Mindfulness is Associated with Better Mental Health in Firefighters

August 20, 2019 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“mindfulness practices work at both a preventative and remedial level by assisting them to maintain higher levels of resilience to deal with their emergency responder roles and helping to reduce and cease distressing reactions after difficult personal and traumatic incidents.” – Mark Molony

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime with 7%-8% of the population developing Post-Traumatic Stress Disorder (PTSD). First responders such as firefighters and police experience traumatic events as part of their jobs and many develop symptoms of PTSD. This is responsible for the fact that wore firefighters and police officers die by suicide than all line-of-duty deaths combined. 103 firefighters and 140 police officers died by suicide in 2017, compared to 93 firefighter and 129 officer line-of-duty deaths.

Obviously, stress and trauma effects are troubling problems for firefighters that need to be addressed. There are a number of therapies that have been developed to treat PTSD. One of which, mindfulness training has been found to be particularly effective. Indeed, mindfulness has been shown to has been shown to reduce the physiological and psychological responses to stress, to reduce suicidality and to reduce the impact of trauma on the individual. So, a firefighter’s level of mindfulness may be associated with better mental health.

In today’s Research News article “Mental health and mindfulness amongst Australian fire fighters.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6570940/), Counson and colleagues recruited healthy firefighters who had experienced trauma in the last 6 months. The firefighters completed measures of mindfulness, anxiety, depression, and psychological well-being.

They found that the higher the firefighters’ levels of mindfulness, the lower the levels of anxiety and depression and the higher the levels of psychological well-being. Hence, mindfulness was found to be associated with better mental health in these firefighters who are exposed to trauma. This study is correlational and no conclusions regarding causation can be reached. But previous research has demonstrated that mindfulness has causal effects on anxiety, depression, and psychological well-being. So, it is likely that the associations seen here were due to causal connections.

These results suggest that mindful firefighters are resistant to the effects of trauma. It has been shown the mindfulness is effective in treating Post-Traumatic Stress Disorder (PTSD). The present results then combined with these previous findings suggest that mindfulness may help to protect firefighters from trauma making it less likely that they’ll develop PTSD.

So, mindfulness is associated with better mental health in firefighters.

“targeted mindfulness training program increases some aspects of firefighter resilience (distress tolerance, positive adjustment, and perseverance). . . . The more lessons firefighters completed, the greater their improvements in both mindfulness and resilience.” – AMRA

CMCS – Center for Mindfulness and Contemplative Studies

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

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

Study Summary

Counson, I., Hosemans, D., Lal, T. J., Mott, B., Harvey, S. B., & Joyce, S. (2019). Mental health and mindfulness amongst Australian fire fighters. BMC psychology, 7(1), 34. doi:10.1186/s40359-019-0311-2

Abstract

Background

While extensive research has highlighted the positive mental health outcomes associated with mindfulness, little work has examined how mindfulness may protect the mental health of first responders exposed to trauma. This is important as there is increasing evidence that mindfulness skills, if protective, can be taught to groups of at-risk workers. The purpose of the current research was to examine the potential role mindfulness may have in supporting the mental health of Australian fire fighters.

Methods

The sample consisted of 114 professional fire fighters who completed demographic and job-related questions followed by measures of mindfulness (FMI-14), well-being (WHO-5), depression (HADS-D) and anxiety (HADS-A). Hierarchical multiple linear regressions were performed to determine whether levels of mindfulness were associated with anxiety, depression and wellbeing after accounting for age and number of years of fire service.

Results

High levels of mindfulness were associated with decreased depression (p ≤ .001) and anxiety (p ≤ .001) as well as increased psychological well-being (p ≤ .001). Measures of mindfulness were able to explain a substantial amount of the variability in well-being (26.8%), anxiety (23.6%) and depression (22.4%), regardless of age and years of fire service.

Conclusions

The present study provides evidence for robust associations between dispositional mindfulness and mental health markers of depression, anxiety and well-being in Australian fire fighters recently exposed to trauma. Mindfulness is a psychological characteristic that may be able to be modified, although further research is required to substantiate these findings and to formally test mindfulness interventions. Such studies would allow greater insight into the underlying mechanisms through which mindfulness may exert its beneficial effects.

Electronic supplementary material

The online version of this article (10.1186/s40359-019-0311-2) contains supplementary material, which is available to authorized users.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6570940/

Improve Resilience in First-Responders with a Smartphone Mindfulness App

May 14, 2019 psyjdc Leave a comment

Improve Resilience in First-Responders with a Smartphone Mindfulness App

By John M. de Castro, Ph.D.

“The mindfulness practices work at both a preventative and remedial level by assisting them to maintain higher levels of resilience to deal with their emergency responder roles and helping to reduce and cease distressing reactions after difficult personal and traumatic incidents.” – Mark Molony

First responders such as firefighters and police experience a great deal of stress and frequent traumatic events and as a part of their jobs. The first-responders need to be resilient in the face of these difficult circumstances to cope with the stress. It is possible that mindfulness training might help. Mindfulness has been shown to increase resilience and reduce the psychological and physiological responses to stress. So, it is reasonable to infer that mindfulness training may help to develop resilience in first-responders and be of benefit to their mental health.

In today’s Research News article “Resilience@Work Mindfulness Program: Results From a Cluster Randomized Controlled Trial With First Responders.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399574/), Joyce and colleagues examine the ability of mindfulness training delivered with a smartphone app to increase the levels of resilience in first-responders. They recruited Primary Rescue and Hazmat firefighters and randomly assigned their stations to either receive 6, 20-25 minute, sessions of mindfulness training or to an Healthy Living control condition. The mindfulness training was based upon Acceptance and Compassion Therapy (ACT) and emphasized mindfulness, self-acceptance, and compassion. Both programs were delivered through a smartphone app. The first-responders were measured before and after training and 6 months later for mindfulness, resilience, cognitive fusion, experiential avoidance and psychological inflexibility, self-compassion, optimism, coping orientation, and life purpose.

