Interpretation Bias Mediates the Effect of Mindfulness and Acceptance on Anxiety and Depression

Interpretation Bias Mediates the Effect of Mindfulness and Acceptance on Anxiety and Depression

 

By John M. de Castro, Ph.D.

 

Anxiety softens when we can create a space between ourselves and what we’re experiencing. When you react in ways that aren’t mindful, they can gradually grow into habits that are detrimental to your health and well-being.” – Mindful

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. A characterizing feature of anxiety disorders is that the sufferer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. This may indicate that treating the cognitive processes that underlie the anxiety may be an effective treatment. Indeed, Mindfulness practices have been shown to be quite effective in altering cognitive processes and  relieving anxiety.

 

Depression is the most common mental illness, affecting over 6% of the population. Depression can be difficult to treat and is usually treated with anti-depressive medication. But drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression. Fortunately, Mindfulness training is also effective for treating depression.

 

A cognitive tendency that can exacerbate anxiety and depression is interpretation bias. This is a tendency to interpret situations in a negative way even when the situation is ambiguous. This can lead to interpreting even neutral situations as threatening. An alternative explanation for the effectiveness of mindfulness training for anxiety and depression is that it may reduce interpretation bias, making it less likely that situations would be interpreted as threatening and thereby lowering anxiety and depression.

 

In today’s Research News article “Mindfulness, Interpretation Bias, and Levels of Anxiety and Depression: Two Mediation Studies.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320741/ ), Mayer and colleagues performed 2 studies to examine the relationships of mindfulness, anxiety, depression, and interpretation bias.

 

In the first study they recruited college students and had them complete online questionnaires and psychometric tests measuring mindfulness, anxiety, depression, and interpretation bias. The variables were then subjected to regression analysis. They found that the higher the level of mindfulness the lower the levels of depression, anxiety, and interpretation bias. They further found that the mindfulness association with reduced anxiety and depression was in part the result of mindfulness’ association with reduced interpretation bias. Mindfulness was both directly associated with lower anxiety and depression and indirectly by being associated with lower levels of interpretation bias which, in turn, was associated with lower anxiety and depression.

 

In the second study they recruited a community sample of adults with mixed ages and had them complete online questionnaires measuring mindfulness, anxiety, depression, interpretation bias, and acceptance of internal sensations. They found similar results for acceptance as they found in study 1 for mindfulness, with the higher the level of acceptance the lower the levels of depression, anxiety, and interpretation bias. Also similar to study 1 they found that the association of acceptance with reduced anxiety and depression was in part the result of acceptance’ association with reduced interpretation bias. Acceptance was both directly associated with lower anxiety and depression and indirectly by being associated with lower levels of interpretation bias which, in turn, was associated with lower anxiety and depression.

 

These are interesting findings but they are correlational. So, no clear conclusions regarding causation can be reached. Previous research, however, has clearly shown a causal connection between mindfulness and acceptance and anxiety and depression. This suggests that the relationships observed in the current study as due to mindfulness and acceptance causing the relief of anxiety and depression.

 

The results suggest that the associations of both mindfulness and acceptance of internal states are associated with lower levels of both anxiety and depression and that these associations are in part due to direct associations with anxiety and depression and also indirect associations involving both mindfulness and acceptance being associated with lower levels of interpretation bias that, in turn, is associated with lower levels of anxiety and depression. This suggests that mindfulness and acceptance, in part, affect anxiety and depression by altering the cognitive interpretation of situations, lowering the tendency to interpret situations as threatening and thereby lowering the anxiety and depression that results from threatening interpretations.

 

So, interpretation bias mediates the effect of mindfulness and acceptance on anxiety and depression.

 

Mindfulness keeps us focused on the present, and helps us meet challenges head on while we appreciate all our senses absorb. On the contrary, focus on the future contributes to anxiety, while perseveration on the past feeds depression.” – Vincent Fitzgerald

 

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

 

Mayer, B., Polak, M. G., & Remmerswaal, D. (2018). Mindfulness, Interpretation Bias, and Levels of Anxiety and Depression: Two Mediation Studies. Mindfulness, 10(1), 55-65.

 

Abstract

In two studies, a possible mediation effect was tested of cognitive interpretation bias in the relation between respectively dispositional mindfulness and acceptance, on the one hand, and symptoms of depression and anxiety, on the other hand. An undergraduate student sample (N = 133; 86% female, Mage = 19.8) and a convenience community sample (N = 186; 66% female, Mage = 36.5) were examined by means of an online questionnaire measuring dispositional mindfulness (FFMQ-SF; Study 1) and acceptance (AAQ-II; Study 2), anxiety (STAI-trait) and depressive (BDI-II) symptoms, and interpretation bias (with the interpretation bias task, IBT). Considering both studies, results showed consistently the expected relations of larger mindfulness skills going together with a smaller cognitive interpretation bias and lower levels of depression and anxiety symptoms. More interestingly, it was found that interpretation bias served as a mediator in the relations between respectively dispositional mindfulness and acceptance, and symptoms of depression and anxiety. With these findings, some more insight in the working mechanisms of mindfulness-based treatments on internalizing psychopathology has been obtained.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320741/

 

Improve Well-Being and Psychological Flexibility with Mindfulness Practice

Improve Well-Being and Psychological Flexibility with Mindfulness Practice

 

By John M. de Castro, Ph.D.

 

“There are an endless variety of ways to meditate and practice mindfulness. . . specific types of mindfulness-meditation seem to have specific benefits. Fine-tuning which type of mindfulness or meditation someone uses as a prescriptive to treat a specific need will most likely be the next big advance in the public health revolution of mindfulness and meditation.” – Christopher Bergland

 

Mindfulness training has been shown to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress. Techniques such as Mindfulness Training, Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) as well as Yoga practice and Tai Chi or Qigong practice have been demonstrated to be effective. This has led to an increasing adoption of these mindfulness techniques for the health and well-being of both healthy and ill individuals.

