Stress

Reduce Stress and Improve Healthcare Worker Well-Being with Mindfulness

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Reduce Stress and Improve Healthcare Worker Well-Being with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The therapeutic applications of mindfulness are considerable and its impact on clinical practice itself appears to be profound. Indeed, several commentators characterize mindfulness as inciting nothing short of a revolution in the way we conduct our mental lives both within the clinic and without.” – Matias P. Raski

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It is estimated that over 45% of healthcare workers experience burnout. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout, in fact, it is a threat to the entire healthcare system. Currently, over a third of healthcare workers report that they are looking for a new job. Hence, burnout contributes to the shortage of doctors and nurses.

 

Preventing burnout has to be a priority. Unfortunately, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout. So, it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices have been shown to reduce the psychological and physiological responses to stress and improve well-being. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, improving sleep and reduce stress.

 

In today’s Research News article “Reducing stress and promoting well-being in healthcare workers using mindfulness-based cognitive therapy for life.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903308/ ) Strauss and colleagues recruited healthy adult healthcare workers and randomly assigned them to either a wait-list control condition or to receive 8 weekly 2-hour group sessions of Mindfulness-Based Cognitive Therapy (MBCT) along with 40 minutes of daily practice.  MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior. MBCT was developed specifically to treat depression. For this study it was modified to be more appropriate for the general population. The participants were measured before and after training for attendance and practice amounts, stress, anxiety, depression, mental well-being, burnout, presenteeism, compassion, and mindfulness.

 

They found that in comparison to baseline and the wait-list control group after Mindfulness-Based Cognitive Therapy (MBCT) there were significant increases in mindfulness, mental well-being, and self-compassion, and significant decreases in anxiety, depression, and stress. They also found that the greater the increases in mindfulness and self-compassion produced by MBCT the greater the increase in mental well-being and the decrease in stress.

 

These findings are similar to those found in previous research with different groups that Mindfulness training increases well-being and self-compassion, and decreases anxiety, depression, and stress. Hence, mindfulness training improves the psychological well-being of healthcare workers. This should help protect them against burnout and increase their resilience in the face of high workplace stress.

 

So, reduce stress and improve healthcare worker well-being with mindfulness.

 

“As we become more adept at dwelling in the living presence of our own experience, we begin to connect more deeply with patients, as well as co-workers and family members. Mindfulness practice provides a simple and practical way to recapture the calling of healing.” – Penn Medicine

 

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

 

Strauss, C., Gu, J., Montero-Marin, J., Whittington, A., Chapman, C., & Kuyken, W. (2021). Reducing stress and promoting well-being in healthcare workers using mindfulness-based cognitive therapy for life. International journal of clinical and health psychology : IJCHP, 21(2), 100227. https://doi.org/10.1016/j.ijchp.2021.100227

 

Background/Objective

Healthcare workers play a critical role in the health of a nation, yet rates of healthcare worker stress are disproportionately high. We evaluated whether mindfulness-based cognitive therapy for life (MBCT-L), could reduce stress in healthcare workers and target a range of secondary outcomes. Method: This is the first parallel randomised controlled trial of MBCT-L. Participants were NHS workers, who were randomly assigned (1:1) to receive either MBCT-L or wait-list. The primary outcome was self-reported stress at post-intervention. Secondary variables were well-being, depression, anxiety, and work-related outcomes. Mixed regressions were used. Mindfulness and self/other-compassion were explored as potential mechanisms of effects on stress and wellbeing. Results: We assigned 234 participants to MBCT-L (n = 115) or to wait-list (n = 119). 168 (72%) participants completed the primary outcome and of those who started the MBCT-L 73.40% (n = 69) attended the majority of the sessions. MBCT-L ameliorated stress compared with controls (B = 2.60, 95% CI = 1.63‒3.56; d = -0.72; p < .0001). Effects were also found for well-being, depression and anxiety, but not for work-related outcomes. Mindfulness and self-compassion mediated effects on stress and wellbeing. Conclusions: MBCT-L could be an effective and acceptable part of a wider healthcare workers well-being and mental health strategy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903308/

 

Reduce Employee Stress with Workplace Yoga

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Reduce Employee Stress with Workplace Yoga

 

By John M. de Castro, Ph.D.

 

“Practicing yoga at the workplace teaches employees to use relaxation techniques to reduce stress and risks of injury on the job. Yoga at the workplace is a convenient and practical outlet that improves work performance by relieving tension and job stress.” – Shira Taylor Gura

 

Work is very important for our health and well-being. We spend approximately 25% of our adult lives at work. How we spend that time is immensely important for our psychological, social, and physical health. But, nearly 2/3 of employees worldwide are unhappy at work. This is partially due to work-related stress which is epidemic in the western workplace. Almost two thirds of workers reporting high levels of stress at work. This stress can result in impaired health and can result in burnout; producing fatigue, cynicism, and professional inefficacy.

 

To help overcome unhappiness, stress, and burnout, mindfulness practices have been implemented in the workplace. Mindfulness has been demonstrated to be helpful in reducing the psychological and physiological responses to stress and for treating and preventing burnout in a number of work environments. Yoga practice has the extra benefits of not only being mindfulness training but also as an exercise. The research has been accumulation. So, it makes sense to step back and summarize what has been learned about the effects of yoga practice in the workplace on employee stress levels.

 

In today’s Research News article “Effectiveness of Workplace Yoga Interventions to Reduce Perceived Stress in Employees: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7739364/ ) Valle and colleagues review, summarize, and perform a meta-analysis of the published controlled research studies of the effectiveness of yoga practice in the workplace for the stress levels and psychological health of employees.

 

They identified 6 controlled trials with a total of 487 participants. They report that these published trials found that yoga interventions in the workplace produced significant reductions in the stress levels of the employees. This replicates previous studies that practicing yoga reduces stress. It is important that the yoga classes were held at work. This makes participation much more convenient, making it more likely. As a result, yoga in the workplace may be a very effective means of reducing stress and thereby reducing employee burnout.

