Improve Attention in Children and Adults with ADHD with Mindfulness

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Improve Attention in Children and Adults with ADHD with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Unlike many tools for ADHD, mindfulness develops the individual’s inner skills. It improves your ability to control your attention by helping to strengthen your ability to self-observe, to train attention, and to develop different relationships to experiences that are stressful. In other words, it teaches you to pay attention to paying attention, and can also make people more aware of their emotional state, so they won’t react impulsively. That’s often a real problem for people with ADHD.” – Carl Sherman

 

Attention Deficit Hyperactivity Disorder (ADHD) is most commonly found in children, but for about half it persists into adulthood. It’s estimated that about 5% of the adult population has ADHD. Hence, this is a very large problem that can produce inattention, impulsivity, hyperactivity, and emotional issues, and reduce quality of life. The most common treatment is drugs, like methylphenidate, Ritalin, which helps reducing symptoms in about 30% of the people with ADHD. Unfortunately, the effectiveness of the drugs appears to be markedly reduced after the first year. In addition, the drugs often have troublesome side effects, can be addictive, and can readily be abused. So, drugs, at present, do not appear to be a good solution, only affecting some, only for a short time, and with unwanted side effects.

 

There are indications that mindfulness training may be an effective treatment for ADHD. It makes sense that it should be, as the skills and abilities strengthened by mindfulness training are identical to those that are defective in ADHD,  attention, impulse control, executive function, emotion control, and mood improvement. In addition, unlike drugs, it is a relatively safe intervention that has minimal troublesome side effects. Since mindfulness is so promising as a treatment, it is important to step back and summarize what has been learned in the scientific research of the effectiveness of mindfulness training for ADHD.

 

In today’s Research News article “The Effectiveness of Mindfulness-Based Intervention in Attention on Individuals with ADHD: A Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6092011/ ), Lee and colleagues review and summarize the published research studies on the effectiveness of mindfulness training for Attention Deficit Hyperactivity Disorder (ADHD) in children and adults. They found 9 articles, 5 with adults, 1 with adults and adolescents, 2 with adolescents, and 1 with children.

 

They report that the published studies on adults with ADHD found that mindfulness training produced significant improvements in attention. With both adolescents and children both teachers and parents reported that after mindfulness training there were significant improvements in attention. Unfortunately, many of these studies used weak experimental designs. Hence, there is a need to perform large scale randomized controlled studies with active controls before firm conclusions can be reached.

 

Mindfulness training, however, focuses on attention, with training to maintain attention in the present moment on a target, such as the breath or feelings from the body. It has been repeatedly shown to improve attention in a wide range of healthy and ill individuals of varying ages. So, it would seem reasonable to predict that mindfulness training would also improve attention in people with ADHD.

 

So, improve attention in children and adults with ADHD with mindfulness training.

 

“ADHD is characterized by difficulties with executive function, not just attention, and mindfulness is an avenue to developing interrelated cognitive skills, many related to executive function, not just attention.” – Mark Bertin

 

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

 

Lee, C., Ma, M. T., Ho, H. Y., Tsang, K. K., Zheng, Y. Y., & Wu, Z. Y. (2017). The Effectiveness of Mindfulness-Based Intervention in Attention on Individuals with ADHD: A Systematic Review. Hong Kong journal of occupational therapy : HKJOT, 30(1), 33-41.

 

Abstract

Background/Objective

Mindfulness-based intervention has received more clinical interest and empirical support for individuals with ADHD especially to improve attention. However, no systematic review has been done to analyze and compare the effectiveness of mindfulness-based intervention on individuals with ADHD in different age groups. This review examined its effectiveness for individuals (children, adolescents and adults) with ADHD to improve attention.

Methods

In 7 databases, totally of 152 studies were identified; 9 met the inclusion and exclusion criteria and were reviewed. Five of the studies recruited adults as the participants, two recruited adolescents as the participants, one recruited both adults and adolescents as the participants and one recruited children as the participants.

Results

It was found that mindfulness-based intervention was comparatively more popularly used in adults with ADHD to improve attention, and the improvement was significant.

Conclusion

It is still unclear whether mindfulness-based intervention is effective for children and adolescence with ADHD due to limited studies available and the limitations of the study design in the reviewed studies. Therefore, more research in the future is required to answer the question.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6092011/

 

Improve the Mental Health of Breast Cancer Survivors with Mindfulness

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Improve the Mental Health of Breast Cancer Survivors with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness-based meditation can help ease the stress, anxiety, fear, and depression that often come along with a breast cancer diagnosis and treatment.” – BreastCancer,org

 

About 12.5% of women in the U.S. develop invasive breast cancer over their lifetimes and every year about 40,000 women die. Indeed, more women in the U.S. die from breast cancer than from any other cancer, besides lung cancer. Breast cancer diagnosis, however, is not always a death sentence. Death rates have been decreasing for decades from improved detection and treatment of breast cancer. Five-year survival rates are now at around 95%. The improved survival rates mean that more women are now living with cancer.

 

Surviving cancer, however, 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). Also, breast cancer survivors can have to deal with a heightened fear of reoccurrence. This is particularly true with metastatic cancer. Additionally, cancer survivors frequently suffer from anxiety, depression, mood disturbance, Post-Traumatic Stress Disorder (PTSD), sleep disturbance, fatigue, sexual dysfunction, loss of personal control, impaired quality of life, an alteration of their body image, and psychiatric symptoms which have been found to persist even ten years after remission. So, safe and effective treatments for the symptoms in breast cancer and the physical and psychological effects of the treatments are needed.

 

Mindfulness training has been shown to help with general cancer recovery and breast cancer recovery. Mindfulness helps to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. Hence, there is a need to intensively study the effectiveness of these programs to help alleviate the mental and physical sequelae of breast cancer survival.

 

In today’s Research News article “Investigating the Effect of Mindfulness-Based Training on Psychological Status and Quality of Life in Patients with Breast Cancer.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165667/ ), Pouy and colleagues recruited women with diagnosed breast cancer at least 6 months after diagnosis and randomly assigned them to either receive either routine care plus 4 weeks of twice a week for 1.5 hours group based mindfulness training or routine care only. The mindfulness training was based upon the Mindfulness-Based Stress Reduction (MBSR) program that includes body scan and focused meditations, yoga practice, and discussion. They were measured before the training and 2 months later for anxiety, depression, stress, physical health, mental health, social relationships, environmental health, quality of life, and life expectancy questionnaire.