 

Mindfulness practice, however, is a complex involving formal and informal practices, and great differences in the frequency and duration of practice. It is not known which of these facets or which combinations of facets are responsible for the beneficial effects of mindfulness. In addition, learning and implementing mindfulness practices can be difficult with a number of impediments and problems present. Hence there is a need to investigate the characteristics of mindfulness practices and the impediments to and supports for practicing mindfulness and their relationship to the well-being and psychological flexibility of the participants.

 

In today’s Research News article “An Exploration of Formal and Informal Mindfulness Practice and Associations with Wellbeing.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320743/  ), Birtwell and colleagues recruited mindfulness practitioners and had them complete a questionnaire on their mindfulness practice, difficulties encountered with practice, and factors that supported their practice. They also completed scales measuring mental well-being and psychological flexibility.

 

They found 37% of the participants learned mindfulness practice through a formal course while the rest learned on their own through books, the internet, or through therapists. Most practiced several times per week or daily for 10 to 45 minutes. 57% of the participants indicated that falling asleep during practice was an impediment to practice and many indicated that finding time to practice was a problem. In support of their practice they reported that it was helpful to set up particular times for practice, to practice with others in groups, and having an accepting and kind attitude toward themselves, particularly during lapses in practice.

 

Correlating practice factors with mental well being and psychological flexibility they found that the greater the frequency and duration of formal and informal practice the greater the levels of mental well-being and psychological flexibility. But, when all of the practice factors were considered they found that the frequency of informal practice was the only one that significantly predicted improved mental well-being and psychological flexibility.

 

Informal practices involved everyday mindful moments such as being mindful while engaged in everyday activities such as “washing the dishes, eating, driving, brushing teeth, walking the dog, drinking coffee, and watching a wild bird or flower.” Hence, it would appear that integrating mindfulness into everyday life is essential for mindfulness to be associated with good mental well-being and psychological flexibility. In other words, feeling psychologically better and being able to approach psychological issues with acceptance and flexibly is best supported by engaging in daily activities mindfully.

 

It needs to be kept in mind that these findings are correlational and conclusions regarding causation cannot be reached. It is possible that people who are flexible and have mental well-being are those who engage in informal practices or some other factor may be responsible for both. There is a need for future manipulative research to determine causation.

 

So, improve well-being and psychological flexibility with mindfulness practice.

 

“Daily meditation is a powerful tool for managing your stress and enhancing your health. But bringing present-moment awareness to all your daily activities is important.” Melissa Young

 

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

 

Birtwell, K., Williams, K., van Marwijk, H., Armitage, C. J., & Sheffield, D. (2018). An Exploration of Formal and Informal Mindfulness Practice and Associations with Wellbeing. Mindfulness, 10(1), 89-99.

 

Abstract

Mindfulness has transdiagnostic applicability, but little is known about how people first begin to practice mindfulness and what sustains practice in the long term. The aim of the present research was to explore the experiences of a large sample of people practicing mindfulness, including difficulties with practice and associations between formal and informal mindfulness practice and wellbeing. In this cross-sectional study, 218 participants who were practicing mindfulness or had practiced in the past completed an online survey about how they first began to practice mindfulness, difficulties and supportive factors for continuing to practice, current wellbeing, and psychological flexibility. Participants had practiced mindfulness from under a year up to 43 years. There was no significant difference in the frequency of formal mindfulness practice between those who had attended a face-to-face taught course and those who had not. Common difficulties included finding time to practice formally and falling asleep during formal practice. Content analysis revealed “practical resources,” “time/routine,” “support from others,” and “attitudes and beliefs,” which were supportive factors for maintaining mindfulness practice. Informal mindfulness practice was related to positive wellbeing and psychological flexibility. Frequency (but not duration) of formal mindfulness practice was associated with positive wellbeing; however, neither frequency nor duration of formal mindfulness practice was significantly associated with psychological flexibility. Mindfulness teachers will be able to use the present findings to further support their students by reminding them of the benefits as well as normalising some of the challenges of mindfulness practice including falling asleep.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320743/

 

Reduce Spinal Degeneration in the Elderly with Tai Chi Practice

Reduce Spinal Degeneration in the Elderly with Tai Chi Practice

 

By John M. de Castro, Ph.D.

 

“Tai Chi has been studied as a form of therapeutic exercise and has been shown to improve balance and prevent falls in the elderly.  It can also be a safe and effective way to improve leg strength, hip range of motion, and posture, and is a gentle way to improve neck, shoulder and arm range of motion and movement patterns. The integration of breathing, movement, and energy awareness aspects of this exercise form equates to a “spine-healthy” activity.” – Denver Back Pain

 

Human life is one of constant change. We revel in our increases in physical and mental capacities during development, but regret their decreases during aging. The aging process involves a systematic progressive decline in every system in the body. It is inevitable and cannot be avoided. This includes our mental abilities which decline with age including impairments in memory, attention, and problem-solving ability. A consequence of the physical decline is impaired balance. It is a particular problem as it can lead to falls. The spine also deteriorates and with age there can be degeneration of the vertebrae and discs.

 

There is some hope for age related decline, however, as there is evidence that it can be slowed. There are some indications that physical and mental exercise can reduce the rate of decline. For example, 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 with aging. Tai Chi is also known to improve spinal health. So, it would seem reasonable to examine the ability of Tai Chi practice to slow or prevent age related increases in the degeneration of the vertebrae and discs.

 

In today’s Research News article “.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5971519/ ), Deng and Xia recruited long-term Tai Chi practitioners between the ages of 50 to 70 years and a group of non-practitioners who were matched for gender, age, weight, height, and body mass index (BMI). All participants underwent a lumbar vertebral Magnetic Resonance Imaging (MRI). The images were evaluated by a blinded radiologist for “lumbar vertebrae with degeneration (osteoporosis, hyperosteogeny) and lumbar discs with degeneration (low signal intensity, herniation).”

 

They found that the Tai Chi practitioners had significantly fewer (27%) degenerated vertebra and significantly fewer (21%) degenerated discs than the matched control participants. The authors attributed the lower amount of degeneration to the strengthening of back muscles that is produced by Tai Chi Practice.

 

This study does not contain randomized groups with manipulated Tai Chi participation. As such, conclusions regarding causation need to be tempered. It is possible that people who have or are prone to lumbar degeneration are the people who do not engage in Tai Chi practice. Randomized Clinical Research is needed to clarify this point.

