relationships, autonomy, environmental mastery, personal growth and purpose in life subscales, employment, work motivation including of satisfaction, integration into the work environment, social acceptance, social performance, job skills, self-esteem, perception of family support and job assertiveness subscales, spiritual experiences and spiritual well-being.

They report that the higher the levels of spirituality and work motivation, the higher the levels of psychological well-being and recovery. When spirituality and work motivation were used together as predictors of recovery only spirituality was significantly related. Similarly, when spirituality and work motivation were used together as predictors of psychological well-being only spirituality was significantly related. Hence, when work motivation is considered, only spirituality is significantly related to psychological well-being and recovery.

These findings for patients with persistent mental illness make sense as spirituality has been found in the past with other groups to be associated with psychological well-being and better mental health. The findings, though, are correlational and as such causation cannot be determined. Only that spirituality is associated with to psychological well-being and recovery can be ascertained. But this association is potentially important and suggests that the promotion of spirituality may be beneficial for patients with persistent mental illness, helping them recover better and be psychologically healthier. This remains for future research.

So, spirituality is associated with improved psychological well-being in patients with persistent mental illness.

“many people with mental illness desire the incorporation of spirituality in their recovery process/treatment.” – Jan-Stella Metheany

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Saiz, J., Galilea, M., Molina, A. J., Salazar, M., Barsotti, T. J., Chopra, D., & Mills, P. J. (2021). Spirituality and Employment in Recovery from Severe and Persistent Mental Illness and Psychological Well-Being. Healthcare (Basel, Switzerland), 9(1), 57. https://doi.org/10.3390/healthcare9010057

Abstract

People diagnosed with severe and persistent mental illness (SPMI) face multiple vulnerabilities, including when seeking employment. Among SPMI patients, studies show that a stronger sense of spirituality can help to reduce psychotic symptoms, increase social integration, reduce the risk of suicide attempts and promote adherence to psychiatric treatment. This study examined how the variables spirituality and employment affect the recovery process and psychological well-being of people with SPMI who attend employment recovery services. The sample consisted of 64 women and men diagnosed with an SPMI. The assessment instruments included the Recovery Assessment Scale, Ryff Psychological Well-Being Scale, Work Motivation Questionnaire, Daily Spiritual Experience Scale, and Functional Assessment of Chronic Illness Therapy—Spiritual Well-Being (FACIT-Sp12). Hierarchical regression analyses were performed to compare three different models for each dependent variable (recovery and psychological well-being). The findings showed that job skills predicted psychological well-being and recovery. When spiritual variables were included in the model, job skills dropped out and the dimension meaning/peace of the FACIT-Sp12 emerged as the only significant predictor variable. Integrating spirituality into recovery programs for people with SPMI may be a helpful complement to facilitate the recovery process and improve psychological well-being.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7827133/

Movement-Based Therapies are Affective for Rehabilitation from Disease

April 30, 2021 psyjdc Leave a comment

Movement-Based Therapies are Affective for Rehabilitation from Disease

By John M. de Castro, Ph.D.

“Tai chi is often described as “meditation in motion,” but it might well be called “medication in motion.” There is growing evidence that this mind-body practice, which originated in China as a martial art, has value in treating or preventing many health problems.” – Havard Health

Mindful movement practices such as yoga and Tai Chi and Qigong have been used for centuries to improve the physical and mental health and well-being of practitioners. But only recently has the effects of these practices come under scientific scrutiny. This research has been accumulating. So, it makes sense to pause and examine what has been learned about the effectiveness of these practice for rehabilitation from disease.

In today’s Research News article “Movement-Based Therapies in Rehabilitation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476461/ ) Phuphanich and colleagues review and summarize the published research studies of the effects of mindful movement practices on rehabilitation from disease.

They report that published research has found that yoga practice reduces fatigue, sleep disturbances, depression, and anxiety and improves the immune system in cancer patients. Yoga has been found to be an effective treatment for mental health issues such as anxiety, depression, and post-traumatic stress disorder (PTSD). Yoga has been found to reduce pain levels, fear avoidance, stress, and sleep disturbance and increases self-efficacy and quality of life in chronic pain patients. Yoga has been found to improve the symptoms of traumatic brain injury, stroke, spinal cord injury, Parkinson disease, dementia, multiple sclerosis, epilepsy, and neuropathies. In addition, yoga has been found to improve systolic and diastolic blood pressures, heart rate, respiratory rate, waist circumference, waist/hip ratio, cholesterol, triglycerides, hemoglobin A1c, and insulin resistance in cardiopulmonary diseases.

They report that the published research has found that Tai Chi and Qigong practices reduce falls in the elderly. Tai Chi and Qigong has been found to reduce pain levels and increase quality of life in chronic pain patients. In addition, there is evidence that Tai Chi and Qigong practices improves depression, anxiety, posttraumatic stress disorder, sleep disturbance, schizophrenia, rheumatoid arthritis, spinal cord injury, traumatic brain injury, and immune disorders.

