Improve Major Depressive Disorder with Mindfulness and Cognitive Therapy

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Improve Major Depressive Disorder with Mindfulness and Cognitive Therapy

 

By John M. de Castro, Ph.D.

 

“mindfulness meditation may help to prevent major depressive disorder in people with subclinical depression.” – Jasmin Collier

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. It is also generally episodic, coming and going. Some people only have a single episode but most have multiple reoccurrences of depression.  Depression can be difficult to treat. It is usually treated with antidepressant medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time.

 

Clearly, there is a need for treatment alternatives that can be effective alone or in combination with drugs. Cognitive Behavioral Therapy (CBT) has been particularly effective for depression. Cognitive Behavioral Therapy attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior. Recently, mindfulness has been added to produce Mindfulness Based Cognitive Therapy (MBCT) and this also has been found to be effective in treating depression. It is important at this point to step back and review the published studies of the application of CBT and MBCT for the prevention of relapse in patients who are in remission from major depressive disorder.

 

In today’s Research News article “The effect of CBT and its modifications for relapse prevention in major depressive disorder: 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/PMC6389220/), Zhang and colleagues review, summarize, and perform a meta-analysis of the relative effectiveness of Cognitive Behavioral Therapy (CBT) and Mindfulness Based Cognitive Therapy (MBCT) for the prevention of relapse in patients who are in remission from major depressive disorder. They found 16 randomized controlled trials with adults who were in remission from diagnosed major depressive disorder.

 

They report that the research found that Cognitive Behavioral Therapy (CBT) was effective in preventing relapse of major depressive disorder in comparison to control conditions even at long-term (up to 6 years) follow-up. They also found that Mindfulness Based Cognitive Therapy (MBCT) was effective in preventing relapse of major depressive disorder in comparison to control conditions but only for patients who had at least 3 prior depressive episodes. They also report that MBCT had equivalent ability to antidepressant drugs for preventing relapses.

 

The published literature presents a clear case for the effectiveness of both Cognitive Behavioral Therapy (CBT) and Mindfulness Based Cognitive Therapy (MBCT) for the prevention of relapse of major depressive disorder. CBT would appear to be effective even for patients who had only one or two prior episodes while MBCT appeared to be effective for patients with a longer history of relapse. Since MBCT contains CBT it is surprising that while CBT was effective for patients with few relapses MBCT was not. This will require further research to clarify this apparent conundrum.

 

Regardless, it is clear from the published controlled research that CBT and MBCT have long-lasting effectiveness for preventing relapse in patients with major depressive disorder and are equivalent to the effectiveness of antidepressant drugs. They may be an excellent substitute for employing drugs. The results suggest that restructuring the aberrant thought processes characteristic of patients with depression is an effective way to prevent relapse. This further suggests that these aberrant thought processes may be an important contributor to causing depression relapse.

 

So, improve major depressive disorder with mindfulness and cognitive therapy.

 

“mindfulness training seems to be a feasible way for people with mild or subthreshold depression to protect against their symptoms getting worse. . . . Mindfulness training can “generate positive emotions by cultivating self-compassion and self-confidence through an upward spiral process,” – Amanda MacMillan

 

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

 

Zhang, Z., Zhang, L., Zhang, G., Jin, J., & Zheng, Z. (2018). The effect of CBT and its modifications for relapse prevention in major depressive disorder: a systematic review and meta-analysis. BMC psychiatry, 18(1), 50. doi:10.1186/s12888-018-1610-5

 

Abstract

Background

The risk of relapse in major depressive disorder (MDD) is associated with high worldwide disease burden. Cognitive behavioral therapy (CBT) and its modifications might be effective in relapse prevention. The aim of this review was to evaluate the efficacy of these treatments for reducing relapse of MDD.

Methods

The retrieval was performed in the databases of MEDLINE via Pubmed, EMBASE and PsycINFO via OVID, The Cochrane Library and four Chinese databases. Clinical trials registry platforms and references of relevant articles were retrieved as well. Hazard ratio (HR) and corresponding 95% confidence interval (CI) were used to pool evidences.

Results

A total of 16 eligible trials involving 1945 participants were included. In the first 12 months, CBT was more efficacious than control in reducing the risk of developing a new episode of depression for MDD patients in remission (HR:0.50, 95%CI:0.35–0.72, I2 = 11%). Mindfulness-based cognitive therapy (MBCT) was more efficacious than control only among patients with 3 or more previous depressive episodes (HR:0.46, 95%CI:0.31–0.70, I2 = 38%). Besides, compared with maintenance antidepressant medication (m-ADM), MBCT was a more effective intervention (HR:0.76, 95%CI:0.58–0.98, I2 = 0%). These positive effects might be only maintained at two and nearly 6 years follow up for CBT.

Conclusion

The use of CBT for MDD patients in remission might reduce risk of relapse. Besides, the effect of MBCT was moderated by number of prior episodes and MBCT might only be effective for MDD patients with 3 or more previous episodes. Further exploration for the influence of previous psychological intervention is required.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6389220/

 

Improve Balance and Mobility and Prevent Falls in Parkinson’s Disease Patients with Tai Chi

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Improve Balance and Mobility and Prevent Falls in Parkinson’s Disease Patients with Tai Chi

 

By John M. de Castro, Ph.D.

 

“There is still so much to learn from research about exactly how exercise improves the physical and mental well-being of people with living with Parkinson’s disease, as well as which combinations or activities yield the best outcomes, but there is no doubt whatsoever that exercise remains one of the best therapies for preserving and enhancing quality of life.” – Davis Phinney

 

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. Parkinson’s Disease (PD) also has psychological effects, especially cognitive decline, anxiety, and depression. All of these symptoms result in a marked reduction in the quality of life.

 

There are no cures for Parkinson’s Disease 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.  In addition, Tai Chi practice has been shown to improve the symptoms of Parkinson’s Disease. Hence, Tai Chi  may be an excellent treatment for the symptoms of Parkinson’s Disease.

 

In today’s Research News article “Effects of Tai Chi Exercise on Reducing Falls and Improving Balance Performance in Parkinson’s Disease: A Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6409066/), Liu and colleagues review, summarize, and perform a meta-analysis on the effectiveness of Tai Chi practice to improve balance and mobility and reduce falls in Parkinson’s Disease (PD) patients. They found and reviewed 5 published randomized controlled trials that compared Tai Chi practice to no intervention, stretching/resistance training, and walking control conditions.

 

They report that the trials found that in comparison to baseline and the control conditions Tai Chi  practice significantly improved balance and functional mobility in the Parkinson’s Disease patients and reduced the number who experienced a fall. This is important as the compromised motor ability of patients with Parkinson’s Disease makes them much more vulnerable to falls and the resultant compromised health. By improving balance and mobility in these patients Tai Chi practice produces enhanced health and well-being.