 

But, those older adults who practiced Tai Chi clearly had less lumbar degeneration. This suggests that this group will have enhanced spinal health and will experience less debilitating back pain as they age.

 

So, reduce spinal degeneration in the elderly with Tai Chi practice.

 

“Strengthening the back stabilizer muscles is very similar to tai chi training. The key is an upright posture, using abdominal breathing, and exercising the stabilizers through the pelvic floor and the transverse abdominus muscles. This is one of the major reasons why tai chi works so well for back pain.” – Kelly Rehan

 

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

 

Deng, C., & Xia, W. (2017). Effect of Tai Chi Chuan on degeneration of lumbar vertebrae and lumbar discs in middle-aged and aged people: a cross-sectional study based on magnetic resonance images. The Journal of international medical research, 46(2), 578-585.

 

Short abstract

Objective

Exercise has a positive effect on physical fitness. Tai Chi Chuan is a traditional Chinese aerobic exercise. We assessed the effect of Tai Chi on the degeneration of lumbar vertebrae and lumbar discs with magnetic resonance images.

Methods

This retrospective cohort study involved 2 groups of participants: 27 Tai Chi practitioners with more than 4 years of experience with regular Tai Chi exercise and 24 sex- and age-matched participants without Tai Chi experience. The lumbar magnetic resonance images of all participants were collected. The numbers of degenerated lumbar vertebrae and lumbar discs were evaluated by the same radiologist, who was blind to the grouping.

Results

The Tai Chi practitioners had significantly fewer degenerated lumbar vertebrae (1.9) and lumbar discs (2.3) than the control group (2.6 and 2.9, respectively). The most severely affected lumbar vertebrae and discs were L5 and L4/L5, respectively.

Conclusion

Regular performance of the simplified Tai Chi 24 form could possibly retard the degeneration of lumbar vertebrae and lumbar discs in middle-aged and aged people.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5971519/

 

Improve Type 2 Diabetes with Yoga

Improve Type 2 Diabetes with Yoga

 

By John M. de Castro, Ph.D.

 

Stress elevates blood sugar, which can lead to more diabetes complications. Yoga helps us center ourselves, and centering calms us and can help keep blood sugar levels balanced.” – Janet Zappe

 

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

 

Type 2 diabetes is a common and increasingly prevalent illness that is largely preventable. One of the reasons for the increasing incidence of Type 2 Diabetes is its association with overweight and obesity which is becoming epidemic in the industrialized world. A leading cause of this is a sedentary life style. Unlike Type I Diabetes, Type II does not require insulin injections. Instead, the treatment and prevention of Type 2 Diabetes focuses on diet, exercise, and weight control. Recently, mindfulness practices have been shown to be helpful in managing diabetes. A mindfulness practice that combines mindfulness with exercise is yoga and it has been shown to be helpful in the treatment of Type II Diabetes. Hence, there is a need to step back and review what has been learned regarding the effectiveness of yoga practice for Type 2 Diabetes.

 

In today’s Research News article “The effects of yoga among adults with type 2 diabetes: 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/PMC5653446/ ), Thind and colleagues review summarize and perform a meta-analysis of the published research literature of the effectiveness of yoga practice for Type 2 Diabetes. They identified 23 published studies that included a control group.

 

They found that the research studies reported that compared to control participants, the patients who practiced yoga had significantly lower blood glucose levels and significantly improved glycemic control as evidenced by blood levels of HbA1c and/or FBG. The yoga participants also had significantly improved blood fat levels including lower levels of total cholesterol, very-low density lipoprotein, low-density lipoprotein, and triglyceride levels and increased high-density lipoprotein levels. In addition, the after yoga training the patients had significantly lower blood pressure and body mass index, and lower levels of the stress hormone cortisol.

 

These are remarkable findings, but most of these studies did not contain an active exercise control condition. So, the great benefits of yoga practice may be due to the physical exercise provided by yoga rather than anything specific to yoga. More research is needed to clarify this point. But, regardless, yoga practice has important benefits for adult patients with Type 2 Diabetes improving blood glycemic and lipid control, lowering blood pressure, body size, and stress hormone levels.

 

So, improve Type 2 Diabetes with Yoga.

 

“But yoga’s benefits for those with diabetes aren’t just physical: the process can help patients with the condition or its pre-indicators on more fundamental levels as well. By calming the awareness and integrating the mind with the body, yoga can relieve the daily stresses that often lie at the heart of diabetic symptoms.” – YogaU

 

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

 

Thind, H., Lantini, R., Balletto, B. L., Donahue, M. L., Salmoirago-Blotcher, E., Bock, B. C., & Scott-Sheldon, L. (2017). The effects of yoga among adults with type 2 diabetes: A systematic review and meta-analysis. Preventive medicine, 105, 116-126.

 

Abstract

The purpose of this meta-analysis was to examine the effects of yoga for glycemic control among adults with type 2 diabetes (T2DM). Comprehensive electronic databases searches located 2559 unique studies with relevant key terms. Studies were included if they (1) evaluated a yoga intervention to promote T2DM management, (2) used a comparison group, (3) reported an objective measure of glycemic control at post-intervention, and (4) had follow-up length or post-test of at least 8 weeks from baseline. Independent raters coded participant, design and methodological characteristics and intervention content. Summary effect sizes and 95% confidence intervals (CI) were calculated. Twenty-three studies with 2473 participants (mean age = 53 years; 43% women) met eligibility criteria. Compared with controls, yoga participants were successful in improving their HbA1c (d + = 0.36, 95% CI = 0.16, 0.56; k = 16), FBG (d+ = 0.58, 95% CI = 0.40, 0.76; k = 20), and PPBG (d + = 0.40, 95% CI = 0.23, 0.56; k = 14). Yoga was also associated with significant improvements in lipid profile, blood pressure, body mass index, waist/hip ratio and cortisol levels. Overall, studies satisfied an average of 41% of the methodological quality (MQ) criteria; MQ score was not associated with any outcome (Ps > 0.05). Yoga improved glycemic outcomes and other risk factors for complications in adults with T2DM relative to a control condition. Additional studies with longer follow-ups are needed to determine the long-term efficacy of yoga for adults with T2DM.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5653446/

 

Reduce Stress and Improve Autonomic Nervous System Function with Tai Chi or Yoga

Reduce Stress and Improve Autonomic Nervous System Function with Tai Chi or Yoga

 

By John M. de Castro, Ph.D.