 

They found that after the mindfulness training the breast cancer survivors had significantly improved quality of life and life expectancy and significantly less anxiety, depression, and stress. Hence, mindfulness training was found to be of great benefit to the patients, improving their quality of life and psychological health. These findings are similar to previous findings that mindfulness training reduces anxiety, depression, and stress and improves quality of life in cancer patients. The current study adds to the accumulating scientific evidence that mindfulness practice significantly beneficial for breast cancer survivors.

 

So, improve the mental health of breast cancer survivors with mindfulness.

 

“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. Scientists caution, however that sustained benefit requires ongoing mindfulness practice.” – BCRF

 

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

 

Pouy, S., Attari Peikani, F., Nourmohammadi, H., Sanei, P., Tarjoman, A., & Borji, M. (2018). Investigating the Effect of Mindfulness-Based Training on Psychological Status and Quality of Life in Patients with Breast Cancer. Asian Pacific journal of cancer prevention : APJCP, 19(7), 1993-1998. doi:10.22034/APJCP.2018.19.7.1993

 

Abstract

Cancer poses substantial challenges to both physical and mental health of patients. On the other hand, breast cancer is one of the most common cancers among Iranian women. Therefore, the present study was conducted to investigate the effect of mindfulness-based training on psychological status and quality of life (QoL) of patients with breast cancer living in Ilam, Iran. This quasi-experimental study was performed on 66 patients diagnosed with breast cancer. The patients assigned into two groups of experimental and control. Experimental group received mindfulness-based group training through eight 90-min sessions. Sessions were conducted twice a week and were completed within 1 month. The research tools included a QoL questionnaire (WHOQOL-BREF), Schneider’s life expectancy questionnaire, and the depression anxiety stress scale (DASS-21). The questionnaires were completed before and during the interviews with the patients 2 months after intervention. Data were analyzed using SPSS (version 16) and running descriptive and analytical statistics. Before the intervention, there was no significant difference between he experimental and control groups considering QoL, life expectancy, depression, anxiety, and stress (p>0.05). However, after the intervention, the patients in the experimental group reported higher QoL and life expectancy and less severe depression, anxiety, and stress (p < 0.05). Considering the positive effect of mindfulness-based training on the psychological status and QoL of patients with breast cancer, we recommend health nurses conduct mindfulness-based training for patients receiving clinical care services.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165667/

 

Reduce Anxiety and Depression with Mindfulness

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Reduce Anxiety and Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Being unwilling to experience negative thoughts, feelings, or sensations is often the first link in a mental chain that can lead to automatic, habitual, and critical patterns of mind becoming re-established. By accepting unpleasant experiences, we can shift our attention to opening up to them. Thus, “I should be strong enough” shifts to “Ah, fear is here,” or “Judgment is present.”—Zindel Segal,

 

Meditation training has been shown to improve health and well-being. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. Meditation practice has been found to improve the regulation of emotions and reduce difficult emotional states such as anxiety and depression.

 

A characterizing feature of anxiety disorders is recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Indeed, Mindfulness practices have been shown to be quite effective in relieving anxiety. Anxiety often co-occurs with depression and mindfulness training is also effective for treating depression. Anxiety disorders and depression have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. So, there is a need to develop alternative treatments. Since mindfulness- based treatments are relatively new, it makes sense to step back and summarize what is known regarding the effectiveness of mindfulness training for anxiety disorders and for depression.

 

In today’s Research News article “Mindfulness-Based Interventions for Anxiety and Depression. The Psychiatric clinics of North America.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5679245/ ), Hofmann and Gomez review and summarize the published research literature on the effectiveness of mindfulness training for the relief of anxiety and depression.

 

They report that randomized controlled trials found that Mindfulness-Based interventions including the Mindfulness-Based Stress Reduction (MBSR), the Mindfulness-Based Cognitive Therapy (MBCT), Dialectical Behavior Therapy, and Acceptance and Commitment Therapy treatment programs were “moderately-to-largely effective at reducing anxiety and depression symptom severity among individuals with a broad range of medical and psychiatric conditions.” They also report that these programs are effective whether provided in person or over the internet. They are consistently more effective than health education, relaxation training, and supportive psychotherapy, but equivalently effective as Cognitive Behavioral Therapy (CBT).

 

Hence, accumulating controlled research has built a strong case for the use of Mindfulness-Based Interventions for the treatment of anxiety and depression. Since, these treatments are generally safe and effective with little if any side effects, they would appear to be preferable to pharmacological treatments.

 

So, reduce anxiety and depression with mindfulness.

 

“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. Far too often when we look to the future, we ask ourselves, “What if,” and the answer we give ourselves is often a prediction of a negative result.” – 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

 

Hofmann, S. G., & Gómez, A. F. (2017). Mindfulness-Based Interventions for Anxiety and Depression. The Psychiatric clinics of North America, 40(4), 739-749.

 

Key Points

  • Research on mindfulness-based interventions (MBIs) for anxiety and depression has increased exponentially in the past decade. The most common include Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT).
  • MBIs have demonstrated efficacy in reducing anxiety and depression symptom severity in a broad range of treatment-seeking individuals.
  • MBIs consistently outperform non-evidence-based treatments and active control conditions, such as health education, relaxation training, and supportive psychotherapy.
  • MBIs also perform comparably to cognitive-behavioral therapy (CBT). The treatment principles of MBIs for anxiety and depression are compatible with those of standard CBT.

Synopsis

This article reviews the ways in which cognitive and behavioral treatments for depression and anxiety have been advanced by the application of mindfulness practices. Research on mindfulness-based interventions (MBIs) has increased exponentially in the past decade. The most common include Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT). MBIs have demonstrated efficacy in reducing anxiety and depression symptom severity in a broad range of treatment-seeking individuals. MBIs consistently outperform non-evidence-based treatments and active control conditions, such as health education, relaxation training, and supportive psychotherapy. MBIs also perform comparably to cognitive-behavioral therapy (CBT). The treatment principles of MBIs for anxiety and depression are compatible with those of standard CBT.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5679245/

 

Reduce Aging Cognitive Decline with Mindfulness

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Reduce Aging Cognitive Decline with Mindfulness

 

By John M. de Castro, Ph.D.

