Social Behavior

Improve the Cognitive, Social, and Psychological States of Mild Alzheimer’s Patients with Mindfulness

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Improve the Cognitive, Social, and Psychological States of Mild Alzheimer’s Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“You have to be patient with Alzheimer’s. Once you understand that it’s a medical condition, you become a little more compassionate. You get less frustrated.” – Kim Campbell

 

The normal aging process involves a systematic progressive decline in every system in the body, the brain included. The elderly often have problems with attention, thinking, and memory, known as mild cognitive impairment. But sometimes the decline is rapid and results in dementia; a progressive loss of mental function produced by degenerative diseases of the brain. It is quite common with about 3% of adults ages 70 to 74, 22% of adults ages 85 to 89 and 33% of adults ages 90 and older. Between 60% to 80% of dementia cases are classified as Alzheimer’s Disease.

 

An encouraging new development is that mindfulness practices such as meditation training and mindful movement practices can significantly reduce these declines in cognitive ability. In addition, it has been found that mindfulness practices reduce the deterioration of the brain that occurs with aging restraining the loss of neural tissue. This suggests that mindfulness may help to relieve some of the symptoms and/or slow the progression of mild Alzheimer’s Disease.

 

In today’s Research News article “Effects of Mindfulness-Based Interventions (MBIs) in Patients with Early-Stage Alzheimer’s Disease: A Pilot Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10046197/ )  Giulietti and colleagues recruited elderly (>70 years old) patients suffering from mild Alzheimer’s disease. They were randomly assigned to either receive no treatment or a once a week for 6-month mindfulness-based intervention including stress management, relaxation, and 15-minute meditations once in treatment and twice at home per week. At baseline and after 6-months the patients were measured with the Mini Mental States Inventory, and for health-related quality of life, depression, spiritual well-being, social status, everyday cognition, and neuropsychiatric symptoms.

 

In comparison to baseline the patients that received the mindfulness-based intervention had significantly greater levels of everyday cognition, spiritual well-being, and social functioning, and lower levels of depression, agitation/aggression, anxiety, apathy, euphoria, sleep, apathy, and appetite. Whereas the control patients had significantly worsening Mini Mental States Inventory, apathy, appetite, and depression.

 

Caution should be exercised in interpreting these results as it was a relatively small pilot study without an active control condition.

 

But the results suggest that mindfulness training improved the cognitive, social, and psychological states of mild Alzheimer’s disease patients while the untreated patients showed a worsening of their cognitive and psychological states.

 

 “People do not realize that Alzheimer’s is not old age. It is a progressive and fatal disease and staggering amounts of people develop Alzheimer’s every day.” – Melina Kanakaredes

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Giulietti MV, Spatuzzi R, Fabbietti P, Vespa A. Effects of Mindfulness-Based Interventions (MBIs) in Patients with Early-Stage Alzheimer’s Disease: A Pilot Study. Brain Sci. 2023 Mar 13;13(3):484. doi: 10.3390/brainsci13030484. PMID: 36979294; PMCID: PMC10046197.

 

Abstract

Bachground In this study, we hypothesize that mindfulness-based interventions (MBIs) may improve well-being and the related outcomes in Alzheimer’s dementia patients (AD-P) at an early stage. MBIs consist of the practice of consciously observing the psychic contents in the present moment (thoughts, sensations, feelings, and other events). This attention allows one to become aware of the psychic contents and integrate them, thus favoring the quality of life and an increase in the mood of practitioners. Methods The randomized controlled study enrolled 22 AD-P at an early stage (age ≥ 60 years) treated with MBIs and 22 patients without treatment (six months of MBI training). Tests (T0–T1 six months): Mini-Mental State Examination (MMPI); Spiritual Well-Being (SWB); Beck Depression Inventory (BDI); SF36. Test-Caregiver: Everyday Cognition scales (ECOG). Results AD-P with mindfulness: Improvement of ECOG (p = 0.026), quality of life (p < 0.001), spiritual well-being (p < 0.001); decrease in depression BDI (p < 0.001). The MMSE remains unchanged. The control group of untreated patients showed a significant worsening in all these dimensions. Conclusions MBI training is effective in increasing quality of life and preventing worsening in patients with early-stage Alzheimer’s dementia.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10046197/

 

Brief Mindfulness Training Improves the Willingness to Help Others.

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Brief Mindfulness Training Improves the Willingness to Help Others.

 

By John M. de Castro, Ph.D.

 

“Never worry about numbers. Help one person at a time and always start with the person nearest you.” – Mother Teresa

 

Homo Sapiens is a very successful species. In part its success has been due to it being a very social species. Members of the species form groups beyond the family unit and work together for the common good. Members also take care of one another. We routinely give to charities which benefit people on the other side of the world. We donate our time as volunteers to build houses for the disadvantaged. We roll down our car windows and hand money to a homeless person on a street corner.  Mindfulness has been shown to increase altruistic behavior. But it is unclear how much training is sufficient to increase the likelihood of helping others.

 

In today’s Research News article “Short Mindfulness Meditation Increases Help-Giving Intention Towards a Stranger in Distress.” (See summary below or view the full text of the study at:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9386648/ ) Malin and Gumpel recruited undergraduate students and randomly assigned them to receive 2 30-minute sessions of mindfulness training, lectures on empathy and compassion, or listening to classical music. Before and after training they were measured for mindfulness, empathy, and emotional responses to a stranger in distress. After training they listened to an interview with a student struggling with a chronic illness. Afterwards they were asked if they’d be willing to volunteer to help students with chronic illnesses.

 

They found that after the mindfulness training there were significant increases in mindfulness and willingness to volunteer to help in comparison to the lecture and music groups. These results suggest that a brief mindfulness training is sufficient to increasing helping behavior. Mindfulness appears to increase altruism even with a brief training.

