Psychosis

Improve Schizophrenia with Mindfulness

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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

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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

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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.

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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 anxiety, depression, Antisocial Personality Disorder, Borderline personality disorder, impulsivity, obsessive compulsive disorder, phobias, post-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

 

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

 

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

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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

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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 anxiety, depression, Antisocial Personality Disorder, Borderline personality disorder, impulsivity, obsessive compulsive disorder, phobias, post-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

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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/

 

 

Improve Cognition in Women with Early Psychosis with Yoga

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By John M. de Castro, Ph.D.

 

“There are basically two different ways in which yoga can help your memory. One is through asanas or postures, and the second way is through breathing exercises. All of these techniques have elements in common. They tend to drive oxygen and blood towards the brain hence making the mind a more tranquil place. Increased serenity will invigorate our mental functions and activities.” – Mira Saraf

 

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 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. There are some indications that aerobic exercise can help lessen these early symptoms. Mindfulness training has also been shown to be beneficial with psychosis. So, it would make sense that yoga, which includes both physical exercise and mindfulness training may be effective. This notion was examined in today’s Research News article “Aerobic exercise and yoga improve neurocognitive function in women with early psychosis.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1421127021244553/?type=3&theater

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

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4849465/

 

Lin and colleagues recruited a large sample of women diagnosed with early stage psychoses and randomly assigned them to either a wait list control condition or to receive 12-weeks of either integrated yoga therapy training or aerobic exercise (walking and cycling). Training occurred for 60 minutes per day for 3 days per week. They were tested at baseline, at the completion of the 12-weeks of training and 18 months later for verbal acquisition, short-term (working) memory, cognitive interference, positive and negative symptoms of psychoses, physical and psychological health, body perception, drug adherence and fitness. They also underwent Magnetic Resonance Imaging (MRI) brain scans.

 

They found that at the conclusion of training there were statistically significant improvements in verbal acquisition, working memory and attention for the yoga group and in verbal retention and working memory for the aerobic exercise group. Both groups had significant improvements in physical and psychological health (lower depression). Aerobic exercise, but not yoga, produced significant increases in the hippocampus gray matter volume in the brain. Importantly, these effects were still present and significant 18 months later, suggesting that the training has long-lasting effects.

 

The results suggest that both yoga and aerobic exercise have lasting beneficial effects for women in the early stages of psychoses, improving physical, psychological, and cognitive performances. There were small differences between the two exercise types, with yoga producing greater improvements in verbal learning and attention than aerobic exercise. These are interesting and exciting findings that suggest that the early physical, psychological, and cognitive symptoms of psychoses in women can be successfully improved with either aerobic exercise or yoga, with perhaps yoga being more effective for the verbal learning and attentional symptoms. This makes sense as yoga involves training in attention.

 

So, improve cognition in women with early psychosis with yoga.

 

“If you or your relatives are trying to improve your memory or offset the risk for developing memory loss or dementia, a regular practice of yoga and meditation could be a simple, safe and low-cost solution to improving your brain fitness.” – Helen Lavretsky
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

Lin, J., Chan, S. K., Lee, E. H., Chang, W. C., Tse, M., Su, W. W., … Chen, E. Y. (2015). Aerobic exercise and yoga improve neurocognitive function in women with early psychosis. NPJ Schizophrenia, 1(0), 15047–. http://doi.org/10.1038/npjschz.2015.47

 

Abstract

Impairments of attention and memory are evident in early psychosis, and are associated with functional disability. In a group of stable, medicated women patients, we aimed to determine whether participating in aerobic exercise or yoga improved cognitive impairments and clinical symptoms. A total of 140 female patients were recruited, and 124 received the allocated intervention in a randomized controlled study of 12 weeks of yoga or aerobic exercise compared with a waitlist group. The primary outcomes were cognitive functions including memory and attention. Secondary outcome measures were the severity of psychotic and depressive symptoms, and hippocampal volume. Data from 124 patients were included in the final analysis based on the intention-to-treat principle. Both yoga and aerobic exercise groups demonstrated significant improvements in working memory (P<0.01) with moderate to large effect sizes compared with the waitlist control group. The yoga group showed additional benefits in verbal acquisition (P<0.01) and attention (P=0.01). Both types of exercise improved overall and depressive symptoms (all P⩽0.01) after 12 weeks. Small increases in hippocampal volume were observed in the aerobic exercise group compared with waitlist (P=0.01). Both types of exercise improved working memory in early psychosis patients, with yoga having a larger effect on verbal acquisition and attention than aerobic exercise. The application of yoga and aerobic exercise as adjunctive treatments for early psychosis merits serious consideration.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4849465/

 

Improve Schizophrenia with Mindfulness

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mindfulness-schizophrenia2-tabak

 

By John M. de Castro, Ph.D.