 

“We know that approximately 50 percent of people diagnosed with mild cognitive impairment—the intermediate stage between the expected declines of normal aging and the more serious cognitive deterioration associated with dementia—may develop dementia within five years.” – Rebecca Erwin Wells

 

The aging process involves a systematic progressive decline in every system in the body, the brain included. This includes our mental abilities (cognition) which decline with age including impairments in memory, attention, and problem solving abilities. It is inevitable and cannot be avoided. An encouraging new development is that mindfulness practices such as meditation training can significantly reduce these declines in cognitive ability. In addition, it has been found that mindfulness practices reduce the deterioration of the brain that occurs with aging restraining the loss of neural tissue. Indeed, the brains of practitioners of meditation and yoga have been found to degenerate less with aging than non-practitioners.

 

Before active dementia occurs, patients show problems with attention, thinking, and memory known as mild cognitive impairment. Intervening at this point may be able to delay or even prevent full blown dementia, So, it is important to study the effectiveness of mindfulness training on older adults with mild cognitive impairment to improve their cognitive performance.

 

In today’s Research News article “The Effects of Mindfulness on Older Adults with Mild Cognitive Impairment.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6159696/ ), Wong and colleagues recruited healthy older adults (> 60 years of age) who were diagnosed with mild cognitive impairment and were meditation naïve. They participated in an 8-week, 1.5 hours per week, program of mindfulness training that included body scan meditation, breath meditation, loving kindness meditation, and everyday mindfulness practice. The participants were also encouraged to practice at home. They were measured before and after training and one year later for cognitive function, psychological health, mindfulness, mindfulness adherence, and daily living functionality.

 

They found that after training the participants had significant improvements in mindfulness and cognitive function. These improvements were no longer significant at the one year follow up. This appears, however, to be due to the level of continuing practice as the greater the amount of meditation practice during the 1-year follow-up period the greater the level of cognitive function. Indeed, those who practiced above the group average had significantly better cognitive performance at the 1-year follow-up than those who were below average in practicing.

 

These results suggest that mindfulness training produces significant cognitive benefits for elderly individuals with mild cognitive impairments. But continued practice is necessary to maintain the benefits. Hence, long-term mindfulness practice may be able to restrain further cognitive decline in these patients and may delay or prevent the onset of dementia. It is clear however, that continuing mindfulness practice is required.

 

So, reduce aging cognitive decline with mindfulness.

 

“What we do know is that long-term engagement in mindfulness meditation may enhance cognitive performance in older adults, and that with persistent practice, these benefits may be sustained. That’s great news for the millions of aging adults working to combat the negative effects of aging on the brain.” – Grace Bullock

 

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

 

Wong, W. P., Coles, J., Chambers, R., Wu, D. B., & Hassed, C. (2017). The Effects of Mindfulness on Older Adults with Mild Cognitive Impairment. Journal of Alzheimer’s disease reports, 1(1), 181-193. doi:10.3233/ADR-170031

 

Abstract

Background:

The current lack of an effective cure for dementia would exacerbate its prevalence and incidence globally. Growing evidence has linked mindfulness to cognitive and psychological improvements that could be relevant for mild cognitive impairment (MCI).

Objective:

To investigate whether mindfulness practice can improve health outcomes of MCI.

Methods:

The study is the first longitudinal mixed-methods observational study with a one-year follow-up period, that customized an eight-week group-based mindfulness training program for older adults with MCI (n = 14). Measures included cognitive function, psychological health, trait mindfulness, adherence to mindfulness practice, and everyday activities functioning as assessed at pre-intervention, post-intervention, and one-year follow-up. Repeated measures ANOVAs, Pearson’s correlation analyses, and Mann-Whitney U tests were performed.

Results:

The MCI participants showed significant improvements in cognitive function (p < 0.05) and trait mindfulness (p < 0.05) after completing the intervention. Between program intervention and one-year follow-up (59 weeks), positive correlations were found between their cognitive function (p < 0.05) and everyday activities functioning (p < 0.05) with the duration of mindfulness meditation; and between trait mindfulness and the level of informal mindfulness practice (p < 0.05). Those who meditated more during these 59 weeks, showed greater improvements in cognitive function (p < 0.05) and everyday activities functioning (p < 0.05), with large effect sizes at the one-year follow-up. Qualitative findings will be reported separately.

Conclusion:

Long-term mindfulness practice may be associated with cognitive and functional improvements for older adults with MCI. Mindfulness training could be a potential efficacious non-pharmacological therapeutic intervention for MCI.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6159696/

Reduce Pain Catastrophizing and Pain with Mindfulness

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Reduce Pain Catastrophizing and Pain with Mindfulness

 

By John M. de Castro, Ph.D.

 

“People often increase the pain experience by adding to the physical sensations with a host of thoughts and feelings, like catastrophizing the pain or trying to suppress and ignore the pain. Mindfulness is a practice of attending to pain — or body sensations — and thoughts and feelings with that present-moment attention in an accepting and curious manner.” – Susan Smalley

 

Fibromyalgia is a mysterious disorder whose causes are unknown. It is very common affecting over 5 million people in the U.S., about 2% of the population with about 7 times more women affected than men. It is characterized by widespread pain, abnormal pain processing, sleep disturbance, and fatigue that lead to psychological distress. Fibromyalgia may also have morning stiffness, tingling or numbness in hands and feet, headaches, including migraines, irritable bowel syndrome, sleep disturbances, thinking and memory problems, and painful menstrual periods. The symptoms are so severe and debilitating that about half the patients are unable to perform routine daily functions and about a third have to stop work. Although it is not itself fatal, suicide rates are higher in fibromyalgia sufferers.