 

“Our prime purpose in this life is to help others. And if you can’t help them, at least don’t hurt them.” – Dalai Lama

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Malin Y, Gumpel TP. Short Mindfulness Meditation Increases Help-Giving Intention Towards a Stranger in Distress. Mindfulness (N Y). 2022;13(9):2337-2346. doi: 10.1007/s12671-022-01963-y. Epub 2022 Aug 18. PMID: 35996549; PMCID: PMC9386648.

 

Abstract

Objectives

Mindfulness practice increases personal well-being, yet its effect on prosocial behaviors is not well-established. Initial studies suggest that an 8-week mindfulness program has a positive effect on help-giving towards a stranger in distress and that a short meditation promotes care towards an ostracized member. This research aims at examining whether a short mindfulness intervention promotes help-giving intention towards a stranger in distress and to understand the role of empathy in this effect.

Methods

A total of 210 undergraduate students were randomly assigned to two sessions of mindfulness practice, music, or lecture control conditions. Participants then listened to a sham interview with a student dealing with a chronic illness and were surveyed on their willingness to volunteer in an organization helping such students. Baseline dispositional empathy and consequent empathic care scales were completed to determine their effect.

Results

A significantly higher percentage of participants were willing to provide help in the mindfulness condition (50.8%), as compared to the music (31.2%) and the lecture (31%) conditions, χ2 (2, N = 189) = 9.51, p = .009. A significantly positive effect of dispositional empathy on empathic care was found in the mindfulness group (b = 1.40, SE = .31, p < .001), but not in the control groups.

Conclusions

This study showed that short mindfulness practice increases help-giving intention as compared to active control groups and moderates the association between dispositional empathy and empathic care. Future research including long-term follow-up will strengthen these findings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9386648/

Mindfulness is Associated with Lower Stigma and Improved Social Engagement in Breast Cancer Survivors

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Mindfulness is Associated with Lower Stigma and Improved Social Engagement in Breast Cancer Survivors

 

By John M. de Castro, Ph.D.

 

“Cancer is a word, not a sentence.”- John Diamond

 

Because of great advances in treatment, many patients today are surviving cancer. But cancer survivors frequently suffer from anxiety, depression, mood disturbance, post-traumatic stress disorder (PTSD), sleep disturbance, fatigue, sexual dysfunction, loss of personal control, impaired quality of life, and psychiatric symptoms which have been found to persist even ten years after remission. Also, cancer survivors can have to deal with a heightened fear of reoccurrence.

 

Safe and effective treatments for the symptoms of cancer and the physical and psychological effects of the treatments are needed. Mindfulness training has been shown to help with general cancer recovery and mindfulness practices have been shown to improve the residual symptoms in cancer survivors. The mechanisms by which mindfulness may help cancer patients need to be explored.

 

Social engagement has positive benefits for cancer patients as they tend to improve the patient’s psychological well-being which, in turn, can reduce stress and the deleterious effects it has on the patient’s physical well-being. Unfortunately, there is a stigma around having cancer which can make the patient less likely to engage socially.

 

.In today’s Research News article “The mediator role of stigma in the association of mindfulness and social engagement among breast cancer survivors in China. Support Care Cancer.” (See summary below or view the full text of the study at:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8861258/ )  Jiang and colleagues demonstrate that mindfulness is associated with greater social engagement and also with the patients having lower beliefs about the stigma surrounding the disease and this helps to improve social engagement.

 

So, in part, mindfulness may improve cancer patients’ psychological well-being by reducing their beliefs about cancer stigma and improving social engagement.

“Cancer cannot cripple love, it cannot shatter hope, it cannot conquer the spirit.” – Unknown

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Jiang N, Zhang YX, Zhao J, Shi HY, Wang T, Jin W, Wang JW, Yu JM. The mediator role of stigma in the association of mindfulness and social engagement among breast cancer survivors in China. Support Care Cancer. 2022 Jun;30(6):5007-5015. doi: 10.1007/s00520-022-06882-1. Epub 2022 Feb 22. PMID: 35192056; PMCID: PMC8861258.

 

Abstract

Purpose

This study aims to explore the association between mindfulness and social engagement among Chinese breast cancer survivors (BCSs) and the mediator role of stigma in the relation of mindfulness and social engagement.

Methods

This cross-sectional study was conducted among 937 BCSs from March to April 2021 in Shanghai, China. Data were collected using the Mindful Attention Awareness Scale, the Stigma Scale for Chronic Illness 8-item version, and the index of social engagement. Descriptive statistics, independent-sample t-test, one-way ANOVA, and regression analyses were used to explore the role of stigma in the association of mindfulness and social engagement among Chinese BCSs.

Results

Social engagement levels differed significantly by participant’s BMI, education level, employment status, personal monthly income, monthly per capita household income. Mindfulness was positively correlated with social engagement, and stigma was negatively correlated with mindfulness and social engagement among Chinese BCSs. Stigma plays a complete mediating role in the relationship between mindfulness and social engagement in BCSs.

Conclusion

In the practice of individual mindfulness intervention on social engagement of BCSs, health care providers should identify and eliminate the constraints, which restrain the reduction of stigma level while individual mindfulness is being enhanced.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8861258/

 

Religiosity/Spirituality is Associated with Better Psychological Well-Being in Older Adults

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Religiosity/Spirituality is Associated with Better Psychological Well-Being in Older Adults

By John M. de Castro, Ph.D.