 

So, reduce employee stress with workplace yoga.

 

“Yoga postures, slow, deep, yogic breathing has also shown to elicit a relaxation response which could contribute to a reduction in stress in the workplace.” – Lisa Rappaport

 

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

 

Della Valle, E., Palermi, S., Aloe, I., Marcantonio, R., Spera, R., Montagnani, S., & Sirico, F. (2020). Effectiveness of Workplace Yoga Interventions to Reduce Perceived Stress in Employees: A Systematic Review and Meta-Analysis. Journal of functional morphology and kinesiology, 5(2), 33. https://doi.org/10.3390/jfmk5020033

 

Abstract

Work-related stress represents a relevant public health issue and solution strategies are mandatory. Yoga is a common approach to manage stress and its effectiveness has been extensively confirmed. Therefore, this study aims systematically to review the effectiveness of Yoga interventions carried out at workplace on work-related stress among employees and to assess their impact quantitatively. Springerlink, MEDLINE, PubMed, CINAHL, Web of Science, Scopus, Cochrane CENTRAL and PEDro databases were searched. Clinical trials comparing workplace Yoga interventions to control groups, and evaluating perceived stress as outcome measure, were assessed for eligibility. All forms and styles of Yoga were considered for the analysis. Out of 3392 initially identified, 6 studies were included in the meta-analysis; 266 participants practicing Yoga interventions at worksite were compared to 221 subjects in control group. Included studies showed “some concerns” about different domains of source of bias. Quantitative analysis showed an overall effect size of −0.67 [95% confidence interval (CI): −0.86, −0.49] in favor of Yoga intervention in reducing stress outcome measures. Hence, workplace Yoga interventions were more effective when compared to no treatment in work-related stress management. Further high-quality studies are needed to improve the validity of these results and to specify more characteristics of the Yoga intervention, such as style, volume, and frequency.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7739364/

 

Yoga Practitioners Have Better Psychological Health During the Covid-19 Lockdown

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Yoga Practitioners Have Better Psychological Health During the Covid-19 Lockdown

 

By John M. de Castro, Ph.D.

 

“the well understood underlying mechanisms for the use of yoga for stress reduction and immune modulation shall be considered as the basis for its complimentary role in the management of an infectious condition like COVID-19.“ – H. R. Nagendra

 

Yoga practice has been shown to improve health and well-being in healthy individuals. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. The COVID-19 pandemic has challenged the mental and physical health of the population. It has created intense stress both for frontline workers but also for people simply isolating at home. Yoga practice is known to decrease the psychological and physical responses to stress. So, yoga practice may be helpful in coping with the mental and physical challenges resulting from the COVID-19 pandemic and lockdown.

 

In today’s Research News article “Yoga an effective strategy for self-management of stress-related problems and wellbeing during COVID19 lockdown: A cross-sectional study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7875402/ ) Sahni and colleagues recruited adults online during the Covid-19 lockdown. They separated the participants into three groups; those who practice yoga, other spiritual practices, and non-practitioners. The participants completed online measures of Covid-19 perceptions, depression, anxiety, perceived stress, general well-being, resilience, peace of mind, and emotion regulation.

 

They found that in comparison to the spiritual practices and non-practitioners, the yoga practitioners had a significantly higher level of Covid-19 perception of personal control, and significantly lower levels of illness concern and emotional impact of COVID19. In addition, the yoga practitioners had significantly lower levels of depression, anxiety, and perceived stress and significantly higher levels of peace of mind. well-being, and cognitive reappraisal strategies of emotion regulation. In general, they found that the longer that the yoga practitioners had practiced, the greater the benefits.

 

This study examined existing groups and there wasn’t random assignment. Hence, the findings could be due to systematic differences between people who choose to engage in yoga, other spiritual practices, or no practice. But previous controlled research has demonstrated that yoga practice causes decreased depression, anxiety, and perceived stress, and increased well-being. So, the difference seen here between groups probably represent the causal effects of yoga practice.

 

These results suggest that practicing yoga makes an individual more resistant to the deleterious psychological effects of the pandemic and the associated lockdown. It appears to improve the practitioners’ psychological well-being, peace of mind, attitude toward the pandemic, and ability to regulate emotions. In addition, the greater the amount of yoga practice, the greater the benefits. These yoga-produced abilities may well underlie yoga practice’s positive impact on various diseases.

 

So, yoga practitioners have better psychological health during the Covid-19 lockdown.

 

“COVID-19 has caused levels of stress and anxiety to skyrocket and it’s (understandably) taking a toll on people’s mental health. One thing that can help? Yoga.”- CorePower Yoga

 

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

 

Sahni, P. S., Singh, K., Sharma, N., & Garg, R. (2021). Yoga an effective strategy for self-management of stress-related problems and wellbeing during COVID19 lockdown: A cross-sectional study. PloS one, 16(2), e0245214. https://doi.org/10.1371/journal.pone.0245214

 

Abstract

This cross-sectional research aims to study the effect of yoga practice on the illness perception, and wellbeing of healthy adults during 4–10 weeks of lockdown due to COVID19 outbreak. A total of 668 adults (64.7% males, M = 28.12 years, SD = 9.09 years) participated in the online survey. The participants were grouped as; yoga practitioners, other spiritual practitioners, and non-practitioners based on their responses to daily practices that they follow. Yoga practitioners were further examined based on the duration of practice as; long-term, mid-term and beginners. Multivariate analysis indicates that yoga practitioners had significantly lower depression, anxiety, & stress (DASS), and higher general wellbeing (SWGB) as well as higher peace of mind (POMS) than the other two groups. The results further revealed that the yoga practitioners significantly differed in the perception of personal control, illness concern and emotional impact of COVID19. However, there was no significant difference found for the measure of resilience (BRS) in this study. Yoga practitioners also significantly differed in the cognitive reappraisal strategy for regulating their emotions than the other two groups. Interestingly, it was found that beginners -those who had started practicing yoga only during the lockdown period reported no significant difference for general wellbeing and peace of mind when compared to the mid- term practitioner. Evidence supports that yoga was found as an effective self- management strategy to cope with stress, anxiety and depression, and maintain wellbeing during COVID19 lockdown.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7875402/

