Improve Addiction Rehabilitation with Acceptance and Commitment Group Therapy

psyjdc Leave a comment

Improve Addiction Rehabilitation with Acceptance and Commitment Group Therapy

 

By John M. de Castro, Ph.D.

 

“ACT looks at a psychological problem in terms of something “physical” in the way, such as a rock that can be moved, or a detour taken around, or a garden plot that needs to be weeded so plants can grow.” – Edie Weinstein

 

Substance abuse and addiction is a terrible problem. It isn’t just illicit drugs but includes many prescriptions drugs especially opioid pain relievers. The over prescription of opioid painkillers in the United States has become a major problem. Opioid abuse, can be deadly. It has become so bad that drug overdose is now the leading cause of injury death, causing more deaths than motor vehicle accidents. This is a problem both of illegal drug use but even more so of abuse of legally obtained prescription drugs. Of the over 44,000 drug overdose deaths in the United States 52% were from prescription drugs. These statistics, although startling, are only the tip of the iceberg. Drug use is associated with suicide, homicide, motor-vehicle injury, HIV infection, pneumonia, violence, mental illness, and hepatitis. It can render the individual ineffective at work, it tears apart families, it makes the individual dangerous both driving and not. It also reduces life expectancy by about 15-20 years from the moment of addiction. An effective treatment for addiction has been elusive. Most programs and therapies to treat addictions have poor success rates.

 

Obviously, there is a need to find effective methods to prevent and treat substance abuse. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Narcotics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers relapse and return to substance abuse. Hence, it is important to find an effective method to not only produce abstinence but also prevent relapses. Mindfulness training has been shown to be a safe and effective treatment for reducing addiction relapse.

 

Acceptance and Commitment Therapy (ACT) is a mindfulness based psychotherapy technique that focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. Additionally, it teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. On the face of it, ACT would appear to address the kinds of defective thought processes that occur in addiction. But, the effectiveness of ACT for opioid addiction has not been adequately tested.

 

In today’s Research News article “Comparing Acceptance and Commitment Group Therapy and 12-Steps Narcotics Anonymous in Addict’s Rehabilitation Process: A Randomized Controlled Trial.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5206327/

Azkhosh and colleagues recruited individuals who were addicted to opiates and randomly assigned them to receive either a group administered Acceptance and Commitment Therapy (ACT), Narcotics Anonymous 12-step program, or usual treatment. Treatment occurred for 12 weeks, meeting once a week for 90 minutes. Before and after treatment and 6 weeks later the participants were measured for psychological wellbeing, and psychological flexibility.

 

They found that at the end of treatment and at follow-up, both treatment groups showed improvements relative to the control group on psychological well-being and psychological flexibility, including the self-acceptance, autonomy, purpose in life, and personal growth subscales. Hence, both Acceptance and Commitment Therapy (ACT) and Narcotics Anonymous 12-step programs improve the psychological components that are needed for successful treatment of opioid addiction. It remains for future research to determine if these effects translate into successful primary treatment and relapse prevention of opioid addiction.

 

So, improve the psychological characteristics needed for addiction rehabilitation with Acceptance and Commitment Therapy.

 

“ACT encourages people to simply notice and accept their thoughts and feelings for what they are: merely thoughts and feelings of no particular importance other than the importance we assign them. People learn to say to themselves, “Oh, I’m having a thought about cocaine. I’m having a feeling it would be fun to use again.” From this perspective, there is no impetus to use cocaine, nor is cocaine fun. It is merely a thought about those things.” – Tom Horvath

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Azkhosh, M., Farhoudianm, A., Saadati, H., Shoaee, F., & Lashani, L. (2016). Comparing Acceptance and Commitment Group Therapy and 12-Steps Narcotics Anonymous in Addict’s Rehabilitation Process: A Randomized Controlled Trial. Iranian Journal of Psychiatry, 11(4), 244–249.

 

Abstract

Objective: Substance abuse is a socio-psychological disorder. The aim of this study was to compare the effectiveness of acceptance and commitment therapy with 12-steps Narcotics Anonymous on psychological well-being of opiate dependent individuals in addiction treatment centers in Shiraz, Iran.

Method: This was a randomized controlled trial. Data were collected at entry into the study and at post-test and follow-up visits. The participants were selected from opiate addicted individuals who referred to addiction treatment centers in Shiraz. Sixty individuals were evaluated according to inclusion/ exclusion criteria and were divided into three equal groups randomly (20 participants per group). One group received acceptance and commitment group therapy (Twelve 90-minute sessions) and the other group was provided with the 12-steps Narcotics Anonymous program and the control group received the usual methadone maintenance treatment. During the treatment process, seven participants dropped out. Data were collected using the psychological well-being questionnaire and AAQ questionnaire in the three groups at pre-test, post-test and follow-up visits. Data were analyzed using repeated measure analysis of variance.

Results: Repeated measure analysis of variance revealed that the mean difference between the three groups was significant (P<0.05) and that acceptance and commitment therapy group showed improvement relative to the NA and control groups on psychological well-being and psychological flexibility.

Conclusion: The results of this study revealed that acceptance and commitment therapy can be helpful in enhancing positive emotions and increasing psychological well-being of addicts who seek treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5206327/

 

Improve Mental Health in Disadvantaged Populations with Mindfulness

psyjdc Leave a comment

Improve Mental Health in Disadvantaged Populations with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness training could be integrated into educational settings on a city, state, or national level, thus promoting health and mental health. Integrating mindfulness-based practices into educational settings could offer the potential to promote a more positive path for our children, something that would be particularly beneficial for disadvantaged urban youth like the kids in our studies.” –  Tamar Mendelson

 

Disadvantaged populations have a disproportionate share of mental health issues. Indeed, the lower the socioeconomic status of an individual the greater the likelihood of a mental disorder. It is estimated that major mental illnesses are almost 3 times more likely in the disadvantaged, including almost double the incidence of depression, triple the incidence of anxiety disorders, alcohol abuse, and eating disorders. These higher incidences of mental health issues occur, in part, due to mental health problems leading to unemployment and poverty, but also to the stresses of life in poverty.