 

The rate of individuals suffering from autonomic nervous system dysfunctions is fast on the rise, due to our high stress and stimulative 21st-century lifestyles. However unknown to many practitioners, there are several natural therapies which are proven to help support the balance of the autonomic nervous system such as meditation and often have fewer side-effects and are better tolerated than many pharmaceutical medications.” –  NaturalHealthBlogger

 

There is an accumulating volume of research findings to demonstrate that Mind-body practices have highly beneficial effects on the health and well-being of humans. These include yoga, tai chi, and qigong, among many others. Because of their proven benefits the application of these practices to relieving human suffering has skyrocketed. Tai Chi has been practiced for thousands of years with benefits for health and longevity. Tai Chi training is designed to enhance function and regulate the activities of the body through regulated breathing, mindful concentration, and gentle movements.  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.

 

One way that these Mind-body practices may have their beneficial effects is by providing balance in the autonomic nervous system. The sympathetic division underlies activation while the parasympathetic division underlies relaxation. When these divisions are out of balance the individual may be overly stressed or overly sedentary. Appropriate balance is important for health and well-being. A measure of balance is provided by the variability of the heart rate. Moderated heart rate variability reflects balance in the autonomic nervous system.

 

In today’s Research News article “Effects of Mind⁻Body Exercises (Tai Chi/Yoga) on Heart Rate Variability Parameters and Perceived Stress: A Systematic Review with Meta-Analysis of Randomized Controlled Trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6262541/ ), Zou and colleagues review, summarize and perform a meta-analysis of the published randomized controlled trials investigating the effects of tai chi and yoga on a measure of autonomic balance; heart rate variability. They discovered 17 research publications reporting on research studies of fair to high quality.

 

They report that after both tai chi or yoga practice there are large significant reductions in perceived stress levels. Also, after practice there were small, albeit significant reductions in the normalized low-frequency component of heart rate variation and the ratio of low frequency to high frequency variations and significant increases in the normalized high-frequency component. These components are thought to be indicative of sympathetic and vagal modulation, sympathetic modulation, and sympathetic activity. These effects on heart rate variation components suggest that after tai chi and yoga practice there is better balance in the autonomic nervous system. Additionally, the published studies indicate that while both tai chi and yoga practice decrease stress and improve autonomic balance, that a minimum of 90 minutes per week of yoga practice produces better results.

 

These results are interesting and important. They suggest that tai chi and especially yoga practice promote health and well-being and may do so by reducing perceived levels of stress and balancing the autonomic nervous system. Yoga practice is generally a more intense exercise and it is likely that this greater intensity of exercise is responsible for yoga’s superiority. But Tai Chi is gentle, safe, and easily practiced conveniently without a professional teacher. Hence, it may be better adapted to integration into the daily lifestyle of the individual.

 

So, reduce stress and improve autonomic nervous system function with tai chi or yoga.

 

Practicing yoga is an excellent way to stimulate and bring circuitry to the important parasympathetic nervous system. The gentle movements and slow rhythmic breathing slow the heart and blood pressure. Yoga redirects blood flow to the reproductive and digestive organs. Regular yoga practice results in a sustained state of strength and health, as well as mind and body balance. Tai Chi is widely used for its variety of health benefits and its adaptability to any age or level of fitness. It is an effective technique that enhances your body’s ability to use the mind to get in touch with the body through the nervous system. The results of continued practice include increased awareness, strengthened nerves, and better coordination, to name a few.” – Aleksandra Eifler

 

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

 

Zou, L., Sasaki, J. E., Wei, G. X., Huang, T., Yeung, A. S., Neto, O. B., Chen, K. W., … Hui, S. S. (2018). Effects of Mind⁻Body Exercises (Tai Chi/Yoga) on Heart Rate Variability Parameters and Perceived Stress: A Systematic Review with Meta-Analysis of Randomized Controlled Trials. Journal of clinical medicine, 7(11), 404. doi:10.3390/jcm7110404

 

Abstract

Background: Heart rate variability (HRV) as an accurate, noninvasive measure of the Autonomous Nervous System (ANS) can reflect mental health (e.g., stress, depression, or anxiety). Tai Chi and Yoga (Tai Chi/Yoga), as the most widely practiced mind–body exercises, have shown positive outcomes of mental health. To date, no systematic review regarding the long-lasting effects of Tai Chi/Yoga on HRV parameters and perceived stress has been conducted. Objective: To critically evaluate the existing literature on this topic. Methods: Five electronic databases (Web of Science, PubMed, Scopus, SportDiscus and Cochrane Library) were searched from the start of the research project to July 2018. Study selection, data extraction, and study quality assessment were independently carried out by two reviewers. The potentially identified randomized controlled trials (RCT) reported the useful quantitative data that were included only for meta-analysis. Results: meta-analysis of 17 medium-to-high quality RCTs showed significantly beneficial effects on HRV parameters (normalized low-frequency, Hedge’s g = −0.39, 95% CI −0.39 to −0.56, p < 0.001, I2 = 11.62%; normalized high-frequency, Hedge’s g = 0.37, 95% CI 0.22 to −0.52, p < 0.001, I2 = 0%; low-frequency to high-frequency ratio, Hedge’s g = −0.58, 95% CI −0.81 to −0.35, p < 0.001, I2 = 53.78%) and stress level (Hedge’s g = −0.80, 95% CI −1.17 to −0.44, p < 0.001, I2 = 68.54%). Conclusions: Stress reduction may be attributed to sympathetic-vagal balance modulated by mind–body exercises. Tai Chi/Yoga could be an alternative method for stress reduction for people who live under high stress or negative emotions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6262541/

 

Reduce Stress and Improve Autonomic Nervous System Function with Tai Chi or Yoga

Reduce Stress and Improve Autonomic Nervous System Function with Tai Chi or Yoga

 

By John M. de Castro, Ph.D.