They found that in comparison to baseline and the control condition, participation in the mindfulness training resulted in a significant increase in adaptive resilience and mindfulness which continued to increase over the 6-month follow-up period. Significant differences in optimism, and the use of instrumental and emotional support were present at the end of training but were not sustained at follow-up. Interestingly, there were no significant differences in “bounce-back” resilience.

Adaptive resilience involves the ability to adapt to stressful life circumstances and events. It involves the “individual’s ability to tolerate experiences such as change, personal problems, illness, pressure, failure, and painful feelings.” On the other hand, “bounce-back” resilience involves the ability to recover from stressful events. Since mindfulness focuses the individual on the present moment, it would be expected that it would influence the experience and coping with stressful events as they’re occurring. This is the case with adaptive resilience. On the other hand, mindfulness moves attention away from past events and would thus not be expected to influence coping with past stressful events as is the case with “bounce-back” resilience. Hence, it makes sense that mindfulness training would affect adaptive resilience and not “bounce-back” resilience.

It is important for the well-being of first responders that they be able to cope with the, at times, intense stress and trauma involved in their jobs. Hence, mindfulness training may be very beneficial as the present results suggest. This may help to prevent illness, burnout, and post-traumatic stress disorder (PTSD). In addition, the fact that mindfulness was taught with a smartphone app is important as it makes the training convenient and adaptable to the individual’s schedule. It is also highly scalable allowing for inexpensive widespread availability of the training.

So, Improve Resilience in First-Responders with a Smartphone Mindfulness App.

“Because PTSD is an anxiety disorder, episodes of distress occur when a person begins to worry about the future based on previous painful, intense or stressful memories. Meditation can help bring that person’s attention back to the current moment, which reduces or eliminates anxiety.” – Erin Fletcher

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

Joyce, S., Shand, F., Lal, T. J., Mott, B., Bryant, R. A., & Harvey, S. B. (2019). Resilience@Work Mindfulness Program: Results From a Cluster Randomized Controlled Trial With First Responders. Journal of medical Internet research, 21(2), e12894. doi:10.2196/12894

Abstract

Background

A growing body of research suggests that resilience training can play a pivotal role in creating mentally healthy workplaces, particularly with regard to protecting the long-term well-being of workers. Emerging research describes positive outcomes from various types of resilience training programs (RTPs) among different occupational groups. One specific group of workers that may benefit from this form of proactive resilience training is first responders. Given the nature of their work, first responders are frequently exposed to stressful circumstances and potentially traumatic events, which may impact their overall resilience and well-being over time.

Objective

This study aimed to examine whether a mindfulness-based RTP (the Resilience@Work [RAW] Mindfulness Program) delivered via the internet can effectively enhance resilience among a group of high-risk workers.

Methods

We conducted a cluster randomized controlled trial (RCT) comprising 24 Primary Fire and Rescue and Hazmat stations within New South Wales. Overall, 12 stations were assigned to the 6-session RAW Mindfulness Program and 12 stations were assigned to the control condition. A total of 143 active full-time firefighters enrolled in the study. Questionnaires were administered at baseline, immediately post training, and at 6-month follow-up. Measurements examined change in both adaptive and bounce-back resilience as well as several secondary outcomes examining resilience resources and acceptance and mindfulness skills.

Results

Mixed-model repeated measures analysis found that the overall test of group-by-time interaction was significant (P=.008), with the intervention group increasing in adaptive resilience over time. However, no significant differences were found between the intervention group and the control group in terms of change in bounce-back resilience (P=.09). At 6-month follow-up, the group receiving the RAW intervention had an average increase in their resilience score of 1.3, equating to a moderate-to-large effect size compared with the control group of 0.73 (95% CI 0.38-1.06). Per-protocol analysis found that compared with the control group, the greatest improvements in adaptive resilience were observed among those who completed most of the RAW program, that is, 5 to 6 sessions (P=.002).

Conclusions

The results of this RCT suggest that mindfulness-based resilience training delivered in an internet format can create improvements in adaptive resilience and related resources among high-risk workers, such as first responders. Despite a number of limitations, the results of this study suggest that the RAW Mindfulness Program is an effective, scalable, and practical means of delivering online resilience training in high-risk workplace settings. To the best of our knowledge, this is the first time a mindfulness-based RTP delivered entirely via the internet has been tested in the workplace.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399574/

Improve Post-Traumatic Stress Disorder (PTSD) with Meditation or Yoga

October 2, 2018 psyjdc Leave a comment

Improve Post-Traumatic Stress Disorder (PTSD) with Meditation or Yoga

By John M. de Castro, Ph.D.

“meditation helps bring about the kind of deep self-awareness, or mindfulness, that can create a therapeutic basis for reducing the symptoms of PTSD. We can meet difficult emotions, difficult memories, and difficult experiences through meditation,” Stephanie Lopez

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime. Only a fraction will develop Post-Traumatic Stress Disorder (PTSD); about 7%-8%. PTSD involves a number of troubling symptoms including reliving the event with the same fear and horror in nightmares or with a flashback. They often experience negative changes in beliefs and feelings including difficulty experiencing positive or loving feelings toward other people, avoiding relationships, avoiding situations that remind them of the event memory difficulties, or see the world as dangerous and no one can be trusted. Sufferers may feel keyed up and jittery, or always alert and on the lookout for danger. They may experience sudden anger or irritability, may have a hard time sleeping or concentrating, may be startled by a loud noise or surprise.

