Cost Effectively Treat Recurrent Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Depression is not only the most common mental illness, it’s also one of the most tenacious. Up to 80 percent of people who experience a major depressive episode may relapse. Drugs may lose their effectiveness over time, if they work at all. But a growing body of research is pointing to an intervention that appears to help prevent relapse by altering thought patterns without side effects: mindfulness-based cognitive therapy, or MBCT”. – Stacy Lu

 

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.

 

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 can be effective even in the cases where drugs fail. Hence, MBCT is a promising alternative treatment. As such, it is important to further investigate its effectiveness. But, costs are also important, so determining the cost-effective of MBCT is also very important.

 

In today’s Research News article “Mindfulness-based cognitive therapy for recurrent major depression: A ‘best buy’ for health care?” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1408935652463690/?type=3&theater

or see summary below, Shawyer and colleagues recruited adults who were in remission from verified Major Depressive Disorder and engaged them in a continuous self-monitoring of depression. They were then randomly assigned them to either receive no-treatment or 8 weeks of 2 hour, once a week, Mindfulness-Based Cognitive Therapy (MBCT) with once a month optional booster sessions for 3 months. They measured days depressed, patient quality of life, and the economic costs of disability and treatment, before and after treatment and 14 and 24 months later.

 

They found that over the two years of the study that the patients receiving MBCT had significantly fewer days (44%) with depression than control patients regardless of whether treatment was performed in primary or secondary care facilities. This resulted in major cost savings, with the yearly costs for mental health treatment for the MBCT treated patients 32% lower and overall health care costs 24% lower than control patients. Hence, Mindfulness-Based Cognitive Therapy (MBCT) was found to be not only an effective treatment for reoccurrence of major depression, but also a cost-effective treatment.

 

MBCT uses mindfulness training and cognitive training to allow the patients to reprogram their thought patterns and how they interpret experiences, recognizing that their thoughts are only, just that, thoughts and not reflective of their selves. They learn to experience their emotions but adaptively react to them, seeing them as simply experiences that come and go. The results of today’s Research News study demonstrates, as have a number of other studies, that this approach is effective for the treatment of recurrent depression. But, in today’s cost conscious medical environment, the study, importantly, demonstrated that MBCT also reduces health care costs. Hence, MBCT improves major depression cost-effectively.

 

So, cost effectively treat recurrent depression with mindfulness.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

“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

 

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Study Summary

Frances Shawyer, Joanne C Enticott, Mehmet Özmen, Brett Inder,and Graham N Meadows Mindfulness-based cognitive therapy for recurrent major depression: A ‘best buy’ for health care? Aust N Z J Psychiatry, October 2016; vol. 50, 10: pp. 1001-1013., first published on April 19, 2016

 

Abstract

Objective: While mindfulness-based cognitive therapy is effective in reducing depressive relapse/recurrence, relatively little is known about its health economic properties. We describe the health economic properties of mindfulness-based cognitive therapy in relation to its impact on depressive relapse/recurrence over 2 years of follow-up.

Method: Non-depressed adults with a history of three or more major depressive episodes were randomised to mindfulness-based cognitive therapy + depressive relapse active monitoring (n = 101) or control (depressive relapse active monitoring alone) (n = 102) and followed up for 2 years. Structured self-report instruments for service use and absenteeism provided cost data items for health economic analyses. Treatment utility, expressed as disability-adjusted life years, was calculated by adjusting the number of days an individual was depressed by the relevant International Classification of Diseases 12-month severity of depression disability weight from the Global Burden of Disease 2010. Intention-to-treat analysis assessed the incremental cost–utility ratios of the interventions across mental health care, all of health-care and whole-of-society perspectives. Per protocol and site of usual care subgroup analyses were also conducted. Probabilistic uncertainty analysis was completed using cost–utility acceptability curves.

Results: Mindfulness-based cognitive therapy participants had significantly less major depressive episode days compared to controls, as supported by the differential distributions of major depressive episode days (modelled as Poisson, p < 0.001). Average major depressive episode days were consistently less in the mindfulness-based cognitive therapy group compared to controls, e.g., 31 and 55 days, respectively. From a whole-of-society perspective, analyses of patients receiving usual care from all sectors of the health-care system demonstrated dominance (reduced costs, demonstrable health gains). From a mental health-care perspective, the incremental gain per disability-adjusted life year for mindfulness-based cognitive therapy was AUD83,744 net benefit, with an overall annual cost saving of AUD143,511 for people in specialist care.

Conclusion: Mindfulness-based cognitive therapy demonstrated very good health economic properties lending weight to the consideration of mindfulness-based cognitive therapy provision as a good buy within health-care delivery.

http://anp.sagepub.com.ezproxy.shsu.edu/content/50/10/1001.full

Improve the Brain’s Regulation of Emotions in PTSD with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness can help people train themselves to get unstuck from a vicious cycle of negative thinking, often a cornerstone of trauma.” – Jennifer Wolkin

 

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime. But, only a fraction will develop Post-Traumatic Stress Disorder (PTSD). But this still results in a frightening number of people with 7%-8% of the population developing PTSD at some point in their life. For military personnel, it’s much more likely for PTSD to develop with about 11%-20% of those who have served in a war zone developing PTSD.