 

The disadvantaged are much more likely to be uninsured, not have mental health services available, and less likely to seek treatment. In addition, when they are treated it is almost exclusively with drugs. These often do not work, have adverse effects, or are not taken as prescribed and are thus ineffective. Most psychotherapies were developed to treat disorders in affluent populations and are not affordable or sensitive to the unique situations and education levels of the disadvantaged. So, very few disadvantaged people with mental health problems are treated with psychotherapies.

 

Hence, there is a great need for alternative treatments for the mentally ill disadvantaged. One increasingly popular alternative is mind-body practices. These include meditation, tai chi, qigong, yoga, guided imagery, etc. In today’s Research News article “Mind–Body Approaches to Treating Mental Health Symptoms Among Disadvantaged Populations: A Comprehensive Review.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4761814/

Burnett-Zeigler and colleagues review the published research literature on the effectiveness of mind-body practices for the treatment of mental health issues in disadvantaged populations.

 

They found that in general mind-body techniques are feasible, acceptable, and efficacious with disadvantaged populations. The published research reports than Mindfulness Based Stress Reduction (MBSR) programs produced significant improvements in disadvantaged populations in general health, social functioning, vitality, physical and emotional role functioning, stress, mindfulness, anxiety, self-compassion, life satisfaction, depression, relationships, awareness, self-acceptance, and self-empowerment, nonreactivity, improved self-care, and decreased distress. The research also reports that yoga practice results in significant improvements in distressed mood, depression, emotional well-being, body weight, depression, and disease-specific quality of life. Other mind-body techniques were also reported to have similar benefits.

 

Hence the published research studies are fairly uniform in finding that mind-body practices can be successfully implemented with disadvantaged populations and produce significant mental health benefits. Although much more research is needed, these are exciting findings. Mind-body techniques show tremendous promise for the mental health needs of the disadvantaged. They can be implemented cost-effectively and many of these practices can be employed at home on convenient schedules. Hence mind-body practices, if implemented broadly, may be major contributors to improved mental health in disadvantaged populations. This, in turn, may lead to better employment possibilities and a route out of poverty.

 

So, improve mental health in disadvantaged populations with mindfulness.

 

“Research and experience have shown that meditation-based or contemplative practices have proven to be beneficial with populations that are considered at risk, marginalized, or oppressed and with those who are incarcerated.” – Sadye Logan

 

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

Burnett-Zeigler, I., Schuette, S., Victorson, D., & Wisner, K. L. (2016). Mind–Body Approaches to Treating Mental Health Symptoms Among Disadvantaged Populations: A Comprehensive Review. Journal of Alternative and Complementary Medicine, 22(2), 115–124. http://doi.org/10.1089/acm.2015.0038

 

Abstract

Mind–body approaches are commonly used to treat a variety of chronic health conditions, including depression and anxiety. A substantial proportion of individuals with depression and anxiety disorders do not receive conventional treatment; disadvantaged individuals are especially unlikely to receive treatment. Mind–body approaches offer a potentially more accessible and acceptable alternative to conventional mental health treatment for disadvantaged individuals, who may not otherwise receive mental health treatment. This review examines evidence for the efficacy of mind–body interventions for mental health symptoms among disadvantaged populations. While rates of utilization were relatively lower for racial/ethnic minorities, evidence suggests that significant proportions of racial/ethnic minorities are using complementary health approaches as health treatments, especially prayer/healers and natural or herbal remedies. This review of studies on the efficacy of mind–body interventions among disadvantaged populations found evidence for the efficacy of mind–body approaches for several mental and physical health symptoms, functioning, self-care, and overall quality of life.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4761814/

 

Relieve Social Anxiety with Mindfulness

psyjdc 2 Comments

Relieve Social Anxiety with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is shown in research to use neural pathways in the brain that cause the nervous system to calm. 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.“ – Jeena Cho

 

It is almost a common human phenomenon that being in a social situation can be stressful and anxiety producing. This is particularly true when asked to perform in a social context such as giving a speech. Most people can deal with the anxiety and can become quite comfortable. But many do not cope well with the anxiety or the level of 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. SAD is the most common form of anxiety disorder occurring in about 7% of the U.S. population.

 

Anxiety disorders have generally been treated with drugs. It has been estimated that 11% of women in the U.S. are taking anti-anxiety medications. But, there are considerable side effects and these drugs are often abused. Although, psychological therapy can be effective it is costly and only available to a small numbers of sufferers. 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). There is a need, however, to investigate the effectiveness of different therapeutic techniques for anxiety disorders.

 

Mindfulness-Based Cognitive Therapy (MBCT) was developed to treat depression but has been found to also be effective for other mood disorders. MBCT 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 mood disorders. In today’s Research News article “The Effectiveness of Mindfulness-Based Cognitive Therapy on Iranian Female Adolescents Suffering From Social Anxiety.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292141/

Ebrahiminejad and colleagues examine the ability of (MBCT) to relieve Social Anxiety Disorder (SAD).

 

They recruited High School students with SAD and randomly assigned them to receive either and 8-week, 1.5 hours once a week, MBCT program or a no-treatment control condition. The students were measured before and after treatment for Social Anxiety and self-esteem. MBCT sessions were held in a group format with 15 students per group. They found that following the MBCT program the students had a significant, 21%, improvement in Social Anxiety and a significant three-fold improvement in self-esteem, while the control groups showed no improvement in either measure. Hence, the results of this pilot study suggest that Mindfulness-Based Cognitive Therapy (MBCT) is effective in treating Social Anxiety Disorder (SAD) in adolescents.

 

Anxiety is a fear of what might happen in the future. Mindfulness training by focusing the individual on the present moment, would tend to counteract anxiety. In addition, the cognitive therapy component of the MBCT program is targeted on changing the thought processes that lead to the anticipation of pending negative consequences. Hence, MBCT both alters the aberrant thinking and the focus on the future, resulting in marked improvement in anxiety disorders.

 

These are potentially important results as SAD is such a common disorder that interferes with the social development of adolescents. It should be pointed out that the control condition received no treatment whatsoever. So, the conclusions must be tempered with the understanding that a number of confounding factors, such as placebo effects, experimenter bias, attentional effects, etc., could be responsible for the outcomes. But, this pilot study demonstrates significant effects and suggests that a randomized controlled clinical trial be conducted that includes an active control condition.