 

The results of the published research strongly suggests that Tai Chi  practice should be routinely prescribed for patients with Parkinson’s Disease. Tai Chi is a gentle and safe mindfulness practice. It is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It is inexpensive to administer, can be performed in groups or alone, at home or in a facility, and can be quickly learned. In addition, it can be practiced in social groups. This can make it fun, improving the likelihood of long-term engagement in the practice. So, Tai Chi practice would appear to be an excellent gentle practice to improve the well-being of patients with Parkinson’s Disease.

 

So, improve balance and mobility and prevent falls in Parkinson’s Disease patients with Tai Chi.

 

“Daily Tai Chi practice is extremely helpful to those with chronic ailments and illnesses like cancer, heart disease, stroke, Parkinson’s, Alzheimer’s, osteoporosis, peripheral neuropathy, respiratory problems and irritable bowel syndrome to name a few,” – Mwezo

 

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

 

Liu, H. H., Yeh, N. C., Wu, Y. F., Yang, Y. R., Wang, R. Y., & Cheng, F. Y. (2019). Effects of Tai Chi Exercise on Reducing Falls and Improving Balance Performance in Parkinson’s Disease: A Meta-Analysis. Parkinson’s disease, 2019, 9626934. doi:10.1155/2019/9626934

 

Abstract

Introduction

Parkinson’s disease (PD) is a common neurodegenerative disorder that may increase the risk of falls, functional limitation, and balance deficits. Tai Chi was used as an option for improving balance in people with PD. The aim of this meta-analysis was to evaluate the effects of Tai Chi on falls, balance, and functional mobility in individuals with PD.

Method

The literature search was conducted in PubMed, the Cochrane Library, CINAHL, PEDro, Medline, Embase, sportDISCUS, Trip, and the National Digital Library of Theses and Dissertations in Taiwan. Randomized controlled trials (RCTs) analyzing the effects of Tai Chi, compared to no intervention or to other physical training, on falls, functional mobility, and balance in PD patients were selected. The outcome measurements included fall rates, Berg Balance Scale (BBS), Functional Reach (FR) test, and the Timed Up and Go (TUG) test. Two reviewers independently assessed the methodological quality and extracted data from the studies using the PEDro scale.

Results

Five RCTs that included a total of 355 PD patients were included in this review. The quality of evidence in these studies was rated as moderate to high. Compared to no intervention or other physical training, Tai Chi significantly decreased fall rates (odds ratio = 0.47, 95% confidence interval (CI) 0.30 to 0.74, and p=0.001) and significantly improved balance and functional mobility (BBS mean difference (MD) = 3.47, 95% CI 2.11 to 4.80, and p < 0.001; FR MD = 3.55 cm, 95% CI 1.88 to 5.23, and p < 0.001; TUG MD = −1.06 s, 95% CI −1.61 to −0.51, and p < 0.001) in people with PD.

Conclusion

This meta-analysis provides moderate- to high-quality evidence from five RCTs that Tai Chi could be a good physical training strategy for preventing falls and improving balance and functional mobility in people with PD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6409066/

 

Improve Physical and Mental Well-Being in the Elderly with Yoga

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Improve Physical and Mental Well-Being in the Elderly with Yoga

 

By John M. de Castro, Ph.D.

 

“Yoga is incredible for an older population to help them maintain their balance, keep their joints flexible, maintain bone health and muscle mass, as well as learn how to cope with their mental state as they witness their bodies aging. Yoga is great for focus, concentration, and emotional wellbeing. Seniors can benefit tremendously from the practice and it gives them a place to quiet their mind and start to slow down in life.” – Kristin McGee

We celebrate the increasing longevity of the population. But aging is a mixed blessing. The aging process involves a systematic progressive decline of the body and the brain. Every system in the body deteriorates including motor function with a decline in strength, flexibility, and balance. It is inevitable. In addition, many elderly experience withdrawal and isolation from social interactions and depression. There is some hope as there is evidence that these declines can be slowed. For example, a healthy diet and a regular program of exercise can slow the physical decline of the body with aging. Also, contemplative practices such as meditation, yoga, and tai chi or qigong have all been shown to be beneficial in slowing or delaying physical and mental decline.

 

Yoga practice has been shown to have a myriad of benefits for psychological and physical health. It is both an exercise and a mind-body practice that stresses both mental attention to present moment movements, breath control, and flexibility, range of motion, and balance. It has been shown to improve balance and flexibility in older individuals.  It is safe and can be practiced by anyone from children to seniors. Recently, there have been a number of high profile athletes who have adopted a yoga practice to improve their athletic performance. But it is not known whether yoga practice is as good as traditional exercise programs in improving the overall functional fitness of sedentary older adults and slow the age related physical decline.

 

In today’s Research News article “The effects of yoga compared to active and inactive controls on physical function and health related quality of life in older adults- systematic review and meta-analysis of randomised controlled trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6451238/), Sivaramakrishnan and colleagues review, summarize, and perform a meta-analysis of the effectiveness of yoga practice for the well-being of aging individuals. They identified 22 randomized controlled trials of yoga practice effects on the physical function and health related quality of life in older (> 60 years) individuals.

 

They report that the research literature found that yoga practice in comparison to both active and inactive controls produced significant improvements in physical function including lower limb strength and lower body flexibility. In comparison to inactive controls yoga practice also produced a significant improvement in balance. Additionally, they report that yoga practice in comparison to both active and inactive controls produced significant improvement in depression levels. In comparison to inactive controls yoga practice also produced significant improvements in perceived mental health, perceived physical health, sleep quality, and vitality.

 

In looking at the research findings in general, it appears that yoga practice has significant benefits for older adults for physical and mental health. The benefits appear the greatest when yoga practice is compared to no activity, but are still present but to a lesser extent when compared to individuals practicing other activities such as walking, Tai Chi, or stretching exercises. Hence, it appears that many of the benefits of yoga practice are due to the exercise provided by yoga rather than the mind-body components of the practice.

 

But yoga practice still has some important benefits in comparison to older individuals engaging in other activities. These benefits would appear to be independent of the exercise and are likely due to the contemplative practice provided by yoga. The antidepressant effects are particularly important as depression is a major problem for the elderly. The improvements in strength and flexibility are also important as these physical abilities deteriorate with aging and contribute to musculoskeletal problems.

 

The current research literature findings, the, suggest that yoga may be an excellent practice for the slowing of age-related decline. It would appear to be superior to many other activities and should be routinely recommended for physical and mental health of the elderly.

