Improve Irritable Bowel Syndrome (IBS) with Mindfulness

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Improve Irritable Bowel Syndrome (IBS) with Mindfulness

 

By John M. de Castro, Ph.D.

 

“IBS causes a huge public health and economic burden in the U.S. The standard of care currently has been diet changes along with medications. A mind-based . . . has the potential to minimize both the public health and economic burden of this debilitating disease,” – Saurabh Sethi

 

Irritable bowel syndrome (IBS) is the most common functional gastrointestinal (GI) disorder with worldwide prevalence rates ranging from 9–23%. In the U.S. the rates generally in the area of 10–15% affecting between 25 and 45 million people. IBS is not life threatening but it is very uncomfortable producing changes in bowel movement patterns, bloating and excess gas, and pain in the lower belly. It is also a major source of absenteeism both at work and in school. IBS is also associated with a marked reduction in the individual’s health quality of life, with disruption of the physical, psychological and social routines of the individuals. At present, there are no known cures for IBS and treatments involve symptomatic relief, often with fairly radical dietary changes.

 

The cause(s) of IBS are not known. But emotion dysregulation is suspected to be involved. It is clear that psychological stress exacerbates the illnesses and anxiety amplifies the symptoms. This suggests that mindfulness or the lack thereof may be involved as mindfulness is known to be helpful in reducing the psychological and physical responses to stress and mindfulness is known to improve emotion regulation. In addition, It has been shown that meditation and yoga can help relieve IBS symptoms.  So, it would make sense to further investigate the effectiveness of mindfulness training and emotion regulation for Irritable Bowel Syndrome (IBS).

 

In today’s Research News article “Comparing the Efficacy of Mindfulness-Based Stress Reduction Therapy with Emotion Regulation Treatment on Quality of Life and Symptoms of Irritable Bowel Syndrome.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6178327/ ), Ghandi and colleagues recruited patients with Irritable Bowel Syndrome (IBS) and randomly assigned them to receive either an 8-week, once a week for 90 minutes program of Mindfulness Based Stress Reduction (MBSR), Emotion Regulation group training, or a wait-list. The MBSR treatment consisted of body scan, meditation, and yoga practices and group discussion with homework. Emotion Regulation training consisted in training on “emotional awareness” and “acceptance”. The patients were measured before and after training and 2 months later for IBS severity and quality of life with IBS.

 

They found that both Mindfulness Based Stress Reduction (MBSR) and Emotion Regulation training produced significant improvements in IBS severity and the quality of life with IBS and that this effectiveness was maintained 2 months later. There were no significant differences in the effectiveness of MBSR and emotion regulation training. Hence, both MBSR and emotion regulation training produce large and lasting improvements in the symptoms of IBS and the quality of life of the patients.

 

Since MBSR training is known to improve emotion regulation, the fact that MBSR and emotion regulation training produced equivalent benefits suggests that MBSR may be effective for IBS because of its ability to improve emotion regulation, particularly improving the emotional responses to stress. It will require further research to examine this possibility.

 

So, improve Irritable Bowel Syndrome (IBS) with mindfulness.

 

“For a person who has IBS, mindfulness-based therapies are thought to help to reduce anxiety related to digestive symptoms. Due to our body’s natural stress response, such anxiety can actually exacerbate the very digestive symptoms that a person with IBS is most concerned about. The theory behind mindfulness-based therapies for IBS is that when you experience less reactivity to physical sensations related to your digestive system, you will experience less unwanted symptoms.” – Barbara Bolen

 

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

Abstract

 

Ghandi, F., Sadeghi, A., Bakhtyari, M., Imani, S., Abdi, S., & Banihashem, S. S. (2018). Comparing the Efficacy of Mindfulness-Based Stress Reduction Therapy with Emotion Regulation Treatment on Quality of Life and Symptoms of Irritable Bowel Syndrome. Iranian journal of psychiatry, 13(3), 175-183.

 

Objective: Irritable bowel syndrome is a common gastrointestinal disorder. The perception of stress and GI-specific anxiety play a key role in irritable bowel syndrome (IBS). The present study aims at comparing the efficacy of mindfulness-based stress reduction therapy with emotion regulation on the quality of life and severity in patients IBS.

Method : This randomized clinical trial was conducted in 3 phases: pretest, posttest, and follow-up. Follow-up was performed 2 months after the last intervention. The study population consisted of 24 IBS patients who were randomly selected according to Rome-IV Criteria and were then divided into 3 eight-member groups: (1) mindfulness-based stress reduction, (2) emotion regulation, and (3) control group. IBS-QOL34 and IBS-SSS were administered as assessment tools to all the 3 groups. The experimental groups were subjected to MBSR and ER psychotherapy, while the control group received no psychological intervention. After the 2-month follow-up, the 3 groups were evaluated again.

Results: The results revealed that MBSR improved the quality of life of IBS patients and dicreased severity of their condition. The findings of between and within subjects design revealed that the difference between MBSR and control groups was significant in IBS at follow-up (p = 0.01).

Conclusion: MBSR could be considered as a new, effective, and stable method in psychotherapy, in irritable bowel syndrome.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6178327/

 

Mindfulness Improves the Symptoms of Post-Traumatic Stress Disorder (PTSD) by Altering Gene Expression

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Mindfulness Improves the Symptoms of Post-Traumatic Stress Disorder (PTSD) by Altering Gene Expression

 

By John M. de Castro, Ph.D.

 

“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

 

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime. But only a fraction will develop Post-Traumatic Stress Disorder (PTSD). But this still results in a frightening number of people with 7%-8% of the population developing PTSD at some point in their life.

 

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

 

Obviously, these are troubling symptoms that need to be addressed. There are a number of therapies that have been developed to treat PTSD. One of which, mindfulness training has been found to be particularly effective. Mindfulness Based Stress Reduction (MBSR) has been found to improve PTSD symptoms. It has been shown that mindfulness practices can alter the brain structures and connectivity and this may underlie the beneficial effects of mindfulness on PTSD. These alterations probably involve changes in the chemistry of the brain particularly with systems associated with stress and depression.

 

In today’s Research News article “Methylation of FKBP5 and SLC6A4 in Relation to Treatment Response to Mindfulness Based Stress Reduction for Posttraumatic Stress Disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6153325/ ), Bishop and colleagues examine the activation of genes associated with stress and depression in patients with PTSD who responded and did not respond to treatment with Mindfulness Based Stress Reduction (MBSR), They examined patients from a previous study of the effectiveness of MBSR for the treatment of PTSD who showed a significant reduction in PTSD symptoms and those that did not. The MBSR treatment consisted of body scan, meditation, and yoga practices and group discussion and occurred in 9 weekly, 2.5 hour sessions. with homework. Blood samples were drawn before and after treatment. They measured the degree of methylation of genes in the he promoter region of SLC6A4 previously associated with depression risk and symptoms and genes in the FKBP5 Intron 7 region identified as a functional regulator of glucocorticoid signaling.

