Improve Caregiving for People with Intellectual Disabilities with Mindfulness

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By John M. de Castro, Ph.D.

 

“mindfulness – or intentionally paying attention to the present moment with nonjudgment – turns out to be equally as beneficial for those of us who are caregivers as it is for those of us who need caregiving. A mindfulness practice can improve not only our experiences of caregiving, but also the ways in which we (re)act as caregivers.” – Jennie Crooks

 

Caring for children and adults with intellectual and developmental disabilities can be difficult. Developmental disabilities are a group of conditions due to an impairment in physical, learning, language, or behavior areas. These conditions begin during the developmental period, may impact day-to-day functioning, and usually last throughout a person’s lifetime. Recent estimates in the United States show that about one in six, or about 15%, of children aged 3 through 17 years have one or more developmental disabilities.

 

Today, most people with intellectual and developmental disabilities live with their families. This places many stresses on the caregivers and their families and stretches their financial resources. Due to these issues, people with severe cases of intellectual and developmental disabilities are often cared for in community and group homes. The staff of these homes, like family caregivers are under high levels of stress for many reasons including that many individuals with intellectual and developmental disabilities are highly aggressive and at time combative.  They sometimes require physical restraint and can cause injuries to the caregiver and to other patients. In addition, the high levels of stress and injury results in many staff leaving.

 

It should be clear that there is a need for methods to reduce the stress, injuries, and burnout of caregivers in community and group homes. Mindfulness training has been found to be helpful for caregivers in the home setting. So, it would be reasonable to expect that mindfulness training may also be helpful for caregivers in community and group homes. In today’s Research News article “Effectiveness of Caregiver Training in Mindfulness-Based Positive Behavior Support (MBPBS) vs. Training-as-Usual (TAU): A Randomized Controlled Trial.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1405689346121654/?type=3&theater

or see summary below or view the full text of the study at:

http://journal.frontiersin.org/article/10.3389/fpsyg.2016.01549/full?utm_source=newsletter&utm_medium=email&utm_campaign=Psychology-w43-2016

Singh and colleagues recruited caregivers of individuals with intellectual and developmental disabilities in a large institutional setting. They were randomly assigned to receive either a Mindfulness-Based Positive Behavior Support (MBPBS) program or the usual training program offered in the facility (Training as Usual; TAU). “The standard 7-day MBPBS protocol was presented in three parts, spread over a 10-week period.” Before and after training they measured patients’ aggressive events, such as hitting, biting, scratching, punching, kicking, slapping, or destroying property, and emergency medications dispensed, the staff’s stress and turnover, and the institutional costs.

 

They found that the staff receiving MBPBS had a significantly greater reduction in stress levels (36%) and had fewer resignations than those receiving TAU (9%). The mindfulness training also produced a significant reduction in the number of aggressive events, emergency medications dispensed, and the need for physical restraints. For the institution, MBPBS training reduced the need for staff, the number of days lost due to injury, and medical and physical rehabilitation therapy services for injured staff and thus saved the facility significant funds.

 

These are exciting findings. Mindfulness training improved the environment and staff stress and reduced costs. That’s quite remarkable given that this is one of the most costly and difficult caregiving challenges there is. It is unclear how improving the mindfulness of the caregivers produced such a marked improvement in the behaviors of the individuals with intellectual and developmental disabilities. Perhaps, being more mindful facilitates the quality of the interactions, calming the patients. As the authors state “We suspect that disciplined meditation practice enables the caregivers to gradually change their relationship to their perceived mental and emotional experiences that arise when providing care to the individuals. . . this mindset enables them to avoid reacting to the challenging behaviors of the individuals based on their premature cognitive commitment to control aggressive behavior through physical restraints and stat medications.”

 

So, improve caregiving for people with intellectual disabilities with mindfulness

 

“Learning to quell distress and anxiety is especially important for parents of children with development disabilities because it’s often a lifetime caregiving commitment.” – Elisabeth M. Dykens

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Singh NN, Lancioni GE, Karazsia BT, Chan J and Winton ASW (2016) Effectiveness of Caregiver Training in Mindfulness-Based Positive Behavior Support (MBPBS) vs. Training-as-Usual (TAU): A Randomized Controlled Trial. Front. Psychol. 7:1549. doi: 10.3389/fpsyg.2016.01549

 

Caregivers of individuals with intellectual and developmental disabilities (IDD) often end up having their medical and psychological well-being compromised due to the stressful nature of caregiving, especially when those in their care engage in aggressive behavior. In this study, we provided caregivers with mindfulness-based training to enable them to better manage their psychological well-being and, through this, to also enhance specific indices of quality of life of the individuals in their care. Thus, the aim of the present study was to evaluate in a randomized controlled trial (RCT) the comparative effectiveness of Mindfulness-Based Positive Behavior Support (MBPBS) and Training-as-Usual (TAU) for caregivers in a congregate care facility for individuals with severe and profound IDD. The comparative effects of the two training conditions were assessed in terms of caregiver variables care recipient variable (number of aggressive events), and agency variables Results showed that MBPBS was significantly more effective than TAU in enabling the caregivers to manage their perceived psychological stress, and to reduce the use of physical restraints and stat medications for aggressive behavior of the individuals in their care. In addition, there were significant reductions in aggressive events by the individuals in their care, 1:1 staffing of individuals with aggressive behavior, and staff turnover. Furthermore, the MBPBS training was significantly more cost-effective than the TAU training. If replicated in future RCT studies, MBPBS may provide an effective means of enhancing socially acceptable bidirectional engagement of caregivers and care recipients within a person-centered context.

http://journal.frontiersin.org/article/10.3389/fpsyg.2016.01549/full?utm_source=newsletter&utm_medium=email&utm_campaign=Psychology-w43-2016

 

Happiness is Just a Spin Away

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By John M. de Castro, Ph.D.

 

 “We tend to forget that happiness doesn’t come as a result of getting something we don’t have, but rather of recognizing and appreciating what we do have.” – Frederick Keonig

 

We were recently driving through Louisiana and passed a billboard advertising a casino with the headline “Happiness is just a spin away.” For the gambler, this is the lure. Each win is a rush of happiness. Unfortunately, it’s short-lived. The next burst of happiness is now right in front of the gambler if they just continue spinning. From a psychological standpoint this is a perfect example of the power of intermittent reinforcement. When a reward is contingent upon an action, in this case pulling the lever on a slot machine, but the dispensing of the reward is not predictable, with the number of pulls needed to produce the reward not predictable, it produces a very potent form of conditioning. It is why gambling is so addictive. The brief rush of a win strongly conditions the lever pulling to get the next rush.