 

There are no completely effective treatments for fibromyalgia. Symptoms are generally treated with pain relievers, antidepressant drugs and exercise. But these only reduce the severity of the symptoms and do not treat the disease directly. Mindfulness practices have also been shown to be effective in reducing pain from fibromyalgia. Some of the effects of mindfulness practices are to alter thought processes, changing what is thought about. In terms of pain, mindfulness training, by focusing attention on the present moment has been shown to reduce worry and catastrophizing. Pain is increased by worry about the pain and the expectation of greater pain in the future. So, mindfulness may reduce worry and catastrophizing and thereby reduce fibromyalgia pain.

 

In today’s Research News article “Interactive effects of pain catastrophizing and mindfulness on pain intensity in women with fibromyalgia.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6198401/ ), Dorado and colleagues recruited adult women suffering with fibromyalgia and had them complete questionnaires measuring mindfulness, pain, pain catastrophizing and fibromyalgia interference in daily activities and keeping a 7-day diary of their daily levels of pain and pain catastrophizing. They then examined predictors of the daily pain intensity and pain catastrophizing.

 

They found a strong positive relationship between pain catastrophizing and pain intensity indicating that the higher the daily levels of catastrophizing the greater the levels of pain. They also found that the higher the levels of mindfulness the lower the levels of daily pain catastrophizing and daily levels of pain. They found that this relationship was modified by facets of mindfulness. In particular, the greater the observing facet of mindfulness the smaller the relationship between daily pain catastrophizing and daily pain intensity. On the other hand, when the mindfulness facets of non-judging and acting with awareness were high then the greater the daily levels of catastrophizing the greater the levels of pain.

 

These relationships suggest that observing mindfully tends to mitigate the relationship of catastrophizing to pain while mindfully non-judging and acting with awareness tends to amplify the relationship. But, overall, mindfulness tends to be associated with lower catastrophizing. It has been shown in other work that mindfulness tends to lower fibromyalgia pain, The present study suggests that it may do so by reducing pain catastrophizing. Even though mindfulness, in general lowers pain and catastrophizing not judging the situation and acting toward it with awareness can actually heighten the effects of catastrophizing on pain.

 

It should be kept in mind that these results are correlational and conclusions about causation cannot be made. In addition, the results are complicated suggesting complex relationships between mindfulness and daily pain and catastrophizing levels. This indicates that further research is needed especially work in which mindfulness is altered by training and then observing the effects of this change on pain levels and catastrophizing and their relationships with each other.

 

So, reduce pain catastrophizing and pain with mindfulness.

 

“When pain is consistently part of your day, you can start to dwell on it. You may feel stress and anxiety about the pain you’re feeling now, as well as pain that may occur in the future. Mindfulness may lead to changes in the brain that provide benefits for those with fibromyalgia.” – Peggy Pletcher

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

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

 

Study Summary

 

Dorado, K., Schreiber, K. L., Koulouris, A., Edwards, R. R., Napadow, V., & Lazaridou, A. (2018). Interactive effects of pain catastrophizing and mindfulness on pain intensity in women with fibromyalgia. Health psychology open, 5(2), 2055102918807406. doi:10.1177/2055102918807406

 

Abstract

The objective of this study was to examine the association between facets of trait mindfulness, pain catastrophizing, and pain severity in a sample of patients with fibromyalgia. Patients with fibromyalgia completed validated baseline and diary assessments of clinical pain, mindfulness, and pain catastrophizing. Multilevel modeling analyses indicated that the daily association between catastrophizing and pain intensity was moderated by certain mindfulness facets. Our findings suggest that various aspects of mindfulness may interact differently with pain and catastrophizing, which may have implications for the design and testing of interventions targeting mindfulness and catastrophizing in fibromyalgia patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6198401/

 

Change the Brain to Reduce Anxiety with Meditation

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Change the Brain to Reduce Anxiety with Meditation

 

By John M. de Castro, Ph.D.

 

“In mindfulness practice you have an opportunity—the mental time and space, if you will—to see more elements of the story, a richer picture. “You may see more clearly as you anticipate a difficult encounter what the underlying emotion is that’s triggered and how it’s showing up in your body.” In this way, you become aware of the full context of the story, like seeing a flower opening in slow-motion photography. With this awareness, over time “your solid belief in a storyline may begin to erode.” – Zindel Segal

 

Meditation training has been shown to improve health and well-being. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. Meditation practice has been found to improve the regulation of emotions and reduce difficult emotional states such as anxiety and depression.

 

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. Meditation practice has been shown to change the brain and the brain’s reaction to emotions. The activity of the amygdala in the brain is highly associated with emotions. Hence, it would appear likely that meditation practice may alter the amygdala’s activity in response to emotions.

 

In today’s Research News article “Atypical Anxiety-Related Amygdala Reactivity and Functional Connectivity in Sant Mat Meditation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6288484/ ), Chen and colleagues recruited healthy highly experienced meditators and healthy meditation naive participants. The meditators practiced Sant Mat meditation for 4 hours per day and had been practicing for at least 4 years. They also had a vegetarian diet and abstained from alcohol. The meditation practice incorporated loving kindness meditation.

 

All participants were measured for their state anxiety and their trait anxiety. The participants viewed colorized pictures of faces while their brain activity was monitored with functional Magnetic Resonance Imaging (fMRI). They were asked to ignore everything about the faces except their color which they responded to with a button press. The faces were both male and female expressing either happy, fearful, or neutral emotions.

 

They found that the meditators were significantly less anxious than the controls in both state and trait anxiety and the greater the number of years of meditation experience the lower the levels of anxiety. The meditators were also significantly slower in responding to the faces color. Slower responding has been associated with lower anxiety. It is well documented that meditation practice lowers anxiety. So, the lower levels in the meditators and slower responding were expected.

 

In terms of the brain amygdala responses to the face stimuli, the meditators had significantly lower responses regardless of the emotion portrayed. In addition, the meditators had a stronger amygdala response to happy faces than fearful faces while the controls had the opposite pattern with higher amygdala responses to fearful faces than happy faces. Mediation analysis indicated that the years of meditation experience was directly related to lower anxiety but the amygdala response partly meditated the effect such that the more years of meditation experience the lower the response of the amygdala and the lower the levels of anxiety.