 

Have Better Sex with Mindfulness

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Have Better Sex with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindful sex involves being able to observe and describe what’s happening inside your body and mind without sorting experiences into “bad” and “good” or trying to change your feelings. When we are able to do that, we can “turn off the autopilot.” – Gina Silverstein

 

Sex is a very important aspect of life. Problems with sex are very common and have negative consequences for relationships. While research suggests that sexual dysfunction is common, it is a topic that many people are hesitant or embarrassed to discuss. Women suffer from sexual dysfunction more than men with 43% of women and 31% of men reporting some degree of difficulty. Hence, sex has major impacts on people’s lives and relationships. Greater research attention to sexual activity and sexual satisfaction and the well-being of the individual is warranted.

 

Mindfulness trainings have been shown to improve a variety of psychological issues including emotion regulation, stress responses, trauma, fear and worry, anxiety, and depression, and self-esteem. Mindfulness training has also been found to improve relationships and to be useful in treating sexual problems. But there is little empirical research on the relationship of mindfulness with sexuality in normal, non-clinical, individuals.

 

In today’s Research News article “Mindfulness in Sexual Activity, Sexual Satisfaction and Erotic Fantasies in a Non-Clinical Sample.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908537/ )  Sánchez-Sánchez and colleagues recruited online adults who were meditation naïve or who practiced meditation for at least 5 months. They completed measures online of mindfulness, body awareness, sexual satisfaction, sexual activity, and sexual fantasies.

 

They found that the meditation practitioners were significantly higher in emotion regulation, family, academics, relationships, sociability, attention, health, sexuality, and leisure and significantly lower in perceived stress. They were also significantly higher in mindfulness, body awareness, sexual satisfaction, sexual activity, and sexual fantasies. They also found that the higher the levels of mindfulness and the amount of mindfulness practice, the higher the levels of body awareness sexual satisfaction and sexual activity. Also, they found that the higher the levels of mindfulness the lower the levels of body dissociation.

 

It should be kept in mind that there was no random assignment and so the groups may be quite different, People who meditate may be systematically different from those who don’t in many ways including the variables measured in this study. But previous research including randomized studies demonstrated that mindfulness produced higher levels of emotion regulation, family, academics, relationships, sociability, attention, health, and sexuality, and lower levels of stress. So, the present findings likely also represent causal connections.

 

These findings suggest that mindfulness is associated with better psychological and physical health and well-being. They also suggest that mindfulness is associated with better sexual function in terms of sexual activity, satisfaction with sex, and relationship quality and even a better sexual fantasy life. Sex is such an important aspect of life that many of the other psychological and physical benefits of mindfulness may emanate from the improved sex life of the individuals. Much more research is needed.

 

So, have better sex with mindfulness.

 

“Think of mindful sex as an invitation, as an opportunity to explore the mystery of sex. The reward is deeper intimacy, more meaningful connections, and (fingers crossed) greater physical pleasure.” – Kayti Christian

 

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

 

Sánchez-Sánchez, L. C., Rodríguez, M., García-Montes, J. M., Petisco-Rodríguez, C., & Fernández-García, R. (2021). Mindfulness in Sexual Activity, Sexual Satisfaction and Erotic Fantasies in a Non-Clinical Sample. International journal of environmental research and public health, 18(3), 1161. https://doi.org/10.3390/ijerph18031161

 

Abstract

The goal of this study is to better understand the relation between the practice of Mindfulness and the sexual activity, sexual satisfaction and erotic fantasies of Spanish-speaking participants. This research focuses on the comparison between people who practice Mindfulness versus naïve people, and explores the practice of Mindfulness and its relation with the following variables about sexuality: body awareness and bodily dissociation, personal sexual satisfaction, partner and relationship-related satisfaction, desire, subjective sexual arousal, genital arousal, orgasm, pain, attitudes towards sexual fantasies and types of sexual fantasies. The sample consisted of 106 selected adults, 32 men and 74 women, who completed six measures on an online survey platform: (a) Mindfulness Attention Awareness Scale (MAAS), (b) Scale of Body Connection (SBC), (c) New Sexual Satisfaction Scale (NSSS), (d) Scale of Sexual Activity in Women (SSA-W) and Men (SSA-M), (e) Hurlbert Index of Sexual Fantasy (HISF), (f) Wilson’s Sex Fantasy Questionnaire. In the MAAS, Body Awareness subscale (SBC), NSSS, SSA-W and SSA-M, HISF and intimate fantasies subscale (Wilson’s questionnaire), people in the Mindfulness condition showed higher scores and these differences were statistically significant. These results may have relevant implications in the sexuality of clinical and non-clinical samples.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908537/

 

Mindfulness-Based Therapies Benefits are Greatly Affected by Social Factors in Therapy

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Mindfulness-Based Therapies Benefits are Greatly Affected by Social Factors in Therapy

 

By John M. de Castro, Ph.D.

 

“Designed to deliberately focus a person’s attention on the present experience in a way that is non-judgmental, mindfulness-based interventions, whether offered individually or in a group setting, may offer benefit to people seeking therapy for any number of concerns.” – Manuel A. Manotas

 

Psychotherapy is an interpersonal transaction. Its effectiveness in treating the ills of the client is to some extent dependent upon the chemistry between the therapist and the client, termed the therapeutic alliance. Research has demonstrated that there is a positive relationship with moderate effect sizes between treatment outcomes and the depth of the therapeutic alliance.