 

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

 

It is clear that a key problem with PTSD sufferers is a difficulty with regulating emotions. So, a technique, like mindfulness training, that improves emotion regulation may be beneficial. Indeed, mindfulness training has been found to be particularly effective for PTSD. Hence, it is important to further investigate mindfulness relationships to emotion regulation in PTSD sufferers in order to optimize treatment. In today’s Research News article “A Pilot Study of Mindfulness-Based Exposure Therapy in OEF/OIF Combat Veterans with PTSD: Altered Medial Frontal Cortex and Amygdala Responses in Social–Emotional Processing.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1407398169284105/?type=3&theater

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

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5028840/

King and colleagues recruited combat veterans with PTSD and examined the effects of mindfulness training on the brain’s processing of emotional stimuli in veterans with PTSD. The veterans were randomly assigned to receive either 16-weeks of, 2-hour sessions, once a week, of group psychotherapy or Mindfulness-Based Exposure Therapy (MBET). MBET involved mindfulness training, self-compassion training, psycho-education, and mindfulness prolonged exposure therapy. Their brains were scanned with functional Magnetic Imaging (f-MRI) 2-weeks before and 2-weeks after training while they were presented with faces expressing either neutral, angry, or fearful emotions.

 

They found that Mindfulness-Based Exposure Therapy (MBET) produced a marked significant reduction in PTSD symptom severity that was greater than that produced by group therapy. They found that regardless of therapy type that relief of PTSD symptoms was associated with increased activation of the dorsal prefrontal cortex which is usually under active in PTSD sufferers. They also found increased activation in brain areas associated with emotion regulation, the medial prefrontal cortex and the rostral anterior cingulate cortex. In addition, the MBET trained veterans showed greater increases in amygdala and fusiform gyrus responses to angry faces, as well as increased response in medial prefrontal cortex to fearful faces. These responses suggest that the mindfulness training resulted in the veterans’ brains being more engaged in processing threatening stimuli.

 

These findings suggest that mindfulness training improves PTSD symptoms by improving the brain’s ability to process emotional stimuli. By paying greater attention to these stimuli they become better at regulating their emotional responses to them. Since, PTSD involves problems with emotions, the improved emotion regulation would be particularly beneficial to the veterans allowing them to better cope with the emotions produced in response to their memories or environmental stimuli.

 

So, improve the brain’s regulation of emotions in PTSD with mindfulness.

 

“Mindfulness can help people cope with and manage their trauma memories, explore their patterns of avoidance when confronting reminders of their trauma, and better understand their reactions to their symptoms. It helps them feel more grounded, and to notice that even very painful memories have a beginning, a middle and an end — that they can become manageable and feel safer. It’s hard work, but it can pay off.” – Anthony King

 

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

King, A. P., Block, S. R., Sripada, R. K., Rauch, S. A. M., Porter, K. E., Favorite, T. K., … Liberzon, I. (2016). A Pilot Study of Mindfulness-Based Exposure Therapy in OEF/OIF Combat Veterans with PTSD: Altered Medial Frontal Cortex and Amygdala Responses in Social–Emotional Processing. Frontiers in Psychiatry, 7, 154. http://doi.org/10.3389/fpsyt.2016.00154

 

Abstract

Combat-related posttraumatic stress disorder (PTSD) is common among returning veterans, and is a serious and debilitating disorder. While highly effective treatments involving trauma exposure exist, difficulties with engagement and early drop may lead to sub-optimal outcomes. Mindfulness training may provide a method for increasing emotional regulation skills that may improve engagement in trauma-focused therapy. Here, we examine potential neural correlates of mindfulness training and in vivo exposure (non-trauma focused) using a novel group therapy [mindfulness-based exposure therapy (MBET)] in Afghanistan (OEF) or Iraq (OIF) combat veterans with PTSD. OEF/OIF combat veterans with PTSD (N = 23) were treated with MBET (N = 14) or a comparison group therapy [Present-centered group therapy (PCGT), N = 9]. PTSD symptoms were assessed at pre- and post-therapy with Clinician Administered PTSD scale. Functional neuroimaging (3-T fMRI) before and after therapy examined responses to emotional faces (angry, fearful, and neutral faces). Patients treated with MBET had reduced PTSD symptoms (effect size d = 0.92) but effect was not significantly different from PCGT (d = 0.43). Improvement in PTSD symptoms from pre- to post-treatment in both treatment groups was correlated with increased activity in rostral anterior cingulate cortex, dorsal medial prefrontal cortex (mPFC), and left amygdala. The MBET group showed greater increases in amygdala and fusiform gyrus responses to Angry faces, as well as increased response in left mPFC to Fearful faces. These preliminary findings provide intriguing evidence that MBET group therapy for PTSD may lead to changes in neural processing of social–emotional threat related to symptom reduction.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5028840/

 

Improve Caregiving for People with Intellectual Disabilities with Mindfulness

 

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

 

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

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 anxietydepressionAntisocial Personality DisorderBorderline personality disorderimpulsivityobsessive compulsive disorderphobiaspost-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

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

 

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

 

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 burnoutincreasing 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

 

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

 

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 regulationstress responsestraumafear and worryanxiety, 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.