These are remarkable findings. The range of disorders that are positively affected by yoga, Tai Chi, and Qigong practices is breathtaking. These practices are also safe and can be widely implemented at relatively low cost and can be performed alone or in groups and at home or in a therapeutic setting. This suggests that these practices should be routinely implemented for rehabilitation from disease.

So, movement-based therapies are affective for rehabilitation from disease.

“Being mindful through any physical activity can not only improve performance in the activity such as yoga, tennis, swimming, etc, but it can also increase flexibility, confidence in movement and generate a sense of body and mind connection that has the potential for improving your overall sense of well-being.“- Anupama Kommu

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

Phuphanich, M. E., Droessler, J., Altman, L., & Eapen, B. C. (2020). Movement-Based Therapies in Rehabilitation. Physical medicine and rehabilitation clinics of North America, 31(4), 577–591. https://doi.org/10.1016/j.pmr.2020.07.002

Abstract

Movement therapy refers to a broad range of Eastern and Western mindful movement-based practices used to treat the mind, body, and spirit concurrently. Forms of movement practice are universal across human culture and exist in ancient history. Research demonstrates forms of movement therapy, such as dance, existed in the common ancestor shared by humans and chimpanzees, approximately 6 million years ago. Movement-based therapies innately promote health and wellness by encouraging proactive participation in one’s own health, creating community support and accountability, and so building a foundation for successful, permanent, positive change.

Key Points – Movement-based therapies

Decrease fear avoidance and empower individuals to take a proactive role in their own health and wellness.
Can benefit patients of any ability; practices are customizable to the individual’s needs and health.
Are safe, cost-effective, and potent adjunct treatments used to supplement (not replace) standard care.
Deliver patient-centered, integrative care that accounts for the physical, psychological, social, and spiritual aspects of health and illness.
Have diverse, evidence-based benefits, including reduction in pain, stress, and debility, and improvements in range of motion, strength, balance, coordination, cardiovascular health, physical fitness, mood, and cognition.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476461/

Reduce the Symptoms of Schizophrenia with Mind-Body Practices

December 28, 2020 psyjdc Leave a comment

Reduce the Symptoms of Schizophrenia with Mind-Body Practices

By John M. de Castro, Ph.D.

“Research shows that some mindfulness-based interventions for psychotic symptoms can afford people a greater acceptance and insight into their experiences. They can also reduce the symptoms of anxiety and depression which often accompany, and may exacerbate, psychotic disorders.” – Adrianna Mendrek

Schizophrenia is the most common form of psychosis. Its 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. 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. Also, there is accumulating research that mindfulness and yoga practices may be beneficial for patients with major mental illnesses. Tai Chi and Qigong practices have also been shown to improve the symptoms of schizophrenia. The evidence is accumulating. So, it makes sense to step back and summarize what has been learned about mind-body practices as treatments for schizophrenia.

In today’s Research News article “Effects of Mind-Body Exercises on Schizophrenia: A Systematic Review With Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7457019/ ) Wei and colleagues review, summarize and perform a meta-analysis of the published controlled research studies of the effectiveness of mind-body practices to improve the symptoms of schizophrenia. They included Tai Chi, Qigong, yoga, and other mindful movement practices. They identified 13 studies (11 randomized controlled trials) employing a total of 1159 patients with schizophrenia.

They report that the published studies found that mind-body practices produced significant improvements of both the positive and negative symptoms of schizophrenia and also depression. In addition, the greater the number of weekly mind-body sessions the greater the improvement in the positive symptoms and the greater the duration of the mind-body sessions the greater the improvements in the negative symptoms.

These results are impressive as schizophrenia is difficult to treat. But the results show that mind-body practices are safe and effective treatments that improve not only the positive and negative symptoms of schizophrenia but also the frequently co-occurring depression. There also appears to be a dose response effect such that the greater the frequency and duration of mind-body practices the greater the benefits. This suggests that mind-body practices should be recommended as a part of the treatment for schizophrenia.

So, reduce the symptoms of schizophrenia with mind-body practices.

“yoga therapy is of particular benefit for those with schizophrenia . . in lessening state anxiety and increasing subjective wellbeing, while also reducing both positive and negative symptoms and improving quality of life.” – Minded Institute

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

Wei, G. X., Yang, L., Imm, K., Loprinzi, P. D., Smith, L., Zhang, X., & Yu, Q. (2020). Effects of Mind-Body Exercises on Schizophrenia: A Systematic Review With Meta-Analysis. Frontiers in psychiatry, 11, 819. https://doi.org/10.3389/fpsyt.2020.00819

Abstract

Background

Mind–body exercises (MBEs) have been widely accepted as a complementary therapy for the patients with low exercise tolerance. Currently, the number of experimental studies investigating the effect of MBEs for improving symptoms in people with schizophrenia is increasing. However, results are inconsistent.

Methods

We systematically reviewed and meta-analyzed the effects of mind–body exercises on schizophrenia. Seven electronic databases (Pubmed, Web of Science, PsycINFO, Embase, Cochrane Central Register of Controlled Trials [CENTRAL], CNKI and Wangfang) were screened through October 2019 and risks of bias of included studies were assessed in Review Manager 5.3.