 

The rate of individuals suffering from autonomic nervous system dysfunctions is fast on the rise, due to our high stress and stimulative 21st-century lifestyles. However unknown to many practitioners, there are several natural therapies which are proven to help support the balance of the autonomic nervous system such as meditation and often have fewer side-effects and are better tolerated than many pharmaceutical medications.” –  NaturalHealthBlogger

 

There is an accumulating volume of research findings to demonstrate that Mind-body practices have highly beneficial effects on the health and well-being of humans. These include yoga, tai chi, and qigong, among many others. Because of their proven benefits the application of these practices to relieving human suffering has skyrocketed. Tai Chi has been practiced for thousands of years with benefits for health and longevity. Tai Chi training is designed to enhance function and regulate the activities of the body through regulated breathing, mindful concentration, and gentle movements.  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.

 

One way that these Mind-body practices may have their beneficial effects is by providing balance in the autonomic nervous system. The sympathetic division underlies activation while the parasympathetic division underlies relaxation. When these divisions are out of balance the individual may be overly stressed or overly sedentary. Appropriate balance is important for health and well-being. A measure of balance is provided by the variability of the heart rate. Moderated heart rate variability reflects balance in the autonomic nervous system.

 

In today’s Research News article “Effects of Mind⁻Body Exercises (Tai Chi/Yoga) on Heart Rate Variability Parameters and Perceived Stress: A Systematic Review with Meta-Analysis of Randomized Controlled Trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6262541/ ), Zou and colleagues review, summarize and perform a meta-analysis of the published randomized controlled trials investigating the effects of tai chi and yoga on a measure of autonomic balance; heart rate variability. They discovered 17 research publications reporting on research studies of fair to high quality.

 

They report that after both tai chi or yoga practice there are large significant reductions in perceived stress levels. Also, after practice there were small, albeit significant reductions in the normalized low-frequency component of heart rate variation and the ratio of low frequency to high frequency variations and significant increases in the normalized high-frequency component. These components are thought to be indicative of sympathetic and vagal modulation, sympathetic modulation, and sympathetic activity. These effects on heart rate variation components suggest that after tai chi and yoga practice there is better balance in the autonomic nervous system. Additionally, the published studies indicate that while both tai chi and yoga practice decrease stress and improve autonomic balance, that a minimum of 90 minutes per week of yoga practice produces better results.

 

These results are interesting and important. They suggest that tai chi and especially yoga practice promote health and well-being and may do so by reducing perceived levels of stress and balancing the autonomic nervous system. Yoga practice is generally a more intense exercise and it is likely that this greater intensity of exercise is responsible for yoga’s superiority. But Tai Chi is gentle, safe, and easily practiced conveniently without a professional teacher. Hence, it may be better adapted to integration into the daily lifestyle of the individual.

 

So, reduce stress and improve autonomic nervous system function with tai chi or yoga.

 

Practicing yoga is an excellent way to stimulate and bring circuitry to the important parasympathetic nervous system. The gentle movements and slow rhythmic breathing slow the heart and blood pressure. Yoga redirects blood flow to the reproductive and digestive organs. Regular yoga practice results in a sustained state of strength and health, as well as mind and body balance. Tai Chi is widely used for its variety of health benefits and its adaptability to any age or level of fitness. It is an effective technique that enhances your body’s ability to use the mind to get in touch with the body through the nervous system. The results of continued practice include increased awareness, strengthened nerves, and better coordination, to name a few.” – Aleksandra Eifler

 

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

 

Zou, L., Sasaki, J. E., Wei, G. X., Huang, T., Yeung, A. S., Neto, O. B., Chen, K. W., … Hui, S. S. (2018). Effects of Mind⁻Body Exercises (Tai Chi/Yoga) on Heart Rate Variability Parameters and Perceived Stress: A Systematic Review with Meta-Analysis of Randomized Controlled Trials. Journal of clinical medicine, 7(11), 404. doi:10.3390/jcm7110404

 

Abstract

Background: Heart rate variability (HRV) as an accurate, noninvasive measure of the Autonomous Nervous System (ANS) can reflect mental health (e.g., stress, depression, or anxiety). Tai Chi and Yoga (Tai Chi/Yoga), as the most widely practiced mind–body exercises, have shown positive outcomes of mental health. To date, no systematic review regarding the long-lasting effects of Tai Chi/Yoga on HRV parameters and perceived stress has been conducted. Objective: To critically evaluate the existing literature on this topic. Methods: Five electronic databases (Web of Science, PubMed, Scopus, SportDiscus and Cochrane Library) were searched from the start of the research project to July 2018. Study selection, data extraction, and study quality assessment were independently carried out by two reviewers. The potentially identified randomized controlled trials (RCT) reported the useful quantitative data that were included only for meta-analysis. Results: meta-analysis of 17 medium-to-high quality RCTs showed significantly beneficial effects on HRV parameters (normalized low-frequency, Hedge’s g = −0.39, 95% CI −0.39 to −0.56, p < 0.001, I2 = 11.62%; normalized high-frequency, Hedge’s g = 0.37, 95% CI 0.22 to −0.52, p < 0.001, I2 = 0%; low-frequency to high-frequency ratio, Hedge’s g = −0.58, 95% CI −0.81 to −0.35, p < 0.001, I2 = 53.78%) and stress level (Hedge’s g = −0.80, 95% CI −1.17 to −0.44, p < 0.001, I2 = 68.54%). Conclusions: Stress reduction may be attributed to sympathetic-vagal balance modulated by mind–body exercises. Tai Chi/Yoga could be an alternative method for stress reduction for people who live under high stress or negative emotions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6262541/

 

Improve Brain Connectivity with Meditation

Improve Brain Connectivity with Meditation

 

By John M. de Castro, Ph.D.