 

“Mindfulness also allows us to become more aware of the stream of thoughts and feelings that we experience and to see how we can become entangled in that stream in ways that are not helpful. This lets us stand back from our thoughts and start to see their patterns. Gradually, we can train ourselves to notice when our thoughts are taking over and realise that thoughts are simply ‘mental events’ that do not have to control us.” – Mark Williams

 

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, and an inability to experience pleasure. The symptoms 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. Hence, there is a need for safe and effective alternative treatments for psychotic disorders. Mindfulness training has been shown to be beneficial for a variety of mental health problems, including anxiety, depression, Antisocial Personality Disorder, Borderline personality disorder, impulsivity, obsessive compulsive disorder, phobias, post-traumatic stress disorder, sexual dysfunction, and suicidality. It also appears to be helpful with psychosis. Hence, there is a need to further investigate the potential of mindfulness as a treatment for schizophrenia. This needs to begin with studying the relationships of mindfulness to the positive and negative symptoms of schizophrenia.

 

In today’s Research News article “Mindfulness in schizophrenia: Associations with self-reported motivation, emotion regulation, dysfunctional attitudes, and negative symptoms.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1402675313089724/?type=3&theater

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

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4591204/

Tabak, Horan, and Green recruited outpatients with schizophrenia who were being treated with drugs and non-schizophrenic individuals as controls. They measured the demographic characteristics of the participants, mindfulness, behavioral inhibition and activation, emotion regulation, and dysfunctional attitudes. They found, as expected, that people with schizophrenia were significantly lower in mindfulness than controls, including lower scores on the describing, acting with awareness, and nonjudging facets of mindfulness. In patients, but not controls, higher levels of mindfulness were associated with higher levels of the reappraisal aspect of emotion regulation and lower levels of the defeatist beliefs dysfunctional attitude.

 

These are encouraging findings that should be viewed as a good first step. Mindfulness is low in patients with schizophrenia. As such, building mindfulness may be a useful treatment. The findings also suggest that mindfulness training in these patients might help to counteract the negative symptoms of schizophrenia by building the ability to regulate emotions and the positive symptoms by reducing dysfunctional, defeatist, attitudes. These findings, though, must be interpreted carefully as these are correlational findings and cannot be used to prove a causal connection. In addition, the patients were receiving drugs and the extent to which low mindfulness may be due to drug effects cannot be determined.

 

Nevertheless, mindfulness training may help to improve schizophrenia.

 

“Mindfulness is not something we can simply ‘plug into’ to fix ourselves, it’s a fundamentally different way of approaching our difficulties and our lives, and is a practice that takes time to develop. Eight-week courses run by appropriately trained providers are the perfect opportunity to develop understanding and practise this approach.” – Sarah Maynard

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are available at the Contemplative Studies Blog http://contemplative-studies.org/wp/

They are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Tabak, N. T., Horan, W. P., & Green, M. F. (2015). Mindfulness in schizophrenia: Associations with self-reported motivation, emotion regulation, dysfunctional attitudes, and negative symptoms. Schizophrenia Research,168(0), 537–542. http://doi.org/10.1016/j.schres.2015.07.030

 

Abstract

Mindfulness-based interventions are gaining empirical support as alternative or adjunctive treatments for a variety of mental health conditions, including anxiety, depression, and substance use disorders. Emerging evidence now suggests that mindfulness-based treatments may also improve clinical features of schizophrenia, including negative symptoms. However, no research has examined the construct of mindfulness and its correlates in schizophrenia. In this study, we examined self-reported mindfulness in patients (n=35) and controls (n=25) using the Five-Facet Mindfulness Questionnaire. We examined correlations among mindfulness, negative symptoms, and psychological constructs associated with negative symptoms and adaptive functioning, including motivation, emotion regulation, and dysfunctional attitudes. As hypothesized, patients endorsed lower levels of mindfulness than controls. In patients, mindfulness was unrelated to negative symptoms, but it was associated with more adaptive emotion regulation (greater reappraisal) and beliefs (lower dysfunctional attitudes). Some facets of mindfulness were also associated with self-reported motivation (behavioral activation and inhibition). These patterns of correlations were similar in patients and controls. Findings from this initial study suggest that schizophrenia patients may benefit from mindfulness-based interventions because they (a) have lower self-reported mindfulness than controls and (b) demonstrate strong relationships between mindfulness and psychological constructs related to adaptive functioning.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4591204/