 

“Both religion and spirituality can have a positive impact on mental health. . .  Both religion and spirituality can help a person tolerate stress by generating peace, purpose and forgiveness.” – Luna Greenstein

 

Spirituality is defined as “one’s personal affirmation of and relationship to a higher power or to the sacred. Spirituality has been promulgated as a solution to the challenges of life both in a transcendent sense and in a practical sense. There have been a number of studies of the influence of spirituality on the physical and psychological well-being of practitioners mostly showing positive benefits, with spirituality encouraging personal growth and mental health. The research evidence has been accumulating. So, it makes sense to pause and summarize what has been learned.

 

In today’s Research News article “Religiosity/Spirituality and Mental Health in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9133607/ ) Coelho-Júnior and colleagues review, summarize, and perform a meta-analysis of the relationship of spirituality and religiosity with the mental health of older adults. They identified 62 published research studies with participants over the age of 60.

 

They report that the published studies found that religiosity/spirituality was associated with significantly lower levels of anxiety, depression, and fear of death and significantly higher levels of overall psychological well-being, satisfaction with life, meaning in life, and social relations. These findings are correlative so causation cannot be determined.

 

But it is clear the older people who are religious and/or spiritual are psychologically healthier.

 

“religious people live longer, on average, than non-religious people.” – Jeff Levin

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Coelho-Júnior, H. J., Calvani, R., Panza, F., Allegri, R. F., Picca, A., Marzetti, E., & Alves, V. P. (2022). Religiosity/Spirituality and Mental Health in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies. Frontiers in Medicine, 9, 877213. https://doi.org/10.3389/fmed.2022.877213

 

Abstract

Objectives

The present study investigated the association between religious and spiritual (RS) practices with the prevalence, severity, and incidence of mental health problems in older adults.

Methods

We conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated older adults aged 60+ years and assessed RS using valid scales and questions from valid scales, and mental health according to validated multidimensional or specific instruments. Studies were retrieved from MEDLINE, LILACS, SCOPUS, CINAHL, and AgeLine databases until July 31, 2021. The risk of bias was evaluated using the Newcastle-Ottawa Quality Assessment Scale (NOS). A pooled effect size was calculated based on the log odds ratio (OR) and Z-scores. This study is registered on PROSPERO.

Results

One hundred and two studies that investigated 79.918 community-dwellers, hospitalized, and institutionalized older adults were included. Results indicated that high RS was negatively associated with anxiety and depressive symptoms, while a positive association was observed with life satisfaction, meaning in life, social relations, and psychological well-being. Specifically, people with high spirituality, intrinsic religiosity, and religious affiliation had a lower prevalence of depressive symptoms. In relation to longitudinal analysis, most studies supported that high RS levels were associated with a lower incidence of depressive symptoms and fear of death, as well as better mental health status.

Conclusion

Findings of the present study suggest that RS are significantly associated with mental health in older adults. People with high RS levels had a lower prevalence of anxiety and depressive symptoms, as well as reported greater life satisfaction and psychological well-being, better social relations, and more definite meaning in life. Data provided by an increasing number of longitudinal studies have supported most of these findings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9133607/

 

Improve Positive Psychological States with Mindfulness

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Improve Positive Psychological States with Mindfulness

 

By John M. de Castro, Ph.D.

 

“So how does meditation lead to greater happiness? “Loving-kindness is designed to elicit positive emotions. We are stretching the way we pay attention by looking for the good in ourselves or wishing ourselves well through loving-kindness.”  – Caren Osten

 

“Meditation leads to concentration, concentration leads to understanding, and understanding leads to happiness” – This wonderful quote from the modern-day sage Thich Nhat Hahn is a beautiful pithy description of the benefits of mindfulness practice. Mindfulness allows us to view our experience and not judge it, not put labels on it, not make assumptions about it, not relate it to past experiences, and not project it into the future. Rather mindfulness lets us experience everything around and within us exactly as it is arising and falling away from moment to moment. Mindfulness meditation has been shown to increase positive emotions and happiness. But there is a need to further investigate the effects of mindfulness on positive emotional states.

 

In today’s Research News article “A New Second-Generation Mindfulness-Based Intervention Focusing on Well-Being: A Randomized Control Trial of Mindfulness-Based Positive Psychology.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8976107/ ) Zheng and colleagues recruited healthy adults and randomly assigned them to either a wait-list control condition or to receive mindfulness meditation instruction for 2.5 hours per week for 6 weeks followed by 20 minutes of meditation practice along with home practice. They were measured before, during (every 2 weeks), after, and 3 months after the treatment for satisfaction with life, positive and negative emotions, psychological well-being, mindfulness, attitudes toward self and others, and self-compassion.

 

They found that the mindfulness meditation program produced a significant reduction in negative emotions and significant increases in self-compassion and environmental mastery. They also found that the greater the amount of meditation practice the higher the levels of positive emotions, positive relations, and awareness.

 

So, mindfulness meditation increased positive psychological states in healthy adults.

 

“In order to have the resiliency to face difficulties . . . we need to find and nurture the positive parts of ourselves, and make a point of paying attention to experiences that give us pleasure.” – Sharon Salzberg

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Zheng, Y., Zhou, J., Zeng, X., Jiang, M., & Oei, T. (2022). A New Second-Generation Mindfulness-Based Intervention Focusing on Well-Being: A Randomized Control Trial of Mindfulness-Based Positive Psychology. Journal of happiness studies, 1–22. Advance online publication. https://doi.org/10.1007/s10902-022-00525-2

 