Obviously, these are serious and troubling symptoms that need to be addressed. There are a number of therapies that have been developed to treat PTSD. One of which, mindfulness training has been found to be particularly effective. Exercise also appears to be effective in treating the symptoms of PTSD. So, it would seem reasonable to examine the meditation and yoga training in treating PTSD.

In today’s Research News article “Meditation and Yoga for Posttraumatic Stress Disorder: A Meta-Analytic Review of Randomized Controlled Trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5939561/ ), Gallegos and colleagues reviewed, summarized and performed a meta-analysis of the 19 published randomized Controlled Trials (RCTs) of the application of mindfulness training, meditation, and/or yoga for the treatment of the symptoms of PTSD. They found that the research reports that all techniques including mindfulness training, meditation, and yoga produced significant improvements in the symptoms of PTSD regardless of whether they were compared to active or inactive control conditions. They all had moderate to large effect sizes.

This summary of the research is very encouraging and suggests that mindfulness, meditation, and yoga training are safe and effective adjunctive treatments for Post-Traumatic Stress Disorder (PTSD). It is not known exactly how these trainings improve PTSD but they are known to reduce the physiological and psychological responses to stress, improve the regulation of emotions, and reduce worry and rumination, all of which should be beneficial for PTSD sufferers.

So, improve Post-Traumatic Stress Disorder (PTSD) with meditation or yoga.

“Veterans struggling with the growing problem of post-traumatic stress disorder (PTSD) have new hope in helping to alleviate their symptoms with Mindful Yoga Therapy (MYT), according to research that finds the specific yoga practices in its protocol can help improve their physical and psychological well-being.” – Mindful Yoga Therapy

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

Gallegos, A. M., Crean, H. F., Pigeon, W. R., & Heffner, K. L. (2017). Meditation and Yoga for Posttraumatic Stress Disorder: A Meta-Analytic Review of Randomized Controlled Trials. Clinical Psychology Review, 58, 115–124. http://doi.org/10.1016/j.cpr.2017.10.004

Abstract

Posttraumatic stress disorder (PTSD) is a chronic and debilitating disorder that affects the lives of 7-8% of adults in the U.S. Although several interventions demonstrate clinical effectiveness for treating PTSD, many patients continue to have residual symptoms and ask for a variety of treatment options. Complementary health approaches, such as meditation and yoga, hold promise for treating symptoms of PTSD. This meta-analysis evaluates the effect size (ES) of yoga and meditation on PTSD outcomes in adult patients. We also examined whether the intervention type, PTSD outcome measure, study population, sample size, or control condition moderated the effects of complementary approaches on PTSD outcomes. The studies included were 19 randomized control trials with data on 1,173 participants. A random effects model yielded a statistically significant ES in the small to medium range (ES = −.39, p < .001, 95% CI [−.57, −.22]). There were no appreciable differences between intervention types, study population, outcome measures, or control condition. There was, however, a marginally significant higher ES for sample size ≤ 30 (ES = −.78, k = 5). These findings suggest that meditation and yoga are promising complementary approaches in the treatment of PTSD among adults and warrant further study.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5939561/

Improve PTSD After Sexual Trauma with Mindfulness Plus Exercise

June 28, 2018 psyjdc Leave a comment

Improve PTSD After Sexual Trauma with Mindfulness Plus Exercise

By John M. de Castro, Ph.D.

“Clinical studies have shown that mindfulness-based treatments can be helpful for people suffering from PTSD. The non-judgmental outlook that mindfulness works to cultivate can help folks accept their thoughts, emotions, and experiences, and reduce the avoidance, intrusive thoughts, and numbness symptoms characteristic of PTSD. Mindfulness practices may decrease survivors’ feelings of guilt, shame, and other negative emotions, and increase their positive feelings toward themselves and others.” – Jezmina Von Thiele

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime. Many, but, only a fraction will develop Post-Traumatic Stress Disorder (PTSD). But this still results in a frightening number of people with 7%-8% of the population developing PTSD at some point in their life. PTSD can be produced by interpersonal violence which includes physical or sexual violence. Sexual violence is all too common with 1 out of every 6 women having experienced attempted or completed rape in their lifetime.

PTSD involves a number of troubling symptoms including reliving the event with the same fear and horror in nightmares or with a flashback. PTSD sufferers avoid situations that remind them of the event this may include crowds, driving, movies, etc. and may avoid seeking help because it keeps them from having to think or talk about the event. They often experience negative changes in beliefs and feelings including difficulty experiencing positive or loving feelings toward other people, avoiding relationships, memory difficulties, or see the world as dangerous and no one can be trusted. Sufferers may feel hyperarousal, feeling keyed up and jittery, or always alert and on the lookout for danger. They may experience sudden anger or irritability, may have a hard time sleeping or concentrating, may be startled by a loud noise or surprise.

In today’s Research News article “MAP Training My Brain™: Meditation Plus Aerobic Exercise Lessens Trauma of Sexual Violence More Than Either Activity Alone.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5924799/ ), Shors and colleagues recruited adult college women and randomly assigned them to one of four conditions; meditation, aerobic exercise, meditation plus aerobic exercise, or no treatment. Meditation and aerobic exercise sessions lasted 30 minutes each. There were 2 sessions per week for 6 weeks. They were measured before and after training for thoughts and feelings following trauma, self-worth, rumination, and stressful life memories.

They found that after the combined meditation plus exercise condition and meditation alone, but not exercise alone or no treatment, there was a significant reduction in thoughts and feelings following trauma. They also found that only after the combined meditation plus exercise condition were there significant reductions in rumination and increases in self-worth. When women who had experience sexual trauma were examined, they found that only after the combined meditation plus exercise condition, were there significant reductions in thoughts and feelings following trauma, and rumination and increases in self-worth.