Improve Psychosis with Mindfulness

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By John M. de Castro, Ph.D.

 

“Compared to other strategies, mindfulness-based training does not see thoughts as either distorted or rational, and does not aim to change or modify emotions and thoughts. Hence the focus not on content but on the relationship with voices. „the utility of mindfulness

-based techniques lies at the intersection between distress and how the individual interacts with this distress.” –  Kate Spiegelhalter

 

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 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.

 

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. The symptoms usually do not appear until late adolescence or early adulthood. Psychotic disorders 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 psychotic disorders.

 

Mindfulness training has been shown to be beneficial for a variety of mental health problems, including anxiety, depression, Antisocial Personality Disorder, Borderline personality disorder, impulsivity, obsessive compulsive disorder, phobias, post-traumatic stress disorder, sexual dysfunction, and suicidality. It also appears to be helpful with psychosis. In today’s Research News article “Mindfulness- and Acceptance-based Interventions for Psychosis: A Systematic Review and Meta-analysis.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1251561991534391/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4756771/

Cramer and colleagues perform a formal summarization (meta-analysis) of the published research studies on the effects on psychoses of mindfulness and acceptance based therapies, which employ mindfulness training.

 

They found that mindfulness therapies reduced total psychotic symptoms, including the positive symptoms of psychoses, hallucinations, delusions, etc.  but did not affect the negative symptoms, loss of interest, flat emotions, etc. The effects appear to be still present as long as a year later. They also saw a reduction in the need for hospitalization. Hence, it appears that mindfulness and acceptance based therapies are effective for treating psychoses. SO, psychoses can be added to the long list of mental health issues helped by mindfulness training.

 

It should be noted, however, that the magnitude of the results were moderate and far from a cure. The mindfulness and acceptance based therapies simply helped to reduce some of the symptoms of psychoses. They should be seen then as a potential component in a package of treatments, which in combination, may markedly improve psychoses.

 

So, improve psychosis with mindfulness.

 

“The core skill to be learned is how to step out of automatic responses to distressing thoughts, images and voices by recognising the negative judgements and ruminative thinking which accompany these experiences and adopting a perspective of mindful awareness.” – Andy Phee

 

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

Cramer, H., Lauche, R., Haller, H., Langhorst, J., & Dobos, G. (2016). Mindfulness- and Acceptance-based Interventions for Psychosis: A Systematic Review and Meta-analysis. Global Advances in Health and Medicine, 5(1), 30–43. http://doi.org/10.7453/gahmj.2015.083

 

Abstract

Background: Mindfulness- and acceptance-based interventions are increasingly studied as a potential treatment for a variety of mental conditions.

Objective: To assess the effects of mindfulness- and acceptance-based interventions on psychotic symptoms and hospitalization in patients with psychosis

Methods: MEDLINE/PubMed, Embase, the Cochrane Library, and PsycINFO were screened from inception through April 2015. Randomized controlled trials (RCTs) were analyzed when they assessed psychotic symptoms or hospitalization in patients with psychosis; affect, acceptance, mindfulness, and safety were defined as secondary outcomes.

Results: Eight RCTs with a total of 434 patients comparing mindfulness-based (4 RCTs) or acceptance-based interventions (4 RCTs) to treatment as usual or attention control were included. Six RCTs had low risk of bias. Moderate evidence was found for short-term effects on total psychotic symptoms, positive symptoms, hospitalization rates, duration of hospitalization, and mindfulness and for long-term effects on total psychotic symptoms and duration of hospitalization. No evidence was found for effects on negative symptoms, affect, or acceptance. No serious adverse events were reported.

Conclusion: Mindfulness- and acceptance-based interventions can be recommended as an additional treatment for patients with psychosis.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4756771/