Abstract

Second-generation mindfulness-based interventions (SG-MBIs) align well with positive psychology philosophy and practices, but trials of SG-MBIs have largely focused on ill-being. This study developed a mindfulness-based positive psychology (MBPP) intervention integrating positive psychology with an SG-MBI to enhance well-being. A randomized control trial was performed to compare MBPP with a waitlist condition among 138 Chinese participants. The results showed that MBPP significantly reduced negative emotions for subjective well-being and significantly improved environmental mastery for psychological well-being. Improvements in self-compassion and negative attitudes but not avoidance, mediated changes in well-being. Changes in positive emotions, positive relations, and awareness were associated with the amount of meditation practice. These findings showed that MBPP is promising for improving well-being and that the positive psychology components play important roles. Broadly, the study illustrated that positive psychology and SG-MBIs can be effectively integrated, and it supported the further application of SG-MBIs from the positive psychology perspective.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8976107/

 

Improve Adolescent Social Behavior with Mindfulness

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Improve Adolescent Social Behavior with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness might help reduce adolescents’ psychological distress through reducing expressive suppression of emotion experiences.” – Ying Ma

 

Adolescence is a time of mental, physical, social, and emotional growth. It is during this time that higher levels of thinking, sometimes called executive function, develops. But adolescence can be a difficult time, fraught with challenges. During this time the child transitions to young adulthood; including the development of intellectual, psychological, physical, and social abilities and characteristics. There are so many changes occurring during this time that the child can feel overwhelmed and unable to cope with all that is required. This can lead to emotional and behavioral problems.

 

Indeed, up to a quarter of adolescents suffer from depression or anxiety disorders, and an even larger proportion struggle with subclinical symptoms. Mindfulness training in adults has been shown to reduce anxiety and depression levels and improve resilience and emotional regulation. In addition, in adolescents it has been shown to improve emotion regulation and to benefit the psychological and emotional health.

 

Dialectical Behavior Therapy (DBT) produces behavior change by focusing on changing the thoughts and emotions that precede problem behaviors, as well as by solving the problems faced by individuals that contribute to problematic thoughts, feelings, and behaviors. In DBT five core skills are practiced; mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness. It is likely, then that DBT would be effective in facilitating emotion regulation in adolescents.

 

In today’s Research News article “Preventing Emotional Dysregulation: Acceptability and Preliminary Effectiveness of a DBT Skills Training Program for Adolescents in the Spanish School System.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8744757/ ) Gasol and colleagues recruited high school students ages 12-15 years and provided them with 30 weekly 50 minute sessions of a modified version of Dialectical Behavior Therapy (DBT). They were measured before and after treatment for satisfaction with life, mental health difficulties and strengths, and emotion regulation.

 

This pilot study found that the program was well received and liked by the students. They also found that after training the adolescents had a significant decrease in peer problems and a significant increase in prosocial behavior. Many improvements in other measures were seen but were not statistically significant. This suggests that mindfulness training may be modestly helpful for improving the social function of adolescents. Since adolescence is a time of major social stress, the program may be useful in helping the teens navigate this difficult time. But more highly controlled studies are needed.

 

So, improve social behavior in adolescents with mindfulness.

 

“mindfulness appears to be a protective individual difference characteristic during adolescence, and capacity for emotion regulation may be implicated in its effects on specific symptoms of psychopathology.” – Christopher Pepping

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Gasol, X., Navarro-Haro, M. V., Fernández-Felipe, I., García-Palacios, A., Suso-Ribera, C., & Gasol-Colomina, M. (2022). Preventing Emotional Dysregulation: Acceptability and Preliminary Effectiveness of a DBT Skills Training Program for Adolescents in the Spanish School System. International journal of environmental research and public health, 19(1), 494. https://doi.org/10.3390/ijerph19010494

 

Abstract

Emotional dysregulation is a key factor in the development and maintenance of multiple disabling mental disorders through a person’s lifespan. Therefore, there is an urgent need to prevent emotional dysregulation as early as possible. The main aim of this study was to evaluate the acceptability and preliminary effectiveness of an adapted Dialectical Behavior Therapy Skills Training program for Emotional Problem Solving in Adolescents (DBT STEPS-A) during secondary school. The sample included 93 adolescents (mean age = 12.78; SD = 0.54; and 53% female) studying in their 2nd year of secondary school in a public center in Catalonia (Spain). Measures of acceptability, difficulties of emotional regulation, mental health problems, and life satisfaction were completed before and after participation in the DBT STEPS-A program during one academic year. The majority of students rated the program as useful (64%) and enjoyed the classes (62%) and 48% of them reported practicing the newly learned skills. Statistically significant improvements were revealed in some emotional regulation-related variables, namely the number of peer problems (p = 0.003; d = 0.52) and prosocial behaviors (p < 0.001; d = −0.82). Although non-significant, the scores in the remaining outcomes indicated a general positive trend in emotional dysregulation, mental health, and life satisfaction. The adapted DBT STEPS-A was very well-accepted and helped overcome some emotional regulation difficulties in Spanish adolescents.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8744757/

 

Improve Borderline Personality Disorder with Mindfulness

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Improve Borderline Personality Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“DBT . . . is considered one of the best treatments for [Borderline Personality Disorder] in terms of documented success rates. . . [Borderline Personality Disorder] is effective in reducing psychiatric hospitalization, substance use, and suicidal behavior. . .  self-injurious behaviors, and the severity of borderline symptoms.” – Kristalyn Salters-Pedneault

 

Borderline Personality Disorder (BPD) is a very serious mental illness that is estimated to affect 1.6% of the U.S. population. It involves unstable moods, behavior, and relationships, problems with regulating emotions and thoughts, impulsive and reckless behavior, and unstable relationships. About ¾ of BPD patients engage in self-injurious behaviors.

 

One of the few treatments that appears to be effective for Borderline Personality Disorder (BPD) is Dialectical Behavior Therapy (DBT). It is targeted at changing the problem behaviors characteristic of BPD including self-injury. Behavior change is accomplished through focusing on changing the thoughts and emotions that precede problem behaviors, as well as by solving the problems faced by individuals that contribute to problematic thoughts, feelings and behaviors. In DBT five core skills are practiced; mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness. The research regarding the effectiveness of DBT reduces for BPD patients has been accumulating. So, it makes sense to step back and summarize what has been learned.