Results

Meta-analysis on 13 studies with 1,159 patients showed moderately significant effects in favor of mind–body exercise intervention to improve positive symptoms (SMD = 0.31; 95% CI 0.01 to 0.60; p = 0.04), negative symptoms (SMD = 0.37; 95% CI 0.14 to 0.60; p = 0.002), and depression (SMD = 0.88; 95% CI 0.63 to 1.13; p<0.00001). Meta-regression analysis revealed that the improvement in positive symptoms was positively associated with the frequency of intervention (p = 0.04), while a marginally significant correlation was observed between the improved negative symptoms and duration of each session (p = 0.06).

Conclusions

This meta-analysis supports the therapeutic effects of MBEs to aid in the treatment of schizophrenia. Further studies need to incorporate rigorous design and large sample size to identify the optimal type and dose of mind–body exercise to inform clinical practices on MBEs’ recommendations for the management of schizophrenia symptoms.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7457019/

Distress Is Lower during a COVID-19 Pandemic Lockdown in Mindful People

December 14, 2020January 28, 2021 psyjdc Leave a comment

Distress Is Lower during a COVID-19 Pandemic Lockdown in Mindful People

By John M. de Castro, Ph.D.

“During the current pandemic, there is so much uncertainty concerning the future, and many threats to our security (physical, social, emotional, and financial). It is totally natural and normal to feel anxious, fearful, and frustrated. . . Mindfulness can help us acknowledge this situation, without allowing us to be carried away with strong emotions; it can, in turn, help bring ourselves back to a centered calm. Only then can we see more clearly what it is we have control over and what it is that we do not.” – Michigan Medicine

Modern living is stressful under the best of conditions. But with the COVID-19 pandemic the levels of stress have been markedly increased. These conditions markedly increase anxiety. This is true for everyone but especially for healthcare workers and people caring for patients with COVID-19 and for people with pre-existing conditions that makes them particularly vulnerable. But it is also true for healthy individuals who worry about infection for themselves or loved ones.

The COVID-19 pandemic has also produced considerable economic stress, with loss of employment and steady income. For the poor this extends to high levels of food insecurity. This not only produces anxiety about the present but also for the future. It is important for people to engage in practices that can help them control their responses to the stress and their levels of anxiety. Mindfulness practices have been found routinely to reduce the psychological and physiological responses to stress, reduce anxiety levels, and improve mood.

In today’s Research News article “Mindfulness, Age and Gender as Protective Factors Against Psychological Distress During COVID-19 Pandemic.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2020.01900/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1437459_69_Psycho_20200922_arts_A ) Conversano and colleagues solicited adult participants online during a government ordered lockdown and had them complete measures of COVID-19 experiences, mindfulness, psychological distress, and mental illness symptoms.

They found strong negative relationships between mindfulness and psychological distress. They found that the higher the levels of mindfulness the lower the levels of psychological distress including somatic symptoms, symptoms of obsessive-compulsive disorder, internalizing symptoms, depression, anxiety, hostility, phobia, paranoia, psychoticism, and sleep disturbance. They also found weak relationships with age and gender such that younger and female participants tended to have higher psychological distress.

It needs to be kept in mind that these results are correlational and as such causation cannot be determined. Mindfulness may produce reduced distress or conversely distress may produce reduced mindfulness or some third factor may produce both. Nevertheless, the results show that during a pandemic lockdown that the people who have high levels of mindfulness also have low levels of psychological distress.

So, distress is lower during a COVID-19 pandemic lockdown in mindful people.

“In many ways, COVID-19 has shown us just how connected and how much the same we really are. All of us—and some of us more than others—are vulnerable to getting sick and none of us wants to become ill. Viewed through the lens of interconnectedness, practicing mindfulness as the coronavirus spreads is not only a way to care for ourselves but a way to care for everyone around us.” – Kelly Baron

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

Conversano C, Di Giuseppe M, Miccoli M, Ciacchini R, Gemignani A and Orrù G (2020) Mindfulness, Age and Gender as Protective Factors Against Psychological Distress During COVID-19 Pandemic. Front. Psychol. 11:1900. doi: 10.3389/fpsyg.2020.01900

Objective: Mindfulness disposition is associated with various psychological factors and prevents emotional distress in chronic diseases. In the present study, we analyzed the key role of mindfulness dispositions in protecting the individual against psychological distress consequent to COVID-19 social distancing and quarantining.

Methods: An online survey was launched on March 13, 2020, with 6,412 responses by April 6, 2020. Socio-demographic information, exposure to the pandemic, and quarantining were assessed together with psychological distress and mindfulness disposition. Multivariate linear regression analysis was performed to study the influence of predictive factors on psychological distress and quality of life in Italian responders during the early days of lockdown. Pearson correlations were calculated to study the relationship between mindfulness and psychiatric symptoms.

Results: Multivariate linear regression run on socio-demographics, COVID-19-related variables, and mindfulness disposition as moderators of overall psychological distress showed that mindfulness was the best predictor of psychological distress (β = −0.504; p < 0.0001). High negative correlations were found between mindfulness disposition and the overall Global Severity Index (r = −0.637; p < 0.0001), while moderate to high associations were found between mindfulness and all SCL-90 sub-scales.