 

“mindfulness meditation training made people with social anxiety disorder feel less anxious and less depressed and improved their self-views.” – Mindful

 

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

Ebrahiminejad, S., Poursharifi, H., Bakhshiour Roodsari, A., Zeinodini, Z., & Noorbakhsh, S. (2016). The Effectiveness of Mindfulness-Based Cognitive Therapy on Iranian Female Adolescents Suffering From Social Anxiety. Iranian Red Crescent Medical Journal, 18(11), e25116. http://doi.org/10.5812/ircmj.25116

 

Abstract

Background

Social anxiety is one of the most common psychological disorders that exists among children and adolescents, and it has profound effects on their psychological states and academic achievements.

Objectives

The aim of this study was to determine the effectiveness of mindfulness-based cognitive therapy (MBCT) on diminishing social anxiety disorder symptoms and improving the self-esteem of female adolescents suffering from social anxiety.

Patients and Methods

Semi-experimental research was conducted on 30 female students diagnosed with social anxiety. From the population of female students who were studying in Tehran’s high schools in the academic year of 2013 – 2014, 30 students fulfilling the DSM-5 criteria were selected using the convenience sampling method and were randomly assigned to control and experimental groups. The experimental group received eight sessions of MBCT treatment. The control group received no treatment. All participants completed the social phobia inventory (SPIN) and Rosenberg self-esteem scale (RSES) twice as pre- and post-treatment tests.

Results

The results from the experimental group indicated a statistically reliable difference between the mean scores from SPIN (t (11) = 5.246, P = 0.000) and RSES (t (11) = -2.326, P = 0.040) pre-treatment and post-treatment. On the other hand, the results of the control group failed to reveal a statistically reliable difference between the mean scores from SPIN (t (12) = 1.089, P = 0.297) and RSES pre-treatment and post-treatment (t (12) = 1.089, P = 0.000).

Conclusions

The results indicate that MBCT is effective on both the improvement of self-esteem and the decrease of social anxiety. The results are in accordance with prior studies performed on adolescents.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292141/

 

Live Longer with Yoga and Meditation

psyjdc 1 Comment

 

Live Longer with Yoga and Meditation

 

By John M. de Castro, Ph.D.

 

“A growing body of research supports the immediate benefits of meditation, such as reduced stress and anxiety levels, lower blood pressure, and enhanced happiness. While these initial perks may be reason enough for us to practice, meditation’s positive impact appears to be even more far-reaching, potentially adding years to our lives and improving cognitive function well into old age.” – Rina Deshpande

 

One of the most exciting findings in molecular biology in recent years was the discovery of the telomere. This is a component of the DNA molecule that is attached to the ends of the strands. Recent genetic research has suggested that the telomere and its regulation is the biological mechanism that produces aging. It has been found that the genes, coded on the DNA molecule, govern cellular processes in our bodies. One of the most fundamental of these processes is cell replication. Cells are constantly turning over. Dying cells or damaged are replaced by new cells. The cells turn over at different rates but most cells in the body are lost and replaced between every few days to every few months. Needless to say, we’re constantly renewing ourselves.

 

As we age the tail of the DNA molecule called the telomere shortens. When it gets very short cells have a more and more difficult time reproducing and become more likely to produce defective cells. On a cellular basis, this is what produces aging. As we get older the new cells produced are more and more likely to be defective. The shortening of the telomere occurs each time the cell is replaced. So, slowly as we age it gets shorter and shorter. This has been called a “mitotic clock.” This is normal. But, telomere shortening can also be produced by oxidative stress, which can be produced by psychological and physiological stress. This is mediated by stress hormones and the inflammatory response. So, chronic stress can accelerate the aging process. In other words, when we’re chronically stressed we get older faster.

 

Fortunately, there is a mechanism to protect the telomere. There is an enzyme in the body called telomerase that helps to prevent shortening of the telomere. It also promotes cell survival and enhances stress-resistance.  Research suggests that processes that increase telomerase activity tend to slow the aging process by protecting the telomere.  One activity that seems to increase telomerase activity and protect telomere length is mindfulness practice. Hence, engaging in mindfulness practices may protect the telomere and thereby slow the aging process.

 

In today’s Research News article “Impact of Yoga and Meditation on Cellular Aging in Apparently Healthy Individuals: A Prospective, Open-Label Single-Arm Exploratory Study.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5278216/

Tolahunase and colleagues examined the effects of a program of yoga and meditation on biomarkers of cellular aging in a healthy population. They recruited healthy adults, aged 35-65 years who led modern sedentary lifestyles and provided them with a 12-week program of Hatha and Raja yogic meditation, breathing exercises, and postures. Sessions were held five days per week for 90 minutes. Participants were measured before and after treatment for a variety of biomarkers of cellular aging.

 

They found that at the end of the 12-week program there were significant reductions in the levels of the oxidative stress and inflammatory response related biomarkers 8-OH2dG, ROS, cortisol, and IL-6suggesting a reduction in chemical activity that tends to increase cellular aging. They also found that there were significant increases in TAC a marker of antioxidant activity, and markers of cellular aging of telomerase activity, an enzyme that protects the telomeres, β-endorphin, BDNF, and sirtuin-1. Hence, they found clear evidence that the meditation and yoga program greatly reduced the underlying biochemical processes of cellular aging in an otherwise healthy group of adults.

 

It should be mentioned that there wasn’t a control condition, particularly one that included light exercise. So, it cannot be determined if the results were due to participant expectancies, experimenter bias, attentional effects, the effects of exercise in a sedentary population, or many other potential confounding factors. A randomized controlled clinical trial including a group engaging in light exercise is needed to clarify the causal factors involved. Regardless of the explanation, this study demonstrated that the yoga and meditation program resulted in improvements in biomarkers that suggest that there was a slowing of the processes of cellular aging that underlie the aging of the body. This suggests that engaging in this or similar programs may lead to a longer, healthier life.

 

So, Live Longer with Yoga and Meditation.