 

They found that after Mindfulness Based Stress Reduction (MBSR) treatment there was a significant reduction in methylation of genes in the FKBP5 Intron 7 region in responders but an increase in non-responders. These genes are associated with stress related responding. Methylation tends to suppress gene expression, So, decreased methylation indicates an increased level of activity in stress related hormonal pathways.

 

These findings are interesting but not surprising as MBSR was developed specifically to improve stress responses. It is interesting that only patients who responded to treatment had this change to the genes underlying stress responding. So, it appears that MBSR is effective for PTSD symptoms but only if it changes stress related gene expression. It will be interesting to examine in the future the factors that result in non-responders being resistant to treatment with MBSR.

 

So, improve the symptoms of post-traumatic stress disorder (PTSD) by altering gene expression with mindfulness.

 

“Many people cope with trauma by distancing themselves from the sensations in their bodies and minds (the most extreme example of this is dissociation). Therefore, bringing one’s attention deliberately back to the body can unzip trauma symptoms they may not be prepared to address. However, mindfulness meditation can be helpful to those with PTSD and a history of trauma when practiced under the guidance of a mental healthcare provider and modified to be better suited for trauma survivors.” – Julia Ozog

 

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

Bishop, J. R., Lee, A. M., Mills, L. J., Thuras, P. D., Eum, S., Clancy, D., Erbes, C. R., Polusny, M. A., Lamberty, G. J., … Lim, K. O. (2018). Methylation of FKBP5 and SLC6A4 in Relation to Treatment Response to Mindfulness Based Stress Reduction for Posttraumatic Stress Disorder. Frontiers in psychiatry, 9, 418. doi:10.3389/fpsyt.2018.00418

 

Abstract

Mindfulness Based Stress Reduction (MBSR) is an effective non-pharmacologic treatment for veterans with PTSD. Extensive work has identified epigenetic factors related to PTSD disease risk and pathophysiology, but how these factors influence treatment response is unclear. Serotonin signaling and hypothalamic-pituitary-adrenal (HPA) axis functioning may be perturbed in PTSD and are molecular pathways targeted by PTSD treatments. To identify potential biomarkers for treatment response, we utilized genomic DNA isolated from peripheral blood samples from veterans with PTSD who were responders (n = 11) or non-responders (n = 11) to MBSR as part of a clinical trial. We assessed methylation levels at CpG sites in regions of the serotonin transporter (SLC6A4) previously associated with expression and depression outcomes, as well as the Intron 7 region of the FK506 binding protein 5 (FKBP5) containing known glucocorticoid response elements suggested to regulate this gene. Selected subjects were matched across MBSR responder status by baseline symptoms, age, sex, current smoking status, and current antidepressant use. Percent methylation was compared between responders and non-responders at baseline (pre-MBSR treatment). Additionally, percent change in methylation from baseline to post-treatment was compared between responders and non-responders. There was a significant time x responder group interaction for methylation in FKBP5 intron 7 bin 2 [F(1, 19) = 7.492, p = 0.013] whereby responders had a decrease in methylation and non-responders had an increase in methylation from before to after treatment in this region. Analyses of the three CpG sites within bin 2 revealed a significant time x responder group interaction for CpG_35558513 [F(1, 19) = 5.551, p = 0.029] which resides in a known glucocorticoid response element (GRE). Decreases in FKBP5 methylation after treatment in responders as compared to increases in non-responders suggest that effective meditation intervention may be associated with stress-related pathways at the molecular level. These preliminary findings suggest that DNA methylation signatures within FKBP5 are potential indicators of response to meditation treatment in PTSD and require validation in larger cohorts.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6153325/

 

Improve Social Anxiety Disorder with Mindfulness

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Improve Social Anxiety Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Using mindfulness, we can begin to notice what happens in the body when anxiety is present and develop strategies to empower clients to “signal safety” to their nervous system. Over time, clients feel empowered to slow down their response to triggers, manage their body’s fear response (fight-or-flight) and increase their ability to tolerate discomfort. The client experiences this as feeling like they have a choice about how they will respond to a trigger.” -Jeena Cho

 

It is a common human phenomenon that being in a social situation can be stressful and anxiety producing. Most people can deal with the anxiety and can become quite comfortable. But many do not cope well and the anxiety is overwhelming, causing the individual to withdraw. Social Anxiety Disorder (SAD) is characterized by a persistent, intense, and chronic fear of being watched and judged by others and feeling embarrassed or humiliated by their actions. This fear may be so severe that it interferes with work, school, and other activities and may negatively affect the person’s ability to form relationships.

 

Anxiety disorders have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for anxiety. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders including Social Anxiety Disorder (SAD). Mindfulness-Based Stress Reduction (MBSR) and also Cognitive Behavioral Therapy (CBT) have been shown to be effective in treating Social Anxiety Disorder (SAD). It is not known, however, if they operate through similar or different mechanisms.

 

In today’s Research News article “Trajectories of social anxiety, cognitive reappraisal, and mindfulness during an RCT of CBGT versus MBSR for social anxiety disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5600696/ ), Goldin and colleagues recruited patients with diagnosed Social Anxiety Disorder (SAD) and randomly assigned them to receive 12 weekly 2..5 hour sessions with daily homework of either Mindfulness-Based Stress Reduction (MBSR) or Cognitive Behavioral Therapy (CBT). MBSR consists of a combination of meditation, body scanning, and yoga practices. Cognitive Behavioral Therapy (CBT) is designed to alter how the patient relates to the thought processes that often underlie and exacerbate mood disorders. They were measured before treatment, once a week during treatment, and every 3 months for the following year for social anxiety, mindfulness, and cognitive reappraisal.

 

They found that both MBSR and CBT produced a progressive significant reduction in social anxiety and significant increases in mindful attitude and reappraisal, changing thinking about social anxiety, over the course of treatment that was maintained for the year following. They also found that the cognitive reappraisal strategy of disputing, challenging anxious thoughts and feelings and reappraisal success significantly increased over the course of treatment and were maintained for the year following but CBT produce a significantly greater increases than MBSR. In addition, they found that MBSR but not CBT produced significant increases in acceptance and acceptance success of anxiety over the course of treatment that were maintained for the year following. In examining the relationships between the variables they found that reappraisal and reappraisal success were significantly associated with the reduction of social anxiety for CBT but not MBSR. On the other hand, reappraisal disputing was significantly associated with reduction of social anxiety for MBSR but not CBT.