Discussion: Findings showed that high dispositional mindfulness enhances well-being and helps in dealing with stressful situations such as the COVID-19 pandemic. Mindfulness-based mental training could represent an effective intervention to stem post-traumatic psychopathological beginnings and prevent the onset of chronic mental disorders.

https://www.frontiersin.org/articles/10.3389/fpsyg.2020.01900/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1437459_69_Psycho_20200922_arts_A

Improve Schizophrenia with Mindfulness

October 2, 2020 psyjdc Leave a comment

Improve Schizophrenia with Mindfulness

By John M. de Castro, Ph.D.

In today’s Research News article “Mindfulness-Based Interventions for People with Schizophrenia: 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/PMC7369977/) Hodann-Caudevilla and colleagues review, summarize, and perform a meta-analysis of the published research studies on the effectiveness of mindfulness training on the symptoms of schizophrenia. The identified 10 published studies that included a total of 1096 participants. The trainings usually included treatment as usual, mindfulness training, psychoeducation, and group exercises.

They report that the published research studies found that mindfulness training resulted in significant increases in mindfulness and significant improvements of overall schizophrenic symptoms after training and also 6-months later with large effect sizes. These improvements were in both the positive and negative symptoms of schizophrenia and the individual’s awareness of their illness.

These results are excellent and suggest that mindfulness training when provided along with the usual treatments produce large and significant improvements in the symptoms of schizophrenia. There has been, for a long time, a worry that mindfulness training for individuals with psychosis might actually exacerbate the illness. But the review suggests that the opposite, in fact, is true with mindfulness training greatly improving the illness.

So, improve schizophrenia with mindfulness.

“There is emerging evidence that mindfulness for psychosis – when used in an adapted form – is safe and therapeutic.” – Paul Charwick

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

Hodann-Caudevilla, R. M., Díaz-Silveira, C., Burgos-Julián, F. A., & Santed, M. A. (2020). Mindfulness-Based Interventions for People with Schizophrenia: A Systematic Review and Meta-Analysis. International journal of environmental research and public health, 17(13), 4690. https://doi.org/10.3390/ijerph17134690

Abstract

(1) Background: There is increasing interest in the practice of mindfulness-based interventions (MBIs) to treat people with schizophrenia, as evidenced by the publication of different randomized controlled trials (RCTs). However, no meta-analysis of RCTs has been carried out to date with the exclusive inclusion of this type of interventions. (2) Objective: To analyze empirical evidence regarding the effectiveness of MBIs for the improvement of clinical parameters associated with schizophrenia. Method: A systematic review and meta-analysis was conducted of RCTs published in the databases PsycINFO, PubMed, WOS, and Cochrane Library. (3) Results: A total of 10 articles (n = 1094) fulfilled the criteria for inclusion in the review. The analysis of these studies suggests that MBIs combined with standard interventions are able to generate significant improvements in a variety of clinical schizophrenia-related parameters, such as the intensity of overall symptomatology (g = 0.72), positive symptoms (g = 0.32), negative symptoms (g = 0.40), functioning level (g = 1.28), and awareness of illness (g = 0.65). (4) Conclusions: There is evidence that supports the effectiveness and safety of MBIs for the treatment of people with schizophrenia. The results obtained by MBIs are comparable to those obtained by cognitive-behavioral therapy for psychosis. However, given the heterogeneity of the applied interventions and the methodological limitations found in the reviewed trials, the results should be interpreted with caution.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7369977/

Mindfulness Improves the Emotion Regulation in Patients with Schizophrenia

August 24, 2020 psyjdc Leave a comment

Mindfulness Improves the Emotion Regulation in Patients with Schizophrenia

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, many of these treatments help indirectly to alleviate psychotic symptoms as well.” – 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. 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. Patients with schizophrenia have difficulty regulating emotions and mindfulness training improves emotion regulation. Hence, it makes sense to investigate the effectiveness of mindfulness training in improving emotion regulation in patients with schizophrenia.

In today’s Research News article “The Effectiveness of a Mindfulness-Based Psychoeducation Programme for Emotional Regulation in Individuals with Schizophrenia Spectrum Disorders: A Pilot Randomised Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075335/), Lam and colleagues recruited adult patients diagnosed with schizophrenia-spectrum disorders and randomly assigned them to a treatment as usual control condition or to receive a 90 minute once a week for 8 weeks Mindfulness-Based Psychoeducation Program (MBPP) including “engagement and empowerment, mindfulness in daily living and problem solving, mindfulness in illness management and equip and prepare for the future.” Patients also performed daily mindfulness practice. They were measured before and after training and 3 months later for the emotion regulation processes of reappraisal and suppression, rumination, psychotic symptoms, mindfulness, anxiety, and depression.

Engagement in the Mindfulness-Based Psychoeducation Program (MBPP) was high with 85% of participants attending 6 or more sessions with average attendance of 6.88 sessions. The average amount of home practice was 31 minutes per week. Hence the program can be successfully implemented and is acceptable to the patients.