 

“Yoga and meditation are well-documented to have psychological, emotional and physical benefits for people at all stages of health, including cancer patients. Now breakthrough research reveals yoga and meditation can positively affect DNA.” – Elaine Gavalas

 

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

 

Tolahunase, M., Sagar, R., & Dada, R. (2017). Impact of Yoga and Meditation on Cellular Aging in Apparently Healthy Individuals: A Prospective, Open-Label Single-Arm Exploratory Study. Oxidative Medicine and Cellular Longevity, 2017, 7928981. http://doi.org/10.1155/2017/7928981

 

Abstract

This study was designed to explore the impact of Yoga and Meditation based lifestyle intervention (YMLI) on cellular aging in apparently healthy individuals. During this 12-week prospective, open-label, single arm exploratory study, 96 apparently healthy individuals were enrolled to receive YMLI. The primary endpoints were assessment of the change in levels of cardinal biomarkers of cellular aging in blood from baseline to week 12, which included DNA damage marker 8-hydroxy-2′-deoxyguanosine (8-OH2dG), oxidative stress markers reactive oxygen species (ROS), and total antioxidant capacity (TAC), and telomere attrition markers telomere length and telomerase activity. The secondary endpoints were assessment of metabotrophic blood biomarkers associated with cellular aging, which included cortisol, β-endorphin, IL-6, BDNF, and sirtuin-1. After 12 weeks of YMLI, there were significant improvements in both the cardinal biomarkers of cellular aging and the metabotrophic biomarkers influencing cellular aging compared to baseline values. The mean levels of 8-OH2dG, ROS, cortisol, and IL-6 were significantly lower and mean levels of TAC, telomerase activity, β-endorphin, BDNF, and sirtuin-1 were significantly increased (all values p < 0.05) post-YMLI. The mean level of telomere length was increased but the finding was not significant (p = 0.069). YMLI significantly reduced the rate of cellular aging in apparently healthy population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5278216/

 

Spiritual Concerns Decrease Quality of Life in Cancer Patients

psyjdc 3 Comments

 

Spiritual Concerns Decrease Quality of Life in Cancer Patients

 

By John M. de Castro, Ph.D.

 

“For some, a cancer diagnosis has the opposite effect on their sense of spirituality. It makes them doubt their beliefs or religious values, challenges their faith, and can cause spiritual distress. Some people become angry with God for allowing them to get cancer or wonder if they are being punished. Spiritual distress can make it harder for patients to cope with cancer and its treatment.” –  National Comprehensive Cancer Network

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis.

 

Religion and spirituality become much more important to people when they’re diagnosed with cancer, when living with advanced cancer, and at end of life care. It is thought that people take comfort in the spiritual when facing their own mortality. There is very little information available, however, regarding the effectiveness of religion and spirituality in relieving the psychological burdens of cancer or on the quality of life of advance cancer patients. Additionally, the impact of spiritual concerns that the patient might have are not known. Concerns such as feelings of being abandoned by God or needing forgiveness for actions in their lives might lead to anxiety and worry rather than comfort.

 

In today’s Research News article “The Relationship of Spiritual Concerns to the Quality of Life of Advanced Cancer Patients: Preliminary Findings.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5206727/

Winkelman and colleagues study the relationship of patients’ spiritual concern to their quality of life with advanced cancer. They recruited terminal cancer patients who were undergoing palliative radiation treatments. They completed measures of religiousness, spirituality, spiritual concerns including spiritual struggles and spiritual seeking, and quality of life including physical and existential quality of life. The patients died on average of 180 days after completing the measures.

 

The majority of the patients experienced one or more forms of spiritual struggle (58%), and most (82%) experienced spiritual seeking. Their struggles included “wondering why God has allowed this to happen” and “wondering whether God has abandoned me.” The most common spiritual seekings were “seeking a closer connection to God” and “thinking about what gives meaning to life.”  They found that the greater the spiritual concerns, spiritual struggles, or spiritual concerns, the lower the patient’s quality of life. Virtually all of the patients indicated that spiritual care was important in their treatment.

 

These results are somewhat surprising in that religiousness and spirituality were not associated with comfort but with poorer quality of life in these terminal cancer patients. In particular, it appears that concerns about the spiritual meaning of their situation were very common and greatly troubled the patients leading to poorer quality of life. Being at peace with God is a very important goal of these patients and their concerns interfered with attaining that peace. Hence, it appears that in hospice and palliative care there should be greater attention paid to the religiousness and spirituality of the patients, particularly to their spiritual concerns, struggles, and seeking. This is important as spiritual concerns trouble them deeply and decrease the quality of life of terminal cancer patients.

 

 “When we took a closer look, we found that patients with stronger spiritual well-being, more benign images of God (such as perceptions of a benevolent rather than an angry or distant God), or stronger beliefs (such as convictions that a personal God can be called upon for assistance) reported better social health. In contrast, those who struggled with their faith fared more poorly.” – Allen Sherman

 

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

Winkelman, W. D., Lauderdale, K., Balboni, M. J., Phelps, A. C., Peteet, J. R., Block, S. D., … Balboni, T. A. (2011). The Relationship of Spiritual Concerns to the Quality of Life of Advanced Cancer Patients: Preliminary Findings. Journal of Palliative Medicine, 14(9), 1022–1028. http://doi.org/10.1089/jpm.2010.0536

 

Abstract

Purpose

Religion and/or spirituality (R/S) have increasingly been recognized as key elements in patients’ experience of advanced illness. This study examines the relationship of spiritual concerns (SCs) to quality of life (QOL) in patients with advanced cancer.

Patients and Methods

Patients were recruited between March 3, 2006 and April 14, 2008 as part of a survey-based study of 69 cancer patients receiving palliative radiotherapy. Sixteen SCs were assessed, including 11 items assessing spiritual struggles (e.g., feeling abandoned by God) and 5 items assessing spiritual seeking (e.g., seeking forgiveness, thinking about what gives meaning in life). The relationship of SCs to patient QOL domains was examined using univariable and multivariable regression analysis.

Results

Most patients (86%) endorsed one or more SCs, with a median of 4 per patient. Younger age was associated with a greater burden of SCs (β = −0.01, p = 0.006). Total spiritual struggles, spiritual seeking, and SCs were each associated with worse psychological QOL (β = −1.11, p = 0.01; β = −1.67, p < 0.05; and β = −1.06, p < 0.001). One of the most common forms of spiritual seeking (endorsed by 54%)—thinking about what gives meaning to life—was associated with worse psychological and overall QOL (β = − 5.75, p = 0.02; β = −12.94, p = 0.02). Most patients (86%) believed it was important for health care professionals to consider patient SCs within the medical setting.