 

In today’s Research News article “Psychological therapies for people with borderline personality disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199382/ ) Storebø and colleagues review and summarize the published randomized controlled trials on the effectiveness of Dialectical Behavior Therapy (DBT). for the treatment of Borderline Personality Disorder (BPD). They found 25 randomized controlled trials.

 

They report that the published research found that Dialectical Behavior Therapy (DBT) compared to treatment as usual, wait-list controls, and no-treatment produced significantly greater reductions in Borderline Personality Disorder (BPD) severity, self-harm, anger, impulsivity, dissociation, psychotic-like symptoms, and emotional instability and significantly greater increases in psychological functioning. There were no significant differences in adverse events between DBT and controls.

 

The published research clearly demonstrates that Dialectical Behavior Therapy (DBT) is a safe and effective treatment for Borderline Personality Disorder (BPD).

 

“‘Dialectical’ means trying to understand how two things that seem opposite could both be true. For example, accepting yourself and changing your behaviour might feel contradictory. But DBT teaches that it’s possible for you to achieve both these goals together.” – Mind

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Storebø, O. J., Stoffers-Winterling, J. M., Völlm, B. A., Kongerslev, M. T., Mattivi, J. T., Jørgensen, M. S., Faltinsen, E., Todorovac, A., Sales, C. P., Callesen, H. E., Lieb, K., & Simonsen, E. (2020). Psychological therapies for people with borderline personality disorder. The Cochrane database of systematic reviews, 5(5), CD012955. https://doi.org/10.1002/14651858.CD012955.pub2

 

Abstract

Background

Over the decades, a variety of psychological interventions for borderline personality disorder (BPD) have been developed. This review updates and replaces an earlier review (Stoffers‐Winterling 2012).

Objectives

To assess the beneficial and harmful effects of psychological therapies for people with BPD.

Search methods

In March 2019, we searched CENTRAL, MEDLINE, Embase, 14 other databases and four trials registers. We contacted researchers working in the field to ask for additional data from published and unpublished trials, and handsearched relevant journals. We did not restrict the search by year of publication, language or type of publication.

Selection criteria

Randomised controlled trials comparing different psychotherapeutic interventions with treatment‐as‐usual (TAU; which included various kinds of psychotherapy), waiting list, no treatment or active treatments in samples of all ages, in any setting, with a formal diagnosis of BPD. The primary outcomes were BPD symptom severity, self‐harm, suicide‐related outcomes, and psychosocial functioning. There were 11 secondary outcomes, including individual BPD symptoms, as well as attrition and adverse effects.

Data collection and analysis

At least two review authors independently selected trials, extracted data, assessed risk of bias using Cochrane’s ‘Risk of bias’ tool and assessed the certainty of the evidence using the GRADE approach. We performed data analysis using Review Manager 5 and quantified the statistical reliability of the data using Trial Sequential Analysis.

Main results

We included 75 randomised controlled trials (4507 participants), predominantly involving females with mean ages ranging from 14.8 to 45.7 years. More than 16 different kinds of psychotherapy were included, mostly dialectical behaviour therapy (DBT) and mentalisation‐based treatment (MBT). The comparator interventions included treatment‐as‐usual (TAU), waiting list, and other active treatments. Treatment duration ranged from one to 36 months.

Psychotherapy versus TAU

Psychotherapy reduced BPD symptom severity, compared to TAU; standardised mean difference (SMD) −0.52, 95% confidence interval (CI) −0.70 to −0.33; 22 trials, 1244 participants; moderate‐quality evidence. This corresponds to a mean difference (MD) of −3.6 (95% CI −4.4 to −2.08) on the Zanarini Rating Scale for BPD (range 0 to 36), a clinically relevant reduction in BPD symptom severity (minimal clinical relevant difference (MIREDIF) on this scale is −3.0 points).

Psychotherapy may be more effective at reducing self‐harm compared to TAU (SMD −0.32, 95% CI −0.49 to −0.14; 13 trials, 616 participants; low‐quality evidence), corresponding to a MD of −0.82 (95% CI −1.25 to 0.35) on the Deliberate Self‐Harm Inventory Scale (range 0 to 34). The MIREDIF of −1.25 points was not reached.

Suicide‐related outcomes improved compared to TAU (SMD −0.34, 95% CI −0.57 to −0.11; 13 trials, 666 participants; low‐quality evidence), corresponding to a MD of −0.11 (95% CI −0.19 to −0.034) on the Suicidal Attempt Self Injury Interview. The MIREDIF of −0.17 points was not reached.

Compared to TAU, psychotherapy may result in an improvement in psychosocial functioning (SMD −0.45, 95% CI −0.68 to −0.22; 22 trials, 1314 participants; low‐quality evidence), corresponding to a MD of −2.8 (95% CI −4.25 to −1.38), on the Global Assessment of Functioning Scale (range 0 to 100). The MIREDIF of −4.0 points was not reached.

Our additional Trial Sequential Analysis on all primary outcomes reaching significance found that the required information size was reached in all cases.

A subgroup analysis comparing the different types of psychotherapy compared to TAU showed no clear evidence of a difference for BPD severity and psychosocial functioning.

Psychotherapy may reduce depressive symptoms compared to TAU but the evidence is very uncertain (SMD −0.39, 95% CI −0.61 to −0.17; 22 trials, 1568 participants; very low‐quality evidence), corresponding to a MD of −2.45 points on the Hamilton Depression Scale (range 0 to 50). The MIREDIF of −3.0 points was not reached.