These results suggest that the combination of exercise plus meditation is much more effective in reducing trauma related psychological symptoms than either alone especially in women who had experienced sexual trauma. This suggests that treating both the mind and the body is particularly effective in dealing with the psychological sequela of trauma. It will be interesting in future research to see if this is also true in treating PTSD in men and with physical and combat trauma.

So, improve PTSD after sexual trauma with mindfulness plus exercise.

“Women who experience sexual violence, and people who experience trauma, tend to ruminate over what happened—asking themselves why it happened or if they could have done something differently. The more you think about it, the more you go over the memories, the more memories you make. MAP Training diminished those thoughts in women who experienced violence.” – Tracey Shors

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Tracey J. Shors, Han Y. M. Chang, Emma M. Millon. MAP Training My Brain™: Meditation Plus Aerobic Exercise Lessens Trauma of Sexual Violence More Than Either Activity Alone. Front Neurosci. 2018; 12: 211. Published online 2018 Apr 23. doi: 10.3389/fnins.2018.00211

Abstract

Sexual violence against women often leads to post-traumatic stress disorder (PTSD), a mental illness characterized by intrusive thoughts and memories about the traumatic event (Shors and Millon, 2016). These mental processes are obviously generated by the brain but often felt in the body. MAP Training My Brain™ is a novel clinical intervention that combines mental training of the brain with physical training of the body (Curlik and Shors, 2013; Shors et al., 2014). Each training session begins with 20-min of sitting meditation, followed by 10-min of slow-walking meditation, and ending with 30-min of aerobic exercise at 60–80% of the maximum heart rate (see maptrainmybrain.com). In previous studies, the combination of mental and physical (MAP) training together significantly reduced symptoms of depression and ruminative thoughts, while reducing anxiety (Shors et al., 2014, 2017; Alderman et al., 2016). We also documented positive changes in brain activity during cognitive control and whole-body oxygen consumption in various populations. In the present pilot study, we asked whether the combination of meditation and aerobic exercise during MAP Training would reduce trauma-related thoughts, ruminations, and memories in women and if so, whether the combination would be more effective than either activity alone. To test this hypothesis, interventions were provided to a group of women (n = 105), many of whom had a history of sexual violence (n = 32). Groups were trained with (1) MAP Training, (2) meditation alone, (3) aerobic exercise alone, or (4) not trained. Individuals in training groups completed two sessions a week for at least 6 weeks. MAP Training My Brain™ significantly reduced post-traumatic cognitions and ruminative thoughts in women with a history of sexual violence, whereas meditation alone, and exercise alone did not. MAP Training significantly enhanced a measure of self-worth, whereas meditation and exercise alone did not. Similar positive effects were observed for all participants, although meditation alone was also effective in reducing trauma-related thoughts. Overall, these data indicate the combination of meditation and exercise is synergistic. As a consequence, MAP Training is preferable and especially so for women who have experienced sexual violence in their past. Simply put, the whole is greater than the sum of its parts.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5924799/

Reduce Psychological Symptoms of Trauma with Mindfulness

February 21, 2018 psyjdc 1 Comment

Reduce Psychological Symptoms of Trauma with Mindfulness

By John M. de Castro, Ph.D.

“Focusing on the present moment? Those with OCD rarely do that. Instead they either find themselves immersed in the world of “what ifs,” worrying about everything that might go wrong, or agonizing over things they think might have already gone wrong. Lots of thinking about the future and the past. Not so much about the present.” – Janet Singer

Trauma leaves in its wake a syndrome of posttraumatic symptoms which can haunt the victims for the rest of their lives. These include persistent recurrent re-experiencing of the traumatic event, including flashbacks and nightmares, loss of interest in life, detachment from other people, increased anxiety and emotional arousal, including outbursts of anger, difficulty concentration, and jumpiness, startling easily. Unfortunately, experiencing trauma is quite common. It has been estimated that over half of adults will experience a significant traumatic event during their lifetime. It’s been estimated that of adolescents, 8% have been exposed to sexual assault, 17% physical assault, and 39% had witnessed violence. This is tragic unto itself, but childhood trauma can continue to affect mental and physical health throughout the individual’s life.

How individuals cope with trauma helps determine the effects of the trauma on their mental health. Trying to avoid thinking about or being in touch with internal experiences, experiential avoidance, disallows the individual from confronting the experiences and could exacerbate the negative effects of the trauma. On the other hand, experiencing the feelings and thoughts completely would allow for better coping. This would be provided by mindfulness. Indeed, mindfulness has been found to be effective for relieving trauma symptoms. In today’s Research News article “Effects of Traumatic Experiences on Obsessive-Compulsive and Internalizing Symptoms: The Role of Avoidance and Mindfulness.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5654743/ ), Kroska and colleagues investigate the roles of mindfulness and experiential avoidance on psychiatric symptoms of trauma in adolescents.

They recruited troubled students from an alternative High School and had them complete measurements of childhood trauma, experiential avoidance, mindfulness, and obsessive-compulsive symptoms. They also recruited college students and had them complete the same measure and additional measures of internalizing, including anxiety and depression. They then performed a statistical analysis of the responses including a mediation analysis.

They found that with the troubled youths, experiential avoidance was associated with greater obsessive-compulsive symptoms. They found that childhood trauma was associated with lower levels of mindfulness, while high levels of mindfulness were associated with lower levels of obsessive-compulsive symptoms. Hence, for the troubled youths, experiential avoidance was associated with greater psychiatric symptoms while mindfulness was associated with lower symptoms and that childhood trauma tended to impair mindfulness.