 

So, improve physical and mental well-being in the elderly with Yoga.

 

“The research on yoga is preliminary, however, initial studies have found a yoga practice to positively correlate with both physical and mental wellness. It’s uncontroversial that yoga can improve strength, flexibility, and endurance, but studies have also found that regular practice may help: Lower the risk of cardiovascular disease, Recovery from strokes and surgery, prevent falls, manage arthritis, pain and inflammation, manage diabetes, manage digestive issues like IBS, improve sleep quality, facilitate the grieving process, and manage depression and anxiety.” – Yoga for Seniors

 

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

 

Sivaramakrishnan, D., Fitzsimons, C., Kelly, P., Ludwig, K., Mutrie, N., Saunders, D. H., & Baker, G. (2019). The effects of yoga compared to active and inactive controls on physical function and health related quality of life in older adults- systematic review and meta-analysis of randomised controlled trials. The international journal of behavioral nutrition and physical activity, 16(1), 33. doi:10.1186/s12966-019-0789-2

 

Abstract

Background

Yoga has been recommended as a muscle strengthening and balance activity in national and global physical activity guidelines. However, the evidence base establishing the effectiveness of yoga in improving physical function and health related quality of life (HRQoL) in an older adult population not recruited on the basis of any specific disease or condition, has not been systematically reviewed. The objective of this study was to synthesise existing evidence on the effects of yoga on physical function and HRQoL in older adults not characterised by any specific clinical condition.

Methods

The following databases were systematically searched in September 2017: MEDLINE, PsycInfo, CINAHL Plus, Scopus, Web of Science, Cochrane Library, EMBASE, SPORTDiscus, AMED and ProQuest Dissertations & Theses Global. Study inclusion criteria: Older adult participants with mean age of 60 years and above, not recruited on the basis of any specific disease or condition; yoga intervention compared with inactive controls (example: wait-list control, education booklets) or active controls (example: walking, chair aerobics); physical function and HRQoL outcomes; and randomised/cluster randomised controlled trials published in English. A vote counting analysis and meta-analysis with standardised effect sizes (Hedges’ g) computed using random effects models were conducted.

Results

A total of 27 records from 22 RCTs were included (17 RCTs assessed physical function and 20 assessed HRQoL). The meta-analysis revealed significant effects (5% level of significance) favouring the yoga group for the following physical function outcomes compared with inactive controls: balance (effect size (ES) = 0.7), lower body flexibility (ES = 0.5), lower limb strength (ES = 0.45); compared with active controls: lower limb strength (ES = 0.49), lower body flexibility (ES = 0.28). For HRQoL, significant effects favouring yoga were found compared to inactive controls for: depression (ES = 0.64), perceived mental health (ES = 0.6), perceived physical health (ES = 0.61), sleep quality (ES = 0.65), and vitality (ES = 0.31); compared to active controls: depression (ES = 0.54).

Conclusion

This review is the first to compare the effects of yoga with active and inactive controls in older adults not characterised by a specific clinical condition. Results indicate that yoga interventions improve multiple physical function and HRQoL outcomes in this population compared to both control conditions. This study provides robust evidence for promoting yoga in physical activity guidelines for older adults as a multimodal activity that improves aspects of fitness like strength, balance and flexibility, as well as mental wellbeing.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6451238/

 

Improve Symptoms and Quality of Life in Breast Cancer Patients with Yoga

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Improve Symptoms and Quality of Life in Breast Cancer Patients with Yoga

 

By John M. de Castro, Ph.D.

 

“Studies have shown mindfulness-based stress reduction can be effective in alleviating anxiety and depression, decreasing long-term emotional and physical side effects of treatments and improving the quality of sleep in breast cancer patients.” – Breast Cancer Research Foundation

 

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 fatigue, stress,  sleep disturbance, and anxiety and depression. Yoga practice is a form of mindfulness training that is also an exercise that has been shown to be beneficial for cancer patients. The research on yoga practice as a treatment for patients recovering from breast cancer has been accumulating. It is thus important to take a step back and summarize what has been learned.

 

In today’s Research News article “Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465041/), Cramer and colleagues review, summarize, and perform a meta-analysis of the effectiveness of yoga practice as a treatment for patients recovering from breast cancer. They identified 24 published research studies, 17 of which compared yoga practice to no-treatment, while 4 compared it to a psychoeducation program while 3 compared it to another exercise.

 

They found that the published research reports that in comparison to no-treatment yoga practice significantly improves health related quality of life and reduces fatigue and disturbance of sleep in women recovering from breast cancer. When compared to psychoeducation programs (4 studies), yoga practice had additional significant reductions of anxiety and depression. But, when compared to other exercise programs (3 studies), no significant effects were reported.

 

These results are interesting and suggest that yoga practice is a safe and effective treatment for women recovering from breast cancer, improving their quality of life and physical and mental well-being. The fact that these benefits were not significantly different from other forms of exercise suggests that the it’s the exercise provided by yoga that is the important aspect of the practice producing the benefits. Regardless, it is clear that yoga practice is quite helpful for the well-being of women recovering from breast cancer.

 

So, improve symptoms and quality of life in breast cancer patients with yoga.

 

“Results show promise for mindfulness-based interventions to treat common psychological problems such as anxiety, stress, and depression in cancer survivors and to improve overall quality of life.” — Linda E. Carlson

 

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

 

Cramer, H., Lauche, R., Klose, P., Lange, S., Langhorst, J., & Dobos, G. J. (2017). Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer. The Cochrane database of systematic reviews, 1(1), CD010802. doi:10.1002/14651858.CD010802.pub2

 

Abstract

Background

Breast cancer is the cancer most frequently diagnosed in women worldwide. Even though survival rates are continually increasing, breast cancer is often associated with long‐term psychological distress, chronic pain, fatigue and impaired quality of life. Yoga comprises advice for an ethical lifestyle, spiritual practice, physical activity, breathing exercises and meditation. It is a complementary therapy that is commonly recommended for breast cancer‐related impairments and has been shown to improve physical and mental health in people with different cancer types.

Objectives

To assess effects of yoga on health‐related quality of life, mental health and cancer‐related symptoms among women with a diagnosis of breast cancer who are receiving active treatment or have completed treatment.

Search methods

We searched the Cochrane Breast Cancer Specialised Register, MEDLINE (via PubMed), Embase, the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1), Indexing of Indian Medical Journals (IndMED), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal and Clinicaltrials.gov on 29 January 2016. We also searched reference lists of identified relevant trials or reviews, as well as conference proceedings of the International Congress on Complementary Medicine Research (ICCMR), the European Congress for Integrative Medicine (ECIM) and the American Society of Clinical Oncology (ASCO). We applied no language restrictions.