 

These are complex but interesting results that suggest that while both MBSR and CBT produce significant reductions in social anxiety and share many similar mechanisms, they also do so in different ways. CBT appears to reduce social anxiety by increasing the cognitive reappraisal strategy of disputing, challenging anxious thoughts and feelings, and its success in reducing anxiety. MBSR, on the other hand, appears to reduce social anxiety by increasing mindful acceptance of anxiety and its success.

 

So, improve social anxiety disorder with mindfulness.

 

“The power of a mindfulness practice, however, may come in the realization that one can live a meaningful life even with social anxiety. Schjerning says that he still feels nervous in social situations but now feels compassion — not judgment — for himself, and sees that “I can be more the person I want to be.” – Jason Drwal

 

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

 

Goldin, P. R., Morrison, A. S., Jazaieri, H., Heimberg, R. G., & Gross, J. J. (2017). Trajectories of social anxiety, cognitive reappraisal, and mindfulness during an RCT of CBGT versus MBSR for social anxiety disorder. Behaviour research and therapy, 97, 1-13.

 

Highlights

CBGT and MBSR produced similar decreases in social anxiety

CBGT (vs. MBSR): greater disputing anxiety and reappraisal success

CBGT: weekly reappraisal and reappraisal success predict social anxiety

MBSR (vs. CBGT): greater acceptance of anxiety and acceptance success

MBSR: weekly mindful attitude and disputing anxiety predict social anxiety

Abstract

Cognitive-Behavioral Group Therapy (CBGT) and Mindfulness-Based Stress Reduction (MBSR) are efficacious in treating social anxiety disorder (SAD). It is not yet clear, however, whether they share similar trajectories of change and underlying mechanisms in the context of SAD. This randomized controlled study of 108 unmedicated adults with generalized SAD investigated the impact of CBGT vs. MBSR on trajectories of social anxiety, cognitive reappraisal, and mindfulness during 12 weeks of treatment. CBGT and MBSR produced similar trajectories showing decreases in social anxiety and increases in reappraisal (changing the way of thinking) and mindfulness (mindful attitude). Compared to MBSR, CBGT produced greater increases in disputing anxious thoughts/feelings and reappraisal success. Compared to CBGT, MBSR produced greater acceptance of anxiety and acceptance success. Granger Causality analyses revealed that increases in weekly reappraisal and reappraisal success predicted subsequent decreases in weekly social anxiety during CBGT (but not MBSR), and that increases in weekly mindful attitude and disputing anxious thoughts/feelings predicted subsequent decreases in weekly social anxiety during MBSR (but not CBGT). This examination of temporal dynamics identified shared and distinct changes during CBGT and MBSR that both support and challenge current conceptualizations of these clinical interventions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5600696/

 

Improve the Psychological State of Patients with Rheumatoid Arthritis with Mindfulness

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Improve the Psychological State of Patients with Rheumatoid Arthritis with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Drugs are effective for rheumatoid arthritis, but they don’t affect the stress pathways that are so fundamental to the condition. Stress symptoms activate inflammation and even heighten the perception of pain. “A mindfulness-based intervention, which targets the multiple components of the body’s stress response, can decrease overall pain severity and increase quality of life.” – Michael Irwin

 

Arthritis is a chronic disease that most commonly affects the joints. Depending on the type of arthritis, symptoms may include pain, stiffness, swelling, redness, and decreased range of motion. It affects an estimated 52.5 million adults in the United States. It is associated with aging as arthritis occurs in only 7% of adults ages 18–44, while 30% adults ages 45–64 are affected, and 50% of adults ages 65 or older. Due to complications associated with rheumatoid arthritis (RA), the lifespan for people with RA may be shortened by 10 years. This is due to a higher incidence of cardiovascular disease in rheumatoid arthritis (RA) patients, with the risk more than double that of non-RA individuals.

 

Obviously, there is a need to explore alternative treatments for rheumatoid arthritis. One possibility is contemplative practice. A variety of which have been shown to have major mental and physical benefits including a reduction in the inflammatory response and have been shown to improve arthritis. In today’s Research News article “Systematic Review and Meta-analysis: Mindfulness-Based Interventions for Rheumatoid Arthritis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233984/ ), DiRenzo and colleagues review and summarize the published randomized clinical trials of mindfulness-based interventions for patients with rheumatoid arthritis.

 

They found only 5 published studies which produced inconclusive results regarding the effectiveness of mindfulness-based interventions on the physical symptoms of rheumatoid arthritis such as pain and inflammation. On the other hand, the research suggests that mindfulness-based interventions improve the psychological states of patients with rheumatoid arthritis including depression, anxiety, and psychological distress. The results, although inconclusive are sufficiently suggestive of positive outcomes that further research is warranted. It is clear that larger better controlled studies are needed before unambiguous conclusions can be reached.

 

So, improve the psychological state of patients with rheumatoid arthritis with mindfulness.

 

“The other thing I think is important to note about our study is that mindfulness meditation can be combined with any rheumatological therapy. It is truly complementary medicine in that sense, done in addition to pharmacological or other intervention. So, for physicians and patients who wonder what they can do to improve well-being, beyond taking medications, this study offers evidence for a beneficial approach to dealing with the psychological distress of RA.” – Elizabeth Pradhan

 

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

DiRenzo, D., Crespo-Bosque, M., Gould, N., Finan, P., Nanavati, J., & Bingham, C. O. (2018). Systematic Review and Meta-analysis: Mindfulness-Based Interventions for Rheumatoid Arthritis. Current rheumatology reports, 20(12), 75. doi:10.1007/s11926-018-0787-4

 

Abstract

Purpose of Review

To determine the efficacy of mindfulness-based interventions (MBIs) on clinical and patient-reported outcomes in rheumatoid arthritis (RA).

Recent Findings

We identified randomized clinical trials from inception through April 2018 from MEDLINE, PsycINFO, EMBASE, CINAHL, Web of Science, the Cochrane Library, and hand searches. After screening 338 references, we included five trials with one post-hoc analysis that evaluated MBIs and collectively included 399 participants. Outcome instruments were heterogeneous across studies. Three studies evaluated RA clinical outcomes by a rheumatologist; one study found improvements in disease activity. A limited meta-analysis found no statistically significant difference in the levels of DAS28-CRP in the two studies that evaluated this metric (− 0.44 (− 0.99, 0.12); I2 0%). Four studies evaluated heterogeneous psychological outcomes, and all found improvements including depressive symptoms, psychological distress, and self-efficacy. A meta-analysis of pain Visual Analog Scale (VAS) levels post intervention from three included studies was not significantly different between MBI participants and control group (− 0.58 (− 1.26, 0.10); I2 0%) although other studies not included in meta-analysis found improvement.