 

“The meditation-and-the-brain research has been rolling in steadily for a number of years now, with new studies coming out just about every week to illustrate some new benefit of meditation. Or, rather, some ancient benefit that is just now being confirmed with fMRI or EEG. The practice appears to have an amazing variety of neurological benefits – from changes in grey matter volume to reduced activity in the “me” centers of the brain to enhanced connectivity between brain regions.“ – Alice Walton

 

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 “Differences in Functional Connectivity of the Insula Between Brain Wave Vibration in Meditators and Non-meditators.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6244630/ ), Jang and colleagues recruited meditation practitioners and meditation naïve participants. The meditation practitioners had been practicing Brain Wave Meditation daily for at least a year. This meditation technique “is designed to help quiet the thinking mind and release negative emotions by performing specific rhythmic physical movements and focusing on bodily sensations.” The participants then underwent resting functional Magnetic Resonance Imaging (fMRI) of their brains.

 

They found that in comparison to the meditation naïve controls the meditators had greater levels of functional connectivity between the Dorsolateral Prefrontal Cortex and the Insula and Thalamus. There was also increased functional connectivity between the Insula and the Superior Temporal Gyrus. The Insula Cortex is thought to be involved in interoceptive awareness, that is the awareness of the body and the sensations from the body. The Thalamus is the major sensory relay in the brain transferring sensory information throughout the brain. The Prefrontal Cortex is thought to be involved in attention and higher-level thinking, cognition.

 

The findings, then, suggest that meditation practice changes the brain in such a way as to improve attention and thought processes regarding internal sensations. This implies better attention to emotional states and better ability to regulate emotions. Indeed, it has been well established that meditation practice improves attention, high level thinking and emotion regulation. This, in turn, may underlie the increases in compassion toward the self and others that has been shown to occur in meditators. Better emotion regulation would increase psychological and physical well-being of practitioners. Thus, some of the benefits of meditation appear to be reflected in changes to the brain which may underlie these benefits.

 

So, improve brain connectivity with meditation.

 

an added bonus of meditating is that the connection between the helpful aspects of the Me Center (i.e. dorsomedial prefrontal cortex) – the part involved in processing information related to people we perceive as being not like us – and the bodily sensation center – involved in empathy – becomes stronger.” – Rebecca Gladding

 

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

 

Jang, J. H., Kim, J. H., Yun, J. Y., Choi, S. H., An, S. C., & Kang, D. H. (2018). Differences in Functional Connectivity of the Insula Between Brain Wave Vibration in Meditators and Non-meditators. Mindfulness, 9(6), 1857-1866.

 

Abstract

The majority of meditation involves focusing attention on internal events or sensations and becoming aware of emotions. The insula cortex, through a functional connection with the prefrontal cortex and other brain regions, plays a key role in integrating external sensory information with internal bodily state signals and emotional awareness. The purpose of this exploratory study was to examine the resting-state functional connectivity of the insula with other brain regions in meditation practitioners and control subjects. Thirty-five Brain Wave Vibration meditation practitioners and 33 controls without meditation experience were included in this study. All subjects underwent 4.68-min resting-state functional scanning runs using magnetic resonance imaging. The anterior and posterior insulae were chosen as seed regions for the functional connectivity map. Meditation practitioners showed significantly greater insula-related functional connectivity in the thalamus, caudate, middle frontal gyrus, and superior temporal gyrus than did controls. Control subjects demonstrated greater functional connectivity with the posterior insula in the parahippocampal gyrus. Our findings suggest that the practice of Brain Wave Vibration meditation may be associated with functional differences in regions related to focused attention, executive control, and emotional awareness and regulation.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6244630/

 

Improve PTSD Symptoms Related to Childhood Sexual Abuse with Mindfulness

Improve PTSD Symptoms Related to Childhood Sexual Abuse with Mindfulness

 

By John M. de Castro, Ph.D.

 

DBT-PTSD significantly reduced the women’s PTSD symptoms, including depression and anxiety. In addition, the women’s PTSD symptoms were still improving six weeks after they completed the treatment, suggesting that they may have learned skills during the study that helped them continue to recover from PTSD after the treatment ended.” – Matthew Tull

 

Childhood sexual abuse is a horrific crime. The trauma created in the victim changes them forever. It changes the trusting innocence of childhood to a confused, guilt ridden, frightening, and traumatized existence. It not only produces short-term trauma which includes both psychological and physical injury, it has long-term consequences. It damages the victim’s self-esteem and creates difficulties entering into intimate relationship in adulthood. It can create post-traumatic stress disorder (PTSD) complete with painful flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event. Victims often experience depression and sometimes become suicidal. It is a heinous crime that haunts the victims for the rest of their lives.

 

Unfortunately, childhood sexual abuse is shockingly common. It is estimated that 20% of girls and 10% of boys have experienced childhood sexual abuse and half of these were forcefully assaulted. Children between the ages of 7 and 13 are the most vulnerable but abuse is also prevalent in adolescence with 16% of children between 14 to 17 having been sexually victimized. Compounding the problem disclosure of sexual abuse is often delayed; children often avoid telling because they are either afraid of a negative reaction from their parents or of being harmed by the abuser. As such, they often delay disclosure until adulthood. This makes it unlikely that they’ll seek help and instead suffer in silence.

 

Mindfulness training has been shown to be effective in treating victims of trauma and PTSD.

Dialectical Behavior Therapy (DBT) focuses on changing the thoughts and emotions that precede problem behaviors, as well as by solving the problems faced by individuals that contribute to problematic thoughts, feelings and behaviors. In DBT five core skills are practiced; mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness. So, it would make sense to explore the effectiveness of DBT for the treatment of adult survivors of childhood sexual abuse.

 

In today’s Research News article “Dialectical behaviour therapy for posttraumatic stress disorder related to childhood sexual abuse: a pilot study in an outpatient treatment setting.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5774406/ ), Steil and colleagues recruited adult healthy women who had experienced childhood sexual abuse and were diagnosed with post-traumatic stress disorder (PTSD). They treated them with Dialectical Behavior Therapy (DBT) in a group for 90 minutes, once a week for 24 weeks. They were measured before and after treatment and 6 weeks later for frequency and intensity of PTSD symptoms, personality disorders, borderline symptoms, depression, and dissociative symptoms.

 

They found that the average duration of the PTSD symptoms prior to treatment was 14.5 years. 81% of the patients completed treatment. Following treatment, the women had significant reductions in PTSD symptoms including fewer intrusions, less avoidances, and hyperarousal episodes with large effect sizes. Treatment also produced large significant reductions in borderline symptoms, depression, and dissociative symptoms. These effects were still present and significant at the 6-week follow-up measurement.