 

These are interesting and entirely consistent results. The amygdala is known to be involved in emotionality. The results suggest that meditation experience alters the amygdala to respond less to emotional stimuli and to respond more to positive emotional stimuli than negative emotional stimuli. These lower responses may be the source of the effect of meditation practice of improved regulation of emotions. The greater responses of the amygdala in meditators to positive emotional stimuli may be the source of the effect of meditation practice of increased happiness.

 

It needs to be recognized that the meditators also had vegetarian diets and abstained from alcohol while the meditation naïve participants did not. It is possible that the differences observed stemmed from these differences rather than the meditation. It should also be noted that the meditators practiced 4 hours per day which is much more than most meditators, placing these meditators as outliers of amounts of meditation practice. Whether similar results may be observed with lower levels of meditation practice should be an important question for future research.

 

So, change the brain to reduce anxiety with meditation.

 

“To me, this amazing brain science and the very real rewards gained from meditation combine to form a compelling argument for developing and/or maintaining a daily practice. It definitely motivates me on those days I don’t “feel” like sitting. So, try to remind yourself that meditating every day, even if it’s only 15 minutes, will keep those newly formed connections strong and those unhelpful ones of the past at bay.” – 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

 

Chen, C., Chen, Y. C., Chen, K. L., & Cheng, Y. (2018). Atypical Anxiety-Related Amygdala Reactivity and Functional Connectivity in Sant Mat Meditation. Frontiers in behavioral neuroscience, 12, 298. doi:10.3389/fnbeh.2018.00298

 

Abstract

While meditation has drawn much attention in cognitive neuroscience, the neural mechanisms underlying its emotional processing remains elusive. Sant Mat meditators were recruited, who adopt a loving-kindness mode of meditation along with a vegetarian diet and an alcohol-restricted lifestyle and novices. We assessed their State-Trait Anxiety Inventory (STAI) and scanned their amygdala reactivity in response to an explicit and implicit (backward masked) perception of fearful and happy faces. In contrast with novices, meditators reported lower STAI scores. Meditators showed stronger amygdala reactivity to explicit happiness than to fear, whereas novices exhibited the opposite pattern. The amygdala reactivity was reduced in meditators regardless of implicit fear or happiness. Those who had more lifetime practice in meditation reported lower STAI and showed a weaker amygdala response to fear. Furthermore, the amygdala in meditators, relative to novices, had a stronger positive functional connectivity with the ventrolateral prefrontal cortex (PFC) to explicit happiness, but a more negative connectivity with the insula and medial orbitofrontal cortex (OFC) to explicit fear. Mediation analysis indicated the amygdala reactivity as the mediator for the linkage between meditation experience and trait anxiety. The findings demonstrate the neural correlates that underpin the beneficial effects of meditation in Sant Mat. Long-term meditation could be functionally coupled with the amygdala reactivity to explicit and implicit emotional processing, which would help reduce anxiety and potentially enhance well-being.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6288484/

 

Reduce Falls in the Elderly with Tai Chi Practice

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Reduce Falls in the Elderly with Tai Chi Practice

 

By John M. de Castro, Ph.D.

 

“Seniors who practice tai chi – a Chinese meditation practice that combines deep breathing and slow, fluid movements – may be less likely to fall than their peers who don’t do this type of exercise.” – Lisa Rapaport

 

The process of aging affects every aspect of the physical and cognitive domains. Every system in the body deteriorates including motor function with a decline in strength, flexibility, and balance. Impaired balance is a particular problem as it can lead to falls. In the U.S. one third of people over 65 fall each year and 2.5 million are treated in emergency rooms for injuries produced by falls. About 1% of falls result in deaths making it the leading cause of death due to injury among the elderly.

 

Falls, with or without injury, also carry a heavy quality of life impact. A growing number of older adults, fear falling and, as a result, limit their activities and social engagements. This can result in further physical decline, depression, social isolation, and feelings of helplessness. It is obviously important to discover methods to improve balance and decrease the number of falls in the elderly.

 

Tai Chi training is designed to enhance and regulate the functional activities of the body through regulated breathing, mindful concentration, and gentle movements. It includes balance training and has been shown to improve balance and coordination. Indeed, Tai Chi training has been shown to reduce the frequency of falls in the elderly. It is not known, however, if Tai Chi training is better or worse than other exercises for reducing falls in the elderly.

 

In today’s Research News article “Effectiveness of a Therapeutic Tai Ji Quan Intervention vs a Multimodal Exercise Intervention to Prevent Falls Among Older Adults at High Risk of Falling: A Randomized Clinical Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233748/ ), Harmer and colleagues recruited  health elderly individuals, 70 years of age or older, who had fallen at least once in the last year and randomly assigned them to one of three groups, Tai Chi, stretching exercise, or multimodal exercise including aerobic exercise, balance, flexibility, and strength exercises. All groups practiced twice a week for 1 hour for 24 weeks. The participants were measured before, in the middle, at the end of training, and monthly follow-up telephone calls for falls, fall injuries, physical performance, and cognitive function.

 

They found that during the 12 weeks of training and 6-month follow-up period that the group that practiced Tai Chi had significantly fewer falls and fewer falls that caused moderate or serious injuries than the multimodal exercise group which, in turn, had fewer falls and injuries than the stretching group. In addition, at the end of training the participants in the Tai Chi group and the multimodal exercise group had significantly greater improvements in cognitive and physical performance than the stretching group.

 

The results are interesting and important. They suggest that engaging in Tai Chi exercise reduces falls and improves physical and cognitive performance in the elderly and that Tai Chi exercise is superior to multimodal exercise and stretching in reducing falls. This is important because of the comparisons of types of exercise showed a significant superiority for Tai Chi Exercise. They are also important because of the severity of the consequences of falling for longevity, health, and well-being of the elderly. As an additional bonus Tai Chi exercise appears to reduce the cognitive decline that routinely occurs with aging.

 

It is important to recognize that Tai Chi is a gentle and safe exercise that is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion, such as stroke recovery. Also, Tai Chi 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 almost ideal gentle exercise to prevent falls in the elderly and improve their physical and cognitive health and well-being.

 

So, reduce falls in the elderly with Tai Chi practice.