Conclusions

SCs are associated with poorer QOL among advanced cancer patients. Furthermore, most patients view attention to SCs as an important part of medical care. These findings underscore the important role of spiritual care in palliative cancer management.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5206727/

Alleviate General Practitioner Burnout with Mindfulness

psyjdc 1 Comment

Alleviate General Practitioner Burnout with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Enhancing the already inherent capacity of the physician to experience fully the clinical encounter—not only its pleasant but also its most unpleasant aspects—without judgment but with a sense of curiosity and adventure seems to have had a profound effect on the experience of stress and burnout. It also seems to enhance the physician’s ability to connect with the patient as a unique human being and to center care around that uniqueness.” – Michael Krasner

 

General Practitioners confront stress on a daily basis. Even moderate levels of stress when prolonged, all too frequently results in a professional burnout. This is the fatigue, cynicism, emotional exhaustion, and professional inefficacy that comes with work-related stress. Healthcare is a high stress occupation. 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. Nearly half plan to look for a new job over the next two years and 80% expressed interest in a new position if they came across the right opportunity.

 

Regardless of the reasons for burnout or its immediate presenting consequences, it is a threat to the healthcare providers and their patients. In fact, it is a threat to the entire healthcare system as it contributes to the shortage of doctors and nurses. Hence, preventing existing healthcare workers from burning out has to be a priority. Mindfulness has been demonstrated to be helpful in treating and preventing burnout. One of the premiere techniques for developing mindfulness and dealing effectively with stress is Mindfulness Based Stress Reduction (MBSR) pioneered by Jon Kabat-Zinn. It is a diverse mindfulness training containing practice in meditation, body scan, and yoga. As a result, there have been a number of trials investigating the application of MBSR to the treatment and prevention of health care worker burnout.

 

In today’s Research News article “Mindfulness-based stress reduction for GPs: results of a controlled mixed methods pilot study in Dutch primary care.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4723221/

Verweij and colleagues investigated the effectiveness of Mindfulness Based Stress Reduction (MBSR) in preventing burnout in General Practitioners. They recruited General Practitioners who were required to participate in continuing professional education courses and offered as an option participation in an 8-week MBSR program. They compared GPs who selected the MBSR program during one 8-week period to those who selected a waitlist condition and received the usual continuing professional education course. They completed measures both before and after the treatment of burnout, work engagement, and mindfulness.

 

They found, not surprisingly, that compared to the waitlist controls, the MBSR program resulted in higher levels of mindfulness. But, importantly, it also significantly decreased levels of burnout depersonalization and increased levels of work dedication. During interviews after completion of the program The GPs reported that the MBSR program helped them to become more aware of their bodily sensations, thoughts, and emotions, of their beliefs and values, and a recognition of the autopilot mode they usually engaged in. They also reported that the MBSR program increased their wellbeing and compassion towards themselves and others, including their patients.

 

The findings from this pilot study are very encouraging. They demonstrate that mindfulness training reduces self-reported burnout, and improves professional dedication, recognition of bodily reactions and how activities have become routinized, and general wellbeing. By improving their awareness of the sensations, thoughts, and actions in the present moment mindfulness training appears to be somewhat an antidote to burnout. This suggests that mindfulness practices should be included in the continuing education of healthcare professionals.

 

So, alleviate general practitioner burnout with mindfulness.

 

“Mindfulness gives doctors permission to attend to their own health and well-being. But is also allows doctors to help patients by listening more, talking less and seeing what the patient needs.” – Mary Breach

 

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

Verweij, H., Waumans, R. C., Smeijers, D., Lucassen, P. L., Donders, A. R. T., van der Horst, H. E., & Speckens, A. E. (2016). Mindfulness-based stress reduction for GPs: results of a controlled mixed methods pilot study in Dutch primary care. The British Journal of General Practice, 66(643), e99–e105. http://doi.org/10.3399/bjgp16X683497

 

Abstract

Background

Burnout is highly prevalent in GPs and can have a negative influence on their wellbeing, performance, and patient care. Mindfulness-based stress reduction (MBSR) may be an effective intervention to decrease burnout symptoms and increase wellbeing.

Aim

To gain insight into the feasibility and effectiveness of MBSR on burnout, empathy, and (work-related) wellbeing in GPs.

Design and setting

A mixed methods pilot study, including a waiting list-controlled pre-/post-study and a qualitative study of the experiences of participating GPs in the Netherlands.

Method

Participants were sent questionnaires assessing burnout, work engagement, empathy, and mindfulness skills, before and at the end of the MBSR training/waiting period. Qualitative data on how GPs experienced the training were collected during a plenary session and with evaluation forms at the end of the course.

Results

Fifty Dutch GPs participated in this study. The MBSR group reported a greater decrease in depersonalisation than the control group (adjusted difference −1.42, 95% confidence interval [CI] = −2.72 to −0.21, P = 0.03). Dedication increased more significantly in the MBSR group than in the control group (adjusted difference 2.17, 95% CI = 0.51 to 3.83, P = 0.01). Mindfulness skills increased significantly in the MBSR group compared with the control group (adjusted difference 6.90, 95% CI = 1.42 to 12.37, P = 0.01). There was no significant change in empathy. The qualitative data indicated that the MBSR course increased their wellbeing and compassion towards themselves and others, including their patients.

Conclusion

The study shows that MBSR for GPs is feasible and might result in fewer burnout symptoms and increased work engagement and wellbeing. However, an adequately powered randomised controlled trial is needed to confirm the study’s findings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4723221/

 

Improve Substance Abuse Treatment with Mindfulness

psyjdc Leave a comment

Improve Substance Abuse Treatment with Mindfulness

 

By John M. de Castro, Ph.D.

 

“It is most often the mind’s interpretation of a stressful life event, not the event itself, that creates the urgent need to get instant relief and leads to substance use or other unwanted behaviors. Mindfulness practices provide a break from stress, teach the client to listen to his/her mind, body, and emotions, and improve the self-acceptance that leads to greater hope and self-efficacy.“ – NAADAC

 

Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use which includes unintentional overdoses, suicides, HIV and AIDS, and trauma. Drug abuse is often more complex than a simple addiction to a substance. Addiction frequently is accompanied by other mental health issues, comorbidities. They include mood and anxiety disorders, antisocial and conduct disorder, smoking and alcohol abuse, and post-traumatic stress disorder (PTSD).