 

I was struck by how well the sign, “Happiness is just a spin away,” captured the western ideas of happiness and how to obtain it. It is a perpetual cycle of reward producing brief happiness followed by the loss of happiness followed by more action to produce another brief happiness. This is what psychologists term the hedonic treadmill. On the face of it, it sounds silly. We would never do that. But, if we look honestly and carefully at our lives we will see that most of it is spent on the hedonic treadmill. We work to purchase a new car and get a rush of happiness, but after a while it fades. So, we pursue a new love interest, and get a rush of happiness, but after a while it fades. So we work to purchase a new home and get a rush of happiness, but after a while it fades. So, we look for a new job and get a rush of happiness, but after a while it fades. And on and on it goes, on the treadmill, pursuing the ephemeral happiness that we can never seem to be able to keep a hold of. So, we spin the wheel again.

 

Humans consider themselves smart people. But, it never seems to occur to most people that there may be something wrong with their idea of how to obtain happiness. After spending the majority of our lives failing to obtain the lasting happiness that we seek, you’d think that we’d catch on that what we’re doing isn’t working, hasn’t ever worked, and there’s no reason to believe that it ever will work. But working against that recognition is a society and a culture that is determined to keep us on the hedonic treadmill. The western consumer culture requires that we keep seeking happiness in things. If we didn’t, the economy might collapse. It is virtually impossible to escape the advertising messages that pervade our everyday lives. Each holds out the promise of happiness if we just use this toothpaste, take this drug, drive this car, see this movie, go to this concert, buy this gadget, etc. The barrage of messages is all geared to keeping us on the treadmill. If there is a crack, a glimmer of vision that something might be wrong, the messaging distracts us by bombarding us with the idea that “happiness is just a spin away.”

 

So, what are we to do? Give up the search for happiness? No, that is a waste of time. We are born with a biological program to seek happiness and to deny it is to fight against our biological nature. So, trying to not seek happiness is as futile as to pursue it on the hedonic treadmill. Fortunately, there is an answer. One so simple, that few see it. It’s right in front of us hidden in our delusions of what makes us happy. It is so simple that we can’t believe that that could be the answer. It is so contrary to the cultural messaging that we can’t trust that it could work even if we saw it. It’s simply to accept what is, enjoy what we have, and be in the present moment.

 

If we adopt the belief that happiness is right here, right now, if we only allow ourselves to accept it, then we will begin to look at our existence differently. We don’t need to search somewhere else. We don’t need to wait to another time. All we need to do is look closely, without judgment at our present experience. We have become so used to it that we can no longer see it. But, what is here in the present moment is actually wondrous and miraculous. Each breath is a miracle. The energy and life just bubbling in and through our bodies is amazing. How can we not be happy when we realize the mystery of our existence and what a gift this precious moment is. We’ve experienced so many similar moments, are so accustomed to them, that it’s difficult to break through and see the wonder in each one. But, just concentrate, if only occasionally, on fully experiencing what is transpiring right now. It just might change your life.

 

Just take a look around. Listen to the bird chirp and wonder at the experience of hearing and the sheer beauty of the singing. Look at the tree where the bird is perched and enjoy its uniqueness. There has never been and never will be one just like it. See its beautiful nuanced colors from the myriad shades of brown of the bark to the shimmering green of its leaves in the sunlight. Look at its roots and be amazed by its stability and strength, at their ability to remove nutrients and water from the ground and move them a 100 feet into the air. Look at its leaves wonder at their ability to use the sun’s energy to create complex molecules and energy from the nutrients. Now look at the person standing under the tree and witness their uniqueness. Marvel at their ability to simply stand or walk and what an amazing feat of balance, dexterity, coordination, and strength it is. Look in their eyes and realize the consciousness that is looking through them and seeing you. Observe their happiness, sadness, joy, fear, etc. and recognize how much just like you they are. Relish the fact that you are not alone. This could go on and on. There is so much right in front of you in this present moment to keep you entertained and awed for days on end.

 

The ultimate reward for making the effort to deeply experience the present moment is the happiness which will grow. Not the ephemeral happiness or the momentary highs of the hedonic treadmill, but an enduring, satisfying, mellow happiness that can be re-invoked at will. Happiness is not “a spin away.” It is always present and accessible in the present. So, get off the treadmill and discover the happiness that has always been present inside you. You only need to stop the seeking elsewhere and just be in the present. Happiness is not somewhere else at some other time. It is here all of the time for the picking. You just have to stop waiting for the results of the “spin” and simply enjoy “spinning.”

 

“There is only one cause of unhappiness: the false beliefs you have in your head, beliefs so widespread, so commonly held, that it never occurs to you to question them.” – Anthony de Mello

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

Improve Schizophrenia with Mindfulness

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mindfulness-schizophrenia2-tabak

 

By John M. de Castro, Ph.D.

 

“Mindfulness also allows us to become more aware of the stream of thoughts and feelings that we experience and to see how we can become entangled in that stream in ways that are not helpful. This lets us stand back from our thoughts and start to see their patterns. Gradually, we can train ourselves to notice when our thoughts are taking over and realise that thoughts are simply ‘mental events’ that do not have to control us.” – Mark Williams

 

Schizophrenia is the most common form of psychosis. It effects about 1% of the population worldwide. It appears to be highly heritable and involves changes in the brain. It is characterized by positive symptoms such as hallucinations; seeing and, in some cases, feeling, smelling or tasting things that aren’t there, or delusions; unshakable beliefs that, when examined rationally, are obviously untrue. It is also characterized by negative symptoms involving a reduced ability to function normally, neglect of personal hygiene, lack of emotion, blank facial expressions, speaking in a monotone, loss of interest in everyday activities, social withdrawal, and an inability to experience pleasure. The symptoms usually do not appear until late adolescence or early adulthood.

 

Schizophrenia is very difficult to treat with psychotherapy and is usually treated with antipsychotic drugs. These drugs, however, are not always effective, sometimes lose effectiveness, and can have some difficult side effects. Hence, there is a need for safe and effective alternative treatments for psychotic disorders. Mindfulness training has been shown to be beneficial for a variety of mental health problems, including anxiety, depression, Antisocial Personality Disorder, Borderline personality disorder, impulsivity, obsessive compulsive disorder, phobias, post-traumatic stress disorder, sexual dysfunction, and suicidality. It also appears to be helpful with psychosis. Hence, there is a need to further investigate the potential of mindfulness as a treatment for schizophrenia. This needs to begin with studying the relationships of mindfulness to the positive and negative symptoms of schizophrenia.