They found that in comparison to baseline and the treatment as usual group after Mindfulness-Based Psychoeducation Program (MBPP) there was a significant improvement in mindfulness and the emotion regulation strategy of reappraisal. These improvements were maintained for 3 months after the end of training. The results suggest that mindfulness training improves the emotion regulation strategy of reappraisal in patients diagnosed with schizophrenia-spectrum disorders.

Reappraisal is a cognitive strategy to reinterpret the origin and meaning of an emotional event to reduce its impact. This is an effective emotion regulation strategy to help the individual cope with emotions. Since, problems with emotions are common in schizophrenia, improving emotion regulation may be of great assistance to them in dealing with the symptoms of the disease.

So, mindfulness improves the emotion regulation in patients with schizophrenia.

“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

Lam, A., Leung, S. F., Lin, J. J., & Chien, W. T. (2020). The Effectiveness of a Mindfulness-Based Psychoeducation Programme for Emotional Regulation in Individuals with Schizophrenia Spectrum Disorders: A Pilot Randomised Controlled Trial. Neuropsychiatric disease and treatment, 16, 729–747. https://doi.org/10.2147/NDT.S231877

Abstract

Background

Emotion dysregulation has emerged as a transdiagnostic factor that potentially exacerbates the risk of early-onset, maintenance, and relapse of psychosis. Mindfulness is described as the awareness that emerges from paying attention to the present moment without judgment. It gently pulls the mind out of the negative emotions induced by the disparity between expectation and reality by focusing on the present moment, instead of worrying about the future or regretting the past. However, only a few research has ever focused on the efficacy of using a mindfulness-based intervention to improve emotion regulation in schizophrenia spectrum disorders.

Purpose

The purpose of this study was to examine the effectiveness of a Mindfulness-Based Psychoeducation Programme (MBPP) on the emotion regulation of individuals with schizophrenia, in particular, to access emotion regulation strategies. The objective of this study was to find out whether MBPP is feasible for improving emotion regulation strategies, in terms of rumination, cognitive reappraisal, and expressive suppression, with a sustainable effect at a three-month follow-up.

Patients and Methods

A single-blinded pilot randomised controlled trial with repeated-measures designs was adopted. Forty-six participants diagnosed with schizophrenia and its subtypes were randomised in either the 8-week mindfulness-based psychoeducation programme or treatment-as-usual (control) group.

Results

The results of the Generalised Estimating Equations test indicated that the MBPP group showed a significant improvement in reappraisal at a three-month follow-up (β = −6.59, Wald’s χ2=4.55, p=0.033), and a significant reduction in rumination across time. However, the Generalised Estimating Equations indicated no significant difference in rumination and expressive suppression in the MBPP group. Two participants reported having unwanted experiences, including feelings of terror and distress during the mindfulness practice.

Conclusion

The MBPP appeared to be effective for improving emotion regulation, which will contribute to future large-scale RCT to confirm the treatment effects in more diverse groups of schizophrenic patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075335/

Reduce Inflammation in Psychiatric Patients with Mindfulness

July 22, 2020 psyjdc Leave a comment

Reduce Inflammation in Psychiatric Patients with Mindfulness

By John M. de Castro, Ph.D.

“mindfulness practice was not directly linked to lower inflammation levels, but that it may have bolstered stress resilience among at-risk adults by preventing an increase in inflammatory biomarker levels.” – Grace Bullock

The immune system is designed to protect the body from threats like stress, infection, injury, and toxic chemicals. One of its tools is the Inflammatory response. This response works quite well for short-term infections and injuries. But when inflammation is protracted and becomes chronic, it can itself become a threat to health. It can produce autoimmune diseases such as colitis, Chron’s disease, arthritis, heart disease, increased cancer risk, lung disease, sleep disruption, gum disease, decreased bone health, psoriasis, and depression. In the elderly it is associated with the onset of dementia.

Needless to say, chronic inflammation can create major health problems. Indeed, the presence of chronic inflammation is associated with reduced longevity. So, it is important for health to control the inflammatory response, allowing it to do its job in fighting off infection but reducing its activity when no external threat is apparent. Of course, it is far better to prevent chronic inflammation in the first place than to treat it later. Mind-body techniques such as yoga, Tai Chi and meditation have been shown to adaptively reduce the inflammatory response. In addition, mindfulness training, has been shown to be effective in treating psychiatric disorders. It is possible that mindfulness acts, in part, to improve psychiatric disorders by decreasing inflammation in these patients.

In today’s Research News article “Effects of Mindfulness-Based Interventions on Biomarkers and Low-Grade Inflammation in Patients with Psychiatric Disorders: A Meta-Analytic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177919/), Sanada and colleagues review, summarize, and perform a meta-analysis of the effectiveness of mindfulness-based interventions in reducing biomarkers of the inflammatory response in psychiatric patients. They discovered 10 published research studies with a total of 998 participants. They included patients diagnosed with anxiety disorders, depression, alcohol abuse, sleep disorders, PTSD, and ADHD.

They report that the published research studies found that mindfulness-based interventions improved the levels of a variety of biomarkers of inflammation with a variety of psychiatric problems. These included event-related potentials, methylation of serotonin transporter genes, IL-6, TNF-α, and adrenocorticotropic hormone. These biomarkers suggest that psychiatric disorders are associated with mild levels of inflammation and that mindfulness-based interventions reduce the levels of these biomarkers.

