ACT and CBT for Social Anxiety

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jealousy or lovesickness: woman and man with girls in background

 

By John M. de Castro, Ph.D.

 

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

 

Everyone experiences occasional anxiety and that is normal. But, frequent or very high levels of anxiety can be quite debilitating. These are termed anxiety disorders and they are the most common psychological problem. In the U.S., they affect over 40 million adults, 18% of the population, with women accounting for 60% of sufferers One out of every three absences from work are caused by high levels of anxiety and it is the most common reason for chronic school absenteeism. In addition, people with an anxiety disorder are three-to-five times more likely to go to the doctor and six times more likely to be hospitalized for psychiatric disorders than non-sufferers, making it a major burden on the healthcare system.

 

It is almost a common human phenomenon that being in a social situation can be stressful and anxiety producing. This is particularly true when asked to perform in a social context such as giving a speech. Most people can deal with the anxiety and can become quite comfortable. But many do not cope well with the anxiety or the level of anxiety is overwhelming, causing the individual to withdraw. Social Anxiety Disorder (SAD) is characterized by a persistent, intense, and chronic fear of being watched and judged by others and feeling embarrassed or humiliated by their actions. This fear may be so severe that it interferes with work, school, and other activities and may negatively affect the person’s ability to form relationships. SAD is the most common form of anxiety disorder occurring in about 7% of the U.S. population.

 

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

 

In today’s Research News article “Cognitive Mediators of Treatment for Social Anxiety Disorder: Comparing Acceptance and Commitment Therapy and Cognitive-Behavioral Therapy.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1286451728045417/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4842179/

Niles and colleagues compare the ability of two common and popular therapies for social anxiety disorder, one mindfulness based, Acceptance and Commitment Therapy (ACT), and one not, Cognitive-Behavioral Therapy (CBT). Individuals with SAD were randomly assigned to receive ACT, CBT, or as a wait-list control. They were assessed for levels of social anxiety, anxiety during public speaking, experiential avoidance, depression, and quality of life before and after treatment and again 6 and 12 months later.

 

They found that both ACT and CBT were effective, significantly reducing the symptoms of social anxiety and that these reductions were still present 6 and 12 months later. They then compared the two treatments for the development of their effectiveness over the course of treatment. Both treatments significantly decreased both experiential avoidance and anxiety during public speaking, but ACT produced a more rapid decrease in both symptoms in the early stages of treatment whereas CBT produced a more rapid decrease in the later stages of treatment.

 

These are exciting findings. Both a therapy containing mindfulness training, ACT, and one that did not, CBT, were very effective for the treatment of Social Anxiety Disorder (SAD), although having different profiles of improvement during the course of treatment. This suggests that there are two new viable treatments for this very prevalent disorder. Future research should investigate which treatment works best for different kinds of patients. Regardless, the results suggest that either ACT or CBT should be used to reduce social anxiety in highly anxious patients.

 

“instead of thinking, “I am so anxious. I will never get through this speech,” mindfulness would have you notice your anxiety with the thought, “Sometimes I have anxious feelings, but they are temporary. I know they will soon pass.” – Arlin Cuncic

 

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

Niles, A. N., Burklund, L. J., Arch, J. J., Lieberman, M. D., Saxbe, D., & Craske, M. G. (2014). Cognitive Mediators of Treatment for Social Anxiety Disorder: Comparing Acceptance and Commitment Therapy and Cognitive-Behavioral Therapy. Behavior Therapy, 45(5), 664–677. http://doi.org/10.1016/j.beth.2014.04.006

 

Abstract

Objective: To assess the relationship between session-by-session mediators and treatment outcomes in traditional cognitive-behavioral therapy (CBT) and acceptance and commitment therapy (ACT) for social anxiety disorder.

Method: Session-by-session changes in negative cognitions (a theorized mediator of CBT) and experiential avoidance (a theorized mediator of ACT) were assessed in 50 adult outpatients randomized to CBT (n = 25) or ACT (n= 25) for DSM-IV social anxiety disorder.

Results: Multilevel modeling analyses revealed significant nonlinear decreases in the proposed mediators in both treatments, with ACT showing steeper decline than CBT at the beginning of treatment and CBT showing steeper decline than ACT at the end of treatment. Curvature (or the nonlinear effect) of experiential avoidance during treatment significantly mediated posttreatment social anxiety symptoms and anhedonic depression in ACT, but not in CBT, with steeper decline of the Acceptance and Action Questionnaire at the beginning of treatment predicting fewer symptoms in ACT only. Curvature of negative cognitions during both treatments predicted outcome, with steeper decline of negative cognitions at the beginning of treatment predicting lower posttreatment social anxiety and depressive symptoms.