 

In today’s Research News article “Mindfulness in schizophrenia: Associations with self-reported motivation, emotion regulation, dysfunctional attitudes, and negative symptoms.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1402675313089724/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4591204/

Tabak, Horan, and Green recruited outpatients with schizophrenia who were being treated with drugs and non-schizophrenic individuals as controls. They measured the demographic characteristics of the participants, mindfulness, behavioral inhibition and activation, emotion regulation, and dysfunctional attitudes. They found, as expected, that people with schizophrenia were significantly lower in mindfulness than controls, including lower scores on the describing, acting with awareness, and nonjudging facets of mindfulness. In patients, but not controls, higher levels of mindfulness were associated with higher levels of the reappraisal aspect of emotion regulation and lower levels of the defeatist beliefs dysfunctional attitude.

 

These are encouraging findings that should be viewed as a good first step. Mindfulness is low in patients with schizophrenia. As such, building mindfulness may be a useful treatment. The findings also suggest that mindfulness training in these patients might help to counteract the negative symptoms of schizophrenia by building the ability to regulate emotions and the positive symptoms by reducing dysfunctional, defeatist, attitudes. These findings, though, must be interpreted carefully as these are correlational findings and cannot be used to prove a causal connection. In addition, the patients were receiving drugs and the extent to which low mindfulness may be due to drug effects cannot be determined.

 

Nevertheless, mindfulness training may help to improve schizophrenia.

 

“Mindfulness is not something we can simply ‘plug into’ to fix ourselves, it’s a fundamentally different way of approaching our difficulties and our lives, and is a practice that takes time to develop. Eight-week courses run by appropriately trained providers are the perfect opportunity to develop understanding and practise this approach.” – Sarah Maynard

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

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

 

Study Summary

Tabak, N. T., Horan, W. P., & Green, M. F. (2015). Mindfulness in schizophrenia: Associations with self-reported motivation, emotion regulation, dysfunctional attitudes, and negative symptoms. Schizophrenia Research,168(0), 537–542. http://doi.org/10.1016/j.schres.2015.07.030

 

Abstract

Mindfulness-based interventions are gaining empirical support as alternative or adjunctive treatments for a variety of mental health conditions, including anxiety, depression, and substance use disorders. Emerging evidence now suggests that mindfulness-based treatments may also improve clinical features of schizophrenia, including negative symptoms. However, no research has examined the construct of mindfulness and its correlates in schizophrenia. In this study, we examined self-reported mindfulness in patients (n=35) and controls (n=25) using the Five-Facet Mindfulness Questionnaire. We examined correlations among mindfulness, negative symptoms, and psychological constructs associated with negative symptoms and adaptive functioning, including motivation, emotion regulation, and dysfunctional attitudes. As hypothesized, patients endorsed lower levels of mindfulness than controls. In patients, mindfulness was unrelated to negative symptoms, but it was associated with more adaptive emotion regulation (greater reappraisal) and beliefs (lower dysfunctional attitudes). Some facets of mindfulness were also associated with self-reported motivation (behavioral activation and inhibition). These patterns of correlations were similar in patients and controls. Findings from this initial study suggest that schizophrenia patients may benefit from mindfulness-based interventions because they (a) have lower self-reported mindfulness than controls and (b) demonstrate strong relationships between mindfulness and psychological constructs related to adaptive functioning.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4591204/

Improve the Physical Discomfort from Cancer Treatment with Yoga

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yoga-cancer2-peppone

 

By John M. de Castro, Ph.D.

 

“Cancer patients who practice yoga as therapy during their treatment often refer to their yoga practice as a life-saver. No matter how sick from treatments and no matter how little energy, many find that the one thing that would bring relief were a gentle set of therapeutic yoga poses geared for cancer patients.” – Yoga U

 

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

 

The improved survival rates mean that more women are now living with cancer. Surviving cancer, however, carries with it a number of problems. “Physical, emotional, and financial hardships often persist for years after diagnosis and treatment. Cancer survivors are also at greater risk for developing second cancers and other health conditions.” (National Cancer Survivors Day). In addition, breast cancer survivors can have to deal with the consequences of chemotherapy, and often experience increased fatigue, pain, and bone loss, reduced fertility, difficulty with weight maintenance, damage to the lymphatic system, heightened fear of reoccurrence, and an alteration of their body image.

 

Treatments often involve aromatase inhibitor therapy which have been shown to be beneficial for survival and reduced rates of reoccurrence, but produce problematic side effects such as joint pain and stiffness, bone loss, and menopausal symptoms. This can lead to patients not adhering to, or even discontinuing treatments. So there is a need for safe and effective treatment for these side effects. Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual psychological symptoms and improve cognitive function. Indeed, yoga practice has been found to improve sleep quality and memory, reduce the side effects from chemotherapy and improve the quality of life in cancer survivors. So, it makes sense to see if yoga can help to improve the side effects of aromatase inhibitor therapy in breast cancer survivors.

 

In today’s Research News article “The effect of YOCAS©® yoga for musculoskeletal symptoms among breast cancer survivors on hormonal therapy. Breast Cancer Research and Treatment.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1401246889899233/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4467273/

Peppone and colleagues recruited breast cancer survivors who were receiving aromatase inhibitor therapy and randomly assigned them to either participate in a twice a week, 75-minute session, 4-week community based yoga training or to receive treatment as usual. Participants were measured for musculoskeletal symptoms both before and after treatment. They found that the yoga treatment group relative to controls improved significantly on almost all measured dimensions of musculoskeletal symptoms, including pain, illness, time in bed, fatigue, muscle aches, arm weakness, sluggishness, and physical ability.

 

These results are very encouraging and suggest that yoga practice may be a safe and effective treatment for the musculoskeletal side effects of aromatase inhibitor therapy for breast cancer survivors. This is important not just for the comfort of the patients, but for their compliance with treatment and ultimate survival. This adds to the long list of beneficial effects of yoga practice. It would be expected that these women would not only have improved side effects but also receive a myriad of other physical and psychological benefits from the yoga practice.

 

So, improve the physical discomfort from cancer treatment with yoga.