 

There are also other factors that may be important for successful therapy. The client’s engagement in the process as well as the therapists interpersonal skills may also be important ingredients in producing successful therapeutic outcomes. There are also important social factors present particularly when the therapy is provided in groups. In addition, formal and informal practice effects are involved. There is little known, however, of the role of these components of therapy on the effectiveness of treatment for mental health issues such as depression.

 

In today’s Research News article “The Contribution of Common and Specific Therapeutic Factors to Mindfulness-Based Intervention Outcomes.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874060/ )  Canby and colleagues recruited patients diagnosed with mild to severe depression and randomly assigned them to receive once a week for 8 weeks, 3 hour sessions of either focused meditation, open monitoring meditation or Mindfulness-Based Cognitive Therapy (MBCT) which contains both focused and open monitoring meditation practices. Before and after the 8-weeks of practice and 3 months later they were measured for empathy, therapeutic alliance, formal and informal mindfulness practices, depression, anxiety, stress, mindfulness, and group therapeutic factors in group therapy: instillation of hope, secure emotional expression, awareness of relational impact, and social learning. Finally, they received structured interviews exploring mindfulness practices and impact of treatment.

 

They found that the over treatment and follow-up the groups had significantly increased mindfulness and significantly decreased anxiety, depression and stress. They found that the higher the ratings of the instructors. the ratings of the groups and the amounts of formal meditation practice the greater the changes. In general, the instructor and group factors had stronger relationships to the psychological improvements than the amount of formal meditation and the amount of informal meditation practice had no relationship with the improvements. The analysis of the structured interviews indicated that the participants found the instructor and group factors including bonding, instilling hope, and expressing feelings were important to their improvements.

 

These results are interesting replicate previous findings of mindfulness-based therapies produce improvements in anxiety, depression, and stress. The results suggest that mindfulness-based therapies have complex effects and changes in mindfulness may be less important than the social environment produced by the instructor and the group. These social factors may account for a large proportion of the benefits to the participants. These results are important as they suggest that empathizing the social interactions involved in therapy may improve the impact of the therapy on the patients’ psychological well-being.

 

So, mindfulness-based therapies benefits are greatly affected by social factors in therapy.

 

“Mindfulness’ strength is in helping us to see more clearly, by giving us the room to not be so quickly reactive. And over time the event does not have to jump to emotional distress, like a grasshopper leaping over a stream.” – Barry Boyce

 

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

 

Canby, N. K., Eichel, K., Lindahl, J., Chau, S., Cordova, J., & Britton, W. B. (2021). The Contribution of Common and Specific Therapeutic Factors to Mindfulness-Based Intervention Outcomes. Frontiers in psychology, 11, 603394. https://doi.org/10.3389/fpsyg.2020.603394

 

Abstract

While Mindfulness-Based Interventions (MBIs) have been shown to be effective for a range of patient populations and outcomes, a question remains as to the role of common therapeutic factors, as opposed to the specific effects of mindfulness practice, in contributing to patient improvements. This project used a mixed-method design to investigate the contribution of specific (mindfulness practice-related) and common (instructor and group related) therapeutic factors to client improvements within an MBI. Participants with mild-severe depression (N = 104; 73% female, M age = 40.28) participated in an 8-week MBI. Specific therapeutic factors (formal out-of-class meditation minutes and informal mindfulness practice frequency) and social common factors (instructor and group ratings) were entered into multilevel growth curve models to predict changes in depression, anxiety, stress, and mindfulness at six timepoints from baseline to 3-month follow-up. Qualitative interviews with participants provided rich descriptions of how instructor and group related factors played a role in therapeutic trajectories. Findings indicated that instructor ratings predicted changes in depression and stress, group ratings predicted changes in stress and self-reported mindfulness, and formal meditation predicted changes in anxiety and stress, while informal mindfulness practice did not predict client improvements. Social common factors were stronger predictors of improvements in depression, stress, and self-reported mindfulness than specific mindfulness practice-related factors. Qualitative data supported the importance of relationships with instructor and group members, involving bonding, expressing feelings, and instilling hope. Our findings dispel the myth that MBI outcomes are exclusively the result of mindfulness meditation practice, and suggest that social common factors may account for much of the effects of these interventions. Further research on meditation should take into consideration the effects of social context and other common therapeutic factors.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874060/

 

Improve Physiological Responses to Stress in Schools with Mind-Body Practices

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Improve Physiological Responses to Stress in Schools with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

“Mindfulness exercises have been shown to help students reduce stress and anxiety, gain conscious control over behaviors and attitudes, and improve focus.” – Robin L. Flanigan

 

In the modern world education is a key for success. Where a high school education was sufficient in previous generations, a college degree is now required to succeed in the new knowledge-based economies. There is a lot of pressure on students to excel so that they can get into the best schools and ultimately the best jobs. As a result, parents and students are constantly looking for ways to improve student performance in school. The primary tactic has been to pressure the student and clear away routine tasks and chores so that the student can focus on their studies. But, this might in fact be counterproductive as the increased pressure can actually lead to stress, depression, and anxiety which can impede the student’s mental health, well-being, and school performance.

 

It is, for the most part, beyond the ability of the individual to change the environment to reduce stress, so it is important that methods be found to reduce the students’ responses to stress; to make them more resilient when high levels of stress occur. Mind-body practices including meditation, mindfulness training, and yoga practice have been shown to reduce the psychological and physiological responses to stress. There is accumulating evidence of the effectiveness of mind-body practices on the students’ stress levels. So, it makes sense to summarize what has been learned.

 

In today’s Research News article “Mind-Body Physical Activity Interventions and Stress-Related Physiological Markers in Educational Settings: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7795448/ ) Strehli and colleagues review, summarize, and perform a meta-analysis of the published research studies on the ability of mind-body practices to lower physiological indicators of stress in schools. They included studies involving elementary school, high school, and college students.