Conclusions: Rate of change in negative cognitions at the beginning of treatment is an important predictor of change across both ACT and CBT, whereas rate of change in experiential avoidance at the beginning of treatment is a mechanism specific to ACT.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4842179/

 

Improve Fitness in Visually Impaired Children with Yoga

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yoga visual impairment2 Mohnaty

By John M. de Castro, Ph.D.

 

“As those of us with good vision can imagine, the loss of something that helps the function of our body and mind can cause a lot of stress, depression, anxiety and sleep deprivation. Well, guess what has been proven to help those who can see with the similar symptoms? Yep, yoga.” – Julie Phillips-Turner

 

Visual impairment is quite common among children and adolescents. “According to the 2014 American Community Survey, there are approximately 543,893 children with vision difficulty in the U.S. According to the 2014 ACS, there are 261,413 girls and 282,480 boys under the age of 18 that have vision difficulty in the U.S.” – American Foundation for the Blind. Due to the impaired vision and its impact on movements and physical activities, the visually impaired children generally have lower fitness levels, including deficits in muscular strength and balance.

 

Yoga practice has been found to improve muscular strength and balance in adults with visual impairment. In today’s Research News article “Yoga Practice Increases Minimum Muscular Fitness in Children with Visual Impairment.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1285660018124588/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4699502/

Mohnaty and colleagues examine the effectiveness of yoga practice to improve muscular strength in 9-16-year old children. They randomly assigned students at a school for the blind to either a yoga practice group or a wait-list control group. The yoga practice consisted of breathing exercises, loosening practices, postures, relaxation and meditation and was practiced for 60 minutes, 5 days per week for 16 weeks. The wait-list control group participated in a vocational training program instead of yoga practice.

 

The students were assessed before during and after the 16-week practice period with the Kraus-Weber test of muscular fitness which includes assessments of abdominal with psoas muscles, upper abdominal without psoas muscles, lower abdominal with psoas muscle, upper back muscles, lower back muscles and back and hamstrings. the Kraus-Weber test is a pass or fail test and if the student failed on any of its six components then they were considered as failing the whole test. They found that by the end of the 16-week practice period that the yoga group had significantly fewer failures of the Kraus-Weber test than the control group. Before practice only 12.2% of the children in the yoga group passed the test. But, by the end of the practice period 97.6% of the children passed while only 64.1% of the control group passed.

 

The study provides clear evidence that practicing yoga can improve muscular fitness in visually impaired children. This is important as the lack of fitness has health consequences for the children and can lead to increased levels of falls and injuries. In addition, yoga practice is known to be safe and to have a wide variety of physical and psychological benefits.

 

So, improve fitness in visually impaired children with yoga.

 

“It’s hard at first, and then they get it. We use the edge of the mat for alignment during the practice. We also do the same sequence of poses each week, which does a lot of work on the floor, and some standing poses, including tree pose. The key is to go slowly and use ujaii breath to help center their weight, and stabilize while keeping their attention inward.” Pam Jeter

 

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

Mohanty, S., Venkata Ramana Murty, P., Pradhan, B., & Hankey, A. (2015). Yoga Practice Increases Minimum Muscular Fitness in Children with Visual Impairment. Journal of Caring Sciences, 4(4), 253–263. http://doi.org/10.15171/jcs.2015.026

 

Abstract

Introduction: Muscle strength, a component for balance, gait and functional mobility is vital for children with visual impairment. Yoga has frequently been demonstrated to improve physical and mental fitness in children. This study aimed to assess the effect of 16 weeks yoga training on muscular fitness in children with visual impairment.

Methods: This was a wait-listed two-armed-matched case–control study. Eighty (41 yoga, 39 control) visual impairment students of both genders aged 9-16 years matched on age, gender and degree of blindness were assessed at pre, mid (after 8 weeks) and post (after 16 weeks) yoga intervention using the Kraus-Weber test.

Results: The percentage of students passed in yoga group were 12.2%, 43.9% and 68.3% whereas percentages in the control group were 23.1%, 30.8% and 30.8% in pre, mid, and post tests respectively. McNemar test showed significant differences between pre and mid, mid and post in the yoga group while those parameters were not significantly different in the control group. Yoga therapy seemed to have considerable benefits for the children’s muscular fitness.

Conclusion: The study suggests that yoga have considerable benefits for improvement of fitness level in children with visual impairment and may be recommended as and effective, alternative, inexpensive low risk training activity option for them.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4699502/

 

Reduce Job Burnout with Mindfulness

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By John M. de Castro, Ph.D.