 

“one of the main reasons that people with cancer use yoga is because it makes them feel good. Yoga teachers promote it as a natural way to help you relax and cope with stress, anxiety and depression. Generally, it can help to lift your mood and enhance well being. Some people with cancer who have used yoga say that it helps calm their mind so that they can cope better with their cancer and its treatment. Others say that it helps to reduce symptoms and side effects such as pain, tiredness, sleep problems and depression. Yoga can sometimes help you to move around more quickly and easily after surgery for cancer.” Cancer Research UK
CMCS – Center for Mindfulness and Contemplative Studies

 

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

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

 

Study Summary

Peppone, L. J., Janelsins, M. C., Kamen, C., Mohile, S. G., Sprod, L. K., Gewandter, J. S., … Mustian, K. M. (2015). The effect of YOCAS©® yoga for musculoskeletal symptoms among breast cancer survivors on hormonal therapy. Breast Cancer Research and Treatment, 150(3), 597–604. http://doi.org/10.1007/s10549-015-3351-1

 

Abstract

Up to 50 % of breast cancer survivors on aromatase inhibitor therapy report musculoskeletal symptoms such as joint and muscle pain, significantly impacting treatment adherence and discontinuation rates. We conducted a secondary data analysis of a nationwide, multisite, phase II/III randomized, controlled, clinical trial examining the efficacy of yoga for improving musculoskeletal symptoms among breast cancer survivors currently receiving hormone therapy (aromatase inhibitors [AI] or tamoxifen [TAM]). Breast cancer survivors currently receiving AI (N = 95) or TAM (N = 72) with no participation in yoga during the previous 3 months were randomized into 2 arms: (1) standard care monitoring and (2) standard care plus the 4-week yoga intervention (2×/week; 75 min/session) and included in this analysis. The yoga intervention utilized the UR Yoga for Cancer Survivors (YOCAS©®) program consisting of breathing exercises, 18 gentle Hatha and restorative yoga postures, and meditation. Musculoskeletal symptoms were assessed pre- and post-intervention. At baseline, AI users reported higher levels of general pain, muscle aches, and total physical discomfort than TAM users (all P ≤ 0.05). Among all breast cancer survivors on hormonal therapy, participants in the yoga group demonstrated greater reductions in musculoskeletal symptoms such as general pain, muscle aches and total physical discomfort from pre-to post-intervention than the control group (all P ≤ 0.05). The severity of musculoskeletal symptoms was higher for AI users compared to TAM users. Among breast cancer survivors on hormone therapy, the brief community-based YOCAS©® intervention significantly reduced general pain, muscle aches, and physical discomfort.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4467273/

 

Reduce Brain Induced Mind Wandering with Meditation

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By John M. de Castro, Ph.D.

 

“Our minds wander, on average 50 percent of the time. The exact rate varies enormously. . . . Noticing where your mind has gone – checking your twitter feed instead of working on that report – gives you the chance for a second thought: “my mind has wandered off again.” That very thought disengages your brain from where it has wandered and activates brain circuits that can help your attention get unstuck and return to the work at hand.” – Daniel Goleman

 

We spend a tremendous amount of our time with our minds wandering and not on the task or the environment at hand. We daydream, plan for the future, review the past, ruminate on our failures, exalt in our successes. In fact, we spend almost half of our waking hours off task with our mind wandering. You’d think that if we spend so much time doing this it must be enjoyable. But, in fact research has shown that when our mind is wandering we are actually unhappier than when we are paying attention to what is at hand.

 

A system of the brain known as the Default Mode Network (DMN) becomes active during wind wandering and relatively quiet during focused on task behavior. It is involved when we are engaged in internally focused tasks such as recalling deeply personal memories, daydreaming, sleeping, imagining the future and trying to take the perspective of others. The DMN involves neural structures including the medial prefrontal cortex, anterior and posterior cingulate cortices, precuneus, inferior parietal cortex, and lateral temporal cortex. These areas of the DMN are functionally connected, such that they are simultaneously active during mind wandering.

 

Meditation is known to reduce the size and activity of the Default Mode Network (DMN) through a process known as neuroplasticity where the size and connectivity of neural structures are modified by experience. In addition, meditation appears to decrease the functional connectivity of these structures.  The research underlying these conclusions, however, suffer from a flaw in that meditation is compared to rest or to non-meditators. It is possible that any active mental task could also have the same effects on the DMN. There is thus a need to investigate the differences between the effects of meditation and other active mental activities on the activity of the DMN.

 

In today’s Research News article “Meditation leads to reduced default mode network activity beyond an active task.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1399745846716004/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4529365/

Garrison and colleagues recruited experienced meditators and non-meditators and scanned their brains (functional Magnetic Imaging, fMRI) while they either followed meditation instructions or an active mental task, making decisions as to whether adjectives applied to the self or to case. As expected the meditators reported less mind wandering during meditation. Importantly, they found that the meditators had significantly lower activity in the Default Mode Network (DMN) than the controls during the meditations but not during the active task.

 

These findings are important in that they demonstrate that the reduction in the DMN activity is not due to just any active mental task but specifically to meditation. The results also replicate the finding that meditation lowers mind wandering and the activity of the DMN. Hence meditation in particular appears to have the ability to reduce mind wandering, improving focus, by decreasing the activity of the brain system responsible for mind wandering.

 

So, reduce brain induced mind wandering with meditation.

 

“new knowledge about the default mode network and the self-reflecting thoughts that it stimulates may facilitate our understanding of how we function in our daily lives. We are more than intellect or the motor control of arms and legs, which is often the focus of brain researchers. Perhaps it may at times be good to know that our brain actually gives us room for our spontaneous thoughts and the associations and emotions that may at first seem a bit weird.” – Marcus Raichle

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Garrison, K. A., Zeffiro, T. A., Scheinost, D., Constable, R. T., & Brewer, J. A. (2015). Meditation leads to reduced default mode network activity beyond an active task. Cognitive, Affective & Behavioral Neuroscience, 15(3), 712–720. http://doi.org/10.3758/s13415-015-0358-3

 

Abstract

Meditation has been associated with relatively reduced activity in the default mode network, a brain network implicated in self-related thinking and mind wandering. However, previous imaging studies have typically compared meditation to rest despite other studies reporting differences in brain activation patterns between meditators and controls at rest. Moreover, rest is associated with a range of brain activation patterns across individuals that has only recently begun to be better characterized. Therefore, this study compared meditation to another active cognitive task, both to replicate findings that meditation is associated with relatively reduced default mode network activity, and to extend these findings by testing whether default mode activity was reduced during meditation beyond the typical reductions observed during effortful tasks. In addition, prior studies have used small groups, whereas the current study tested these hypotheses in a larger group. Results indicate that meditation is associated with reduced activations in the default mode network relative to an active task in meditators compared to controls. Regions of the default mode showing a group by task interaction include the posterior cingulate/precuneus and anterior cingulate cortex. These findings replicate and extend prior work indicating that suppression of default mode processing may represent a central neural process in long-term meditation, and suggest that meditation leads to relatively reduced default mode processing beyond that observed during another active cognitive task.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4529365/

 

Improve Resilience with Mindfulness

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By John M. de Castro, Ph.D.