With the college students they found that childhood trauma was associated with both greater experiential avoidance and with lower mindfulness, especially the observing facet of mindfulness. In addition, obsessive-compulsive symptoms were associated with higher levels of avoidance and lower levels of mindfulness. In looking at internalizing, anxiety and depression, a similar pattern emerged. Childhood trauma was associated with both greater experiential avoidance and with lower mindfulness and internalizing symptoms were associated with higher levels of avoidance and lower levels of mindfulness.

These results suggest that childhood trauma is associated with higher levels of psychiatric symptoms including both obsessive-compulsive and internalizing symptoms and that these associations of childhood trauma are mediated by higher levels of experiential avoidance and lower levels of mindfulness. This further suggests the nature of the mechanisms for trauma effects on mental health, with trauma acting through increasing avoidance and decreasing mindfulness to impair mental health.

These findings may help to improve therapeutic interventions for the treatment of the symptoms of trauma. They suggest that treatments targeted at increasing mindfulness and lowering experiential avoidance would produce great mental health benefits for survivors of childhood trauma.

“Our results suggest that mindfulness may provide some resilience against the poor adult health outcomes that often result from childhood trauma,” – Robert Whitaker

CMCS – Center for Mindfulness and Contemplative Studies

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

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

Study Summary

Kroska, E. B., Miller, M. L., Roche, A. I., Kroska, S. K., & O’Hara, M. W. (2018). Effects of Traumatic Experiences on Obsessive-Compulsive and Internalizing Symptoms: The Role of Avoidance and Mindfulness. Journal of Affective Disorders, 225, 326–336. http://doi.org/10.1016/j.jad.2017.08.039

Abstract

Background

Trauma exposure is associated with adverse psychological outcomes including anxiety, depression, and obsessive-compulsive (OC) symptoms. Adolescence is increasingly recognized as a period of vulnerability for the onset of these types of psychological symptoms. The current study explored the mediating roles of experiential avoidance and mindfulness processes in the association between retrospective reports of childhood trauma and current internalizing and OC symptoms in adolescents.

Method

A group of at-risk adolescents (N =51) and a group of college students (N =400) reported on childhood trauma, experiential avoidance, mindfulness, anxiety, depressive, and OC symptoms. Mediation analyses were performed to examine the mechanistic roles of avoidance and mindfulness in the association between trauma and internalizing and OC-specific symptoms.

Results

In the group of at-risk adolescents, experiential avoidance and mindfulness both significantly mediated the association between childhood trauma and OC symptoms. In the college student sample, experiential avoidance mediated the association between trauma and OC symptoms. Experiential avoidance, as well as the observe, act with awareness, and nonjudgmental facets of mindfulness all significantly mediated the association between trauma and internalizing symptoms.

Limitations

The group of at-risk adolescents was small, and the college student group was demographically homogeneous. All data was self-report and cross-sectional.

Conclusion

The current study demonstrated that experiential avoidance and mindfulness processes may be the mechanisms through which the association between trauma and obsessive-compulsive and trauma and internalizing symptoms exist in adolescents. These findings provide potential targets for clinical intervention to improve outcomes for adolescents who have experienced trauma.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5654743/

Improve Stress and Trauma Effects on Children with Mindfulness

May 2, 2017 psyjdc Leave a comment

Improve Stress and Trauma Effects on Children with Mindfulness

By John M. de Castro, Ph.D.

“mindfulness practice helps children connect with positive emotional and social experiences, often things that a traumatized brain struggles to do.” – Mindful

Trauma comes in many forms, from abuse to warfare, from children to the elderly, from natural and man-made causes, and from the rich to the poor. But, regardless of the cause or the characteristics of the individuals, it leaves in its wake a syndrome of posttraumatic symptoms which can haunt the victims for the rest of their lives. These include persistent recurrent re-experiencing of the traumatic event, including flashbacks and nightmares, loss of interest in life, detachment from other people, increased anxiety and emotional arousal, including outbursts of anger, difficulty concentration, and jumpiness, startling easily.

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime. Over a third of children interviewed in school had experienced at least one trauma and 9% had experienced at least 5 traumatic events. It’s been estimated that of adolescents, 8% have been exposed to sexual assault, 17% physical assault, and 39% had witnessed violence. It is estimated that 15% of children show symptoms of Posttraumatic Stress Disorder (PTSD). This is tragic unto itself, but childhood trauma can continue to affect mental and physical health throughout the individual’s life. So, it is important to develop methods to help individuals cope with trauma.

There have been many treatments employed each with varying but limited success. Most treatments have been used with adults. There is very little research investigating the effects of treatment on childhood trauma. Mindfulness training has been found to be effective for trauma in adults, particularly from the middle and upper classes. Yoga has been shown to be effective with trauma in children. In today’s Research News article “The Role of Mindfulness in Reducing the Adverse Effects of Childhood Stress and Trauma.” See summary below or view the full text of the study at: http://www.mdpi.com/2227-9067/4/3/16/htm

Ortiz and Sibinga review the published research literature on the effectiveness of mindfulness practices on the physical and psychological effects of childhood trauma.

They report that the results of published studies support the effectiveness of mindfulness training to mitigate the effects of childhood trauma in adults. It appears to buffer stress and improve resilience and as a result reduces the later psychological and physical effects of the trauma, including anxiety, depression, stress, burnout, post-traumatic stress disorder, sleep disorders, addictions, decreased quality of life, cardiovascular disease, obesity, metabolic syndrome, inflammation, and obesity. They also report that published studies of the effects of mindfulness practices on children who have experienced trauma find that, like with adults, school children who have experienced trauma show significant improvements in mental and physical symptoms, including, resilience, anxiety, depression, self-hostility, negative emotions, rumination, sleep, self-esteem, post-traumatic stress disorder symptoms, suicidal thoughts, quality of life, social behavior, and coping ability.