Summary

There are few trials evaluating the effect of MBIs on outcomes in patients with RA. Preliminary findings suggest that MBIs may be a useful strategy to improve psychological distress in those with RA.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233984/

Reduce Pain with Mindfulness

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Reduce Pain with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Meditation (which is the ‘formal’ practice of mindfulness) actually changes the way the mind perceives pain (2) so that it’s more bearable. It is a natural and effective way to ease physical pain.” – Melli O’Brien

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain.

 

Pain involves both physical and psychological issues. The stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. So, reducing the emotional reactions to pain may be helpful in pain management. There is an accumulating volume of research findings to demonstrate that mind-body therapies have highly beneficial effects on the health and well-being of humans. Mindfulness practices have been shown to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. Indeed, mindfulness practices are effective in treating pain in adults.

 

Hospital inpatients frequently are in pain and the management of that pain is important to the patients and to the amount of hospitalization time. It is not known whether mindfulness training is effective for the relief of acute pain in hospitalized patients. In today’s Research News article “Randomized Controlled Trial of Brief Mindfulness Training and Hypnotic Suggestion for Acute Pain Relief in the Hospital Setting.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5602767/ ), Garland and colleagues examined the effectiveness of mindfulness training in comparison to hypnotic suggestion and psychoeducation for the relief of inpatient acute pain.

 

They recruited hospital inpatients who reported intolerable pain that was not adequately managed. They were randomly assigned to receive either mindfulness training in a “single, scripted 15-min training session in focused attention on breathing and body sensations, with concomitant metacognitive monitoring and acceptance of discursive thoughts, negative emotions, and pain”, or a hypnotic suggestion in a “single, scripted 15-min self-hypnosis session which invited patients to roll their eyes upward, close their eyes, and breathe deeply, focus on sensations of floating, and imagine the visual, auditory, olfactory, and tactile details of a pleasant scene of their choosing”, or a psychoeducation session of a “single 15-min session in which a social worker provided empathic responses to the patient and then attempted to increase perception of pain control by reviewing common behavioral pain coping strategies (e.g., stretching, using hot and cold compresses).” They were measured before and after the training for pain intensity, pain unpleasantness, anxiety, relaxation, pleasant body sensations, and desire for opioids.

 

They found that both the mindfulness and the hypnotic suggestion groups but not the psychoeducation group had significant decreases in pain intensity and pain unpleasantness. The mindfulness group also reported significantly higher relaxation and pleasant body sensations after training than the psychoeducation group while the hypnotic suggestion group reported significantly lower desire for opioids after training than the psychoeducation group. All three groups showed a reduction in anxiety.

 

Hence, a brief mindfulness training or hypnotic suggestion in hospital patients significantly improved their pain and psychological state. These are interesting results that suggest that these trainings may be useful for the relief of acute pain in hospital patients. But this trial was very brief. It remains for future research to establish the duration of effectiveness and the ability of continued training to potentiate the effectiveness and its duration.

 

So, reduce pain with mindfulness.

 

“When we’re in pain, we want it to go away. Immediately. And that’s understandable. Chronic pain is frustrating and debilitating. . . The last thing we want to do is pay more attention to our pain. But that’s the premise behind mindfulness, a highly effective practice for chronic pain.” –  Margarita Tartakovsky

 

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

Garland, E. L., Baker, A. K., Larsen, P., Riquino, M. R., Priddy, S. E., Thomas, E., Hanley, A. W., Galbraith, P., Wanner, N., … Nakamura, Y. (2017). Randomized Controlled Trial of Brief Mindfulness Training and Hypnotic Suggestion for Acute Pain Relief in the Hospital Setting. Journal of general internal medicine, 32(10), 1106-1113.

 

Abstract

Background

Medical management of acute pain among hospital inpatients may be enhanced by mind-body interventions.

Objective

We hypothesized that a single, scripted session of mindfulness training focused on acceptance of pain or hypnotic suggestion focused on changing pain sensations through imagery would significantly reduce acute pain intensity and unpleasantness compared to a psychoeducation pain coping control. We also hypothesized that mindfulness and suggestion would produce significant improvements in secondary outcomes including relaxation, pleasant body sensations, anxiety, and desire for opioids, compared to the control condition.

Methods

This three-arm, parallel-group randomized controlled trial conducted at a university-based hospital examined the acute effects of 15-min psychosocial interventions (mindfulness, hypnotic suggestion, psychoeducation) on adult inpatients reporting “intolerable pain” or “inadequate pain control.” Participants (N = 244) were assigned to one of three intervention conditions: mindfulness (n = 86), suggestion (n = 73), or psychoeducation (n = 85).

Key Results

Participants in the mind-body interventions reported significantly lower baseline-adjusted pain intensity post-intervention than those assigned to psychoeducation (p < 0.001, percentage pain reduction: mindfulness = 23%, suggestion = 29%, education = 9%), and lower baseline-adjusted pain unpleasantness (p < 0.001). Intervention conditions differed significantly with regard to relaxation (p < 0.001), pleasurable body sensations (p = 0.001), and desire for opioids (p = 0.015), but all three interventions were associated with a significant reduction in anxiety (p < 0.001).

Conclusions

Brief, single-session mind-body interventions delivered by hospital social workers led to clinically significant improvements in pain and related outcomes, suggesting that such interventions may be useful adjuncts to medical pain management.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5602767/

 

Happy New Year with Mindfulness

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Happy New Year with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The object of a new year is not that we should have a new year. It is that we should have a new soul.”  ~G.K. Chesterton

 

At the stroke of midnight on December 31st all over the world revelers ring in the new calendar year with a hearty celebration. It’s a celebration of a relatively arbitrary day that has been designated as the first day of a new calendar year. The celebration of the solstice, 10 days before, at least has astrological meaning as the shortest day of the year. But, January 1 has no such physical meaning. January 1 was designated as the start of the year by Julius Caesar in 45 BC. That date was chosen to honor the Roman God Janus, the god of beginnings, whose two faces allowed him to look back into the past and forward into the future. That symbolism has stuck as the new year’s celebration involves a reflection about the year past and hope for the year to come.