Hence the published research literature suggests that mindfulness-based interventions are effective in reducing the levels of inflammation in psychiatric patients and improving their health status. These results provide an explanation for the effectiveness of mindfulness for the improvement of anxiety disorders, depression, alcohol abuse, sleep disorders, PTSD, and ADHD. They did not report on the mechanisms by which mindfulness reduces inflammation. But high on the list of possibilities has to be the ability of mindfulness training to reduce the physiological and psychological responses to stress as stress can increase inflammatory responses.

So, reduce inflammation in psychiatric patients with mindfulness.

“mindfulness techniques may be more effective in relieving inflammatory symptoms than other activities that promote well-being.” – ScienceDaily

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

Sanada, K., Montero-Marin, J., Barceló-Soler, A., Ikuse, D., Ota, M., Hirata, A., Yoshizawa, A., Hatanaka, R., Valero, M. S., Demarzo, M., Campayo, J. G., & Iwanami, A. (2020). Effects of Mindfulness-Based Interventions on Biomarkers and Low-Grade Inflammation in Patients with Psychiatric Disorders: A Meta-Analytic Review. International journal of molecular sciences, 21(7), 2484. https://doi.org/10.3390/ijms21072484

Abstract

Mindfulness-Based Interventions (MBIs) present positive effects on mental health in diverse populations. However, the detailed associations between MBIs and biomarkers in patients with psychiatric disorders remain poorly understood. The aim of this study was to examine the effects of MBIs on biomarkers in psychiatric illness used to summarise the effects of low-grade inflammation. A systematic review of PubMed, EMBASE, PsycINFO, and the Cochrane Library was conducted. Effect sizes (ESs) were determined by Hedges’ g and the number needed to treat (NNT). Heterogeneity was evaluated. A total of 10 trials with 998 participants were included. MBIs showed significant improvements in the event-related potential amplitudes in attention-deficit hyperactivity disorder, the methylation of serotonin transporter genes in post-traumatic stress disorder, the salivary levels of interleukin 6 (IL-6) and tumour necrosis factor alpha (TNF-α) in depression, and the blood levels of adrenocorticotropic hormone (ACTH), IL-6, and TNF-α in generalised anxiety disorder. MBIs showed low but significant effects on health status related to biomarkers of low-grade inflammation (g = −0.21; 95% confidence interval (CI) –0.41 to −0.01; NNT = 8.47), with no heterogeneity (I2 = 0; 95% CI 0 to 79). More trials are needed to establish the impact of MBIs on biomarkers in psychiatric illness.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177919/

Reduce Hallucinations in Schizophrenia with Mindfulness

June 23, 2020 psyjdc Leave a comment

Reduce Hallucinations in Schizophrenia with Mindfulness

By John M. de Castro, Ph.D.

“mindfulness-based interventions can give people a greater acceptance and insight into their experiences of psychosis, so they are less bothered by them, even if hallucinations and other symptoms are not eliminated.” – Adrianna Mendrek

Psychoses are mental health problems that cause people to perceive or interpret things differently from those around them. This might involve hallucinations; seeing, hearing 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.

Mindfulness training has been shown to be beneficial for patients with psychosis including reducing hallucinations. In today’s Research News article “Mindfulness Mediates the Effect of a Psychological Online Intervention for Psychosis on Self-Reported Hallucinations: A Secondary Analysis of Voice Hearers From the EviBaS Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7145894/), Lüdtke and colleagues recruited patients with schizophrenia who have delusions of hearing voices and randomly assigned them to receive online training that included a module on mindfulness or to a waitlist control condition. They completed a online training module online for 8 weeks. The module consisted of trainings on ”mindfulness, worry and rumination, social competence, self-worth, depression, sleep, and metacognitive biases, such as “jumping to conclusions” and took about 1 hour to complete. The mindfulness module consisted of “24 web pages, which contained text, pictures, and audio files.” They were measured before and after training for antipsychotic medication dosage, positive, negative, and global symptoms of schizophrenia, mindfulness, and distress caused by hearing voices.

They found that in comparison to baseline and the waitlist control participants that the online modules training group had significantly higher levels of mindfulness and lower levels of hallucinations. In addition, a mediation analysis found that the reduction in hallucinations was, in part, mediated by mindfulness. That is the training reduced hallucinations directly and also indirectly by increasing mindfulness that, in turn, reduced hallucinations. The online modules were a complex of trainings and mindfulness was just one component. So, it is not possible to ascribe the results to mindfulness training alone.

It was surprising that the online modules training did not reduce distress from hearing voices as was the intent of the study, but rather unexpectedly reduced overall hallucinations in the schizophrenic patients. Previous research has shown that Mindfulness-Based Cognitive Therapy (MBCT) can reduce the distress caused by hearing voices. This suggests that the cognitive therapy component of the treatment which attempts to alter the thought processes used to judge and interpret experiences was critical. Hence, mindfulness training itself may reduce overall hallucinations while alterations of cognitive process is required to decrease the distress produced by hearing voices.