 

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

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. 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.

 

Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Sleep disruption is an important consequence of the stress. “Poor or inadequate sleep can contribute to poor personal health and burnout and adversely affect the quality of care” (Kemper et al. 2016).

Burnout 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.

 

Preventing burnout has to be a priority. But, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout, so it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices including yoga practice have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, and improving sleep.

 

So, it makes sense to investigate how mindfulness training during healthcare education may promote resilience and lower the likelihood of future burnout in healthcare workers. In today’s Research News article “Dispositional mindfulness and employment status as predictors of resilience in third year nursing students: a quantitative study.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1398515100172412/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5050545/

Chamberlain and colleagues recruited third-year nursing students and had them complete measures of mindfulness, resilience, compassion, and burnout. They found that for these nursing students the single best predictor of resilience was mindfulness, particularly acceptance; accepting without judging things just as they are. The next most powerful predictor was expectancy for a successful next career step. High levels of mindfulness were also associated with increased compassion and reduced fatigue in compassion.

 

The results are encouraging, but must be interpreted with caution. The study was correlational and nothing was manipulated, so causation cannot be determined. But the results suggest that mindfulness is very important for resilience. In particular the ability to take what comes and accept it without judgement helps to maintain the individual’s resilience. Since resilience is important for being able to cope with and bounce back from the stress of the occupation, mindfulness may be important for preventing burnout. In addition, the results suggest that mindfulness is associated with persistence of compassion, an important capacity for nurses.

 

These results need to be followed up with a randomized controlled trial in which these nursing students are trained in mindfulness, to determine if mindfulness is causally responsible for these important benefits. If this was confirmed it would strongly suggest that mindfulness training be included in the nursing curriculum; improving resilience and compassion, making them better nurses who are less likely to burn out.

 

So, improve resilience with mindfulness.

 

“The findings provide support for universities to develop strategies that promote mindfulness. Mindfulness training could provide a practical means of enhancing resilience, and personality characteristics like optimism, zest, and patience.” – Badri Bajaj

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Chamberlain, D., Williams, A., Stanley, D., Mellor, P., Cross, W., & Siegloff, L. (2016). Dispositional mindfulness and employment status as predictors of resilience in third year nursing students: a quantitative study. Nursing Open,3(4), 212–221. http://doi.org/10.1002/nop2.56

 

Abstract

Background: Nursing students will graduate into stressful workplace environments and resilience is an essential acquired ability for surviving the workplace. Few studies have explored the relationship between resilience and the degree of innate dispositional mindfulness, compassion, compassion fatigue and burnout in nursing students, including those who find themselves in the position of needing to work in addition to their academic responsibilities.

Aim: This paper investigates the predictors of resilience, including dispositional mindfulness and employment status of third year nursing students from three Australian universities.

Design: Participants were 240 undergraduate, third year, nursing students. Participants completed a resilience measure (Connor–Davidson Resilience Scale, CD‐RISC), measures of dispositional mindfulness (Cognitive and Affective Mindfulness Scale Revised, CAMS‐R) and professional quality of life (The Professional Quality of Life Scale version 5, PROQOL5), such as compassion satisfaction, compassion fatigue and burnout.

Method: An observational quantitative successive independent samples survey design was employed. A stepwise linear regression was used to evaluate the extent to which predictive variables were related each to resilience.

Results: The predictive model explained 57% of the variance in resilience. Dispositional mindfulness subset acceptance made the strongest contribution, followed by the expectation of a graduate nurse transition programme acceptance, with dispositional mindfulness total score and employment greater than 20 hours per week making the smallest contribution. This was a resilient group of nursing students who rated high with dispositional mindfulness and exhibited hopeful and positive aspirations for obtaining a position in a competitive graduate nurse transition programme after graduation.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5050545/

 

Get More Attentive with Meditation

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By John M. de Castro, Ph.D.

 

“We practice meditation in the end not to become great meditators but to have a different life. As we deepen the skills of concentration, mindfulness, and compassion, we find we have less stress, more fulfillment, more insight, and vastly more happiness. We transform our lives.” – Sharon Salzberg

 

In modern everyday life, we are constantly bombarded with a myriad of stimuli, from music, movies, TV, traffic noise, games, telephone calls, texts, emails, tweets, posts, etc. The generations who have grown up in the midst of this cacophony, claim to have developed multitasking skills, such that they can simultaneously work with multiple tasks and sources of information. At first glance they appear to have developed useful skills that the older generation can only marvel at. But, upon closer inspection of the abilities of the multitaskers, it has been found that they actually have impaired attentional abilities and are more easily distracted from what they’re doing. In other words, the multitasking has damaged their ability to focus on any one thing.

 

Mindfulness training may be an antidote to the impaired attention and distractibility of the multitaskers. One of the primary effects of meditation training is an improvement in the ability to pay attention to the task at hand and ignore interfering stimuli. This is an important consequence of meditation training and produces improvements in thinking, reasoning, and creativity. Hence it would seem that mindfulness training would strengthen the exact capacities that are weakened by chronic multitasking.

 

There are, however, a wide variety of meditation techniques and it is not known which work best for improving attention and executive function. In focused attention meditation, the individual practices paying attention to a single meditation object, learns to filter out distracting stimuli, including thoughts, and learns to stay focused on the present moment, filtering out thoughts centered around the past or future. On the other hand, in open monitoring meditation, the individual opens up awareness to everything that’s being experienced regardless of its origin. These include bodily sensations, external stimuli, and even thoughts. The meditator just observes these stimuli and lets them arise and fall away without paying them any further attention.

 

In today’s Research News article “Attentional orienting and executive control are affected by different types of meditation practice.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/pb.627681673922429.-2207520000.1480417754./1397217773635478/?type=3&theater

or see summary below. Tsai and Chou recruited meditators who practiced focused attention meditation, or who practiced open monitoring meditation, and meditation naive controls. They measured mindfulness and then compared the three groups for their performance on a visual attention task. The task measured three separate components of attention, alerting, orienting, and executive control (filtering irrelevant stimuli). As expected, the two meditation groups had significantly higher levels of mindfulness than the control group. In regards to attention, the meditators demonstrated superior ability to orient and to filter out irrelevant stimuli (executive control). They found that the higher the level of mindfulness, the better the meditators were in executive control. Finally, they found that the open monitoring meditators were significantly superior to the focused meditators in their ability to orient to the attentional stimulus.