BPD‐specific psychotherapy did not reduce attrition compared with TAU. Adverse effects were unclear due to too few data.

Psychotherapy versus waiting list or no treatment

Greater improvements in BPD symptom severity (SMD −0.49, 95% CI −0.93 to −0.05; 3 trials, 161 participants), psychosocial functioning (SMD −0.56, 95% CI −1.01 to −0.11; 5 trials, 219 participants), and depression (SMD −1.28, 95% CI −2.21 to −0.34, 6 trials, 239 participants) were observed in participants receiving psychotherapy versus waiting list or no treatment (all low‐quality evidence). No evidence of a difference was found for self‐harm and suicide‐related outcomes.

Individual treatment approaches

DBT and MBT have the highest numbers of primary trials, with DBT as subject of one‐third of all included trials, followed by MBT with seven RCTs.

Compared to TAU, DBT was more effective at reducing BPD severity (SMD −0.60, 95% CI −1.05 to −0.14; 3 trials, 149 participants), self‐harm (SMD −0.28, 95% CI −0.48 to −0.07; 7 trials, 376 participants) and improving psychosocial functioning (SMD −0.36, 95% CI −0.69 to −0.03; 6 trials, 225 participants). MBT appears to be more effective than TAU at reducing self‐harm (RR 0.62, 95% CI 0.49 to 0.80; 3 trials, 252 participants), suicidality (RR 0.10, 95% CI 0.04, 0.30, 3 trials, 218 participants) and depression (SMD −0.58, 95% CI −1.22 to 0.05, 4 trials, 333 participants). All findings are based on low‐quality evidence. For secondary outcomes see review text.

Authors’ conclusions

Our assessments showed beneficial effects on all primary outcomes in favour of BPD‐tailored psychotherapy compared with TAU. However, only the outcome of BPD severity reached the MIREDIF‐defined cut‐off for a clinically meaningful improvement. Subgroup analyses found no evidence of a difference in effect estimates between the different types of therapies (compared to TAU) .

The pooled analysis of psychotherapy versus waiting list or no treatment found significant improvement on BPD severity, psychosocial functioning and depression at end of treatment, but these findings were based on low‐quality evidence, and the true magnitude of these effects is uncertain. No clear evidence of difference was found for self‐harm and suicide‐related outcomes.

However, compared to TAU, we observed effects in favour of DBT for BPD severity, self‐harm and psychosocial functioning and, for MBT, on self‐harm and suicidality at end of treatment, but these were all based on low‐quality evidence. Therefore, we are unsure whether these effects would alter with the addition of more data.

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Plain language summary

Psychological therapies for people with borderline personality disorder

Background

People affected by borderline personality disorder (BPD) often have difficulties with controlling their impulses and emotions. They may have a poor self‐image, experience rapid changes in mood, harm themselves and find it hard to engage in harmonious interpersonal relationships. Different types of psychological treatments (‘talking treatments’) have been developed to help people with BPD. The effects of these treatments must be investigated to decide how well they work and if they can be harmful.

Objective

This review summarises what we currently know about the effect of psychotherapy in people with BPD.

Methods

We compared the effects of psychological treatments on people affected by BPD who did not receive treatment or who continued their usual treatment, were on a waiting list or received active treatment.

Findings

We searched for relevant research articles, and found 75 trials (4507 participants, mostly female, mean age ranging from 14.8 to 45.7 years). The trials examined a wide variety of psychological treatments (over 16 different types). They were mostly conducted in outpatient settings, and lasted between one and 36 months. Dialectical behaviour Therapy (DBT) and Mentalisation‐Based Treatment (MBT) were the therapies most studied.

Psychotherapy compared with usual treatment

Psychotherapy reduced the severity of BPD symptoms and suicidality and may reduce self‐harm and depression whilst also improving psychological functioning compared to usual treatment. DBT may be better than usual treatment at reducing BPD severity, self‐harm and improving psychosocial functioning. Similarly, MBT appears to be more effective than usual treatment at reducing self‐harm, suicidality and depression. However, these findings were all based on low‐quality evidence and therefore we are uncertain whether or not these results would change if we added more trials. Most trials did not report adverse effects, and those that did, found no obvious unwanted reactions following psychological treatment. The majority of trials (64 out of 75) were funded by grants from universities, authorities or research foundations. Four trials reported that no funding was received. For the remaining trials (7), funding was not specified.

Psychotherapy versus waiting list or no treatment

Psychotherapy was more effective than waiting list at improving BPD symptoms, psychosocial functioning, and depression, but there was no clear difference between psychotherapy, and waiting list for outcomes of self‐harm, and suicide‐related outcomes.

Conclusions

In general, psychotherapy may be more effective than usual treatment in reducing BPD symptom severity, self‐harm, suicide‐related outcomes and depression, whilst also improving psychosocial functioning. However, only the decrease in BPD symptom severity was found to be at a clinically important level. DBT appears to be better at reducing BPD severity, self‐harm, and improving psychosocial functioning compared to usual treatment and MBT appears more effective than usual treatment at reducing self‐harm and suicidality. However, we are still uncertain about these findings as the quality of the evidence is low.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199382/

 

Improve Psychological Well-Being of Elementary School Children with Mindfulness

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Improve Psychological Well-Being of Elementary School Children with Mindfulness

 

By John M. de Castro, Ph.D.

 

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

 

Childhood is a miraculous period during which the child is dynamically absorbing information from every aspect of its environment. This is particularly evident during the elementary school years. Mindfulness training in school has been shown to have very positive effects. These include improvements in the cognitive, psychological, emotional and social domains. It is important to teach skills that improve well-being early in life. This can affect individuals throughout their lives. So, there is a need to further study the ability of mindfulness training to improve the well-being of elementary school students.