 

They identified 26 published studies, 80% of which were yoga based. They report that the published research found that the mind-body practices resulted in significant decreases in heart rate, systolic and diastolic blood pressure, and stress hormone (cortisol) levels. These effects were stronger for the college students and less so for high school and elementary school children.

 

The results suggest that mind-body practices reduce the physiological indicators of stress in school children and adolescents. This fits with previous findings with a variety of groups that mindfulness practices reduce the physiological responses to stress. This is thought to result from increases in balance in the autonomic nervous system. Regardless the published research literature suggests that mind-body practices are beneficial for school students, particularly college students, reducing their levels of stress.

 

So, improve physiological responses to stress in schools with mind-body practices.

 

“Students who engage in mindful movement activities can see a multitude of benefits, including increased strength and energy, better posture, reduced stress and improved attentiveness, self-confidence, self-awareness and self-care habits. Mind-body exercises also provide ways to build and strengthen relationships with others.” – Accredited Schools Online

 

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

 

Strehli, I., Burns, R. D., Bai, Y., Ziegenfuss, D. H., Block, M. E., & Brusseau, T. A. (2020). Mind-Body Physical Activity Interventions and Stress-Related Physiological Markers in Educational Settings: A Systematic Review and Meta-Analysis. International journal of environmental research and public health, 18(1), 224. https://doi.org/10.3390/ijerph18010224

 

Abstract

Mind–Body Physical Activity (MBPA) in educational settings is one possible preventive strategy for ameliorating stress-related physiological health parameters. The objectives of this study were to conduct a systematic review of the literature with meta-analyses on the effects of MBPA on stress-related physiological health markers in primary, secondary, and higher education students. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the search for peer-reviewed articles published in English was conducted in PubMed, EBSCOhost, PsychInfo, Scopus, and Cochrane Library databases. Criteria for inclusion consisted of empirical studies targeting the student population (primary, secondary, higher education), studies examining the effectiveness of an MBPA intervention, studies including a control or comparison group (pre-test/post-test studies excluded), studies targeting physiological marker outcomes such as heart rate, blood glucose, cortisol, and blood pressure, and finally, studies examining interventions implemented within educational settings. Twenty-six interventions were eligible for the review and quantitative synthesis, which comprised a total of 1625 participants, with 783 students serving within the control/comparison group. There were statistically significant and large pooled effects for MBPA effectiveness for lowering heart rate (Hedges’ g = −1.71, 95% Confidence Interval (CI): −2.43, −0.98), cortisol (Hedges’ g = −1.32, 95% CI: −2.50, −0.16), and systolic and diastolic blood pressure (Hedges’ g = −1.04, 95% CI: −1.53, −0.58). These effects tended to be stronger in older students compared to younger students. Most analyses were characterized as having high heterogeneity and only 10 of the 26 studies were characterized as good quality (38.4%). MBPA interventions may have a positive impact on specific physiological health markers in students, especially in students within higher education. However, higher-quality research is needed in this area.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7795448/

 

Mindfulness is Associated with Lower Stress and Improved Parkinson’s Disease Symptoms

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Mindfulness is Associated with Lower Stress and Improved Parkinson’s Disease Symptoms

 

By John M. de Castro, Ph.D.

 

“By training your mind to be present, you can feel the benefits in your everyday life. It can be particularly helpful when facing challenges that Parkinson’s brings.” – Parkinson’s UK

 

Parkinson’s Disease (PD) is an incurable progressive degenerative disease of the central nervous system. The condition is caused by the death of nerve cells in the brain that produce the neurotransmitter dopamine. There are around seven million people worldwide and one million people in the U.S. living with PD and about 60,000 people are diagnosed with PD every year. PD is associated with aging as the vast majority of patients are diagnosed after age 50. In fact, it has been speculated that everyone would eventually develop PD if they lived long enough.

 

Its physical symptoms include resting tremor, slow movements, muscle rigidity, problems with posture and balance, loss of automatic movements, and slurring of speech. PD itself is not fatal but is often associated with related complications which can reduce life expectancy, such as falls, choking, and cardiovascular problems. PD also has psychological effects, especially cognitive decline, anxiety, and depression. Balance is a particular problem as it effects mobility and increases the likelihood of falls, restricting activity and reducing quality of life.

 

There are no cures for Parkinson’s Disease (PD) or even treatments to slow its progression. There are only treatments that can produce symptomatic relief. So, there is a need to discover new and different treatments. Mindfulness training has been found to improve the psychological symptoms and the quality of life with PD patients.  If mindfulness is indeed a help to PD patients, then the relationship between mindfulness and PD symptoms should be present in everyday, real world, patients.

 

In today’s Research News article “Stress and mindfulness in Parkinson’s disease – a survey in 5000 patients.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7813889/ ) van der Heide and colleagues sent online surveys to Parkinson’s Disease (PD) patients and normal control participants. The surveys contained measures of mindfulness, self-compassion, perceived stress, rumination, Parkinson’s anxiety, and additional questions about PD symptoms, stress, and other factors associated with the disease.

 

They found that the Parkinson’s Disease (PD) patients in comparison to controls had significantly lower levels of mindfulness and significantly higher levels stress, and depression. They also found that the higher the levels of stress that the PD patients reported the lower the levels of mindfulness, self-compassion and quality of life and the higher the levels of rumination and disease severity. When the patients were asked what strategies, they used to reduce stress they reported that they used exercise and mindfulness most often. The patients reported that mindfulness improved all of their symptoms, including tremor, gait, slowness of movement, dyskinesia, anxiety, depression, and sleeping problems. In addition, the more the patients used mindfulness, the better their symptoms.