 

“Balance training based on the Chinese martial arts discipline tai ji quan — better known as tai chi — reduced falling risks among the elderly more than conventional forms of exercise.” – Ashley Lyles

 

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

 

Li, F., Harmer, P., Fitzgerald, K., Eckstrom, E., Akers, L., Chou, L. S., Pidgeon, D., Voit, J., … Winters-Stone, K. (2018). Effectiveness of a Therapeutic Tai Ji Quan Intervention vs a Multimodal Exercise Intervention to Prevent Falls Among Older Adults at High Risk of Falling: A Randomized Clinical Trial. JAMA internal medicine, 178(10), 1301-1310.

 

Key Points

Question

Is a fall prevention–specific tai ji quan intervention clinically more effective in reducing falls among older adults at high risk of falling than a stretching intervention (control) or a standard multimodal exercise intervention?

Findings

In a randomized clinical trial involving 670 adults 70 years or older with a history of falls or impaired mobility, the therapeutic tai ji quan intervention effectively reduced falls by 58% compared with the stretching exercise (control intervention) and by 31% compared with a multimodal exercise intervention.

Meaning

For older adults at high risk of falling, a therapeutically tailored tai ji quan intervention was more effective than stretching or multimodal exercises in reducing the incidence of falls.

Question

Is a fall prevention–specific tai ji quan intervention clinically more effective in reducing falls among older adults at high risk of falling than a stretching intervention (control) or a standard multimodal exercise intervention?

Findings

In a randomized clinical trial involving 670 adults 70 years or older with a history of falls or impaired mobility, the therapeutic tai ji quan intervention effectively reduced falls by 58% compared with the stretching exercise (control intervention) and by 31% compared with a multimodal exercise intervention.

Meaning

For older adults at high risk of falling, a therapeutically tailored tai ji quan intervention was more effective than stretching or multimodal exercises in reducing the incidence of falls.

Question

Is a fall prevention–specific tai ji quan intervention clinically more effective in reducing falls among older adults at high risk of falling than a stretching intervention (control) or a standard multimodal exercise intervention?

Findings

In a randomized clinical trial involving 670 adults 70 years or older with a history of falls or impaired mobility, the therapeutic tai ji quan intervention effectively reduced falls by 58% compared with the stretching exercise (control intervention) and by 31% compared with a multimodal exercise intervention.

Meaning

For older adults at high risk of falling, a therapeutically tailored tai ji quan intervention was more effective than stretching or multimodal exercises in reducing the incidence of falls.

 

Abstract

Importance

Falls in older adults are a serious public health problem associated with irreversible health consequences and responsible for a substantial economic burden on health care systems. However, identifying optimal choices from among evidence-based fall prevention interventions is challenging as few comparative data for effectiveness are available.

Objective

To determine the effectiveness of a therapeutically tailored tai ji quan intervention, Tai Ji Quan: Moving for Better Balance (TJQMBB), developed on the classic concept of tai ji (also known as tai chi), and a multimodal exercise (MME) program relative to stretching exercise in reducing falls among older adults at high risk of falling.

Design, Setting, and Participants

A single-blind, 3-arm, parallel design, randomized clinical trial (February 20, 2015, to January 30, 2018), in 7 urban and suburban cities in Oregon. From 1147 community-dwelling adults 70 years or older screened for eligibility, 670 who had fallen in the preceding year or had impaired mobility consented and were enrolled. All analyses used intention-to-treat assignment.

Interventions

One of 3 exercise interventions: two 60-minute classes weekly for 24 weeks of TJQMBB, entailing modified forms and therapeutic movement exercises; MME, integrating balance, aerobics, strength, and flexibility activities; or stretching exercises.

Main Outcomes and Measures

The primary measure at 6 months was incidence of falls.

Results

Among 670 participants randomized, mean (SD) age was 77.7 (5.6) years, 436 (65%) were women, 617 (92.1%) were white, 31 (4.6%) were African American. During the trial, there were 152 falls (85 individuals) in the TJQMBB group, 218 (112 individuals) in the MME group, and 363 (127 individuals) in the stretching exercise group. At 6 months, the incidence rate ratio (IRR) was significantly lower in the TJQMBB (IRR, 0.42; 95% CI, 0.31-0.56; P < .001) and MME groups (IRR, 0.60; 95% CI, 0.45-0.80; P = .001) compared with the stretching group. Falls were reduced by 31% for the TJQMBB group compared with the MME group (IRR, 0.69; 95% CI, 0.52-0.94; P = .01).

Conclusions and Relevance

Among community-dwelling older adults at high risk for falls, a therapeutically tailored tai ji quan balance training intervention was more effective than conventional exercise approaches for reducing the incidence of falls.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233748/Importance

 

Improve Psychomotor Perform of Intellectually Disabled Children with Yoga

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Improve Psychomotor Perform of Intellectually Disabled Children with Yoga

 

By John M. de Castro, Ph.D.

 

“Special needs experts agree that yoga activities make a positive impact on individuals with special needs.  These activities improve mobility, strength, and digestion for individuals with disabilities.” – Cara Batema

 

Intellectual disabilities involve below average intelligence and relatively slow learning. They are quite common, affecting an estimated 10% of individuals worldwide. These disabilities present problems for the children in learning mathematics, reading and writing. These difficulties, in turn, affect performance in other academic disciplines. The presence of intellectual disabilities can have serious consequences for the psychological well-being of the children, including their self-esteem and social skills. In addition, anxiety, depression, and conduct disorders often accompany learning disabilities. Not as well known is that children with intellectual disabilities also have motor problems.

 

Mindfulness training has been shown to improve attention, memory, and learning and increase success in school. Exercise has been shown to improve psychomotor performance in children with intellectual disabilities. Yoga is both a mindfulness practice and an exercise that also tends to improve motor ability. So, it would make sense to explore the application of yoga training for the treatment of children with intellectual disabilities.

 

In today’s Research News article “Effect of yoga practices on psycho-motor abilities among intellectually disabled children.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165980/ ), Pise and colleagues recruited children aged 10 to 15 years from a school for the intellectually disabled. They were randomly assigned to a no-treatment control group or to receive yoga training for 1 hour per day, 5 days per week, for 12 weeks. The practice consisted of relaxation, postures, breathing exercises, and meditation. They were measured before and after training for balance, eye-hand coordination, agility, and reaction time.