Selection criteria

Randomised controlled trials were eligible when they (1) compared yoga interventions versus no therapy or versus any other active therapy in women with a diagnosis of non‐metastatic or metastatic breast cancer, and (2) assessed at least one of the primary outcomes on patient‐reported instruments, including health‐related quality of life, depression, anxiety, fatigue or sleep disturbances.

Data collection and analysis

Two review authors independently collected data on methods and results. We expressed outcomes as standardised mean differences (SMDs) with 95% confidence intervals (CIs) and conducted random‐effects model meta‐analyses. We assessed potential risk of publication bias through visual analysis of funnel plot symmetry and heterogeneity between studies by using the Chi2 test and the I2 statistic. We conducted subgroup analyses for current treatment status, time since diagnosis, stage of cancer and type of yoga intervention.

Main results

We included 24 studies with a total of 2166 participants, 23 of which provided data for meta‐analysis. Thirteen studies had low risk of selection bias, five studies reported adequate blinding of outcome assessment and 15 studies had low risk of attrition bias.

Seventeen studies that compared yoga versus no therapy provided moderate‐quality evidence showing that yoga improved health‐related quality of life (pooled SMD 0.22, 95% CI 0.04 to 0.40; 10 studies, 675 participants), reduced fatigue (pooled SMD ‐0.48, 95% CI ‐0.75 to ‐0.20; 11 studies, 883 participants) and reduced sleep disturbances in the short term (pooled SMD ‐0.25, 95% CI ‐0.40 to ‐0.09; six studies, 657 participants). The funnel plot for health‐related quality of life was asymmetrical, favouring no therapy, and the funnel plot for fatigue was roughly symmetrical. This hints at overall low risk of publication bias. Yoga did not appear to reduce depression (pooled SMD ‐0.13, 95% CI ‐0.31 to 0.05; seven studies, 496 participants; low‐quality evidence) or anxiety (pooled SMD ‐0.53, 95% CI ‐1.10 to 0.04; six studies, 346 participants; very low‐quality evidence) in the short term and had no medium‐term effects on health‐related quality of life (pooled SMD 0.10, 95% CI ‐0.23 to 0.42; two studies, 146 participants; low‐quality evidence) or fatigue (pooled SMD ‐0.04, 95% CI ‐0.36 to 0.29; two studies, 146 participants; low‐quality evidence). Investigators reported no serious adverse events.

Four studies that compared yoga versus psychosocial/educational interventions provided moderate‐quality evidence indicating that yoga can reduce depression (pooled SMD ‐2.29, 95% CI ‐3.97 to ‐0.61; four studies, 226 participants), anxiety (pooled SMD ‐2.21, 95% CI ‐3.90 to ‐0.52; three studies, 195 participants) and fatigue (pooled SMD ‐0.90, 95% CI ‐1.31 to ‐0.50; two studies, 106 participants) in the short term. Very low‐quality evidence showed no short‐term effects on health‐related quality of life (pooled SMD 0.81, 95% CI ‐0.50 to 2.12; two studies, 153 participants) or sleep disturbances (pooled SMD ‐0.21, 95% CI ‐0.76 to 0.34; two studies, 119 participants). No trial adequately reported safety‐related data.

Three studies that compared yoga versus exercise presented very low‐quality evidence showing no short‐term effects on health‐related quality of life (pooled SMD ‐0.04, 95% CI ‐0.30 to 0.23; three studies, 233 participants) or fatigue (pooled SMD ‐0.21, 95% CI ‐0.66 to 0.25; three studies, 233 participants); no trial provided safety‐related data.

Authors’ conclusions

Moderate‐quality evidence supports the recommendation of yoga as a supportive intervention for improving health‐related quality of life and reducing fatigue and sleep disturbances when compared with no therapy, as well as for reducing depression, anxiety and fatigue, when compared with psychosocial/educational interventions. Very low‐quality evidence suggests that yoga might be as effective as other exercise interventions and might be used as an alternative to other exercise programmes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465041/

 

Improve Psychiatric Disorders with Mindfulness

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Improve Psychiatric Disorders with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Is mindfulness better than medication or other therapies? No, probably not; But if you are someone who doesn’t believe in taking medication or seeing an individual therapist you might be more inclined to engage in the practice of mindfulness. So, it becomes, ‘OK, we have a modality that people like, it’s appealing and accessible to them, so they’re more motivated to use it.’ [In that case] mindfulness may work better for them.” – Patricia Rockman

 

There are vast numbers of people who suffer with mental illnesses. In the United states it has been estimated that in any given year 1 in 5 people will experience a mental illness. Many are treated with drugs. But drug treatment can produce unwanted side effects, don’t work for many patients, and often can lose effectiveness over time. Mindfulness practices provide a safe alternative treatment. They have been found to be helpful with coping with these illnesses and in many cases reducing the symptoms of the diseases. Hence, it appears that mindfulness practices are safe and effective treatments for a variety of psychiatric conditions including anxiety, depression, psychoses, addictions, etc..

 

The research is accumulating. Hence it makes sense to step back and summarize what has been learned regarding the effectiveness of mindfulness-based treatments for psychiatric conditions. In today’s Research News article “Mindfulness-based interventions for psychiatric disorders: 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/PMC5741505/), Goldberg and colleagues review, summarize, and perform a meta-analysis of the effectiveness of mindfulness-based treatments for psychiatric conditions. They examined randomized controlled trials that employed mindfulness trainings that included meditation practice and home practice. Any psychiatric disorder, including schizophrenia, addictions, eating disorders, anxiety, smoking and chronic pain, were included with depression the most frequently studied. They identified 142 randomized controlled trials that included a total of 12,005 participants.

 

They found that mindfulness treatments produced significantly greater improvements in psychiatric symptoms than no-treatment control conditions, minimal treatment, non-specific active, and specific active control conditions. They also found that mindfulness treatments produced equivalent improvements in psychiatric symptoms, when compared to evidence-based treatments such as cognitive behavioral therapy (CBT) and drugs. These effects were present immediately after treatment and at follow-up on average 6.43 months after the conclusion of treatment.

 

These results are remarkable. Mindfulness treatments were found to be safe, effective, and lasting for a wide variety of psychiatric disorders and as effective as recognized evidenced based treatments including drug treatments. It is amazing that such a simple and safe treatment could be effective for such a range of disorders, virtually any disorder. How this could be possible is not known, and should be a focus of future research. But focusing on the present moment would appear to an important mechanism for redirecting thinking away from the focus on past and future that appears to produce stress and exacerbate the disorders.