 

These are interesting but correlational findings, so causation cannot be determined. But previous studies have shown the mindfulness training reduces stress and improves the symptoms of Parkinson’s Disease (PD). So, the present associations are probably due to causal connections between mindfulness, stress, and PD symptoms. It appears that stress exacerbates PD symptoms and mindfulness reduces stress and PD symptoms. This further suggests that mindfulness practices should be taught to PD patients. This potentially would improve their well-being and reduce their suffering.

 

So, mindfulness is associated with lower stress and improved Parkinson’s Disease symptoms.

 

“well-structured mindfulness programs have been proven to be quite effective in areas that directly affect Parkinson’s, such as reducing stress levels, combating depression, and refining body image.” – Matt Zepelin

 

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

 

van der Heide, A., Speckens, A., Meinders, M. J., Rosenthal, L. S., Bloem, B. R., & Helmich, R. C. (2021). Stress and mindfulness in Parkinson’s disease – a survey in 5000 patients. NPJ Parkinson’s disease, 7(1), 7. https://doi.org/10.1038/s41531-020-00152-9

 

Abstract

Many Parkinson’s disease (PD) patients notice that motor symptoms worsen during stress, and experience stress-related neuropsychiatric symptoms such as anxiety and depression. Here we investigated which personal and disease characteristics are associated with perceived stress in PD, which PD symptoms are sensitive to stress, and we assessed self-reported benefits of stress-reducing strategies such as mindfulness. We sent an online survey to the Fox Insight cohort (n = 28,385 PD patients, n = 11,413 healthy controls). The survey included specific questions about the influence of stress on PD symptoms, use of stress-reducing strategies, and several validated scales measuring perceived stress, anxiety, dispositional mindfulness, rumination, and self-compassion. We received completed surveys from 5000 PD patients and 1292 controls. Patients perceived more stress than controls. Among patients, stress was correlated with increased rumination (R = 0.65), lower quality of life (R = −0.56), lower self-compassion (R = −0.65), and lower dispositional mindfulness (R = −0.48). Furthermore, patients indicated that stress significantly worsened both motor symptoms – especially tremor – and non-motor symptoms. Physical exercise was most frequently used to reduce stress (83.1%). Mindfulness was practiced by 38.7% of PD respondents, who noticed improvement in both motor and non-motor symptoms. Among non-users, 43.4% were interested in gaining mindfulness skills. We conclude that PD patients experience greater levels of stress than controls, and that stress worsens both motor and non-motor symptoms. Mindfulness may improve PD symptom severity, with the strongest effects on anxiety and depressed mood. These findings justify further controlled studies to establish the merits of mindfulness and other stress-alleviating interventions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7813889/

Improve Psychological, Physiological, and Epigenetic Markers of Type 2 Diabetes with Mind-Body Practices

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Improve Psychological, Physiological, and Epigenetic Markers of Type 2 Diabetes with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

“Diabetes, like many other chronic diseases, can also affect the mind. Similarly the mind has great power to influence the body.” – Diabetes UK

 

Diabetes is a major health issue. It is estimated that 30 million people in the United States and nearly 600 million people worldwide have diabetes and the numbers are growing. Type II Diabetes results from a resistance of tissues, especially fat tissues, to the ability of insulin to promote the uptake of glucose from the blood. As a result, blood sugar levels rise producing hyperglycemia. Diabetes is heavily associated with other diseases such as cardiovascular disease, heart attacks, stroke, blindness, kidney disease, and circulatory problems leading to amputations. As a result, diabetes doubles the risk of death of any cause compared to individuals of the same age without diabetes.

 

Type 2 diabetes is largely preventable. One of the reasons for the increasing incidence of Type 2 Diabetes is its association with overweight and obesity which is becoming epidemic in the industrialized world. A leading cause of this is a sedentary life style. Current treatments for Type 2 Diabetes focus on diet, exercise, and weight control. Recently, mindfulness practices have been shown to be helpful in managing diabetes. Mindful movement practices such as Tai Chi and Qigong  and yoga are mindfulness practices that are also gentle exercises. There is accumulating research on the effectiveness of these mind-body practices for the treatment of Type 2 Diabetes. So, it makes sense to examine what has been learned.

 

In today’s Research News article “Changes Induced by Mind-Body Intervention Including Epigenetic Marks and Its Effects on Diabetes.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7865217/ ) Yang and colleagues review and summarize the published research studies of the effects of mind-body practices on the symptoms of Type 2 Diabetes including epigenetic markers.

 

They report that moving meditation practices such as Tai Chi and Qigong  and yoga have been shown to significantly improve blood glucose, HbA1c, postprandial blood glucose, total cholesterol, and both low-density and high-density lipoprotein cholesterol. Mindfulness meditation has been shown to significantly improve HbA1c, diabetes-related distress, depression, and stress. In addition, mind-body interventions produce epigenetic changes reflected in DNA methylation modification. More study is needed but these epigenetic changes may underlie the improvements in Type 2 Diabetes produced by mind-body interventions.

 

Mind-body interventions have been repeatedly demonstrated to significantly reduce depression, anxiety and stress. These psychological states tend to aggravate Type 2 Diabetes. Since mind-mind-body practices reduce depression, anxiety and stress, they produce improvements in the symptoms of diabetes. In addition, mind-body practices produce physiological changes that can improve the symptoms of Type 2 Diabetes. These include activation of the parasympathetic (relaxation) nervous system, lower stress hormone (cortisol) secretion, reduced inflammation, and even reduced age based physiological changes.

 

These are remarkable findings that suggest that mind-body practices are effective in producing psychological and physiological changes that are very beneficial for the relief of the symptoms of Type 2 Diabetes. These benefits are reflected in changes on the epigenetic level that might ultimately be responsible for the benefits. Clearly, mind-body practices should be incorporated into Type 2 Diabetes treatment programs.