 

Don’t Look Back

 

To some extent this looking back into the past and forward into the future is the antithesis of mindfulness which emphasizes the present moment. Our recollection of the past is, in fact, an illusion. When we look at the past we view it with the distorted lens of memory and the delusions that we have about the self. The memories of what happened during the last year bare only a fleeting resemblance to what actually happened. Recollections tend to be dominated by hazy and distorted memories of emotionally charged events and neglects everyday times of calm and contentment. When we look back we primarily remember the highs and the lows and believe that if we could simply keep repeating the highs and eliminate the lows then we’d be truly happy. This is the trap sometimes known as the hedonic treadmill. We keep seeking the highs and are unhappy when we can’t reproduce them or if we are successful are unhappy to find that we can’t maintain them. Unfortunately, our New Year’s celebration and our resolutions reinforce and amplify these ideas propelling us to even greater unhappiness in the new year.

 

Our view of the past is additionally distorted by the beliefs that we have about ourselves. These self-concepts are mainly incorrect and terribly distorted. Western culture, by its adoration of extraordinary and unrealistic models of perfection, produces and reinforces rampant self-dislike. We can never really attain the societal norm of perfection and this makes us feel horribly deficient. As a result, most westerners don’t like what they are and want to be different. As a consequence, people look back on the events of the year and interpret them through the lens of self-dislike.

 

We remember primarily those events that conform to our beliefs about what we should be, but cannot achieve. This creates a vicious cycle where the low self-esteem and self-worth causes us to remember events that exemplify this self-concept, creating even greater self-dislike. Those rare events that reveal us to be adequate are quickly forgotten. The events of the past year, then, are perceived as evidence to support our harsh view of ourselves. Rather than accurately remembering what actually happened during the year, our recollections are dominated by this distorted reality. So, don’t look back at the past year, rather look carefully and mindfully at yourself. You need to develop self-acceptance, before you can ever hope to have an honest idea of what the past contained.

 

Don’t Look to the Future

 

These distortions also color our thoughts about the upcoming year. We resolve to change ourselves to better conform to our unrealistic beliefs about what we should be. The New year’s resolutions that are such a common part of our new year’s celebration are a direct outgrowth of our self-dislike. The problem with these new year’s resolutions is that they are a declaration that we’re not happy with ourselves or the way things are. We want to be different. That’s not bad unto itself. Striving to better oneself is a good thing. The problem is that what we desire for ourselves is usually totally unrealistic as it’s based on a distorted reality. But, we strongly believe that this is what we need to be happy. It’s all a delusion that’s doomed to failure. In fact, research has suggested that only 8% of these resolutions are ever achieved.

 

Better New Year’s Resolutions

 

We need to craft a new set of resolutions, based upon self-acceptance, and a realistic view about what needs to be and can be achieved. The resolutions should be to better see things, including ourselves as they really are. To look at the world and ourselves mindfully without judgment, just as we are. These are the kinds of resolutions that can really work towards, not making us happy, but letting us be happy in the coming year; to simply experience the happiness that has been within us all along.

 

There are some rules of thumb about these resolutions. Don’t be too grandiose. Don’t set goals of perfection. Small steps with a recognition that you won’t always be successful are recommended. Make a resolution to practice mindfulness. Pick a practice that you not only can do, but that you can comfortably sustain. The only one perfect right practice is the one that you’ll do and keep doing. It may be meditation, yoga, body scan, tai chi or qigong, contemplative prayer, or another of the many available practices or some combination of practices. The only thing that matters is that you’re drawn to it, comfortable doing it, and you’ll stick with it. Once you start, don’t try too hard. Remember the Buddha recommended the middle way, with right effort, not too much and not too little. Practice nonjudgmentally. Don’t judge whether you’re doing it right or wrong, whether the particular practice was good or bad, or whether you’re making progress or not. Just practice. Just relax and let the practice do you. You don’t need to do it.

 

Focus on Now

 

All of these various practices promote nonjudgmental attention to what is occurring in the present moment, the now. Slowly you come to realize that the now is the only time available where you can be satisfied and happy. The past are only nows that are gone and the future are only nows that have yet to happen. So, focus on the present moment. It’s where life happens. If you can learn to be happy right now, then you’ll be able to happy in the future when it becomes now. As you look calmly, nonjudgmentally, and deeply at what is happening right now you begin to see the beauty and wonder that is there all of the time. You just need to stop ruminating about the past and worrying about the future. Learn to enjoy the moment.

 

Focusing on the present moment the impermanence of all things becomes evident. In the present we can observe things rising up and then falling away. Change is constant. If things are bad at the moment, you can be sure that it’ll change. So, be patient. On the other hand, if things are good, know also that this will change too. Don’t try to hang onto what is present. Learn to enjoy the moment as it is. These observations reveal that every moment is new. It has never happened before and it will never happen again. Every moment is a new opportunity. Don’t worry about it passing. The next moment will again provide a new opportunity. Make the most of it. If you can learn to do this, you’ll enjoy life to its fullest, as the dynamically changing perpetual now.

 

Renewal

 

In the new year, we need to not think about a “happy new year.” Rather think about a “happy new day.” In fact, it’s best to think about each “happy new moment.” Focus on the present moment and wish yourself and everyone else a “happy new moment.” Every moment is a unique opportunity to experience life as it is, appreciate its wonder, and enjoy it while it’s here, in the present moment. Each moment is an opportunity for renewal. If we’re not happy in the moment, we can be in the next. We have a new opportunity every new moment. If we pay attention to them, we can use the opportunity to create happiness.

 

So, have a “happy new moment” with mindfulness.

 

“Empty your glass and feel your way through this New Year. If it feeds your soul, do it. If it makes you want to get out of bed in the morning with a smile, carry on. Be present and let your energy synchronise with the earth and give you the clarity to move forward and be comfortable and contented with who you are. Let your intuition guide you through a wonderful year and attract an abundance of positive opportunity.” – Alfred James

 

“Many of us are thinking about new year’s resolutions and taking stock at this time, but how many of those typical resolutions are just ‘self’ improvement projects (which means we’re trying to get more, be more or have more) rather than ways to actually embrace the life we already have right here and now?” – Mrs. Mindfulness

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Improve Coping Strategies to Stress with Mindfulness

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Improve Coping Strategies to Stress with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Student life can be stressful, but that doesn’t mean students have to let stress take over their lives. By incorporating mindfulness and meditation into daily routines, students can not only relieve the pressure, but also improve their memory, focus and ultimately their grades.” – Todd Braver

 

In the modern world education is a key for success. Where a high school education was sufficient in previous generations, a college degree is now required to succeed in the new knowledge-based economies. There is a lot of pressure on students to excel so that they can get the best jobs after graduation. This stress might in fact be counterproductive as the increased pressure can actually lead to stress and anxiety which can impede the student’s physical and mental health, well-being, and school performance. It is, for the most part, beyond the ability of the individual to change the environment to reduce stress, so it is important that methods be found to reduce the college students’ responses to stress; to make them more resilient when high levels of stress occur.