 

So, improve psychiatric disorders with mindfulness.

 

“While mindfulness might seem unconventional, it’s an increasingly accepted method of achieving a healthier mind. Therapists who teach mindfulness techniques to their clients do so to help them cope with mental health challenges and strive for a sense of peace.” – Faith Onimiya

 

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

 

Goldberg, S. B., Tucker, R. P., Greene, P. A., Davidson, R. J., Wampold, B. E., Kearney, D. J., & Simpson, T. L. (2017). Mindfulness-based interventions for psychiatric disorders: A systematic review and meta-analysis. Clinical psychology review, 59, 52–60. doi:10.1016/j.cpr.2017.10.011

 

Abstract

Despite widespread scientific and popular interest in mindfulness-based interventions, questions regarding the empirical status of these treatments remain. We sought to examine the efficacy of mindfulness-based interventions for clinical populations on disorder-specific symptoms. To address the question of relative efficacy, we coded the strength of the comparison group into five categories: no treatment, minimal treatment, non-specific active control, specific active control, and evidence-based treatment. A total of 142 non-overlapping samples and 12,005 participants were included. At post-treatment, mindfulness-based interventions were superior to no treatment (d = 0.55), minimal treatment (d = 0.37), non-specific active controls (d = 0.35), and specific active controls (d = 0.23). Mindfulness conditions did not differ from evidence-based treatments (d = −0.004). At follow-up, mindfulness-based interventions were superior to no treatment conditions (d = 0.50), non-specific active controls (d = 0.52), and specific active controls (d = 0.29). Mindfulness conditions did not differ from minimal treatment conditions (d = 0.38) and evidence-based treatments (d = 0.09). Effects on specific disorder subgroups showed the most consistent evidence in support of mindfulness for depression, pain conditions, smoking, and addictive disorders. Results support the notion that mindfulness-based interventions hold promise as evidence-based treatments.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5741505/

 

Improve the Psychological State of Heart Disease Patients with Mindfulness

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Improve the Psychological State of Heart Disease Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Not only can meditation improve how your heart functions, but a regular practice can enhance your outlook on life and motivate you to maintain many heart-healthy behaviors, like following a proper diet, getting adequate sleep, and keeping up regular exercise,” – John Denninger

 

Cardiovascular disease is the number one killer, claiming more lives than all forms of cancer combined. “Heart disease is the leading cause of death for both men and women. About 610,000 people die of heart disease in the United States every year–that’s 1 in every 4 deaths. Every year about 735,000 Americans have a heart attack.” (Centers for Disease Control). A myriad of treatments has been developed for heart disease including a variety of surgical procedures and medications. In addition, lifestyle changes have proved to be effective including quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Unfortunately, for a variety of reasons, 60% of heart failure patients decline participation, making these patients at high risk for another attack.

 

Safe and effective alternative treatments for cardiovascular disease are contemplative practices, such as meditation, tai chi, and yoga, have also been shown to be helpful for heart health. These practices have also been shown to reduce the physiological and psychological responses to stress and to be helpful for producing the kinds of lifestyle changes needed to prevent heart disease such as smoking cessation, and weight reduction. They have also been shown to be effective in maintaining cardiovascular health and the treatment of cardiovascular disease. Hence it is reasonable to continue studying the effects of mindfulness training on patients with cardiovascular disease.

 

In today’s Research News article “Effectiveness of mindfulness-based stress reduction program on quality of life in cardiovascular disease patients.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465573/), Jalali and colleagues recruited patients with cardiovascular disease and randomly assigned them either to a wait-list control or to receive and 8-week program of Mindfulness-Based Stress Reduction (MBSR)  that includes body scan and focused meditations, yoga practice, and discussion. Training occurred once a week for 2.5 hours and included daily home practice. They were measured before and after training and 3 months later for self-efficacy and their health.

 

They found that compared to baseline and the wait-list control group, the group that received the program of Mindfulness-Based Stress Reduction (MBSR) had significantly increased self-efficacy and quality of life that persisted 3 months after treatment. Hence. MBSR training appears to be safe, effective, and lasting treatment that is very helpful for patients with cardiovascular disease, improving self-efficacy and quality of life.

 

The improved self-efficacy is very important. It suggests that the patients feel better able to control their health. It suggests that they are more willing to take control of their lives to improve their health. It is well known that changes in lifestyle are very important for the treatment of cardiovascular disease. So, improved self-efficacy would predict that the patients would be more likely to adopt and maintain these lifestyle changes. This would inevitably lead to an improved health and quality of life.

 

So, improve the psychological state of heart disease patients with mindfulness.

 

“Given the proven role of stress in heart attacks and coronary artery disease, effective meditation would be appropriate for almost all patients with coronary artery disease.” – Joon Sup Lee

 

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

 

Jalali, D., Abdolazimi, M., Alaei, Z., & Solati, K. (2019). Effectiveness of mindfulness-based stress reduction program on quality of life in cardiovascular disease patients. International journal of cardiology. Heart & vasculature, 23, 100356. doi:10.1016/j.ijcha.2019.100356

 

Abstract

Introduction

Cardiovascular disease is one of the most fatal physical illnesses that impose many financial losses on societies every year.

Aim

This study was to investigate the effectiveness of a mindfulness-based stress reduction (MBSR) program on self-efficacy and quality of life in patients with cardiovascular disease.

Material and methods

The samples of this clinical trial were 60 patients who were selected by convenience sampling from patients were diagnosed, clinically interviewed by a cardiologist and randomized to two groups; experimental and control, and then completed Sherer et al. General Self-Efficacy Scale and 36-item Short Form Survey three times; pre-test, post-test, and after 3 months of follow-up. MBSR Program includes the methods that patients learn to calm their minds and body to help them cope with disease that was based on self-efficacy and quality of life. Data analysis was performed by the SPSS v22 using t-test and ANOVA.

Results

The results show that the mean pre-test scores of self-efficacy and quality of life of patients were not significantly different between the experimental and control groups (P > 0.05). However, the mean scores of the two variables were found to be significantly different between the experimental group and the control group on the post-test and follow-up as the research hypotheses were examined (P < 0.01). So that the means of self-efficacy were 60.80 ± 5.91 and 60.40 ± 7.03 and quality of life were 103.80 ± 9.35 and 101.10 ± 9.13 at post-test and 3 months later respectively in experimental group.