 

They found that in comparison to baseline after the yoga training there were significant increases balance, eye-hand coordination, and agility, and decreases in reaction time. In comparison to the no treatment control group, the yoga group after training had significantly greater balance and faster reaction times. Hence, yoga practice appears to improve motor performance in children with intellectual disabilities.

 

 

These results were obtained with a no-treatment control condition. They need to be repeated with an active control condition such as a different exercise to determine if it was yoga practice itself or the exercise provided by yoga practice that was responsible for the improvements. But, nonetheless, the results suggest that yoga practice may be beneficial for children with intellectual disabilities. Improved motor ability might affect their performance in activities and sports and thereby improve their self-esteem.

 

So, improve psychomotor perform of intellectually disabled children with yoga.

 

“Yoga for special needs classes provide a sense of belonging and community. These adaptive yoga classes focus on building strength, developing regulation skills through breathing, improving mobility and maintaining/improving overall health and emotional well-being.” – Project Yoga

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Pise, V., Pradhan, B., & Gharote, M. (2018). Effect of yoga practices on psycho-motor abilities among intellectually disabled children. Journal of exercise rehabilitation, 14(4), 581-585. doi:10.12965/jer.1836290.145

 

Abstract

The children with intellectual disabilities show disorders at motor development and coordination. Hence, the objective of this study was to see the effect of yoga practices on psycho-motor abilities of intellectually disabled children. Seventy intellectually disabled children were divided into experimental group and control group. Both experimental and control group were assessed on the first day and after 12 weeks of the yoga intervention for static balance, eye hand coordination, agility and reaction time. The subjects of experimental group then underwent a training of yoga practices, for 1 hr for a total period of 12 weeks. The result of within group comparison revealed significant improvement in static balance, eye hand coordination, agility, and reaction time (P< 0.001) in subjects of yoga group however no change was observed in control group. The present study demonstrated that 12 weeks of yoga is effective in improving psycho-motor abilities of intellectually disabled children.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165980/

 

Increase Wellness and Decrease Burnout in Medical Students with Mindfulness

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Increase Wellness and Decrease Burnout in Medical Students with Mindfulness

 

By John M. de Castro, Ph.D.

 

“training in mindfulness – focusing controlled attention on physical sensations, thoughts, and emotions in the present moment – helps students to acknowledge and process the stresses and strains of their work.” – Cathy Kerr

 

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

 

Preventing burnout has to be a priority. Unfortunately, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout, so it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, and improving sleep. It would be best to provide techniques to combat burnout early in a medical career. Medical School is extremely stressful and many students show distress and express burnout symptoms. Medical school may be an ideal time to intervene.

 

In today’s Research News article “A Targeted Mindfulness Curriculum for Medical Students During Their Emergency Medicine Clerkship Experience.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6040904/ ), Chung and colleagues in an uncontrolled pilot study delivered a mindfulness curriculum to students during their training in emergency medicine. The training was delivered in 4-weekly 60 minute sessions that included meditation practice, readings, journaling, discussion, and developing a personal wellness plan. They completed questionnaires before and after the 4 weeks of training and 6 months later regarding the impact of the training on their behavior and attitudes.

 

They found that in comparison to baseline, after training there were significant improvements in self-reported behaviors and attitudes. The students reported increased confidence in their ability to meditate and be mindful, explain these skills to others, and recommend these practices to others. They also reported that they practiced meditation and mindfulness more often and talked to others about these practices. In addition, they reported that wellness was important to medical students and that they were using their own wellness plan. Importantly, these improvements were still present 6 months after the completion of the training.

 

These are very preliminary results from an uncontrolled pilot study and need to be verified in a randomized controlled trial with objective measures of wellness and resistance to stress. Previous controlled studies, however, have shown that mindfulness training is effective in treating and preventing burnout and reducing the psychological and physiological responses to stress. So, these present results are suggestive that this simple brief curriculum may produce similar benefits.

 

It is important to use a brief training and this one only involved 4 hours of formal instruction. Medical students have a vast amount of important information to learn and master in a limited amount of time. They do not have the luxury of unused time for extensive instruction. So, a brief training that produces positive results that persist could be very valuable to their health and well-being during this stressful time and during a stressful career.

 

So, increase wellness and decrease burnout in medical students with mindfulness.

 

“I have taken my own advice. I am still at it: sitting on the deck, focusing on my breath, watching my thoughts, clearing my mind amid the shrill end-of-summer calls of the cicadas. I think I have noticed an effect — I feel a deeper sense of acceptance in my life, without losing a passion or resolve to change things for the better.” – Manoj Jain

 

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

 

Chung, A. S., Felber, R., Han, E., Mathew, T., Rebillot, K., & Likourezos, A. (2018). A Targeted Mindfulness Curriculum for Medical Students During Their Emergency Medicine Clerkship Experience. The western journal of emergency medicine, 19(4), 762-766.

 

Abstract

Introduction

Despite high rates of burnout in senior medical students, many schools provide the majority of their wellness training during the first and second preclinical years. Students planning a career in emergency medicine (EM) may be at particularly high risk of burnout, given that EM has one of the highest burnout rates of all the specialties in the United States We developed an innovative, mindfulness-based curriculum designed to be integrated into a standard EM clerkship for senior medical students to help students manage stress and reduce their risk of burnout.

Methods

The curriculum included these components: (1) four, once-weekly, 60-minute classroom sessions; (2) prerequisite reading assignments; (3) individual daily meditation practice and journaling; and (4) the development of a personalized wellness plan with the help of a mentor. The design was based on self-directed learning theory and focused on building relatedness, competence, and autonomy to help cultivate mindfulness.

Results

Thirty students participated in the curriculum; 20 were included in the final analysis. Each student completed surveys prior to, immediately after, and six months after participation in the curriculum. We found significant changes in the self-reported behaviors and attitudes of the students immediately following participation in the curriculum, which were sustained up to six months later.