So, reduce hallucinations in schizophrenia with mindfulness.

“mindfulness skills can provide these individuals with an alternative way of relating to their symptoms, moving from a judgemental and controlling stance to a more compassionate, accepting view. The effectiveness of mindfulness-based approaches for people with psychosis has been demonstrated in controlled clinical settings and in the community.” – Carly Samson

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

Lüdtke, T., Platow-Kohlschein, H., Rüegg, N., Berger, T., Moritz, S., & Westermann, S. (2020). Mindfulness Mediates the Effect of a Psychological Online Intervention for Psychosis on Self-Reported Hallucinations: A Secondary Analysis of Voice Hearers From the EviBaS Trial. Frontiers in Psychiatry, 11, 228. https://doi.org/10.3389/fpsyt.2020.00228

Abstract

Background

Psychological online interventions (POIs) could represent a promising approach to narrow the treatment gap in psychosis but it remains unclear whether improving mindfulness functions as a mechanism of change in POIs. For the present study, we examined if mindfulness mediates the effect of a comprehensive POI on distressing (auditory) hallucinations.

Methods

We conducted a secondary analysis on voice hearers (n = 55) from a randomized controlled trial evaluating a POI for psychosis (EviBaS; trial registration NCT02974400, clinicaltrials.gov). The POI includes a module on mindfulness and we only considered POI participants in our analyses who completed the mindfulness module (n = 16).

Results

Participants who completed the mindfulness module reported higher mindfulness (p = 0.015) and lower hallucinations (p = 0.001) at post assessment, compared to controls, but there was no effect on distress by voices (p = 0.598). Mindfulness mediated the POI’s effect on hallucinations (b = −1.618, LLCI = −3.747, ULCI = −0.054) but not on distress by voices (b = −0.057, LLCI = −0.640, ULCI = 0.915).

Limitations and Discussion

Completion of the mindfulness module was not randomized. Hence, we cannot draw causal inferences. Even if we assumed causality, it remains unclear which contents of the POI could have resulted in increased mindfulness and reduced hallucinations, as participants completed other modules as well. In addition, confounding variables could explain the mediation and the sample size was small. Nonetheless, the overall pattern of results indicates that the POI is likely to improve mindfulness, and that increased mindfulness could partially explain the POI’s efficacy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7145894/

Improve the Symptoms of Psychosis with Mindfulness

June 6, 2020 psyjdc Leave a comment

Improve the Symptoms of Psychosis with Mindfulness

By John M. de Castro, Ph.D.

“There is increasing evidence that specially adapted mindfulness techniques can be used safely and effectively in the management and treatment of severe mental health problems, such as psychosis.” – Carly Samson

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.

Mindfulness training has been shown to be beneficial for patients with psychosis. Implementing interventions early in the disease progression may maximize the benefits. This training improves a number of different facets of mindfulness. These include describing, observing, acting with awareness, non-judging, and nor-reacting facets. It has not been established which of these facets is critical for symptom improvement

In today’s Research News article “The Role of Five Facets of Mindfulness in a Mindfulness-Based Psychoeducation Intervention for People With Recent-Onset Psychosis on Mental and Psychosocial Health Outcomes.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078358/), Chien and colleagues recruited patients in the early stages of psychosis (< 5 years since onset) including schizophrenia, schizophreniform/schizoaffective disorders or other psychotic disorders. They were randomly assigned to receive either mindfulness-based psychoeducation, conventional psychoeducation, or treatment-as-usual. The mindfulness-based psychoeducation program was a Mindfulness-Based Stress Reduction (MBSR) modified for psychotic patients and consisted of one session every other week for 24 weeks along with daily practice of 20 minutes. They were measured before and after the program and 6 and 18 months later for positive and negative psychotic symptoms, process of recovery, insight, treatment attitude, level of functioning, and mindfulness.

They found that in comparison to baseline and the control groups the patients who received mindfulness-based psychoeducation had significantly greater increases in mindfulness that persisted at the 18-month follow-up. They also found that greater the increases in mindfulness the greater the improvements in positive and negative psychotic symptoms, process of recovery, insight, treatment attitude, and level of functioning. Psychosocial functioning was the most highly related symptom while psychotic symptoms were less associated. Of the facets of mindfulness, only the observing and acting with awareness facets were significantly associated with the symptom improvements.

These results are interesting and suggest that mindfulness can be improved in psychotic patients with training and that these improvements are related to improvements in symptoms. It appears that training that improves the patient’s ability to observe what is occurring in the present moment and to act with awareness in response to what is occurring are the most important aspects of mindfulness for symptom improvement. It would make sense that these abilities would be particularly useful for psychosocial functioning. Psychotic symptoms are extremely difficult to treat. So, these results suggest that mindfulness training may be a helpful program for psychotic patients in the early stages of the disease.

So, improve the symptoms of psychosis with mindfulness.