Conclusion

Self-efficacy and quality of life of cardiovascular patients could be improved by providing an MBSR program.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465573/

 

Change Brain Connectivity for Better Attention and Thinking with Mindfulness

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Change Brain Connectivity for Better Attention and Thinking with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness meditation training increases resting state connectivity between top-down executive control regions, highlighting an important mechanism through which it reduces stress levels.” – Daniel Reed

 

There has accumulated a large amount of research demonstrating that mindfulness has significant benefits for psychological, physical, and spiritual wellbeing. It even improves high level thinking known as executive function and emotion regulation and compassion. Its positive effects are so widespread that it is difficult to find any other treatment of any kind with such broad beneficial effects on everything from thinking to mood and happiness to severe mental and physical illnesses. This raises the question of how mindfulness training could produce such widespread and varied benefits. One possibility is that mindfulness practice results in beneficial changes in the nervous system.

 

The nervous system is a dynamic entity, constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. These changes in the brain are called neuroplasticity. Over the last decade neuroscience has been studying the effects of contemplative practices on the brain and has identified neuroplastic changes in widespread areas. In other words, mindfulness practice appears to mold and change the brain, producing psychological, physical, and spiritual benefits. The changes are complex and require sophisticated brain scanning techniques to detect. Hence there is a need to continue investigating the nature of these changes in the brain produced by meditation.

 

In today’s Research News article “Trait Mindfulness and Functional Connectivity in Cognitive and Attentional Resting State Networks.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6473082/), Parkinson and colleagues recruited undergraduate students who had never meditated, measured them for mindfulness, and scanned their brains under resting conditions with functional Magnetic Resonance Imaging (fMRI). They examined the functional connectivity of a number of established neural networks and their relationship with mindfulness.

 

They found that mindfulness was negatively related to the functional connectivity of the Default Mode Network (DMN) and positively related to the functional connectivity of the Salience Network, the Central Executive Network, and Attention Network. The Default Mode Network (DMN) has been shown to be associated with mind wandering and self-referential thinking. It is not surprising that mindfulness would be associated with lower levels of the functioning of this network. Indeed, previous work has demonstrated that mindfulness is associated with reduced “mind wandering.”

 

The Salience Network is involved in detecting and filtering important stimuli in the environment from the environment and thereby gets involved in a myriad of high level psychological and social functions. The results suggest that being more mindful is associated with being more sensitive to important information.

 

The Central Executive Network has been shown to be associated with high level thinking and behavioral control. Hence, the results further suggest that high mindfulness is associated with improved cognition. Indeed, mindfulness has been shown through extensive research to be associated with better cognitive ability.

 

Finally, the Attention Network has been found to be associated with, no surprise, the ability to attend and focus. This suggests that high mindfulness is associated with improved attention ability. Again, this reflects other research which demonstrated that mindfulness is associated with a greater ability to attend.

 

Hence the study demonstrated the associations with mindfulness with functional connectivity in various neural networks tracks the demonstrated effects of mindfulness on the individual’s ability to focus, think, and stay in the present moment. This further suggests that changes in the operations of the brain are produced by mindfulness and that hese changes in turn produced improved functional capacities.

 

So, change brain connectivity for better attention and thinking with mindfulness.

 

“Just 11 hours of learning a meditation technique induce positive structural changes in brain connectivity by boosting efficiency in a part of the brain that helps a person regulate behavior in accordance with their goals,” – University of Oregon

 

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

 

Parkinson, T. D., Kornelsen, J., & Smith, S. D. (2019). Trait Mindfulness and Functional Connectivity in Cognitive and Attentional Resting State Networks. Frontiers in Human Neuroscience, 13, 112. doi:10.3389/fnhum.2019.00112

 

Abstract

Mindfulness has been described as an orienting of attention to the present moment, with openness and compassion. Individuals displaying high trait mindfulness exhibit this tendency as a more permanent personality attribute. Given the numerous physical and mental health benefits associated with mindfulness, there is a great interest in understanding the neural substrates of this trait. The purpose of the current research was to examine how individual differences in trait mindfulness associated with functional connectivity in five resting-state networks related to cognition and attention: the default mode network (DMN), the salience network (SN), the central executive network (CEN), and the dorsal and ventral attention networks (DAN and VAN). Twenty-eight undergraduate participants completed the Five-Facet Mindfulness Questionnaire (FFMQ), a self-report measure of trait mindfulness which also provides scores on five of its sub-categories (Observing, Describing, Acting with Awareness, Non-judging of Inner Experience, and Non-reactivity to Inner Experience). Participants then underwent a structural MRI scan and a 7-min resting state functional MRI scan. Resting-state data were analyzed using independent-component analyses. An analysis of covariance (ANCOVA) was performed to determine the relationship between each resting state network and each FFMQ score. These analyses indicated that: (1) trait mindfulness and its facets showed increased functional connectivity with neural regions related to attentional control, interoception, and executive function; and (2) trait mindfulness and its facets showed decreased functional connectivity with neural regions related to self-referential processing and mind wandering. These patterns of functional connectivity are consistent with some of the benefits of mindfulness—enhanced attention, self-regulation, and focus on present experience. This study provides support for the notion that non-judgmental attention to the present moment facilitates the integration of regions in neural networks that are related to cognition, attention, and sensation.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6473082/

 

Reduce Teacher Stress and Burnout with Mindfulness

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Reduce Teacher Stress and Burnout with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness programs in the workplace may help employees better deal with stress, and develop the ability to observe negative emotions and automatic thought patterns and behaviors, and remain calm, present, self-aware and alert, rather than succumbing to the slippery slope of negative emotions.” – B. Grace Bullock

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. This often produces burnout; fatigue, cynicism, emotional exhaustion, and professional inefficacy. Teachers experience burnout at high rates. Roughly a half a million teachers out of a workforce of three million, leave the profession each year and the rate is almost double in poor schools compared to affluent schools. Indeed, nearly half of new teachers leave in their first five years.

 

Burnout frequently results from emotional exhaustion. This exhaustion not only affects the teachers personally, but also the students, as it produces a loss of enthusiasm, empathy, and compassion. Regardless of the reasons for burnout or its immediate presenting consequences, it is a threat to schools and their students. In fact, it is a threat to the entire educational systems as it contributes to the shortage of teachers. Hence, preventing burnout has to be a priority.

Mindfulness has been demonstrated to be helpful in treating and preventing burnout.

 

In today’s Research News article “Can mindfulness mitigate the energy-depleting process and increase job resources to prevent burnout? A study on the mindfulness trait in the school context.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6448859/), Guidetti and colleagues examine the relationship of mindfulness to teacher burnout. They recruited primary, middle, and secondary school teachers and had them complete questionnaires measuring teacher mindfulness, teacher stress, meaningfulness of work, and burnout, including emotional exhaustion, and depersonalization.