 

In a second experiment Tsai and Chou manipulate meditation practice to see if the practice caused the improvements in attention. They recruited meditation naïve college students who were randomly assigned to receive either 3 months of focused attention meditation training or no training. The students were measured on the attentional task both before and after the 3-month training. They found that the focused attention meditation produced a significant improvement in the ability to filter out irrelevant stimuli (executive control) and the higher the level of mindfulness, the better the meditators were in executive control. Thus they demonstrated that meditation practice causes improvements in the attentional ability to ignore irrelevant stimuli.

 

The results suggest the obvious that practicing paying attention improves paying attention. But, less obvious, is that the practice improves the abilities to shift attention when needed, orienting, and to not be distracted by things that are not relevant to the task at hand, executive function. This latter ability appears to be better developed by open monitoring meditation than by focused attention meditation. This would seem counter intuitive as one would think that part of practicing focusing would be to learn to ignore non-focal stimuli. In fact, it did in comparison to non-meditators. But, surprisingly, open monitoring meditation was superior. It may be that practicing just allowing things to be as they are without letting them attract attention may be the better way to learn to ignore distractors. Being used to not responding appears to make the individual better at not responding when needed.

 

So, get more attentive with meditation.

 

“The practice of insight meditation revolves around the art of meditative attention. Its basic tool is ‘bare’ or primary attention which uncovers or lays bare things as they really are. In this way, a non-reactive, unconditioned awareness is acquired that leads to insight knowledge.” – Ven Pannyavaro

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Tsai MH, Chou WL. Attentional orienting and executive control are affected by different types of meditation practice. Conscious Cogn. 2016 Oct 3;46:110-126. doi: 10.1016/j.concog.2016.09.020.

 

Highlights

  • We studied the relationship between meditationskills and functions of attention.
  • Focused attention meditation only improved execution control function.
  • Open monitoring meditation improved execution control and orientation functions.

Abstract

Several studies have demonstrated the beneficial effects of meditation on attention. The present study investigated the relationship between focused attention (FA) and open monitoring (OM) meditation skills and the various functions of attention. In Experiment 1, we executed theattention network test and compared the performance of experts on dandao meditation with that of ordinary people on this test. The results indicated that the experts specializing in OM meditation demonstrated greater attentional orienting ability compared with those specializing in FA meditation and the control group. In addition, both expert groups registered improvements in their executive control abilities compared with the control group. In Experiment 2, we trained beginners in FA meditation for 3months. The results showed that the experimental group exhibited significantly enhanced executive control ability. We infer that FA meditation skills promote executive control function and OM meditation skills promote both executive control and attentional orienting functions.

 

Improve Sexual Function with Mindfulness

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By John M. de Castro, Ph.D.

 

“A key factor in having better sex is actually being there when you’re having it. Being there not just physically — being fully present, in thought, word and deed. it’s about really showing up and tuning in, to the moment, yourself and your partner.” –  Marsha Lucas

 

Problems with sex are very common, but, with the exception of male erectile dysfunction, driven by the pharmaceutical industry, it is rarely discussed and there is little research. The Puritanical attitudes toward sex in the U.S., in particular, produce inhibitions toward overt explorations of the issues surrounding sex. But, these problems have a major impact on people’s lives and deserve far more attention. While research suggests that sexual dysfunction is common, it is a topic that many people are hesitant or embarrassed to discuss. Women suffer from sexual dysfunction more than men with 43% of women and 31% of men reporting some degree of difficulty. It is amazing that such an important human behavior is can be problematic for so many people without an outcry for more study and research.

 

Problems with sex with women can involve reduced sex drive, difficulty becoming aroused, vaginal dryness, lack of orgasm and decreased sexual satisfaction. Sexual function in women involves many different systems in the body, including physical, psychological and hormonal factors. So, although, female sexual dysfunction is often caused by physical/medical problems, it is also frequently due to psychological issues. This implies that it many cases may be treated with activities that are effective in working with psychological problems. Mindfulness trainings have been shown to improve a variety of psychological issues including emotion regulation, stress responses, trauma, fear and worry, anxiety, and depression, and self-esteem. So, perhaps mindfulness training could help resolve psychological issues that might be affecting sexual behavior. Hence, it would make sense to investigate the effectiveness of mindfulness training as a treatment for female sexual dysfunction.

 

In today’s Research News article “A Pilot Study of Eight-Session Mindfulness-Based Cognitive Therapy Adapted for Women’s Sexual Interest/ Arousal Disorder.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1396097427080846/?type=3&theater

or see summary below. Paterson, Handy, and Brotto recruited women who were diagnosed with Sexual Interest/Arousal Disorder (SIAD) and provided for them an 8-week program of group Mindfulness-Based Cognitive Therapy adapted for sexual issues (MBCT-S). This program included mindfulness training, cognitive therapy, and sex therapy. Before and after treatment they were assessed for sexual interest, sex-related distress, overall sexual function, mindfulness, self-compassion, interoceptive awareness, depression, rumination, anxiety, and treatment expectations. They found that following treatment the women had significant improvements in overall sexual function (26%), sexual desire (60%), sex-related distress (20%). There were also significant improvements in mindfulness, interoceptive awareness, depression, rumination, and anxiety. In addition, they found that the improvement in overall sexual function was due, in part, to the treatment producing increased mindfulness and self-compassion, and decreased depression. So, MBCT-S improved the psychological and sexual health of the women.

 

These are interesting and potentially important preliminary findings. This was a small trial without a control condition, so conclusions need to be tempered with the understanding that the significant differences between before and after treatment may be due to experimental contamination including placebo effects. In addition, it cannot be determined if the effects may have been produced by any kind of therapy and not necessarily MBCT-S. Indeed, before the therapy commenced that participants expressed moderate expectations of treatment success, suggesting significant subject expectancy effects that could make any program appear successful. But, regardless, the outcomes were compelling enough to justify performing a large randomized controlled trial.