 

The results suggest that Dialectical Behavior Therapy (DBT) is a safe, lasting, and effective treatment for PTSD symptoms resulting from childhood sexual abuse. But this was a pilot study without a control group. It relied upon before and after treatment comparisons. As such, there are many potential confounding factors. But the results are so positive and beneficial that a large randomized controlled clinical trial is warranted.

 

So, improve PTSD symptoms related to childhood sexual abuse with mindfulness.

 

“Mindfulness has been shown to be an effective stress reduction practices in general, but there may be other ways it works for people with PTSD as well. Recent research suggests that mindfulness may help to mitigate the relationship between maladaptive thinking and posttraumatic distress.” – Matthew Tull

 

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

 

Regina Steil, Clara Dittmann, Meike Müller-Engelmann, Anne Dyer, Anne-Marie Maasch, Kathlen Priebe. Dialectical behaviour therapy for posttraumatic stress disorder related to childhood sexual abuse: a pilot study in an outpatient treatment setting. Eur J Psychotraumatol. 2018; 9(1): 1423832. Published online 2018 Jan 19. doi: 10.1080/20008198.2018.1423832

 

ABSTRACT

Background: Dialectical behaviour therapy for posttraumatic stress disorder (DBT-PTSD), which is tailored to treat adults with PTSD and co-occurring emotion regulation difficulties, has already demonstrated its efficacy, acceptance and safety in an inpatient treatment setting. It combines elements of DBT with trauma-focused cognitive behavioural interventions.

Objective: To investigate the feasibility, acceptance and safety of DBT-PTSD in an outpatient treatment setting by therapists who were novice to the treatment, we treated 21 female patients suffering from PTSD following childhood sexual abuse (CSA) plus difficulties in emotion regulation in an uncontrolled clinical trial.

Method: The Clinician Administered PTSD Symptom Scale (CAPS), the Davidson Trauma Scale (DTS), the Borderline Section of the International Personality Disorder Examination (IPDE) and the Borderline Symptom List (BSL-23) were used as primary outcomes. For secondary outcomes, depression and dissociation were assessed. Assessments were administered at pretreatment, post-treatment and six-week follow-up.

Results: Improvement was significant for PTSD as well as for borderline personality symptomatology, with large pretreatment to follow-up effect sizes for completers based on the CAPS (Cohens d = 1.30), DTS (d = 1.50), IPDE (d = 1.60) and BSL-23 (d = 1.20).

Conclusion: The outcome suggests that outpatient DBT-PTSD can safely be used to reduce PTSD symptoms and comorbid psychopathology in adults who have experienced CSA.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5774406/

 

Quality of Life of Patients with Cardiovascular Disease is Higher with Spirituality

Quality of Life of Patients with Cardiovascular Disease is Higher with Spirituality

 

By John M. de Castro, Ph.D.

 

Positive beliefs, comfort, and strength gained from religion, meditation, and prayer can contribute to well being. It may even promote healing. Improving your spiritual health may not cure an illness, but it may help you feel better. It also may prevent some health problems and help you cope better with illness, stress, or death.” – FamilyDoctor

 

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 be helpful for producing the kinds of lifestyle changes needed to prevent heart disease such as smoking cessationweight reduction, and stress reduction. Indeed, yoga practice is both a mindfulness training technique and a physical exercise.

 

Spirituality is defined as “one’s personal affirmation of and relationship to a higher power or to the sacred.” Spirituality has been promulgated as a solution to the challenges of life both in a transcendent sense and in a practical sense. The transcendent claims are untestable with the scientific method. But the practical claims are amenable to scientific analysis. There have been a number of studies of the relationship of spirituality with the physical and psychological well-being of practitioners mostly showing positive benefits, with spirituality related to greater personal growth and mental health. So, it would make sense to review what is known regarding the relationship of spirituality and religiosity to the psychological state of patients with cardiovascular disease.

 

In today’s Research News article “Association of religiosity and spirituality with quality of life in patients with cardiovascular disease: a systematic review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196107/  ), Abu and colleagues review and summarize the published research literature on the relationship of spirituality and religiosity to the quality of life of patients with cardiovascular disease. They found and reviewed 15 published studies that assessed spirituality and/or religiosity and global, mental, physical, or disease-related quality of life. All studies were correlational in nature without any active manipulations. Eleven of the studies included patients with heart failure, 2 with acute myocardial infarction, 1 with congenital heart disease, and 1 with multiple diagnoses.

 

They report that 10 of the 15 reviewed studies reported significant positive associations between spirituality and/or religiosity and quality of life in patients with cardiovascular disease; the greater the levels of spirituality and/or religiosity, the higher the quality of life. These results are correlational and conclusions regarding causality cannot be confidently made. Even reverse causation is possible such that a higher quality of life with heart disease produces greater spirituality and/or religiosity. In addition, only 2/3 of the studies reported significant results suggesting that the relationships are not highly robust.

 

The findings, though, regardless of causality suggest that spirituality and/or religiosity is related to better quality of life in patients with cardiovascular disease. Spirituality and/or religiosity have been shown to be related to resilience and low levels of stress, greater mental health, and better adherence to pharmacologic and non-pharmacologic therapy. These relationships with spirituality and/or religiosity would tend to predict better outcomes and quality of life in the patients. It is also possible that the social relationships and support supplied by spiritual or religious communities are responsible for the relationship. Regardless, it would appear that spirituality and/or religiosity are associated with better quality of life in patients with cardiovascular disease.

 

There are more than 50 studies in which religious practices were found to be protective against cardiovascular disease, including death due to heart attacks and strokes as well as against numerous risk factors such as high blood pressure and elevated cholesterol and triglyceride levels.” – Michael Murray

 

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

 

Hawa O. Abu, Christine Ulbricht, Eric Ding, Jeroan J. Allison, Elena Salmoirago-Blotcher, Robert J. Goldberg, Catarina I. Kiefe. Association of religiosity and spirituality with quality of life in patients with cardiovascular disease: a systematic review. Qual Life Res. 2018; 27(11): 2777–2797.