 

There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers relapse and return to substance abuse, possibility because of the failure to address comorbidities. Hence, it is important to find an effective method to treat both addiction but also accompanying conditions. Mindfulness training has been shown to be a safe and effective treatment of addiction and relapse prevention. It has also been shown to be effective for a variety of other mental health issues including anxiety, depression, antisocial and conduct disorder, smoking and alcohol abuse, and post-traumatic stress disorder (PTSD). Hence, mindfulness training would appear to be a potential treatment that can be added to traditional substance abuse treatment programs to both address addiction and accompanying comorbid disorders.

 

In today’s Research News article “Mindfulness-Oriented Recovery Enhancement Versus CBT for Co-Occurring Substance Dependence, Traumatic Stress, and Psychiatric Disorders: Proximal Outcomes from a Pragmatic Randomized Trial.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752876/

Garland and colleagues compared the effectiveness of a mindfulness-based addiction treatment program with another well-established therapy, cognitive behavioral therapy (CBT), and with the usual treatment for addiction. They recruited homeless men with a substance abuse disorder and comorbid mental health issues and randomly assigned them to either receive 10 weeks of a group-based Mindfulness-Oriented Recovery Enhancement (MORE) program, group-based cognitive behavioral therapy (CBT), or usual treatment. At the beginning and end of the 10-week treatment, they measured the participants’ trauma history, drug cravings, post-traumatic stress symptoms, psychiatric distress, mindfulness, positive and negative feelings, and readiness to change.

 

They found that all treatments improved depression, but Mindfulness-Oriented Recovery Enhancement (MORE) treatment produced improvements in drug cravings, post-traumatic stress symptoms, mindfulness, and negative feelings, that were significantly greater than cognitive behavioral therapy (CBT), or usual treatment. In addition, mediation analysis revealed that the improvements in drug cravings and post-traumatic stress symptoms was mediated by increases in mindfulness. That is the Mindfulness-Oriented Recovery Enhancement (MORE) treatment significantly improved mindfulness which, in turn, produced significant improvements in drug cravings and post-traumatic stress symptoms.

 

These are particularly compelling findings as MORE was found to be superior to a well-established treatment technique, cognitive behavioral therapy (CBT). This is a powerful research design that controls for most sources of confounding. So, it appears clear that adding mindfulness practice to addiction treatment significantly improves outcomes.

 

So, improve substance abuse treatment with mindfulness.

 

“mindfulness enhances our ability to be non-reactive. This is key in drug treatment because oftentimes we seek immediate gratification; we want to feel good right now, or we want the negative feeling we’re experiencing to stop right now. This leads to reactive thinking, feeling, and behaving, and can be a catapult for drug use. When we practice mindfulness we practice responding to our experience with a non-reactive, non-judgmental attitude. This helps us maintain autonomy over our behavior. We may not have control over whether a craving for a drug arises, but we can control how we respond to such a craving. The irony is that when we practice simply observing the craving; letting it arise and letting it pass away (rather than actively trying to push it away or avoid it), we are left with more of an ability to regulate ourselves.´- Center for Adolescent Studies

 

 

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., Roberts-Lewis, A., Tronnier, C. D., Graves, R., & Kelley, K. (2016). Mindfulness-Oriented Recovery Enhancement Versus CBT for Co-Occurring Substance Dependence, Traumatic Stress, and Psychiatric Disorders: Proximal Outcomes from a Pragmatic Randomized Trial. Behaviour Research and Therapy, 77, 7–16. http://doi.org/10.1016/j.brat.2015.11.012

 

Abstract

In clinical settings, there is a high comorbidity between substance use disorders, psychiatric disorders, and traumatic stress. As such, transdiagnostic therapies are needed to address these co-occurring issues efficiently. The aim of the present study was to conduct a pragmatic randomized controlled trial comparing Mindfulness-Oriented Recovery Enhancement (MORE) to group Cognitive-Behavioral Therapy (CBT) and treatment-as-usual (TAU) for previously homeless men residing in a therapeutic community. Men with co-occurring substance use and psychiatric disorders, as well as extensive trauma histories, were randomly assigned to 10 weeks of group treatment with MORE (n=64), CBT (n=64), or TAU (n=52). Study findings indicated that from pre- to post-treatment MORE was associated with modest yet significantly greater improvements in substance craving, post-traumatic stress, and negative affect than CBT, and significantly greater improvements in post-traumatic stress and positive affect than TAU. A significant indirect effect of MORE on decreasing craving and post-traumatic stress by increasing dispositional mindfulness was observed, suggesting that MORE may target these issues via enhancing mindful awareness in everyday life. This pragmatic trial represents the first head-to-head comparison of MORE against an empirically-supported treatment for co-occurring disorders. Results suggest that MORE, as an integrative therapy designed to bolster self-regulatory capacity, may hold promise as a treatment for intersecting clinical conditions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752876/

 

Prevent Depression Relapse and Lessen Residual Symptoms with Mindfulness

psyjdc Leave a comment

Prevent Depression Relapse and Lessen Residual Symptoms with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Through mindfulness, individuals start to see their thoughts as less powerful. These distorted thoughts – such as “I always make mistakes” or “I’m a horrible person” – start to hold less weight. We ‘experience’ thoughts and other sensations, but we aren’t carried away by them. We just watch them come and go.” – William Marchand

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. It is also generally episodic, coming and going. Some people only have a single episode but most have multiple reoccurrences of depression.  Depression can be difficult to treat and 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 be applied when the typical treatments fail. Mindfulness training is another alternative treatment for depression. It has been shown to be an effective treatment for depression and is also effective for the prevention of its recurrence. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression and has been found to reduce depression alone or in combination with anti-depressive drugs and can even be effective even in the cases where drugs fail,.  MBCT 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 depression.

 

In today’s Research News article “Mindfulness Based Cognitive Therapy for Residual Depressive Symptoms and Relapse Prophylaxis.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4706736/

Segal and colleagues reviewed the recent published research literature on the effectiveness of MBCT for depression, remission, and residual symptoms. They indicate that the current research provides evidence that MBCT acts to alter neural structures that are involved in depressive symptoms including increased activations in the insula and prefrontal cortex, which are involved in interoceptive awareness and emotion regulation, processes deficient in depressed individuals. They also report that MBCT has been found to be as effective or perhaps more effective than antidepressant drugs in relieving depression, preventing relapse, and decreasing residual symptoms.