 

They found significant relationships between mindfulness and the psychological state of the teachers with the higher the teacher’s levels of mindfulness the lower the levels of stress, emotional exhaustion, and depersonalization and the higher the levels of meaningfulness of work. A confirmatory factor analysis revealed that mindfulness was related to burnout (both emotional exhaustion and depersonalization) both directly and indirectly. High levels of mindfulness not only were directly related to burnout but also indirectly by being related to lower levels of stress and higher levels of meaningfulness of work which in turn were related to lower levels of burnout.

 

These results are correlational, so caution must be exercised in inferring causation. Previous research, however, has clearly demonstrated that mindfulness training results in decreased burnout in multiple occupations. So, it is likely that mindfulness is the cause of the lower levels of burnout observed in the current study with teachers. The current results show how mindfulness is related to lower teacher burnout. It does so both directly and indirectly through its relationships with stress and meaningfulness of work.

 

So, reduce teacher stress and burnout with mindfulness.

 

“when teachers practice mindfulness, students’ misbehavior and other stressors become like water off a duck’s back, allowing them to stay focused on what teachers really want to do: teach.” – Vicki Zakrzewski 

 

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

 

Guidetti, G., Viotti, S., Badagliacca, R., Colombo, L., & Converso, D. (2019). Can mindfulness mitigate the energy-depleting process and increase job resources to prevent burnout? A study on the mindfulness trait in the school context. PloS one, 14(4), e0214935. doi:10.1371/journal.pone.0214935

 

Abstract

Background

Past studies in the teaching context provided evidence of the role of mindfulness-based intervention in improving occupational wellbeing. This study aims to increase the extant knowledge by testing the mechanism that links teachers’ mindfulness at work to occupational wellbeing. Rooted in the job demand–resource model, the mindfulness trait is conceptualized as a personal resource that has the ability to impact and interact with job demands and resources, specifically workload stress appraisal and perceived meaningfulness of work, in affecting teachers’ burnout.

Methods

A sample of primary, middle, and secondary school teachers (N = 605) completed a questionnaire that aimed to assess teachers’ mindfulness trait and the measures of the quality of occupational life in the school context. Confirmatory factor analysis (CFA) was conducted to test the model fit indices; further analyses were performed to test the hypotheses about mediation and moderation effects.

Results

The CFA showed good model fit indices. Further analyses highlighted that teachers’ mindfulness is negatively associated with workload stress appraisal and that positively influenced work meaning, in turn mediating the relationship between mindfulness and burnout. Finally, mindfulness moderated the effect of workload stress appraisal on burnout.

Conclusions

Rooted in the job demand–resource model, this study emphasizes an underrepresented personal resource, that is, the mindfulness trait at work, and the links that favor its impact on burnout. Practical and future research implications are also discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6448859/

 

Change the Brain to Improve Resilience with Meditation

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Change the Brain to Improve Resilience with Meditation

 

By John M. de Castro, Ph.D.

 

“Mindful people … can better cope with difficult thoughts and emotions without becoming overwhelmed or shutting down (emotionally). Pausing and observing the mind may (help us) resist getting drawn into wallowing in a setback.” – Badri Bajaj

 

Psychological well-being is sometimes thought of as a lack of mental illness. But it is more than just a lack of something. It is a positive set of characteristics that lead to happy, well-adjusted life. These include the ability to be aware of and accept one’s strengths and weaknesses, to have goals that give meaning to life, to truly believe that your potential capabilities are going to be realized, to have close and valuable relations with others, the ability to effectively manage life issues especially daily issues, and the ability to follow personal principles even when opposed to society. But stress can interfere with the individual’s ability to achieve these goals.  When highly stressed, resilience is required to cope with the stress and continue on the path to psychological well-being.

 

One way that mindfulness practices such as meditation may improve resilience is by altering the brain. The nervous system is a dynamic entity, constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. These changes in the brain are called neuroplasticity. Over the last decade neuroscience has been studying the effects of contemplative practices on the brain and has identified neuroplastic changes in widespread areas. In other words, mindfulness practice appears to mold and change the brain, producing psychological, physical, and spiritual benefits. The changes in the brain, however, that are responsible for increased resilience are unknown.

 

In today’s Research News article “The Immediate and Sustained Positive Effects of Meditation on Resilience Are Mediated by Changes in the Resting Brain.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6448020/), Kwak and colleagues recruited healthy adults to participate in a 4-day retreat. They were randomly assigned to a meditation retreat or a relaxation retreat. They were measured before and after the retreat and 3 months later for mindfulness, resilience, and religious preference. Also, before and after the retreat the participants underwent functional Magnetic Resonance Imaging (f-MRI) of their brains.

 

They found that in comparison to baseline and the relaxation retreat participants, the meditation retreat participants at the 3-month follow-up had significant increases in both mindfulness and resilience. They also found that the meditation group had significantly increased functional connectivity between the left rostral anterior cingulate cortex and the dorsomedial prefrontal cortex, precuneus, and angular gyrus. In addition, the greater the increase in the functional connectivity in the meditation retreat group the greater the increases in resilience and mindfulness. The increase in resilience was associated with the increase in mindfulness and this association was found to be partially mediated by the change in functional connectivity. In other words, increased mindfulness was associated with increased resilience directly and also indirectly by its association with the increased functional connectivity which was in turn associated with greater resilience.

 

The results are interesting and suggest that the effect of meditation on resilience is due to increases in mindfulness that change the brain to produce greater resilience. In particular, meditation appears to increase the functional connectivity between brain regions, the cingulate cortex and the prefrontal cortex and the precuneus, and angular gyrus, and thus is partially responsible for increased resilience.

 

Resilience is very important for the individual to be able to withstand the stress and negative events in life. Meditation appears to change the brain to help people better cope with the stresses of life. This may underlie, at least in part, the psychological and physical benefits of meditation practice.

 

So, change the brain to improve resilience with meditation.