 

“Mindfulness’s deliberate presence allows for improvement in care of peers and patients even when not directly caring for them in a medical manner. And it is this deliberate presence that can provide individuals with tools to be mentally and emotionally centered in a professional field that demands continuously increasing forms of self-sacrifice.” – Ayoosh Pareek

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations burnout is all too prevalent. This is the fatigue, cynicism, emotional exhaustion, and professional inefficacy that comes with work-related stress. Healthcare and teaching are high stress occupations. It is estimated that over 45% of healthcare workers experience burnout with emergency medicine at the top of the list, over half experiencing 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. Teachers also experience burnout at high rates. Roughly a half a million teachers out of a workforce of three million, leave the profession each year and the rate is almost double in poor schools compared to affluent schools. Indeed, nearly half of new teachers leave in their first five years.

 

Burnout frequently results from emotional exhaustion. This exhaustion not only affects the healthcare providers and teachers personally, but also the patients and students, as it produces a loss of enthusiasm, empathy, and compassion. Regardless of the reasons for burnout or its immediate presenting consequences, it is a threat to the healthcare providers and their patients and to schools and their students. In fact, it is a threat to the entire healthcare and educational systems as it contributes to the shortage of doctors, nurses, and teachers. Hence, preventing burnout has to be a priority. Mindfulness has been demonstrated to be helpful in treating and preventing burnout.

 

In today’s Research News article “Systematic Review of Mindfulness Practice for Reducing Job Burnout.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1284829924874264/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4776732/

Luken and Sammons reviewed the published research literature on the effectiveness of mindfulness training in treating professional burnout. They found that all of the published studies used between-groups designs with waitlist control groups. The studies also employed either modified forms of the Mindfulness-Based Stress Reduction (MBSR) program or other mindfulness training programs. They found that the majority of the published research literature provided clear evidence of efficacy. Mindfulness training was found to significantly reduce burnout in both healthcare professionals and teachers.

 

The hallmark of Mindfulness-Based Stress Reduction (MBSR) and mindfulness training in general is the reduction in stress; not actual stress but the individual’s physical and psychological responses to stress. Stress is still felt but the individual reacts less and responds more adaptively to it. This is very helpful in dealing with the high levels of stress that teachers and healthcare workers experience on a daily basis. It is this stress that drains the individual and eventually produces exhaustion. Hence, stress reduction is a major contributor to the observed reduction in burnout.

 

Mindfulness training also makes the individual more aware of their own immediate physical and emotional state. Since this occurs in real time, it provides the individual the opportunity to recognize what is happening and respond to it effectively before it contributes to an overall state of burnout. Indeed, mindfulness training has been shown to significantly improve emotion regulation. This produces clear experiencing of the emotion in combination with the ability to respond to the emotion adaptively and effectively. So, teachers and healthcare worker can recognize their state, realize its origins, not let it affect their performance, and respond to it appropriately, perhaps by the recognition that rest is needed. This too contributes to mindfulness training’s ability to reduce burnout.

 

So, reduce job burnout with mindfulness.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

“While the practice of mindfulness is never a “cure-all”, research suggests that it is a powerful foundation upon which teachers can start to build their social-emotional skills—and, in turn, improve their teaching. So while we may never be able to stop that student from making an offensive remark, we can control our reaction—which, in the end, may make the student think twice about doing it again.” – Vicki Zakrzewski

 

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

 

Study Summary

Luken, M., & Sammons, A. (2016). Systematic Review of Mindfulness Practice for Reducing Job Burnout. The American Journal of Occupational Therapy, 70(2), 7002250020p1–7002250020p10. http://doi.org/10.5014/ajot.2016.016956

 

Abstract

OBJECTIVE. A systematic search and critical appraisal of interdisciplinary literature was conducted to evaluate the evidence for practicing mindfulness to treat job burnout and to explore implications for occupational therapy practitioners.

METHOD. Eight articles met inclusion criteria. Each study was assessed for quality using the Physiotherapy Evidence Database scale. We used the U.S. Agency for Health Care Policy and Research guidelines to determine strength of evidence.

RESULTS. Of the studies reviewed, participants included health care professionals and teachers; no studies included occupational therapy practitioners. Six of the 8 studies demonstrated statistically significant decreases in job burnout after mindfulness training. Seven of the studies were of fair to good quality.