 

The published recent research suggests that MBCT might have its benefits for depression by lowering worry and rumination which are major contributors to depression. MBCT has also been shown to be effective for other mood disorders and for eating disorders, medically ill populations, such as cancer or diabetes, and pain management. In addition, these effects have been shown to occur regardless of whether MBCT is delivered in face-to-face group formats or individually on-line.

 

Hence, the research indicates that MBCT is a highly effective treatment of depression, relapse prevention, and residual symptoms, for other mood disorders, for medical diseases, and for pain. It has been shown to be safe with few if any adverse effects, and can be delivered with cost-effective on-line programs. Much of its effectiveness appears to be from cognitive changes, making the patient more mindful of the present moment and reconfiguring errant thought processes producing reductions in worry and rumination. Thus, a clear case is building that MBCT should be one of the primary treatments used especially for depression.

 

So, prevent depression relapse and lessen residual symptoms with mindfulness.

 

“mindfulness meditation “helps individuals step back from the ruminative thinking processes widely found to underlie a depressive episode.” – “Lara Fielding

 

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

Segal, Z. V., & Walsh, K. M. (2016). Mindfulness Based Cognitive Therapy for Residual Depressive Symptoms and Relapse Prophylaxis. Current Opinion in Psychiatry, 29(1), 7–12. http://doi.org/10.1097/YCO.0000000000000216

 

Key Points

Data from multiple RCTs indicates that MBCT is effective in preventing relapse and reducing residual symptoms in patients with recurrent depression who are in clinical remission.

Studies of the mechanisms of change in MBCT point to reductions in rumination and increases in metacognitive awareness as being consistently associated with clinical benefits

In an effort to reduce barriers to care, MBCT has been adapted for online delivery – Mindful Mood Balance – with early data suggesting good patient engagement and outcomes.

Mindfulness meditation is associated with increased activations in the insula and prefrontal cortex, neurological changes that parallel behavioural changes in interoceptive awareness and emotion regulation.

 

Abstract

Purpose of review

This article reviews the recent evidence for mindfulness based cognitive therapy (MBCT) for patients with residual depressive symptoms or in remitted patients at increased risk for relapse.

Recent findings

Randomized controlled trials have shifted focus from comparing MBCT with treatment-as-usual to comparing MBCT against interventions. These studies have provided evidence for the efficacy of MBCT on par with maintenance antidepressant pharmacotherapy and leading to a relative reduction of risk on the order of 30–40%. Perhaps fuelled by these data, recent efforts have focused on extending MBCT to novel populations, such as acutely depressed patients, those diagnosed with health anxiety, social anxiety, fibromyalgia, or multiple chemical sensitivities as well migrating MBCT to online platforms so that it is more widely available. Neuroimaging studies of patients in structured therapies which feature mindfulness meditation, have reported findings that parallel behavioural changes, such as increased activation in brain regions subsuming self-focus and emotion regulation (prefrontal cortex) and interoceptive awareness (insula).

Summary

The current evidence base for MBCT is strongest for its application as a prophylactic intervention or for residual depressive symptoms, with early data suggesting additional indications outside the mood disorders. Future work will need to address dose-effect relationships between mindfulness practice and clinical benefits as well as establishing the rates of uptake for online MBCT so that its benefits can be compared to in-person groups. Additionally, validating current or novel neural markers of MBCT treatment response will allow for patient matching and optimization of treatment response.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4706736/

 

Improve Sleep with Mindfulness

psyjdc Leave a comment

Improve Sleep with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness meditation appears to be a viable treatment option for adults with chronic insomnia and could provide an alternative to traditional treatments for insomnia.” – Ethan Green

 

Modern society has become more around-the-clock and more complex producing considerable pressure and stress on the individual. The advent of the internet and smart phones has exacerbated the problem. The resultant stress can impair sleep. Indeed, it is estimated that over half of Americans sleep too little due to stress. As a result, people today sleep 20% less than they did 100 years ago. Not having a good night’s sleep has adverse effects upon the individual’s health, well-being, and happiness. Yet over 70 million Americans suffer from disorders of sleep and about half of these have a chronic disorder. It has been estimated that 30 to 35% of adults have brief symptoms of insomnia, 15 to 20% have a short-term insomnia disorder, and 10% have chronic insomnia

 

Insomnia is more than just an irritant. Sleep deprivation is associated with decreased alertness and a consequent reduction in performance of even simple tasks, decreased quality of life, increased difficulties with memory and problem solving, increased likelihood of accidental injury including automobile accidents, and increased risk of dementia and Alzheimer’s disease. It also can lead to anxiety about sleep itself. This is stressful and can produce even more anxiety about being able to sleep. About 4% of Americans revert to sleeping pills. But, these do not always produce high quality sleep and can have problematic side effects. So, there is a need to find better methods to treat insomnia. Contemplative practices have been reported to improve sleep amount and quality and help with insomnia. The importance of insomnia underscores the need to further investigate safe and effective alternatives to drugs.

 

In today’s Research News article “The Quest for Mindful Sleep: A Critical Synthesis of the Impact of Mindfulness-Based Interventions for Insomnia.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5300077/

Garland and colleagues review the published research literature on the effects of mindfulness-based interventions on sleep. They identified 7 studies, 6 of which used randomized controlled trials. In most of these studies the mindfulness training consisted of either Mindfulness-Based Stress Reduction (MBSR) or Mindfulness-Based Cognitive Therapy (MBCT) programs. They concluded that these studies demonstrated that mindfulness training can produce significant improvement in the severity of insomnia and sleep disturbance in healthy individuals, people with chronic disease, and with older adults.

 

These are encouraging results that suggest that mindfulness training is effective for improving sleep in a variety of sick and health individuals of varying ages. It is not known exactly how mindfulness acts to improve sleep. But, it can be speculated that the ability of mindfulness training to improve the psychological and physiological responses to stress may be involved.

Since high levels of stress are almost universal in modern populations and stress has been shown to contribute to sleep disturbance, it would seem reasonable to believe that reduction of the individual’s response to stress would improve sleep. Hence, mindfulness training may be an important alternative to drugs in the treatment of sleep problems. This improvement of sleep, in turn, can contribute to the individual’s overall health and well-being.

 

So, improve sleep with mindfulness.