 

Nevertheless, the results may indicate that mindfulness based therapy tailored for sexual dysfunction may be a safe and effective means to treat Sexual Interest/Arousal Disorder (SIAD). Sex is very important in relationships and, to some extent, bonding and holding partners together. It can also be very important for the individual’s mental and physical well-being and feelings of self-worth. So, addressing sexual issues is important for the health of the individual and the family and these results suggest that MBCT-S may be a safe and effective treatment.

 

So, improve sexual function with mindfulness.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

“Sexual health is an integral component of quality of life and sexual dysfunction impacts mood, well-being, relationship satisfaction, and many domains of quality of life. Improvements in sexual functioning can positively impact each of these domains.” – Lori Brotto

 

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

 

Study Summary

Laurel Q. P. Paterson, Ariel B. Handy & Lori A. Brotto (2016): A Pilot Study of Eight-Session Mindfulness-Based Cognitive Therapy Adapted for Women’s Sexual Interest/ Arousal Disorder, The Journal of Sex Research, DOI: 10.1080/00224499.2016.1208800

 

Abstract

While few treatment options exist for low sexual desire and arousal, the most common sexual dysfunction in women, a growing body of research supports the efficacy of mindfulness-based approaches. The mechanisms underlying improvements, and whether they are due to mindfulness practice or other treatment components, are unclear. As a result, we designed and pilot-tested an eight-session group mindfulness-based cognitive therapy for sexuality (MBCT-S) program that includes more extensive practice of mindfulness skills and closely aligns with the evidence-based MBCT program for depression and anxiety. A total of 26 women (mean age 43.9, range 25 to 63) with a diagnosis of sexual interest/arousal disorder participated in eight weekly group sessions, before and after which they completed validated questionnaires. The majority of women attended all sessions and completed the recommended at-home mindfulness exercises. Compared to baseline, women reported significant improvements in sexual desire, overall sexual function, and sex-related distress, regardless of treatment expectations, relationship duration, or low desire duration. Depressed mood and mindfulness also significantly improved and mediated increases in sexual function. These pilot data suggest that eight-session MBCT-S is feasible and significantly improves sexual function, and provide the basis for a larger randomized-controlled trial (RCT) with a longer follow-up period.

 

Improve Diseased Kidney Function with Yoga

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By John M. de Castro, Ph.D.

 

“Yoga combines both physical and spiritual elements which helps restores the body and revitalizes the mind. Some of the poses in yoga can improve the over health of the kidney and improve kidney function. This is an important step for preventing kidney problems and for slowing the progression of kidney disease.” – National Kidney Foundation

 

Chronic Kidney Disease (CKD) is a serious and all too common medical problem that involves a gradual loss of kidney function over time. As a result, the body retains fluid and harmful wastes build up. This leads to feelings of fatigue, trouble concentrating, poor appetite, trouble sleeping, muscle cramps, swollen feet and ankles, puffiness around your eyes, dry, itchy skin, and need to urinate more often. It is not unusual for people to not realize that they have chronic kidney disease until their kidney function is down to 25% of normal. CKD can eventually lead to complete kidney failure requiring dialysis, to replace the work of the failed kidneys, or a kidney transplant. It is estimated that CKD is present in more than 26 million Americans. Without effective treatment, CKD can lead to heart disease and reduced longevity. There are, however, no cures for CKD and treatment focuses on slowing the progression of the kidney damage, usually by controlling the underlying cause.

 

Yoga practice has been found to be effective with treating a number of conditions that can lead to Chronic Kidney Disease (CKD). These include hypertension, diabetes, and artherosclerosis. So, it would seem reasonable to test yoga practice as a treatment for CKD. In today’s Research News article “Effects of 6 months yoga program on renal functions and quality of life in patients suffering from chronic kidney disease.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/pb.627681673922429.-2207520000.1480152606./1393155440708378/?type=3&theater

or see summary below or view the full text of the study at:

http://www.ijoy.org.in/article.asp?issn=0973-6131;year=2017;volume=10;issue=1;spage=3;epage=8;aulast=Pandey

Pandy and colleagues recruited patients with Chronic Kidney Disease (CKD) and randomly assigned them to receive either treatment as usual or 6-months of yoga practice. The practice consisted of 15-20 minutes of poses, 10-15 minutes of breathing exercises, and 20 minutes of relaxation. Before and over the 6-months of treatment they measured the patients’ quality of life, blood pressure, blood urea, sodium, potassium, and creatinine levels. They found that at the end of 6-months of yoga practice there was a significant reduction of blood pressure, nonsignificant reduction in blood urea and serum creatinine, and significant improvement in physical and psychological quality of life in comparison to the treatment as usual group. In addition, there was a reduction in the need for dialysis in the yoga practice group.

 

These are encouraging results and suggest that yoga practice may be a safe and effective treatment for Chronic Kidney Disease (CKD).  The study, however, examined only a small number of patients and sufficient statistical power was not present to detect many possible effects. So, the study needs to be replicated with a larger sample of CKD patients. Also, it needs to be recognized that the study lacked a group who performed another light exercise over the treatment period. So, it cannot be determined if yoga practice is necessary for the benefits or if any light exercise would produce similar benefits. Regardless, it appears that the practice of yoga can help improve kidney function in patients with Chronic Kidney Disease (CKD).

 

So, improve diseased kidney function with yoga.

 

“Yoga has been around for more than two millennia and has helped people everywhere overcome their medical conditions the natural way. While it is an effective method of keeping your kidneys healthy, yoga should not be used as a substitute for any medications that your doctor might have prescribed.” – India Times

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Pandey RK, Arya TV, Kumar A, Yadav A. Effects of 6 months yoga program on renal functions and quality of life in patients suffering from chronic kidney disease. Int J Yoga [serial online] 2017 [cited 2016 Nov 23];10:3-8. Available from: http://www.ijoy.org.in/text.asp?2017/10/1/3/186158

 

Abstract

Aim: To study the effect of 6 months yoga program in patients suffering from chronic kidney disease (CKD).
Materials and Methods: Fifty-four patients with CKD were studied and divided into two groups (yoga group and control group) to see the effect of yoga in CKD. Patients in the yoga group were offered yoga therapy along with other conventional treatment modalities, while the control group was only on conventional treatment. Subjects in yoga group were trained to perform specific yogic asanas for at least 5 days a week for 40-60 min a day. Regular monitoring of blood pressure, renal function, requirement of a number of dialysis, and quality of life (QOL) indicators were done. Fifty patients (yoga – 25; control-25) completed 6 months follow-up.
Results: In yoga group, a significant reduction of systolic and diastolic blood pressure, significant reduction in blood urea and serum creatinine levels, and significant improvement in physical and psychological domain of the World Health Organization QOL (as assessed by BREF QOL scores) were seen after 6 months. In control group, rise of blood pressure, deterioration of renal function, and QOL were observed. Poststudy comparison between the two groups showed a statistically significant reduction of blood pressure, nonsignificant reduction in blood urea and serum creatinine, and significant improvement in physical and psychological domain of QOL in yoga group as compared to control group. For subjects in yoga group, the need for dialysis was less when compared to control group although this difference was statistically insignificant. Except for inability of some patients to perform certain yogic asanas no adverse effect was found in the study.
Conclusion: Six months yoga program is safe and effective as an adjuvant therapy in improving renal functions and QOL of CKD patients.

http://www.ijoy.org.in/article.asp?issn=0973-6131;year=2017;volume=10;issue=1;spage=3;epage=8;aulast=Pandey

Get Parents Out of the Dumps with Mindfulness

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By John M. de Castro, Ph.D.