 

So, improve psychological, physiological, and epigenetic markers of type 2 diabetes with mind-body practices.

 

“meditation strategies can be useful adjunctive techniques to lifestyle modification and pharmacological management of diabetes and help improve patient wellbeing.” Gagan Priya

 

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

Yang, H. J., Koh, E., Sung, M. K., & Kang, H. (2021). Changes Induced by Mind-Body Intervention Including Epigenetic Marks and Its Effects on Diabetes. International journal of molecular sciences, 22(3), 1317. https://doi.org/10.3390/ijms22031317

 

Abstract

Studies have evidenced that epigenetic marks associated with type 2 diabetes (T2D) can be inherited from parents or acquired through fetal and early-life events, as well as through lifelong environments or lifestyles, which can increase the risk of diabetes in adulthood. However, epigenetic modifications are reversible, and can be altered through proper intervention, thus mitigating the risk factors of T2D. Mind–body intervention (MBI) refers to interventions like meditation, yoga, and qigong, which deal with both physical and mental well-being. MBI not only induces psychological changes, such as alleviation of depression, anxiety, and stress, but also physiological changes like parasympathetic activation, lower cortisol secretion, reduced inflammation, and aging rate delay, which are all risk factors for T2D. Notably, MBI has been reported to reduce blood glucose in patients with T2D. Herein, based on recent findings, we review the effects of MBI on diabetes and the mechanisms involved, including epigenetic modifications.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7865217/

Mindfulness and Exercise Reduce Depression in College Students

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Mindfulness and Exercise Reduce Depression in College Students

 

By John M. de Castro, Ph.D.

 

“Mindfulness is as popular at colleges nationwide. It’s someone giving themselves uninterrupted mental space. . . It’s a time to stop and refocus your purpose. Studies show the practice may be an antidote to the high levels of stress and depression seen on college campuses.” – Susan Donaldson James

 

In the modern world education is a key for success. There a lot of pressure on university students to excel so that they can get the best jobs after graduation. The pressure can actually lead to stress, anxiety, and depression which can impede the student’s mental health, well-being, and school performance.

 

It is, for the most part, beyond the ability of the individual to change the environment to reduce stress, so it is important that methods be found to reduce the college students’ responses to stress; to make them more resilient when high levels of stress occur. Contemplative practices including meditation, mindfulness training, exercise, Tai Chi and Qigong, and yoga practice have been shown to reduce the psychological and physiological responses to stress, relieve anxiety, and reduce depression So, it would seem important to examine various techniques to relieve the stress and its consequent symptoms in college students.

 

In today’s Research News article “Effects of aerobic exercise, traditional Chinese exercises, and meditation on depressive symptoms of college student: A meta-analysis of randomized controlled trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7793414/ ) Song and colleagues reviewed, summarized, and performed a meta-analysis of the published randomized controlled trials of the effects of aerobic exercise, meditation, or traditional Chinese exercises on depression, anxiety, and stress in college students. traditional Chinese exercises included tai chi, Baduanjin, qigong, and other mind-body therapies. They identified 44 published trials.

 

They report that the published trials found that aerobic exercise, meditation, and traditional Chinese exercises all improved depression in the college students. On the other hand, only aerobic exercise produced a significant reduction in anxiety levels and only aerobic exercise and traditional Chinese exercises produced significant reductions in stress.

 

The findings regarding depression make sense as all three types of interventions have been found to be effective in relieving depression. But previous studies with diverse groups have found that meditation is effective for anxiety and stress and traditional Chinese exercises are also effective for anxiety. So, it may well be that the review included only college students may be responsible for these failures to find significant effects. In addition, there were no studies included that involved the use of meditation for stress and only 2 for the effects of traditional Chinese exercises on anxiety. Regardless, the results clearly show that all three practices are effective in relieving depression.

 

So, mindfulness and exercise reduce depression in college students.

 

“Although the research on long-term benefits is still scarce, much of it has shown that long-term mindfulness practitioners tend to have improved health outcomes, enhanced psychological well-being and better attentional function.” – Affordable College Onine

 

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

 

Song, J., Liu, Z. Z., Huang, J., Wu, J. S., & Tao, J. (2021). Effects of aerobic exercise, traditional Chinese exercises, and meditation on depressive symptoms of college student: A meta-analysis of randomized controlled trials. Medicine, 100(1), e23819. https://doi.org/10.1097/MD.0000000000023819

 

Abstract

Background:

Non-pharmacological intervention methods such as rehabilitation training or psychological treatment are mostly used in the treatment of depression owing to the limitation of adverse reactions such as drug treatment. However, the best non-pharmacological treatment strategy for depression in college students is unclear. Therefore, it is significant to discover non-drug intervention methods that can improve the depression symptoms of college students.

Method:

Electronic databases as of Sep 15, 2019, were searched, and reference lists and pharmaceutical dossiers were reviewed to detect published and unpublished studies from the date of their inception to Sep 15, 2019. With document quality evaluations and data extraction, Meta-Analysis was performed using a random effect model to evaluate the intervention effect of the aerobic exercise, traditional Chinese exercises, and meditation.

Results:

A total of 44 original studies were included. The random effect model was used to combine the effect values with Standard Mean Difference (SMD), and the results were: aerobic exercise [SMD = –0.53, 95% CI (–0.77, –0.30), I2 = 80%, P < .001], traditional Chinese exercises [SMD = –0.42, 95% CI (–0.74, –0.10), I2 = 90%, P = .01], meditation [SMD = –0.51, 95% CI (–0.90, –0.12), I2 = 79%, P = .01]. There was greater heterogeneity among the included studies: aerobic exercise (I2 = 80%, P < .001), traditional Chinese medicine methods (I2 = 90%, P < .001), and meditation (I2 = 79%, P < .001).