These are outstanding findings that strongly suggest that mindfulness training is an effective therapeutic strategy to help both children and adults cope with the psychological and physical sequalae of trauma. With the high prevalence rates of trauma in childhood, mindfulness training may be a needed solution to the short- and lont-term effects of this rampant problem.

So, improve the stress and trauma effects on children with mindfulness.

“mindfulness may provide some resilience against the poor adult health outcomes that often result from childhood trauma. Mindfulness training may help adults, including those with a history of childhood trauma, to improve their own well-being and be more effective with children.” – Robert Whitaker

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

Ortiz, R.; Sibinga, E.M. The Role of Mindfulness in Reducing the Adverse Effects of Childhood Stress and Trauma. Children 2017, 4, 16.

Abstract

Research suggests that many children are exposed to adverse experiences in childhood. Such adverse childhood exposures may result in stress and trauma, which are associated with increased morbidity and mortality into adulthood. In general populations and trauma-exposed adults, mindfulness interventions have demonstrated reduced depression and anxiety, reduced trauma-related symptoms, enhanced coping and mood, and improved quality of life. Studies in children and youth also demonstrate that mindfulness interventions improve mental, behavioral, and physical outcomes. Taken together, this research suggests that high-quality, structured mindfulness instruction may mitigate the negative effects of stress and trauma related to adverse childhood exposures, improving short- and long-term outcomes, and potentially reducing poor health outcomes in adulthood. Future work is needed to optimize implementation of youth-based mindfulness programs and to study long-term outcomes into adulthood.

http://www.mdpi.com/2227-9067/4/3/16/htm

Improve High Level Cognitive Function in Traumatized Adolescents with Yoga

April 17, 2017 psyjdc Leave a comment

Improve High Level Cognitive Function in Traumatized Adolescents with Yoga

By John M. de Castro, Ph.D.

“With the girls in India, I’ve found that they most enjoy Thai massage, partner yoga, and expansive, “outer- focused” yoga. I believe that they greatly benefit from receiving loving touch, and they love watching an adult yoga teacher acting silly! It is rare that they share a dynamic with an adult that is not structured. With our volunteers, we have the opportunity to teach them yoga as a source of play, connection, laughter. The giggles abound, but when meditation time comes they are very observant.” – Rob Schware

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. These difficulties can be markedly amplified by negative life events during childhood. Losing both parents during childhood is traumatic. It occurs to an estimated 13 million children worldwide. Many are raised by relatives, but, many also end up in orphanages.

Adolescence should be a time of mental, physical, social, and emotional growth. It is during this time that higher levels of thinking, sometimes called executive function, develops. These executive functions are an important foundation for success in the complex modern world. Being orphaned is severely traumatic and it is well known that trauma during childhood disrupts cognitive development. It has even been shown to affect brain development. So, it is important to find methods to mitigate the effects of this trauma on orphans’ development.

Yoga practice has been shown to have a large number of beneficial effects on the psychological, emotional, and physical health of the individual and is helpful in the treatment of mental and physical illness. The acceptance of yoga practice has spread from the home and yoga studios to its application with children in schools. Studies of these school programs have found that yoga practice produces a wide variety of positive psychosocial and physical benefits. These include improved mood state, self-control, social abilities, self-regulation, emotion regulation, self-esteem, and ability to focus. In addition, yoga practice produces improvements in student grades and academic performance. They have also shown that the yoga practice produces lower levels of anxiety, depression, general distress, rumination, and intrusive thoughts.

It is reasonable then to hypothesize that yoga practice might help the intellectual development of orphans. In today’s Research News article “Effect of yoga program on executive functions of adolescents dwelling in an orphan home: A randomized controlled study.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5198826/

Purohit and Pradhan recruited adolescents (aged 11 to 16 years) residing in an orphanage. They randomly assigned the orphans to either receive yoga training or to a wait-list control condition. The yoga practice occurred 90 minutes per day, 4 days per week, for 3 months, and consisted of relaxation, postures, breathing exercises, and concentration. Before and after treatment the adolescents were administered a number of tests of executive function, including memory, cognitive inhibition, processing speed, mental flexibility, and decision making.

They found that the orphans who practiced yoga had significant improvements in overall cognition, executive functions, cognitive inhibition, memory, attention, and processing speed. These effects all occurred with moderate effect sizes. Hence, yoga practice appeared to produce improved higher level thinking in the orphans. The weakness in the study was that the control condition was a wait-list. Future research should contain active control conditions such as light exercise, group interactions etc. to demonstrate that the effects were due to yoga practice itself and not to a number of possible confounding factors.

There is no doubt, though, that these traumatized children benefited from the yoga practice. Anything that can improve the life and mental capabilities of these children is a step forward and a help to these emotionally needy adolescents, make their lives more enjoyable, and help toward future success.

So, improve high level cognitive function in traumatized adolescents with yoga.

“In essence, yoga is a practice of service to humanity. Yoga is a tool of transformation. With that transformed Self, you can show up for others and be of service.” – Mark Lilly

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

Purohit, S. P., & Pradhan, B. (2017). Effect of yoga program on executive functions of adolescents dwelling in an orphan home: A randomized controlled study. Journal of Traditional and Complementary Medicine, 7(1), 99–105. http://doi.org/10.1016/j.jtcme.2016.03.001

Abstract

Executive function (EF) is important for physical and mental health of children. Studies have shown that children with poverty and early life stress have reduced EF. The aim of the study was to evaluate the effect of Yoga program on the EF of orphan adolescents. Seventy two apparently healthy orphan adolescents randomized and allocated into two groups as Yoga group (n = 40; 14 girls, age = 12.69 ± 1.35 yrs) and Wait List Control (WLC) group (n = 32, 13 girls, age = 12.58 ± 1.52 yrs). Yoga group underwent three months of Yoga program in a schedule of 90 min per day, four days per week whereas the WLC group followed the routine activities. They were assessed by Stroop Color-Word Task, Digit Symbol Substitution Test (DSST), Digits Span Test and Trial Making Test (TMT) at the beginning and end of the program.