 

“a lot of the work is about learning to make peace with our imperfections. Because we’re going to do things that are going to land our kids in therapy, we’re gonna do things that hurt our kids. We can beat ourselves up. But if, instead, we were able to make peace with our imperfections and begin to regulate our emotional state, we can be calmer and more present for our kids and cultivate some self-compassion.” – Elisha Goldstein

 

Clinically diagnosed depression is the most common form of mental illness, affecting over 6% of the population. In general, it involves feelings of sadness, emptiness or hopelessness, irritability or frustration, loss of interest or pleasure in most or all normal activities, sleep disturbances, tiredness and lack of energy, anxiety, agitation, feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things that aren’t your responsibility, suicidal thoughts, and suicide attempts or completed suicide. Needless to say individuals with depression are miserable and need help.

 

Depression does not occur in isolation. When an individual in a family is depressed, it affects all of the members of the family. When it is a parent, it affects how the child is raised and what he/she experiences during the formative years. This can have long-lasting effects on the child. So, it is important to study how depression affects childrearing and the child and what are the factors that might mitigate or eliminate the effects of parental depression on the child. Mindfulness training has been shown to both reduce depression and to improve parenting. Mindfulness-Based Cognitive Therapy (MBCT) was developed specifically to treat depression and has been found to reduce depression alone or in combination with antidepressive drugs.  Hence, it is reasonable to study the effects of MBCT on parents who suffer with depression and their children.

 

In today’s Research News article “Manual Development and Pilot Randomised Controlled Trial of Mindfulness-Based Cognitive Therapy Versus Usual Care for Parents with a History of Depression.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/pb.627681673922429.-2207520000.1480075619./1392058374151418/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010613/

Mann and colleagues recruited parents with children who were attending an outpatient depression clinic and randomly assigned them to either continue with treatment as usual or receive a form of Mindfulness-Based Cognitive Therapy that was adapted for parents (MBCT-P). They were measured before therapy and 4 and 9 months after for depression, parental stress, mindfulness, self-compassion, and the children’s behavior. They found that the Mindfulness-Based Cognitive Therapy for parents (MBCT-P) treatment program in comparison to treatment as usual significantly reduced depression and improved mindfulness and self-compassion at 9-months after treatment. They also found that there were significantly fewer behavior problems with the children.

 

These are very interesting and promising results. They suggest that this newly developed Mindfulness-Based Cognitive Therapy for parents (MBCT-P) program is a safe, effective, and long lasting treatment for parental depression which, in turn, leads to improved behavior in the children. It should be noted that this was a small pilot trial and the results need to be confirmed with a larger number of participants before making firm conclusions. But, the fact that significant results were obtained from such a small sample suggests that the effects of MBCT-P are robust.

 

That MBCT-P relieved depression and improved mindfulness and self-compassion should be expected given the large array of research demonstrating the effectiveness of Mindfulness-Based Cognitive Therapy for depression. It is an important, but not surprising, consequence of MBCT-P that the children’s behavior was improved. It can be speculated that with the depression relived the parents are better able to engage with their children and be more effective and mindful parents. Future research should investigate precisely what changes occur in parenting behaviors after MBCT-P training and how they affect the children.

 

So, get parents out of the dumps with mindfulness.

 

“Mindfulness helps parents emerge from autopilot and end ineffective habits, Bertin said. For instance, instead of getting frustrated and yelling at your child during a homework session – like you might usually do — you’re able to pause and observe your feelings, and act in a calmer, and perhaps more effective way.” – Mark Bertin

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Mann, J., Kuyken, W., O’Mahen, H., Ukoumunne, O. C., Evans, A., & Ford, T. (2016). Manual Development and Pilot Randomised Controlled Trial of Mindfulness-Based Cognitive Therapy Versus Usual Care for Parents with a History of Depression. Mindfulness, 7(5), 1024–1033. http://doi.org/10.1007/s12671-016-0543-7

 

Abstract

Parental depression can adversely affect parenting and children’s development. We adapted mindfulness-based cognitive therapy (MBCT) for parents (MBCT-P) with a history of depression and describe its development, feasibility, acceptability and preliminary estimates of efficacy. Manual development involved interviews with 12 parents who participated in MBCT groups or pilot MBCT-P groups. We subsequently randomised 38 parents of children aged between 2 and 6 years to MBCT-P plus usual care (n = 19) or usual care (n = 19). Parents were interviewed to assess the acceptability of MBCT-P. Preliminary estimates of efficacy in relation to parental depression and children’s behaviour were calculated at 4 and 9 months post-randomisation. Levels of parental stress, mindfulness and self-compassion were measured. Interviews confirmed the acceptability of MBCT-P; 78 % attended at least half the sessions. In the pilot randomised controlled trial (RCT), at 9 months, depressive symptoms in the MBCT-P arm were lower than in the usual care arm (adjusted mean difference = −7.0; 95 % confidence interval (CI) = −12.8 to −1.1; p = 0.02) and 11 participants (58 %) in the MBCT-P arm remained well compared to 6 (32 %) in the usual care arm (mean difference = 26 %; 95 % CI = −4 to 57 %; p = 0.02). Levels of mindfulness (p = 0.01) and self-compassion (p = 0.005) were higher in the MBCT-P arm, with no significant differences in parental stress (p = 0.2) or children’s behaviour (p = 0.2). Children’s behaviour problems were significantly lower in the MBCT-P arm at 4 months (p = 0.03). This study suggests MBCT-P is acceptable and feasible. A definitive trial is needed to test its efficacy and cost effectiveness.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010613/