 

In today’s Research News article “Randomized Trial on the Effects of a Mindfulness Intervention on Temperament, Anxiety, and Depression: A Multi-Arm Psychometric Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8945710/ ) Poli and colleagues recruited 5th grade students. They were measured before and after either 8 weeks of mindfulness training or no treatment for anxiety depression, and temperament.

 

They found that mindfulness training reduced anxiety levels and inhibition to novelty and increased attention, social orientation, positive emotionality. These results suggest that mindfulness training improves the psychological well-being of elementary school children.

 

Mindfulness improves the well-being of kids.

 

“mental wellbeing does not mean being happy all the time and it does not mean you won’t experience negative or painful emotions, such as grief, loss, or failure, which are a part of normal life. However, whatever your age, mindfulness can help you lead a mentally healthier life and improve your wellbeing.” – Mental Health Foundation

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Poli, A., Maremmani, A., Gemignani, A., & Miccoli, M. (2022). Randomized Trial on the Effects of a Mindfulness Intervention on Temperament, Anxiety, and Depression: A Multi-Arm Psychometric Study. Behavioral sciences (Basel, Switzerland), 12(3), 74. https://doi.org/10.3390/bs12030074

 

Abstract

Mindfulness is a mental state that can be achieved through meditation. So far, studies have shown that practicing mindfulness on a consistent and regular basis can improve attentional functions and emotional well-being. Mindfulness has recently begun to be used in the field of child development. The goal of this study is to assess if a mindfulness program may help primary school students in reducing anxiety and depression while also improving their temperamental characteristics. This multi-arm pre-post study included 41 subjects recruited in the fifth year of two primary school classes. Participants were randomly assigned to the experimental and control groups. The experimental group, but not the control group, underwent an eight-week mindfulness training. Every week, the program included 60-min group sessions. QUIT (Italian Questionnaires of Temperament) and TAD (Test for Anxiety and Depression in Childhood and Adolescence) were used to assess temperament, and anxiety and depression, respectively. Both groups were administered both instruments before and after mindfulness intervention. The mindfulness program lowered anxiety levels and was effective in changing temperament dimensions: there was an increase in social orientation (SO), positive emotionality (PE), and attention (AT), as well as a decrease in inhibition to novelty (IN) and negative emotionality. Path analysis revealed that AT may promote the improvement of both SO and IN. Similarly, PE may be promoted by the decrease of IN. Clinical implications are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8945710/

 

Improved Psychological Well-Being and Cognition is Reported by Adult who Engage in Microdosing of Psychedelic Substances

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Improved Psychological Well-Being and Cognition is Reported by Adult who Engage in Microdosing of Psychedelic Substances

 

By John M. de Castro, Ph.D.

 

“After a 40-year moratorium, the psychedelic renaissance has begun: rigorous scientific methods can now be used to investigate psychedelics as potential medicines and for “the betterment of well people”. – Thomas Anderson

 

Psychedelic substances such as peyote, mescaline, LSD, Bufotoxin, ayahuasca and psilocybin 

have been used almost since the beginning of recorded history to alter consciousness and produce spiritually meaningful experiences. More recently hallucinogenic drugs such as MDMA (Ecstasy) and Ketamine have been similarly used. People find the experiences produced by these substances extremely pleasant. eye opening, and even transformative. They often report that the experiences changed them forever. Psychedelics and hallucinogens have also been found to be clinically useful as they markedly improve mood, increase energy and enthusiasm and greatly improve clinical depression.

 

Recently doses of psychedelic substances that are small enough that they do not produce psychedelic effects (microdoses) have been employed repeatedly in real world settings. They have been reported to produce reductions in the symptoms of depression and anxiety, improve cognitive function, and promote social interaction. But there is little systematic research on the effects of repeated psychedelic microdosing.

 

In today’s Research News article “Psychedelic Microdosing: Prevalence and Subjective Effects.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282936/ ) Cameron and colleagues recruited adult volunteers to complete an anonymous online survey of “Recreational Drug and Alcohol Use”. The survey requested information regarding familiarity with psychedelic microdosing. personal practices, drugs used, and any changes observed in depression, anxiety, memory, sociability, focus/attention, and physical health.

 

They found that of the 2347 respondents the majority (59%) were familiar with psychedelic microdosing but only 13 % ever practiced it and only 4% were currently practicing. LSD and Psilocybin were the most common drugs used in microdosing. Males, veterans, and less educated participants were significantly more likely to practice psychedelic microdosing.

 

In comparison to participants who did not microdose, those that did reported significantly greater reductions in depression anxiety and greater improvements in memory, attention, and sociability. Males again reported the greatest improvements. The majority of the participants who stopped microdosing attributed it to difficulty in obtaining the drugs and their legal riskiness.

 

These results were produced by an anonymous survey and there was no way to ascertain the veracity of the responses. In addition, there were no comparison to other spontaneously used drugs to determine demand characteristics or placebo effects. Hence, the results are from a self-selected sample, have strong expectancy effect, and with no objective verification of the responses. So, these results must be viewed as preliminary. Nevertheless, the findings suggest that psychedelic microdosing is viewed by those engaging in it as beneficial for their psychological well-being and cognitive ability. These are interesting results that suggest that further investigation in warranted to determine if this practicemay be useful in improving well-being.

 

So, improved psychological well-being and cognition is reported by adult who engage in microdosing of psychedelic substances.