The repeated measures ANOVA showed significant difference in time and group interactions (p < 0.05) for all subtests of Stroop Color-Word Task and Digit Span Test and part-A of TMT whereas there were no significant difference found in DSST and TMT (part-B).

The post-hoc test with Bonferroni adjustment also showed significant improvements (p < 0.001) within the Yoga group in all test scores while in wrong score of DSST did not exhibit significant reduction. Whereas the WLC group, showed significant improvement (p < 0.05) in Stroop Color, Color-Word score, net score of DSST, Digit Span forward and Digit Span Total.

Three months Yoga program was found useful for the young orphan adolescents in improving their executive functions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5198826/

Reduce Interpersonal Trauma Symptoms with Mindfulness

January 25, 2017April 28, 2022 psyjdc Leave a comment

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Reduce Interpersonal Trauma Symptoms with Mindfulness

By John M. de Castro, Ph.D.

“mindfulness meditation training improves your brain’s ability to help you manage stress, and these changes improve a broad range of stress-related health outcomes, such as your inflammatory health,” David Creswell

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime. Trauma produced by one person on another, interpersonal trauma, frequently involves intimate partners and can occur as personal assault, sexual assault, witnessing family violence, and sudden loss of a loved one. This is common particularly with low income women. The psychological consequences can be profound and endure over a lifetime, and can result in Post-Traumatic Stress Disorder (PTSD).

Another common consequence of the stress produced by trauma is an increase in inflammation. The immune system is designed to protect the body from threats like stress, infection, injury, and toxic chemicals. One of its tools is the inflammatory response. This response works quite well for short-term infections and injuries. But when inflammation is protracted and becomes chronic, such as can occur with trauma, it can itself become a threat to health. It can produce autoimmune diseases such as colitis, Chron’s disease, arthritis, heart disease, increased cancer risk, lung disease, sleep disruption, gum disease, decreased bone health, and psoriasis. Indeed, the presence of chronic inflammation is associated with reduced longevity. In addition, it can exacerbate the psychological issues produced by trauma including increasing the severity depression.

Mindfulness training has been shown to both help improve the symptoms of trauma and to reduce the inflammatory response. So, it would be reasonable to predict that mindfulness training would be useful in reducing the inflammation resulting from interpersonal trauma in women. In today’s Research News article “Mindfulness-Based Stress Reduction to Enhance Psychological Functioning and Improve Inflammatory Biomarkers in Trauma-Exposed Women: A Pilot Study.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1462456350444953/?type=3&theater

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

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4624080/

Gallegos and colleagues recruited low-income women who had experienced interpersonal trauma and provided them with an 8-week Mindfulness-Based Stress Reduction (MBSR) treatment. Measurements were taken before, during (4^th week), and immediately after treatment, and 4 weeks later of traumatic events, cognitive performance, perceived stress, anxiety, emotion regulation, PTSD symptoms, and mindfulness. In addition, blood was drawn and assayed for markers of inflammation.

They found that the MBSR treatment significantly increased mindfulness and emotion regulation and decreased perceived stress, anxiety, depression, and PTSD symptoms. In addition, attendance at MBSR sessions was significantly related to decreases in IL-6 levels, a marker of inflammation. All of these improvements were maintained 4-weeks after the end of MBSR training. Hence Mindfulness-Based Stress Reduction (MBSR) produced significant and lasting improvement in both the psychological and inflammatory effects of interpersonal trauma. It should be kept in mind that no control condition was employed. So, the results could have been produced by a placebo effect and any form of treatment might have produced comparable improvements. A controlled clinical trial is needed to confirm that MBSR was responsible for the effects.

It comes as no surprise that mindfulness training had these effects in women who experienced interpersonal trauma as mindfulness training has been previously been shown with other groups to produce improvement in mindfulness, emotion regulation, perceived stress, anxiety, depression, PTSD symptoms, and inflammation. What the present study contributes is a demonstration that these benefits also occur in women who have experienced interpersonal trauma.

So, reduce interpersonal trauma symptoms with mindfulness.

“Mindfulness meditation reduces levels of interleukin 6 by altering patterns of functional connectivity: communication between different regions of the brain. “By modulating functional connectivity, you’re affecting the cell groups that influence the release of inflammatory markers and stress hormones,” – Adrienne Taren

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Gallegos, A. M., Lytle, M. C., Moynihan, J. A., & Talbot, N. L. (2015). Mindfulness-Based Stress Reduction to Enhance Psychological Functioning and Improve Inflammatory Biomarkers in Trauma-Exposed Women: A Pilot Study. Psychological Trauma : Theory, Research, Practice and Policy, 7(6), 525–532. http://doi.org/10.1037/tra0000053