 

So, it would seem important to examine various techniques to improve coping strategies for stress in college students. Contemplative practices including meditation, mindfulness training, and yoga practice have been shown to reduce the psychological and physiological responses to stress. Indeed, these practices have been found to reduce stress and improve psychological health in college students.  In today’s Research News article “Differential Effect of Level of Self-Regulation and Mindfulness Training on Coping Strategies Used by University Students.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6210926/ ), Fuente and colleagues examined the ability of students to cope with the stress of final exams and the ability of mindfulness training to produce more effective coping strategies.

 

They recruited college students and randomly assigned them to receive either 10 weeks, once a week for 1.5 hours, mindfulness training or to a no-treatment control condition. They were measured before and after training (during final exams) for self-regulation, including goal setting, perseverance, decision-making, and learning from mistakes, and coping strategies, including avoidant distraction, reducing anxiety and avoidance, preparing for the worst, emotional venting and isolation, resigned acceptance, family help and counsel, self-talk, positive reappraisal and firmness, communicating feelings and social support, and seeking alternative reinforcements.

 

They found that there was an increase in coping strategies at the end of training during final exams for those students who were high in self-regulation. With students with low levels of self-regulation mindfulness training appeared to help by decreasing emotion-focused coping particularly preparing for the worst, resigned acceptance, emotional venting, and isolation, and by increasing positive coping including positive reappraisal and firmness, self-talk, help for action.

 

These results suggest that students who have difficulty with regulating their own behavior benefit the most from mindfulness training, decreasing ineffective coping strategies and increasing effective strategies. So, mindfulness training improves the student’s ability to cope with stress effectively when the student has difficulty regulating themselves. This makes sense as students who are self-disciplined can deal with stress without mindfulness, but those who are not self-disciplined need the assistance of the non-judgmental awareness characteristic of mindfulness to identify the most effective coping strategies to deal with the stress.

 

So, improve coping strategies to stress with mindfulness.

 

“a mindfulness intervention can help reduce distress levels in college students during a stressful exam week, as well as increase altruistic action in the form of donating to charity.” – AMRA

 

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

Fuente, J., Mañas, I., Franco, C., Cangas, A. J., & Soriano, E. (2018). Differential Effect of Level of Self-Regulation and Mindfulness Training on Coping Strategies Used by University Students. International journal of environmental research and public health, 15(10), 2230. doi:10.3390/ijerph15102230

 

Abstract

The purpose of this research was to verify, in a group of psychology students, whether mindfulness training in conjunction with the individual’s level of self-regulation behavior would produce a change in the use of coping strategies. A total of 38 students participated in this study, with one experimental group and one control group, in a randomized controlled trial. Observation of the experimental group revealed a significant decrease in specific emotion-focused, negative coping strategies (preparing for the worst, resigned acceptance, emotional venting, and isolation), and a significant increase in specific problem-focused, positive coping (positive reappraisal and firmness, self-talk, help for action), in combination with students’ existing low-medium-high level of self-regulation. The importance and usefulness of mindfulness techniques in Higher Education is discussed, in conjunction with differences in university students’ level of self-regulation behavior.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6210926/

 

Mindfulness is Associated with Higher Emotional Intelligence

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Mindfulness is Associated with Higher Emotional Intelligence

 

By John M. de Castro, Ph.D.

 

“Mindful emotion regulation represents the capacity to remain mindfully aware at all times, irrespective of the apparent valence or magnitude of any emotion that is experienced. It does not entail suppression of the emotional experience, nor any specific attempts to reappraise or alter it in any way. Instead, MM involves a systematic retraining of awareness and nonreactivity, leading to defusion from whatever is experienced, and allowing the individual to more consciously choose those thoughts, emotions and sensations they will identify with, rather than habitually reacting to them. In this way, it erodes the automatic process of appraisal that gives rise to disturbing emotions in the first place” – Richard Chambers

 

Mindfulness practice has been shown to improve emotion regulation. Practitioners demonstrate the ability to fully sense and experience emotions, but respond to them in more appropriate and adaptive ways. In other words, mindful people are better able to experience yet control their responses to emotions. This is a very important consequence of mindfulness. Humans are very emotional creatures and these emotions can be very pleasant, providing the spice of life. But when they get extreme, they can produce misery and even mental illness. The ability of mindfulness training to improve emotion regulation is thought to be the basis for a wide variety of benefits that mindfulness provides to mental health and the treatment of mental illness especially depression and anxiety disorders.

 

Adolescence should be a time of mental, physical, social, and emotional growth. But adolescence can be a difficult time, fraught with challenges. During this time the child transitions to young adulthood; including the development of intellectual, psychological, emotional, physical, and social abilities and characteristics. There are so many changes occurring during this time that the child can feel overwhelmed and unable to cope with all that is required. Making these profound changes successfully requires a good deal or flexibility, adapting and changing with the physical, psychological, and social changes of adolescence and particularly to regulating the extreme fluctuations of emotions occurring during this time.

 

Hence, developing mindfulness and emotional regulation is important especially during adolescence. In today’s Research News article “Emotional Intelligence and Mindfulness: Relation and Enhancement in the Classroom With Adolescents.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2018.02162/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_830687_69_Psycho_20181120_arts_A ), Rodríguez-Ledo and colleagues examine the relationship between emotional intelligence and mindfulness in adolescent school students, aged 11 to 14 years. They were randomly assigned to receive either 9 months of once a week for 55 minutes mindfulness, attention, and emotional intelligence training or no training. The students were measured before and after training for emotional intelligence, emotional development, socialization, empathy, and mindfulness. The mindfulness measure included scales of kinesthetic, internal, and external mindfulness. Kinesthetic mindfulness was paying attention to movements, internal mindfulness was paying attention to mental and emotional states, while external mindfulness was paying attention to stimuli outside of the individual.

 

Examining the pretest measures they found that the higher the levels of mindfulness the higher the levels of emotional development, emotional intelligence, empathy, and self-control in social situations. The relationships with emotional development and emotional intelligence were especially strong for kinesthetic and internal mindfulness suggesting that the ability to attend to internal states is particularly important for understand and regulating their own emotions. The relationships with empathy was especially strong for external and internal mindfulness suggesting that the ability to attend to the environment and the internal state are particularly important for understanding others emotions. Finally, they found that the mindfulness training significantly increased kinesthetic and internal mindfulness.