Conclusion

Although this was a pilot study, our pilot curriculum had a significantly sustained self-reported behavioral impact on our students. In the future, this intervention could easily be adapted for any four-week rotation during medical school to reduce burnout and increase physician wellness.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6040904/

Improve Mental Health and Well-Being with Smartphone APP Mindfulness Training

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Improve Mental Health and Well-Being with Smartphone APP Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“The seemingly simple act of mindfulness may help reduce the impact of stress, anxiety, depression, and chronic pain. Mindfulness is the act of paying attention to moments of experience with an accepting and friendly attitude so as to observe with all the senses what is happening in each moment. The practice of mindfulness is an effective means of enhancing and maintaining optimal mental health and overall well-being.” – APA

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress. The vast majority of the mindfulness training techniques, however, require a certified trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. As an alternative, Mindfulness training programs over the internet and with smartphone apps have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. These online and smartphone app trainings have been shown to be effective. But the question arises as to the relative effectiveness of various online and mobile trainings in inducing mindfulness and improving psychological health.

 

In today’s Research News article “Efficacy and Moderation of Mobile App-Based Programs for Mindfulness-Based Training, Self-Compassion Training, and Cognitive Behavioral Psychoeducation on Mental Health: Randomized Controlled Noninferiority Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231823/ ), Mak and colleagues compared the efficacy of 3 smartphone aps that trained for either mindfulness, self-compassion, or cognitive behavioral psychoeducation, to improve mental health and well-being in adults.

 

They recruited adults online and randomly assigned each to one of the three trainings. The participants downloaded the apps for their smartphones. The trainings were delivered in 28 daily sessions. The mindfulness exercises, included body scan, mindful breathing, mindful eating, and mindful walking. Self-Compassion training consisted compassionate body scan, affectionate breathing, loving-kindness meditation for beginners, compassionate walking, soften-allow-soothe, self-compassion break, and self-compassion journaling. Cognitive behavioral psychoeducation included relaxation skills, coping strategies for stress, problem-solving skills, emotional management skills, and cognitive strategies for negative thoughts.

 

The participants completed online measures of mental well-being, psychological distress, mindfulness, self-compassion, discomfort with emotions, ambiguity tolerance, program satisfaction, and utilization before and after training and 3 months later. There were, unfortunately relatively low participation rates with 28% of the recruited participants who downloaded the apps never activated them. Of those that did only 24% completed their program and only 17% completed the follow-up measures. Most of the attrition occurred in the first week.

 

They found that all three trainings produced significant enhancements of mental well-being and mindfulness and significant reductions in psychological distress that persisted at the 3-month follow-up. Self-compassion, and cognitive behavioral psychoeducation trainings, but not mindfulness, resulted in higher self-compassion at the end of training but this was no longer significant at follow-up.

 

This study did not have a control condition for comparison, so the conclusions have to be tempered with the understanding that contaminants such as placebo effects, and time and practice-based contaminants might be responsible for the results. In addition, the high attrition rates may be responsible for the results as those who were not helped by the apps terminated participation leaving only those who were improving left in the sample.

 

On the other hand, other controlled studies have demonstrated the efficacy of mindfulness and self-compassion trainings and cognitive behavioral psychoeducation in improving psychological health and well-being. So, the results from the present study are likely due to the trainings and not contaminants. Hence, these findings are suggestive that the three smartphone apps are able to improve the mental health and well-being of otherwise normal adults. This is important as being able to deliver these trainings over smartphones allows for the distribution of these mental health improving programs economically to widespread audiences.

 

So, improve mental health and well-being with smartphone app mindfulness training.

 

“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. Stay tuned!” – Christopher Bergland

 

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

 

Mak, W. W., Tong, A. C., Yip, S. Y., Lui, W. W., Chio, F. H., Chan, A. T., & Wong, C. C. (2018). Efficacy and Moderation of Mobile App-Based Programs for Mindfulness-Based Training, Self-Compassion Training, and Cognitive Behavioral Psychoeducation on Mental Health: Randomized Controlled Noninferiority Trial. JMIR mental health, 5(4), e60. doi:10.2196/mental.8597

 

Abstract

Background

Mindfulness-based interventions, self-compassion training, and cognitive behavioral therapy have garnered much evidence in its salutary effects on mental health. With increasing application of smartphone and mobile technology on health promotion, this study investigated the efficacy and possible moderators of mindfulness, self-compassion, and cognitive behavioral psychoeducation training mobile apps in the improvement of mental health.

Objective

The aim of this study was to examine the efficacy of 3 mobile app–based programs: mindfulness-based program, self-compassion program, and cognitive behavioral psychoeducation program in improving mental well-being and reducing psychological distress. Changes in mindful awareness and self-compassion were also assessed. To further delineate the suitability of each program for different types of individuals, individual difference variables (ie, discomfort with emotions and tolerance for ambiguity) were explored for potential moderation.

Methods

This study was a 3-arm, randomized, controlled, noninferiority trial examining the efficacy of mindfulness-based program, self-compassion program, and cognitive behavioral psychoeducation. Participants were randomized into either 1 of the 3 conditions. Throughout the 4-week, 28-session program, participants spent 10-15 min daily reviewing the course content and practicing various related exercises. At preprogram, postprogram, and 3-month follow-up, participants also completed Web-based measures of mental well-being, psychological distress, mindful-awareness, and self-compassion as well as the proposed moderators.

Results

Among the 2161 study participants, 508 and 349 completed the post- and 3-month follow-up assessment, respectively. All 3 conditions (mindfulness-based program: N=703; cognitive behavioral psychoeducation: N=753; self-compassion program: N=705) were found to be efficacious in improving mental well-being and reducing psychological distress. All conditions enhanced mindful awareness at postprogram. Significant interaction effect was found on self-compassion; cognitive behavioral psychoeducation and self-compassion program, but not mindfulness-based program, significantly enhanced self-compassion at postprogram. No significant differences regarding usage and users’ satisfaction were found among the 3 conditions. None of the proposed moderators were found to be significant.

Conclusions

Mindfulness-based, self-compassion, and cognitive behavioral psychoeducation mobile apps were efficacious in improving mental well-being and reducing psychological distress among adults at postprogram and 3-month follow-up. Future app-based psychological training programs should consider gamification and personalization of content or feedback to enhance engagement and mitigate the high attrition rates that are common in app-based health promotion programs.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231823/