Abstract

This study examined the effects of a Mindfulness-Based Stress Reduction (MBSR) program on psychological functioning and inflammatory biomarkers in women with histories of interpersonal trauma. The 8-week MBSR program was conducted at a community-based health center and participants (N = 50) completed several measures of psychological functioning at study entry as well as 4 weeks, 8 weeks, and 12 weeks later. Inflammatory biomarkers were assayed from blood collected at each assessment. A series of linear mixed model analyses were conducted to measure the effect of attendance and time on the dependent variables. Time was associated with significant decreases in perceived stress, depression, trait and state anxiety, emotion dysregulation, and post-traumatic stress symptoms as well as increases in mindfulness. Session attendance was associated with significant decreases in interleukin (IL)-6 levels. This pilot study demonstrated the potential beneficial effects of MBSR on psychological functioning and the inflammatory biomarker IL-6 among trauma-exposed and primarily low-income women. Decreases in inflammation have implications for this population, as interpersonal trauma can instigate chronic physiological dysregulation, heightened morbidity, and premature death. This study’s preliminary results support efforts to investigate biological remediation with behavioral interventions in vulnerable populations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4624080/

Trauma May Reduce Mindfulness

September 21, 2015 psyjdc Leave a comment

“People with BPD are like people with third degree burns over 90% of their bodies. Lacking emotional skin, they feel agony at the slightest touch or movement.” ― Marsha M. Linehan

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. BPD is associated with high rates of co-occurring depression, anxiety disorders, substance abuse, eating disorders, self-harm, suicidal behaviors, and completed suicides. Needless to say it is widespread and debilitating.

BPD has not responded well to a variety of therapies with the exception of Dialectical Behavior Therapy (BPT). It is interesting that DBT emphasizes mindfulness. This suggests that there may be a relationship between the etiology of Borderline Personality Disorder and mindfulness. In addition 30 to 90 % of BPD cases are associated with high rates of early traumatic experiences including sexual, physical and emotional abuse. Also, mindfulness has been shown to reduce the impact of trauma on the individual http://contemplative-studies.org/wp/index.php/2015/07/17/dont-be-afraid-2-dealing-with-trauma/. All of this suggests that childhood trauma may affect BPD by lowering mindfulness.

In today’s Research News article “Borderline personality disorder (BPD) is a serious mental illness marked by unstable moods, behavior, and relationships.”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1091537470870178/?type=1&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4518520/

Elices and colleagues measure childhood trauma, personality and mindfulness in a sample of individuals with relatively severe Borderline Personality Disorder (BPD). They found, although did not report, that the degree of mindfulness measured was very low in the BPD sample than occurs in the general population. They also reported high levels of childhood trauma in the BPD sample.

One of the most interesting findings was that the mindfulness characteristics of acting with awareness and non-judging were negatively associated with childhood trauma, but only with sexual abuse. That is for individual with BPD who experienced sexual abuse in childhood there were lower levels of acting with awareness and non-judging than with BPD sufferers who didn’t experience this form of trauma. Given the mindfulness scores were low to begin with and that sexual abuse is negatively associated with mindfulness, suggests that trauma may make a bad situation worse.

These are very preliminary results and do not clearly make a case for childhood trauma affecting Borderline Personality Disorder by lowering mindfulness, the results are compatible with this idea. It obviously needs to be explored further.

So, improve mindfulness to combat the effects of trauma.

“Thirty seconds of pure awareness is a long time, especially after a lifetime of escaping yourself at all costs.” ― Kiera Van Gelder

CMCS – Center for Mindfulness and Contemplative Studies

Control PTSD with Mindfulness

September 15, 2015 psyjdc Leave a comment

“It is as though some old part of yourself wakes up in you, terrified, useless in the life you have, its skills and habits destructive but intact, and what is left of the present you, the person you have become, wilts and shrivels in sadness or despair: the person you have become is only a thin shell over this other, more electric and endangered self. The strongest, the least digested parts of your experience can rise up and put you back where you were when they occurred; all the rest of you stands back and weeps.” – Peter Straub

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime. But, only a fraction will develop Post-Traumatic Stress Disorder (PTSD). But this still results in a frightening number of people with 7%-8% of the population developing PTSD at some point in their life. For military personnel it’s much more likely for PTSD to develop with about 11%-20% of those who have served in a war zone developing PTSD.

Obviously, these are troubling symptoms that need to be addressed. There are a number of therapies that have been developed to treat PTSD. One of which, mindfulness training has been found to be particularly effective (see links below).

In today’s Research News article “Mindfulness-Based Stress Reduction for Posttraumatic Stress Disorder among Veterans: A Randomized Clinical Trial”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1088524461171479/?type=1&theater

Polusny and colleagues tested Mindfulness Based Stress Reduction (MBSR) against Present Centered Group Therapy (PCGT) for the treatment of PTSD in military veterans. They found that MBSR was superior to PCGT and produced clinically significant improvements in PTSD symptoms and improved quality of life and mindfulness skills in the veterans. This superiority was enduring as it was present not only at the end of treatment but also significantly two months later.

These are exciting results that mindfulness practice can be of significant help for PTSD sufferers but especially because the treatment was superior to another form of therapy. In addition, its’ effectiveness continued to produce improvements even two months after the completion of therapy.

It is not known how mindfulness training could be so effective for PTSD. It can be speculated that the improvement in present moment awareness might have helped by focusing on the individual on the present rather than the past when the trauma occurred and by reducing rumination about the past. In addition, mindfulness training is known to improve emotion regulation and this may allow the veterans to not avoid but fully experience the emotions and then respond to them in a constructive fashion.

Regardless, it’s clear that PTSD sufferers benefit from mindfulness training.

“Often it isn’t the initiating trauma that creates seemingly insurmountable pain, but the lack of support after.” – S. Kelley Harrell

CMCS – Center for Mindfulness and Contemplative Studies

LINKS

Yoga has been shown to be effective in treating children who have experienced trauma http://contemplative-studies.org/wp/index.php/2015/07/17/yoga-for-trauma-in-children/ and mindfulness has been shown to improve an individual’s ability to deal with the aftermath of trauma http://contemplative-studies.org/wp/index.php/2015/07/17/dont-be-afraid-2-dealing-with-trauma/