Conclusions:

This study revealed that the depression symptoms of college students can be effectively improved by aerobic exercise, traditional Chinese exercises, and meditation. Aerobic exercise would have a better effect on anxiety and stress while traditional Chinese exercise would have a better effect on stress. Further research (such as high-quality randomized controlled trials and long-term follow-up) is required to evaluate the effects of aerobic exercise, traditional Chinese exercise, and meditation on the depressive symptoms of college students to further apply complementary and alternative therapies.

Ethics and dissemination:

The results of the effects of aerobic exercise, traditional Chinese exercises, and meditation on depressive symptoms for a college student will be reported in a peer-reviewed publication. Hopefully, our findings from this meta-analysis can provide the most up-to-date evidence for the contribution to preventing the occurrence of depressive symptoms in college students.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7793414/

 

Improve the Psychological Well-Being of Breast Cancer Survivors with Mindfulness

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Improve the Psychological Well-Being of Breast Cancer Survivors with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is a good resource for dealing with the physical and psychological symptoms of metastatic disease. Women who were more mindful tended to have lower symptoms of metastatic breast cancer, including pain severity and interference, fatigue, psychological distress, and sleep disturbance.” – Lauren Zimmaro

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. The Mindfulness-Based Stress Reduction (MBSR) program is a mindfulness training program that includes meditation practice, body scan, yoga, and discussion along with daily home practice. MBSR has been shown to be beneficial for cancer patients in general and also specifically for the symptoms of breast cancer survivors. So, it makes sense to further explore the effectiveness of MBSR training for the treatment of breast cancer survivors.

 

In today’s Research News article “Mindfulness-Based Stress Reduction in Post-treatment Breast Cancer Patients: Immediate and Sustained Effects Across Multiple Symptom Clusters.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771358/ ) Reich and colleagues recruited breast cancer survivors and randomly assigned them to either usual care or to receive a 6-week, once a week for 2-hours, Mindfulness-Based Stress Reduction (MBSR) modified for breast cancer survivors. They were measured before and after training and 6 weeks later for worry, fear of cancer recurrence, anxiety, depression, perceived stress, mindfulness, symptom severity, sleep quality, fatigue, pain, cognition, and health-related quality of life.

 

They found with factor analysis that the measures fit into 4 clusters; pain, cognition, fatigue, and psychological. They found that in comparison to baseline the usual care, Mindfulness-Based Stress Reduction (MBSR) produced significant improvement in the psychological and fatigue clusters, but not the cognitive or pain clusters. These effects were still present 6 weeks later.

 

These findings suggest that Mindfulness-Based Stress Reduction (MBSR) is an effective treatment to relieve the psychological and fatigue symptoms of breast cancer survivors. This corresponds with prior findings that mindfulness improves the symptoms of breast cancer survivors and reduces anxiety, depression, and perceived stress, and improves emotional well-being and also reduces fatigue and improves sleep quality.

 

The observed improvements produced by Mindfulness-Based Stress Reduction (MBSR) markedly improves the quality of life and reduces the suffering of these cancer patients. These are clinically significant. It has been shown that an improved psychological outlook is associated with better physical recovery. Hence, these findings suggest that MBSR or other mindfulness training programs, should be incorporated into the routine care of breast cancer survivors.

 

So, improve the psychological well-being of breast cancer survivors with mindfulness.

 

“Mindfulness is a state of mind which we can all acquire and use to support our wellbeing physically, emotionally and mentally. . .  Having cancer, or specifically breast cancer, is no exception. Our cancer experiences take up a lot of energies, mental focus and can drain us emotionally. It is important to have a few tools to help us create ‘down’ and ‘out’ times, and to replenish and reconnect with who we are.“ – Breast Cancer Now

 

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

 

Reich, R. R., Lengacher, C. A., Alinat, C. B., Kip, K. E., Paterson, C., Ramesar, S., Han, H. S., Ismail-Khan, R., Johnson-Mallard, V., Moscoso, M., Budhrani-Shani, P., Shivers, S., Cox, C. E., Goodman, M., & Park, J. (2017). Mindfulness-Based Stress Reduction in Post-treatment Breast Cancer Patients: Immediate and Sustained Effects Across Multiple Symptom Clusters. Journal of pain and symptom management, 53(1), 85–95. https://doi.org/10.1016/j.jpainsymman.2016.08.005

 

Abstract

Context.

Breast cancer survivors (BCS) face adverse physical and psychological symptoms, often co-occurring. Biologic and psychological factors may link symptoms within clusters, distinguishable by prevalence and/or severity. Few studies have examined the effects of behavioral interventions or treatment of symptom clusters.

Objectives.

The aim of this study was to identify symptom clusters among post-treatment BCS and determine symptom cluster improvement following the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR(BC)) program.

Methods.

Three hundred twenty-two Stage 0–III post-treatment BCS were randomly assigned to either a six-week MBSR(BC) program or usual care. Psychological (depression, anxiety, stress, and fear of recurrence), physical (fatigue, pain, sleep, and drowsiness), and cognitive symptoms and quality of life were assessed at baseline, six, and 12 weeks, along with demographic and clinical history data at baseline. A three-step analytic process included the error-accounting models offactor analysis and structural equation modeling.

Results.

Four symptom clusters emerged at baseline: pain, psychological, fatigue, and cognitive. From baseline to six weeks, the model demonstrated evidence of MBSR(BC) effectiveness in both the psychological (anxiety, depression, perceived stress and QOL, emotional well-being) (P = 0.007) and fatigue (fatigue, sleep, and drowsiness) (P < 0.001) clusters. Results between six and 12 weeks showed sustained effects, but further improvement was not observed.

Conclusion.

Our results provide clinical effectiveness evidence that MBSR(BC) works to improve symptom clusters, particularly for psychological and fatigue symptom clusters, with the greatest improvement occurring during the six-week program with sustained effects for several weeks after MBSR(BC) training.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771358/