 

These results are interesting and suggests that mindfulness training is effective in making school children more sensitive to their internal states and not to the external environment. Attention to these internal states appears to be related to emotional intelligence. So, adolescents can be trained in mindfulness of their internal milieu and this is related to their emotional intelligence. This makes sense as emotions are changes in internal states and the first step in regulating them is to become aware of them.

 

Since adolescence is a time of emotional upheaval, these skills may be particularly important for the navigation of this difficult time of development. It remains for future research to determine if mindfulness training of adolescents can have long lasting effects on their ability to regulate their emotions and successfully transition to adulthood.

 

“The appearance of things change according to the emotions and thus we see magic and beauty in them, while the magic and beauty are really in ourselves.” – Kahlil Gibran

 

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

 

Rodríguez-Ledo C, Orejudo S, Cardoso MJ, Balaguer Á and Zarza-Alzugaray J (2018) Emotional Intelligence and Mindfulness: Relation and Enhancement in the Classroom With Adolescents. Front. Psychol. 9:2162. doi: 10.3389/fpsyg.2018.02162

 

Emotional intelligence (EI) and mindfulness are two constructs that have been separately studied, and the relation between them still remains unclear. Research in this area has not attempted to go further into how enhancing EI and mindfulness together can achieve better improvements in this ability to attend mindfully. To bridge this knowledge gap, our research goal was to study the relationship between EI and the mindfulness competence in our study sample and to assess the impact of implementing EI and a mindfulness competence developmental program (SEA) about participants’ mindfulness competence. The sample consisted of 156 students aged 11–14 years old from a Spanish public high school. One hundred and eight participants were randomly assigned to the experimental condition, and the remaining 48 were to the control condition. The instruments used to evaluate EI were the CDE-SEC, EQi-Youth Version and the General Empathy Scale. Mindfulness on the School Scope Scale was used to assess mindfulness competences. Social adaptation was evaluated by using the social abilities and adjustment questionnaire BAS3. All the instruments where answered by the participants and have been adapted to a sample of youths with such age specifications. The results showed that EI and mindfulness were related to many of the variables measured by the instruments. Showing a good mindfulness competence was particularly related to having a good general level of the EI trait, and to many of the assessed social and emotional variables. The data indicated a significant relation between the mindfulness competence and having better general empathy skills or being better socially adjusted to the school context. The data also indicated a significant effect on participants’ interior and kinesthetic mindfulness competence after implementing the SEA Program. These findings corroborate the relationship between EI and mindfulness, and the possibility of enhancing mindfulness by applying a direct intervention program in the classroom.

https://www.frontiersin.org/articles/10.3389/fpsyg.2018.02162/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_830687_69_Psycho_20181120_arts_A

 

Promote Healthy Eating and Physical Activity in Adolescents with Yoga

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Promote Healthy Eating and Physical Activity in Adolescents with Yoga

 

By John M. de Castro, Ph.D.

 

“But, after coming back to Vinyasa yoga, and making it a daily practice, my eating habits have completely changed. I now crave fruit, vegetables, whole grains and other yummy nutritional things. And I haven’t had to even think about it or “engage in battle” with my brain for one second. The healthy choice is the only choice I want.” – Leslie Lewis

 

Eating is produced by two categories of signals. Homeostatic signals emerge from the body’s need for nutrients, is associated with feelings of hunger, and usually work to balance intake with expenditure. Non-homeostatic eating, on the other hand, is not tied to nutrient needs or hunger but rather to the environment and or to the pleasurable and rewarding qualities of food. These cues can be powerful signals to eat even when there is no physical need for food.

 

Mindful eating involves paying attention to eating while it is occurring, including attention to the sight, smell, flavors, and textures of food, to the process of chewing and may help reduce intake by affecting the individual’s response to non-homeostatic cues for eating. Indeed, high levels of mindfulness are associated with lower levels of obesity. Hence, mindful eating may counter non-homeostatic eating. Yoga is a mindfulness technique and yoga practice has been found to reduce emotional eating, reduce eating disorders, and improve mental health and dieting in the obese. Hence, yoga practice may be a method to improve healthy eating and physical activity in adolescents.

 

In today’s Research News article “Yoga’s potential for promoting healthy eating and physical activity behaviors among young adults: a mixed-methods study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5932774/ ), Watts and colleagues recruited middle and high school adolescents and had them complete measures of yoga practice, fruit and vegetable intake, sugar sweetened beverages, snack foods, fast foods, physical activity, and body size. A subset of the sample was recruited for qualitative interviews.

 

They found that those adolescents who practiced yoga had healthier diets and greater physical activity; including significantly greater consumption of fruits and vegetables and lower consumption of fast foods, snack foods, and sugar sweetened beverages. In addition, the greater the number of hours of yoga practice the better the diets and the greater the physical activity. In the interviews the adolescents indicated that yoga practice increased their mindful eating, cravings for healthier foods, and motivation for healthier eating, improved their management of stress and emotional eating. Also, they indicated that yoga practice increased their strength and flexibility and their desire to engage in other physical activities.

 

It should be kept in mind that these results are correlational and causation cannot be determined. But the results suggest that practicing yoga is associated with a constellation of healthy practices including healthier eating and greater physical activity. This is important as adolescence is the time when eating disorders and obesity develop. It is also the time for the establishment of eating and exercise habits. Thus, yoga practice may be a means to intervene early in life to establish a healthier lifestyle and promote health and well-being throughout life. It remains for future research to examine the effects of training adolescents in yoga on their health and well-being.

 

So, promote healthy eating and physical activity in adolescents with yoga.

 

“One of the unique aspects of yoga as an activity is its holistic approach. Yoga practitioners focus on both mental and physical well-being. Similarly, food yoga isn’t only about cooking and eating, it’s about considering your thoughts and emotions as well.” – Yalla Mediteranian

 

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

Watts, A. W., Rydell, S. A., Eisenberg, M. E., Laska, M. N., & Neumark-Sztainer, D. (2018). Yoga’s potential for promoting healthy eating and physical activity behaviors among young adults: a mixed-methods study. The international journal of behavioral nutrition and physical activity, 15(1), 42. doi:10.1186/s12966-018-0674-4

 

Abstract

Background

A regular yoga practice may have benefits for young adult health, however, there is limited evidence available to guide yoga interventions targeting weight-related health. The present study explored the relationship between participation in yoga, healthy eating behaviors and physical activity among young adults.