“There is emerging evidence that mindfulness for psychosis – when used in an adapted form – is safe and therapeutic.” – Paul Chadwick

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., Chow, K. M., Chong, Y. Y., Bressington, D., Choi, K. C., & Chan, C. (2020). The Role of Five Facets of Mindfulness in a Mindfulness-Based Psychoeducation Intervention for People With Recent-Onset Psychosis on Mental and Psychosocial Health Outcomes. Frontiers in psychiatry, 11, 177. https://doi.org/10.3389/fpsyt.2020.00177

Abstract

Objective: This study aimed to examine how five facets of mindfulness may be associated with the changes in psychotic patients’ health outcomes after participating in a mindfulness-based psychoeducation group (MBPEG) program.

Methods: Longitudinal follow-up data from two pragmatic randomized controlled trials of MBPEG for psychotic patients were used for this study. A total of 124 patients who completed the MBPEG program were included in this analysis. Patient outcomes (psychotic symptoms, functioning, insight into illness/treatment, subjective recovery) and five facets of mindfulness were assessed at baseline and six, 12 and 24 months post-intervention. Areas under the curve of individual outcomes in repeated-measures were computed using trapezoidal method, rescaled to the original possible range of the underlying variable and used for correlation and regression analyses.

Results: All mean scores of the five facets increased across time and were significantly correlated with the improvements in all patient outcomes (p-values ranged from <0.001 to <0.05), except “non-judging” facet and symptom severity. Regression analyses revealed that only “observing” and “acting with awareness” were significantly associated with positive changes across all outcomes (increase in adjusted R2 ranged from 5.9% to 24.2%, p < 0.001).

Conclusions: Two facets of mindfulness, “observing” and “acting with awareness,” were related to positive outcomes of psychotic patients after participating in the MBPEG. More efforts in addressing these two facets of mindfulness can be considered to increase the efficacy of mindfulness-based interventions in psychosis.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078358/

Improve the Psychological Health of Patients with Early Psychosis with Mindfulness

January 11, 2020 psyjdc Leave a comment

Improve the Psychological Health of Patients with Early Psychosis with Mindfulness

By John M. de Castro, Ph.D.

“for people with psychosis without severe social anxiety, learning mindfulness strategies in a group format is greatly appreciated and offers clear benefits—in terms of participants being more active, less depressed and less anxious.” – Tania Lecomte

Mindfulness training has been shown to be beneficial for patients with psychosis. Implementing interventions early in the disease progression may maximize the benefits. It would be even better to intervene before full-blown symptoms emerge. Research in this area is accumulating. Hence, it makes sense to review and summarize the studies to assess the state of the understanding of the effectiveness of early intervention with mindfulness training in patients at risk for or in early stages of psychosis.

In today’s Research News article “Clinical Effects of Mindfulness-Based Intervention in Patients With First Episode Psychosis and in Individuals With Ultra-High Risk for Transition to Psychosis: A Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6837071/ ), Vignaud and colleagues reviewed and summarized the 9 published research studies on the effectiveness of mindfulness training for the treatment of patients at ultra-high risk (1 article) for or in early stages (8 articles) of psychosis.

They report that the 9 published research studies found that mindfulness training was safe and effective and produced significant improvements in anxiety, depression and quality of life in these patients. There were insufficient studies assessing the positive and negative symptoms of psychosis to reach any conclusions. It would be useful for future studies to examine in more depth the positive and negative symptoms of psychosis.

It is well established that mindfulness training produces improvements in anxiety and depression and improves the quality of life in diverse types of patients. The findings of the present review suggest that it has these same benefits for patients at risk for or in early stages of psychosis. It was disappointing that the currently available findings did not include long-term follow-up. It would be important to establish whether mindfulness interventions early in the disease progression might reduce the deterioration that normally occurs over time.

So, improve the psychological health of patients with early psychosis with mindfulness.

“mindfulness, is effective in alleviating distress in individuals with psychosis who are hearing voices.” – Batya Swift Yasgur

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

Vignaud, P., Reilly, K. T., Donde, C., Haesebaert, F., & Brunelin, J. (2019). Clinical Effects of Mindfulness-Based Intervention in Patients With First Episode Psychosis and in Individuals With Ultra-High Risk for Transition to Psychosis: A Review. Frontiers in psychiatry, 10, 797. doi:10.3389/fpsyt.2019.00797

Abstract

Objectives: Recent clinical studies and meta-analyses have reported the clinical effects of mindfulness-based interventions as a complementary treatment for patients with schizophrenia, but their possible efficacy in patients with first episode of psychosis (FEP) and in individuals with ultra-high risk (UHR) of transition to psychosis is less clear. Here, we investigated the current evidence on the usefulness of mindfulness-based interventions in these two populations.

Methods: We conducted a systematic search of the literature according to the PRISMA guidelines.

Results: Among the 102 references retrieved, 9 responded to the inclusion criteria (8 in FEP patients and 1 in UHR individuals). In FEP patients, mindfulness interventions are well-tolerated and have a satisfactory level of adherence. The clinical benefits consist primarily of reduced anxiety and sadness and improved quality of life. None of the studies reported any increase in positive symptoms.

Conclusion: Future sham-controlled studies with large sample sizes are needed to definitively conclude on the clinical interest of mindfulness-based interventions in FEP patients and UHR individuals as well as to understand their underlying mechanisms of action.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6837071/