 

“We have an epidemic of mental health problems, with existing treatments that don’t work for everyone. We need to follow the lead of patients who are taking these initiatives to improve their wellbeing and reduce suffering.” – Zach Walsh

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Cameron, L. P., Nazarian, A., & Olson, D. E. (2020). Psychedelic Microdosing: Prevalence and Subjective Effects. Journal of psychoactive drugs, 52(2), 113–122. https://doi.org/10.1080/02791072.2020.1718250

 

Abstract

Anecdotal reports suggest that the administration of sub-hallucinogenic doses of psychedelic compounds on a chronic, intermittent schedule—a practice known as psychedelic microdosing—is becoming increasingly popular among young adults due to its purported ability to reduce symptoms of depression and anxiety while improving cognitive function and promoting social interaction. Using an anonymous online survey, we collected data from 2347 people to 1) assess the prevalence of psychedelic microdosing and characterize the demographics of microdosers, 2) determine whether microdosers associate the practice with changes in mood, cognitive function, social interaction, or physiology, and 3) investigate frequent motives for discontinuing the practice. Fifty-nine percent of respondents (NT = 2183) reported familiarity with the concept of psychedelic microdosing, with 17% (383 respondents, NT=2200) having engaged in this practice. Microdosers attributed psychedelic microdosing with improving their mood, decreasing their anxiety, and enhancing their memory, attention, and sociability. The most frequently cited reasons for quitting microdosing (NT = 243) were the risks associated with taking an illegal substance (24.28%) and the difficulty of obtaining psychedelic compounds (22.63%). Overall, our findings suggest that psychedelic microdosing is relatively common and is subjectively associated with a broad spectrum of socio-affective, cognitive, and physical outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282936/

Improve Cognitive and Socio-Emotional Skills in Children with Mindfulness

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Improve Cognitive and Socio-Emotional Skills in Children with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Teaching mindfulness to kids can also help shape three critical skills developed in early childhood: paying attention and remembering information, shifting back and forth between tasks, and behaving appropriately with others.” – Christopher Willard

 

Childhood is a miraculous period during which the child is dynamically absorbing information from every aspect of its environment. This is particularly evident during the elementary school years. Mindfulness training in school has been shown to have very positive effects. These include improvements in the cognitive, psychological, emotional and social domains. Importantly, mindfulness training in school appears to improve attentional ability which is fundamental to success in all aspects of academic performance. The research evidence has been accumulating. So, there is a need to summarize what has been learned.

 

In today’s Research News article “Exploring the Effects of Meditation Techniques Used by Mindfulness-Based Programs on the Cognitive, Social-Emotional, and Academic Skills of Children: A Systematic Review.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.660650/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1778822_a0P58000000G0YfEAK_Psycho_20211123_arts_A ) Filipe and colleagues review and summarize the published controlled research studies on the effects of mindfulness training on 6-12 year old children. They found 29 published research articles.

 

They report that the published research found that mindfulness training produced significant improvements in the children’s cognitive skills, including overall executive functions, attention, concentration, inhibitory control, cognitive flexibility, and immediate auditory-verbal memory. They also found that there were significant improvements in socio-emotional skills, including stress, wellbeing, mindfulness, self-esteem, resilience, psychological happiness, empathy, perspective-taking, emotional control, optimism, depression, internalizing problems, peer aggression, prosocial behavior, peer acceptance, anxiety, self-control, self-regulation, mental health problems, quality of life, self-compassion, acceptance, relaxation, happiness, aggressive behaviors, and social competence. But only one of the 29 studies reported improvements in academic skills.

 

The published research makes a strong case for the effectiveness of mindfulness training to improve the cognitive and socio-emotional skills on children. But there is little evidence for improvement in academic performance. Unfortunately, only 9 of the 29 studies employed strong research designs (randomized controlled trails). So, there is a need for further research with high quality research designs. Nevertheless, the consistency and magnitude of the findings suggest robust positive effects of mindfulness trainings on a myriad of cognitive, social, and emotional skills in children. These are important benefits for these developing humans that may have important contributions to their growth and well-being, perhaps eventually making them better adults. As such, mindfulness training should be incorporated into the school curriculum.

 

So, improve cognitive and socio-emotional skills in children with mindfulness.

 

“For children, mindfulness can offer relief from whatever difficulties they might be encountering in life. It also gives them the beauty of being in the present moment.” – Annaka Harris

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Filipe MG, Magalhães S, Veloso AS, Costa AF, Ribeiro L, Araújo P, Castro SL and Limpo T (2021) Exploring the Effects of Meditation Techniques Used by Mindfulness-Based Programs on the Cognitive, Social-Emotional, and Academic Skills of Children: A Systematic Review. Front. Psychol. 12:660650. doi: 10.3389/fpsyg.2021.660650

 

There is evidence for the positive impact of mindfulness in children. However, little is known about the techniques through which mindfulness practice results in differential outcomes. Therefore, this study intended to systematically review the available evidence about the efficacy of meditation techniques used by mindfulness-based programs on cognitive, socio-emotional, and academic skills of children from 6 to 12 years of age. The review was registered on the PROSPERO database, and the literature search was conducted according to PICO criteria and PRISMA guidelines. The EBSCO databases were searched, and 29 studies were eligible: nine randomized controlled trials and 20 quasi-experimental studies. All the included randomized controlled trials were rated as having a high risk of bias. Overall, the evidence for mindfulness techniques improving cognitive and socio-emotional skills was reasonably strong. Specifically, for cognitive skills, results showed that all the interventions used “body-centered meditations” and “mindful observations.” Regarding socio-emotional skills, although all the studies applied “body-centered meditations” and “mindful observations,” “affect-centered meditations” were also frequent. For academic skills, just one quasi-experimental trial found improvements, thus making it difficult to draw conclusions. Further research is crucial to evaluate the unique effects of different meditation techniques on the cognitive, social-emotional, and academic skills of children.

https://www.frontiersin.org/articles/10.3389/fpsyg.2021.660650/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1778822_a0P58000000G0YfEAK_Psycho_20211123_arts_A