 

“The emotional soup that follows a stressful event can whip up negative stories about yourself or others that goes on and on, beyond being useful. Mindfulness reduces this rumination and, if practiced regularly, changes your brain so that you’re more resilient to future stressful events.” – Shamash Alidina

 

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

 

Kwak, S., Lee, T. Y., Jung, W. H., Hur, J. W., Bae, D., Hwang, W. J., … Kwon, J. S. (2019). The Immediate and Sustained Positive Effects of Meditation on Resilience Are Mediated by Changes in the Resting Brain. Frontiers in human neuroscience, 13, 101. doi:10.3389/fnhum.2019.00101

 

Abstract

While recent studies have explored the maintenance of the effect of meditation on stress resilience, the underlying neural mechanisms have not yet been investigated. The present study conducted a highly controlled residential study of a 4-day meditation intervention to investigate the brain functional changes and long-term effects of meditation on mindfulness and resilience. Thirty participants in meditation practice and 17 participants in a relaxation retreat (control group) underwent magnetic resonance imaging scans at baseline and post-intervention and completed the Cognitive and Affective Mindfulness Scale (CAMS) and Resilience Quotient Test (RQT) at baseline, post-intervention, and the 3-month follow-up. All participants showed increased CAMS and RQT scores post-intervention, but only the meditation group sustained the enhancement after 3 months. Resting-state functional connectivity (rsFC) between the left rostral anterior cingulate cortex (rACC) and the dorsomedial prefrontal cortex (dmPFC), precuneus, and angular gyrus was significantly increased post-intervention in the meditation group compared with the relaxation group. The changes in rACC-dmPFC rsFC mediated the relationship between the changes in the CAMS and RQT scores and correlated with the changes in the RQT score both immediately and at 3 months post-intervention. Our findings suggest that increased rACC-dmPFC rsFC via meditation causes an immediate enhancement in resilience that is sustained. Since resilience is known to be associated with the preventative effect of various psychiatric disorders, the improvement in stress-related neural mechanisms may be beneficial to individuals at high clinical risk.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6448020/

 

Improve Obsessive-Compulsive Disorder With Mindfulness

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Improve Obsessive-Compulsive Disorder With Mindfulness

 

By John M. de Castro, Ph.D.

 

“To be able to focus on what is really happening in any given moment, as opposed to dwelling on the past or anticipating the future, takes away the power of OCD.” – Janet Singer

 

Obsessive-Compulsive Disorder (OCD) sufferer have repetitive anxiety producing intrusive thoughts (obsessions) that result in repetitive behaviors to reduce the anxiety (compulsions). In a typical example of OCD, the individual is concerned about germs and is unable to control the anxiety that these thoughts produce. Their solution is to engage in ritualized behaviors, such as repetitive cleaning or hand washing that for a short time relieves the anxiety. The obsessions and compulsions can become so frequent that they become a dominant theme in their lives. Hence OCD drastically reduces the quality of life and happiness of the sufferer and those around them. About 2% of the population, 3.3 million people in the U.S., are affected at some time in their life.

 

Fortunately, OCD can be treated and Mindfulness training has been shown to be effective in treating OCD. In addition, changing the maladaptive thought processes occurring in OCD through Cognitive Restructuring (CR) has also been shown to be effective. In today’s Research News article “A randomized waitlist-controlled trial comparing detached mindfulness and cognitive restructuring in obsessive-compulsive disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6426247/), Rupp and colleagues compare the effectiveness of mindfulness training and cognitive restructuring in treating Obsessive-Compulsive Disorder (OCD).

 

They recruited patients with Obsessive-Compulsive Disorder (OCD) and randomly assigned them to receive either cognitive restructuring or detached mindfulness training or to a wait-list control condition. The treatments were delivered in 100-minute sessions, twice a week for two weeks and contained homework assignments. Cognitive restructuring targets distorted thinking that underlies OCD and teaches the patient to observe the thoughts and question the appraisals produced by the thoughts. Detached mindfulness training also targets the distorted thinking that underlies OCD but teaches the patient to observe the thoughts and detach from them, see them as separate from themselves. They were measured before and after training and 4 weeks later for intelligence, depression, psychological disorders, and Obsessive-Compulsive Disorder (OCD) symptoms.

 

They found that compared to baseline and the wait-list control group both treatments resulted in significant reductions in OCD symptoms that were clinically significant and maintained at the 4-week follow-up. There were also small deceases in depression levels in the patients after both treatments. Hence, both treatments improved the symptoms of patients suffering from Obsessive-Compulsive Disorder (OCD). Hence brief training in cognitive restructuring or detached mindfulness are effective in treating OCD symptoms.

 

It has previously been demonstrated that Mindfulness training is effective in treating OCD. The current study suggests that an unusual mindfulness technique, detached mindfulness, may also be effective. It appears that very different types of treatments, cognitive restructuring and detached mindfulness are effective in treating the symptoms of Obsessive-Compulsive Disorder (OCD). The control condition, however, received no treatment. So, it is possible that the improvements observed may have been due to subject expectancy effects (placebo effects) and not to the treatments. Future research should include placebo control conditions.

 

So, improve obsessive-compulsive disorder with mindfulness.

 

“a person trapped by an endless cycle of washing, checking, or cleaning is experiencing exactly the same struggle with accepting thoughts, feelings, and sensations as people with intrusive thoughts.  So, mindfulness is really for anyone who wants to stop feeling like what is going on inside their mind is a burden.  It’s hard to imagine anyone with OCD who would wish to continue feeling that way.” – John Hershfield

 

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

 

Rupp, C., Jürgens, C., Doebler, P., Andor, F., & Buhlmann, U. (2019). A randomized waitlist-controlled trial comparing detached mindfulness and cognitive restructuring in obsessive-compulsive disorder. PloS one, 14(3), e0213895. doi:10.1371/journal.pone.0213895

 

Abstract

Objective

Whereas research has demonstrated the efficacy of cognitive restructuring (CR) for obsessive-compulsive disorder (OCD), little is known about the efficacy of specific metacognitive interventions such as detached mindfulness (DM). Therefore, this study compared the efficacy of CR and DM as stand-alone interventions.

Design

We conducted a randomized waitlist-controlled trial. n = 43 participants were randomly assigned to either DM or CR. Out of those participants, n = 21 participants had been previously assigned to a two-week waitlist condition.

Materials and methods

In both conditions, treatment comprised four double sessions within two weeks. Assessment took place at baseline (Pre1), after treatment (Post) and four weeks after the end of treatment (FU). There was a second baseline assessment (Pre2) in the waitlist group. Independent evaluators were blinded concerning the active condition. Adherence and competence ratings for the two therapists were obtained from an independent rater.

Results

40 patients completed the treatment. Two patients dropped out because of exacerbated depression. There were no further adverse events. Both CR and DM were shown to be superior to waitlist and equally effective at reducing OCD symptoms from pre to post assessment as measured with the Y-BOCS (CR: d = 1.67, DM: d = 1.55). In each of the two treatment conditions, eight patients (40%) exhibited a clinical significant change at post assessment.

Conclusions

The results of this clinical trial suggest the potential efficacy of DM as a stand-alone intervention for OCD, however, our findings need to be interpreted with caution. Results indicate that both CR and DM should be considered as possible alternative treatments for OCD, whereas the working mechanisms of DM have yet to be elucidated.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6426247/