Methods

The present mixed-methods study used data collected as part of wave 4 of Project EAT (Eating and Activity in Teens and Young Adults), a population-based cohort study in Minneapolis-St. Paul, Minnesota. Young adults (n = 1820) completed the Project EAT survey and a food frequency questionnaire, and a subset who reported practicing yoga additionally participated in semi-structured interviews (n = 46). Analyses of survey data were used to examine cross-sectional associations between the frequency of yoga practice, dietary behaviors (servings of fruits and vegetables (FV), sugar-sweetened beverages (SSBs) and snack foods and frequency of fast food consumption), and moderate-to-vigorous physical activity (MVPA). Thematic analysis of interview discussions further explored yoga’s perceived influence on eating and activity behaviors among interview participants.

Results

Regular yoga practice was associated with more servings of FV, fewer servings of SSBs and snack foods, less frequent fast food consumption, and more hours of MVPA. Interviews revealed that yoga supported healthy eating through motivation to eat healthfully, greater mindfulness, management of emotional eating, more healthy food cravings, and the influence of the yoga community. Yoga supported physical activity through activity as part of yoga practice, motivation to do other forms of activity, increased capacity to be active, and by complementing an active lifestyle.

Conclusions

Young adult yoga practitioners reported healthier eating behaviors and higher levels of physical activity than non-practitioners. Yoga should be investigated as an intervention for young adult health promotion and healthy weight management.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5932774/

 

Reduce Treatment-Resistant Depression with Mindfulness

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Reduce Treatment-Resistant Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“MBCT is a major achievement. Based on a coherent body of experimental work, the treatment has proven its worth in reducing the recurrence of depression and, as a consequence, changing the future prospects of numerous people whose lives are blighted by repeated episodes of this disabling condition.“ – David Clark

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. Depression can be difficult to treat and is usually treated with anti-depressive medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression. Even after remission some symptoms of depression may still be present (residual symptoms).

 

Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering. Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail.

 

The most commonly used mindfulness technique for the treatment of depression is Mindfulness-Based Cognitive Therapy (MBCT).  MBCT was developed specifically to treat depression. It involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. MBCT has been shown to be as effective as antidepressant drugs in relieving the symptoms of depression and preventing depression reoccurrence and relapse. In addition, it appears to be effective as either a supplement to or a replacement for these drugs.

 

In today’s Research News article “Mindfulness-based cognitive therapy for patients with chronic, treatment-resistant depression: A pragmatic randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6175087/ ), Cladder-Micus and colleagues recruited adult patients with current depression who had failed to respond to antidepressant drug treatment. All participants continued with treatment as usual including antidepressant medication, psychological treatment, support by a psychiatric nurse, or day‐hospital treatment. Half of the participants were randomly assigned to receive 8 weeks, 2,5 hour once a week, of group based Mindfulness-Based Cognitive Therapy (MBCT). They were measured before and after treatment and 3 and 6 months later for depressive symptoms, remission, rumination, quality of life, mindfulness, and self-compassion.

 

They found that the addition of Mindfulness-Based Cognitive Therapy (MBCT) to treatment as usual resulted in decreased depressive symptoms which was significant only for participants who completed the program. There was a 42% remission rate for the MBCT group that was significantly better than the 22% rate in the treatment as usual group. The MBCT group also had significantly improved mindfulness and self-compassion.

 

These results are impressive and corroborate previous findings that MBCT is an effective treatment for depression and its recurrence and even in the cases where drugs fail. Depressed patients are suffering and if the depression isn’t lifted by drug treatments, the suffering becomes chronic. The fact that MBCT can help these treatment resistant patients, reducing depressive symptoms and producing remissions in greater numbers of patients, should not be underestimated. Since suicide is a real possibility in these patients, MBCT may not only be reducing suffering but actually saving lives,

 

So, reduce treatment-resistant depression with mindfulness.

 

“MBCT was developed for people with recurring episodes of depression or unhappiness, to prevent relapse. It has been proven effective in patients with major depressive disorder who have experienced at least three episodes of depression.” – Psychology Today

 

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

Abstract

Cladder-Micus, M. B., Speckens, A., Vrijsen, J. N., T Donders, A. R., Becker, E. S., & Spijker, J. (2018). Mindfulness-based cognitive therapy for patients with chronic, treatment-resistant depression: A pragmatic randomized controlled trial. Depression and anxiety, 35(10), 914-924.

 

Background

Chronic and treatment‐resistant depressions pose serious problems in mental health care. Mindfulness‐based cognitive therapy (MBCT) is an effective treatment for remitted and currently depressed patients. It is, however, unknown whether MBCT is effective for chronic, treatment‐resistant depressed patients.

Method

A pragmatic, multicenter, randomized‐controlled trial was conducted comparing treatment‐as‐usual (TAU) with MBCT + TAU in 106 chronically depressed outpatients who previously received pharmacotherapy (≥4 weeks) and psychological treatment (≥10 sessions).

Results

Based on the intention‐to‐treat (ITT) analysis, participants in the MBCT + TAU condition did not have significantly fewer depressive symptoms than those in the TAU condition (–3.23 [–6.99 to 0.54], d = 0.35, P = 0.09) at posttreatment. However, compared to TAU, the MBCT + TAU group reported significantly higher remission rates (χ 2(2) = 4.25, φ = 0.22, P = 0.04), lower levels of rumination (–3.85 [–7.55 to –0.15], d = 0.39, P = 0.04), a higher quality of life (4.42 [0.03–8.81], d = 0.42, P = 0.048), more mindfulness skills (11.25 [6.09–16.40], d = 0.73, P < 0.001), and more self‐compassion (2.91 [1.17–4.65], d = 0.64, P = 0.001). The percentage of non‐completers in the MBCT + TAU condition was relatively high (n = 12, 24.5%). Per‐protocol analyses revealed that those who completed MBCT + TAU had significantly fewer depressive symptoms at posttreatment compared to participants receiving TAU (–4.24 [–8.38 to –0.11], d = 0.45, P = 0.04).

Conclusion

Although the ITT analysis did not reveal a significant reduction in depressive symptoms of MBCT + TAU over TAU, MBCT + TAU seems to have beneficial effects for chronic, treatment‐resistant depressed patients in terms of remission rates, rumination, quality of life, mindfulness skills, and self‐compassion. Additionally, patients who completed MBCT showed significant reductions in depressive symptoms. Reasons for non‐completion should be further investigated.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6175087/