 

Abstract

Purpose

This review systematically identified and critically appraised the available literature that has examined the association between religiosity and/or spirituality (R/S) and quality of life (QOL) in patients with cardiovascular disease (CVD).

Methods

We searched several electronic online databases (PubMed, SCOPUS, PsycINFO, and CINAHL) from database inception until October 2017. Included articles were peer-reviewed, published in English, and quantitatively examined the association between R/S and QOL. We assessed the methodological quality of each included study.

Results

The 15 articles included were published between 2002 and 2017. Most studies were conducted in the US and enrolled patients with heart failure. Sixteen dimensions of R/S were assessed with a variety of instruments. QOL domains examined were global, health-related, and disease-specific QOL. Ten studies reported a significant positive association between R/S and QOL, with higher spiritual well-being, intrinsic religiousness, and frequency of church attendance positively related with mental and emotional well-being. Approximately half of the included studies reported negative or null associations.

Conclusions

Our findings suggest that higher levels of R/S may be related to better QOL among patients with CVD, with varying associations depending on the R/S dimension and QOL domain assessed. Future longitudinal studies in large patient samples with different CVDs and designs are needed to better understand how R/S may influence QOL. More uniformity in assessing R/S would enhance the comparability of results across studies. Understanding the influence of R/S on QOL would promote a holistic approach in managing patients with CVD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196107/

 

Sleep and Fatigue is not Improved in Prostate Cancer Patients Undergoing Radiotherapy with Qigong/Tai Chi Exercise

Sleep and Fatigue is not Improved in Prostate Cancer Patients Undergoing Radiotherapy with Qigong/Tai Chi Exercise

 

By John M. de Castro, Ph.D.

 

“While most studies to date fail to show that qigong has a direct effect on cancer, several studies have found this practice to have a positive impact on the well-being and quality of life for people living with cancer.” – Lynne Eldridge

 

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. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis.

 

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. It is estimated that 15 million adults and children with a history of cancer are alive in the United States today. But, surviving cancer carries with it a number of problems. “Physical, emotional, and financial hardships often persist for years after diagnosis and treatment. Cancer survivors are also at greater risk for developing second cancers and other health conditions.” National Cancer Survivors Day.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression.. Tai Chi or Qigong practice has been shown to improve quality of life, reduce fatigue, and lower blood pressure and cortisol levels. Qigong is a very gentle and safe practice. So, it makes sense to further study its utility for cancer patients.

 

In today’s Research News article “Qigong/tai chi for sleep and fatigue in prostate cancer patients undergoing radiotherapy: a randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5378667/ ), McQuade and colleagues recruited prostate cancer patients undergoing radiotherapy and randomly assigned them to one of three conditions; Qigong/Tai Chi; light exercise; or wait-list control. The Qigong/Tai Chi and light exercise training occurred three times per week for 40 minutes during radiotherapy treatment. Light exercise consisted of stretching and light resistance exercise matched to the exertion level of the Qigong/Tai Chi exercise. They were measured before, during, and after treatment and 1 and 3 months later for sleep disturbance, fatigue, and health-related quality of life.

 

They found that midway through treatment the Qigong/Tai Chi group slept better than the other groups but these differences were not maintained at the end of treatment or on follow-up. There were no significant effects or treatment on fatigue or quality of life. In some ways these results are disappointing and suggest that Qigong/Tai Chi is not effective in helping prostate cancer patients during radiotherapy.

 

Radiotherapy, however, produces considerable side effects including hot flashes and urinary symptoms that are highly predictive of sleep disturbance, fatigue, and quality of life. In addition, Qigong/Tai Chi exercise has been shown to improve quality of life, reduce fatigue in other cancer patients after treatment. It will require future research to determine if Qigong/Tai Chi exercise conducted after radiotherapy is completed may be beneficial for these patients.

 

“Tai Chi and Qigong are ancient forms of exercise that fit the bill for helping patients with cancer get moving and improve their overall sense of well-being. Tai Chi practice can help with pain conditions, especially pain involving muscles and joints; it can also reduce stress and anxiety and improve the quality of sleep.” – Susan Yaguda

 

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

 

McQuade, J. L., Prinsloo, S., Chang, D. Z., Spelman, A., Wei, Q., Basen-Engquist, K., Harrison, C., Zhang, Z., Kuban, D., Lee, A., … Cohen, L. (2016). Qigong/tai chi for sleep and fatigue in prostate cancer patients undergoing radiotherapy: a randomized controlled trial. Psycho-oncology, 26(11), 1936-1943.

 

Abstract

Objectives

Sleep disturbances and fatigue are common in prostate cancer patients undergoing radiotherapy. Prior research suggests mind-body techniques may improve these outcomes. We conducted a randomized-controlled trial of qigong/tai chi (QGTC) in men with prostate cancer undergoing radiotherapy.

Methods

Men with prostate cancer starting definitive radiation were randomized to one of three groups: (1) QGTC; (2) light exercise (LE); or (3) wait list control (WLC). Sleep disturbances (PSQI) and fatigue (BFI) were assessed at baseline, mid-radiotherapy (T2), during the last week of radiotherapy (T3) and at 1 (T4) and 3 months (T5) after the end of radiotherapy. Patients in the QGTC and LE groups attended three 40-minute classes per week throughout radiotherapy.

Results

Ninety patients were randomized to the three groups (QGTC=26; LE=26; WLC=24). QGTC group reported longer sleep duration at mid-XRT (QGTC=7.01 hours; LE=6.42; WL=6.50; p=0.05) but this difference did not persist over time. There were no group differences in other domains of sleep or fatigue. Exploratory analyses conducted to examine the effect of health-related QOL (EPIC and AUA score) on sleep and fatigue showed significant correlations across multiple domains.

Conclusions

QGTC during radiation for prostate cancer resulted in superior sleep duration midway through radiation, but this effect was not durable and there were no differences in other domains of sleep or fatigue. Exploratory analysis demonstrated that both sleep and fatigue were highly correlated with prostate cancer related physical symptoms. Future mind-body intervention studies should incorporate multi-modal therapy focused on improving physical symptoms in this population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5378667/