 

“By taking this mindful attitude, sleep is facilitated by simply being aware of the moment-to-moment experience of relaxing into the bed, without judging or being critical of that experience, so that the mind can gently slip into sleep.” – John Cline

 

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

Sheila N. Garland, Eric S. Zhou, Brian D. Gonzalez, Nicole Rodriguez. The Quest for Mindful Sleep: A Critical Synthesis of the Impact of Mindfulness-Based Interventions for Insomnia. Curr Sleep Med Rep. 2016 Sep; 2(3): 142–151.. doi: 10.1007/s40675-016-0050-3

 

Abstract

Mindfulness-Based Interventions (MBIs) for insomnia and sleep disturbances are receiving increasing clinical and research attention. This paper provides a critical appraisal of this growing area investigating the application of MBIs for people with insomnia and sleep disturbance. First, we discuss the theoretical justification for how mindfulness meditation practice may affect sleep processes. Second, we provide a focused review of literature published between January 1, 2012 and April 1, 2016 examining the impact of MBIs on sleep, broken down by whether insomnia or sleep disturbance was a primary or secondary outcome. Recommendations for future research are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5300077/

 

Improve Emotions in Quitting Smokers by Increasing Relaxation with Mindfulness

psyjdc Leave a comment

Improve Emotions in Quitting Smokers by Increasing Relaxation with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Depressed individuals tend to smoke at higher rates; at the same time, depressive symptoms make it more difficult to quit. Consequently, depressed individuals suffer from a higher rate of smoking-related diseases. Developing and implementing effective smoking cessation interventions for this vulnerable population is a public health priority.” – Haruka Minami

 

“Tobacco use remains the single largest preventable cause of death and disease in the United States. Cigarette smoking kills more than 480,000 Americans each year, with more than 41,000 of these deaths from exposure to secondhand smoke. In addition, smoking-related illness in the United States costs more than $300 billion a year. In 2013, an estimated 17.8% (42.1 million) U.S. adults were current cigarette smokers.”  (Centers for Disease Control and Prevention).

 

There are a wide variety of methods and strategies to quit smoking which are to only a very limited extent effective. According to the National Institutes of Health, about 40% of smokers who want to quit make a serious attempt to do so each year, but fewer than 5% actually succeed. Most people require three or four failed attempts before being successful. One problem is that nicotine is one of the most addictive substances known and withdrawal from nicotine is very stressful, producing many physical and psychological problems, including negative emotional states and depression. In essence the addict feels miserable without the nicotine. This promotes relapse to relieve the discomfort.

 

Better methods to quit which can not only promote quitting but also prevent relapse are badly needed. Mindfulness practices have been found to be helpful in treating addictions, including nicotine addiction, and reducing the risk of relapse. But, it is not known how mindfulness produces these beneficial effects. One possibility is that mindfulness training helps to relieve the stress, negative emotions, and depression that accompanies nicotine withdrawal. In today’s Research News article “Coping Mediates the Association of Mindfulness with Psychological Stress, Affect, and Depression Among Smokers Preparing to Quit.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5296771/

Vidrine and colleagues examine this issue by studying the relationship of mindfulness to stress, negative emotions, and depression in smokers entering a smoking cessation treatment program. They recruited adult smokers from an urban population who were willing to partake in a mindfulness-based quitting smoking program. Prior to the therapy program the participants completed measures of nicotine dependence, mindfulness, coping mechanisms, positive and negative emotions, and depression.

 

Analyzing these responses, they found that the higher the levels of mindfulness the lower the levels of perceived stress, negative emotions, and depression and the higher the levels of positive emotions. In other words, being mindful was associated with better emotional health. In addition, they found that that the higher the levels of mindfulness the greater use of coping methods of catharsis, seeking social support, religion, and relaxation. Hence, mindful people used adaptive methods to cope with discomfort and stress. Employing a sophisticated statistical technique of mediation analysis, they were able to demonstrate that mindfulness increased coping through relaxation which resulted in reduced perceived stress and depression, and higher positive emotions. They were also able to demonstrate that coping with catharsis was able to magnify the association of mindfulness with lower negative emotions.

 

These results are very interesting and suggest that mindfulness may be able to assist in smoking cessation by reducing the negative consequences of nicotine withdrawal, in particular by increasing relaxation which in turn reduces perceived stress and depression, and heightens positive feelings. They also suggest that the coping strategy of catharsis acts by amplifying the ability of mindfulness to reduce negative feelings. These findings have implications for smoking cessation. They suggest that including relaxation and catharsis practices in a mindfulness-based smoking cessation treatment program might strengthen its ability to assist the smoker to quit.

 

So, improve emotions in quitting smokers by increasing relaxation with mindfulness.

 

“Mindfulness seems to be beneficial by helping smokers cope with craving. Cigarette craving can be a powerful motivator, and one of the major reasons for relapse. But mindfulness is effective at helping people cope with strong emotions, such as those experienced with depression, anxiety, and pain.” – Cecilia Westbrook

 

 

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

Jennifer Irvin Vidrine, Michael S. Businelle, Lorraine R. Reitzel, Yumei Cao, Paul M. Cinciripini, Marianne T. Marcus, Yisheng Li, David W. Wetter. Coping Mediates the Association of Mindfulness with Psychological Stress, Affect, and Depression Among Smokers Preparing to Quit. Mindfulness (N Y),  2015 Jun; 6(3): 433–443. doi: 10.1007/s12671-014-0276-4

 

Abstract

It is not surprising that smoking abstinence rates are low given that smoking cessation is associated with increases in negative affect and stress that can persist for months. Mindfulness is one factor that has been broadly linked with enhanced emotional regulation. This study examined baseline associations of self-reported trait mindfulness with psychological stress, negative affect, positive affect, and depression among 158 smokers enrolled in a smoking cessation treatment trial. Several coping dimensions were evaluated as potential mediators of these associations. Results indicated that mindfulness was negatively associated with psychological stress, negative affect and depression, and positively associated with positive affect. Furthermore, the use of relaxation as a coping strategy independently mediated the association of mindfulness with psychological stress, positive affect, and depression. The robust and consistent pattern that emerged suggests that greater mindfulness may facilitate cessation and attenuate vulnerability to relapse among smokers preparing for cessation. Furthermore, relaxation appears to be a key mechanism underlying these associations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5296771/