CONCLUSION. There is strong evidence for the use of mindfulness practice to reduce job burnout among health care professionals and teachers. Research is needed to fill the gap on whether mindfulness is effective for treating burnout in occupational therapy practitioners.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4776732/

 

Improve Physical Rehabilitation with Mindfulness

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By John M. de Castro, Ph.D.

 

“When it comes to chronic pain, the key is learning to live with it rather than vainly trying to avoid or eradicate it. Mindfulness practice is a wonderful opportunity to do just that. It helps to shift the locus of control from the outside (“this is happening to me and there is nothing I can do about it”) to the inside (“this is happening to me but I can choose how I relate to it”).” – Christiane Wolf

 

Mindfulness practices have been shown to be effective in promoting physical and psychological health. As a result of mindfulness’ ability to reduce the physiological and psychological responses to stress these practices have been found to be helpful in treating a number of medical disorders. In addition, because of mindfulness’ ability to improve emotion regulation and reduce worry and rumination these practices have been found to be helpful in treating a number of psychological disorders. There is such a wide variety of benefits that the application of mindfulness training is being explored for an ever expanding list of conditions.

 

In today’s Research News article “Mindfulness Interventions in Physical Rehabilitation: A Scoping Review.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1284023361621587/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4834757/

Hardison and colleagues examine the effectiveness of mindfulness training in assisting rehabilitation from a variety of physical disorders. To do this, they reviewed the published research literature on the effects of mindfulness training on recovery from any illness, injury, or disability of the neurological, musculoskeletal, or other body system that could be treated within a medical or rehabilitation setting. A number of different mindfulness practices were employed in the studies including Mindfulness-Based Stress Reduction (MBSR), Acceptance and Commitment Therapy, and General Mindfulness.

 

They found that, in general the literature reported that mindfulness training was effective in treating musculoskeletal and pain disorders such as chronic musculoskeletal pain, work-related musculoskeletal injury, and knee surgery. These studies reported mixed results regarding mindfulness training effects on reducing the pain accompanying these disorders, but they routinely found that mindfulness produced significant improvements in acceptance of pain and functioning with pain, and reduced distress. They also found that, in general the published research found that mindfulness training was effective in treating recovery from traumatic brain injury (TBI). Mindfulness training improved the patients’ cognitive functioning, physical health, self-efficacy, quality of life, vitality, emotionality and mental health and reduced the distress produced by the TBI symptoms.

 

These results are potentially very important and suggest that mindfulness training is effective in improving the process of rehabilitation from a number of musculoskeletal and pain disorders and traumatic brain injury. This adds to the already extensive list of applications of mindfulness training to assist in prevention and recovery from medical disorders. It is not known exactly what effects of mindfulness training might be responsible for these benefits. But, it is reasonable to speculate that improvements in stress responses, emotion regulation, and worry and rumination are involved.

 

So, the published research literature suggests that mindfulness training should be included in the interventions recommended for rehabilitation from physical disorders.

 

“From the broadest vantage point, mindful clinical practice holds possibilities when used in conjunction with other strategies. It helps patients to take a step back, assess their experiences and move toward compassionate self-care. We owe it to our patients to help them discover their own pockets of rest, relief and comfort.” – Reji Mathew

 

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

Hardison, M. E., & Roll, S. C. (2016). Mindfulness Interventions in Physical Rehabilitation: A Scoping Review. The American Journal of Occupational Therapy, 70(3), 7003290030p1–7003290030p9. http://doi.org/10.5014/ajot.2016.018069

 

Abstract

A scoping review was conducted to describe how mindfulness is used in physical rehabilitation, identify implications for occupational therapy practice, and guide future research on clinical mindfulness interventions. A systematic search of four literature databases produced 1,524 original abstracts, of which 16 articles were included. Although only 3 Level I or II studies were identified, the literature included suggests that mindfulness interventions are helpful for patients with musculoskeletal and chronic pain disorders and demonstrate trends toward outcome improvements for patients with neurocognitive and neuromotor disorders. Only 2 studies included an occupational therapist as the primary mindfulness provider, but all mindfulness interventions in the selected studies fit within the occupational therapy scope of practice according to the American Occupational Therapy Association’s Occupational Therapy Practice Framework: Domain and Process. Higher-level research is needed to evaluate the effects of mindfulness interventions in physical rehabilitation and to determine best practices for the use of mindfulness by occupational therapy practitioners.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4834757/

 

 

Simplify to Break Through

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“As you simplify your life, the laws of the universe will be simpler; solitude will not be solitude, poverty will not be poverty, nor weakness weakness.” – Henry David Thoreau

 

Science has been a tremendous success. It has produced the knowledge and understandings that have allowed us to control our environment, prevent and cure diseases, communicate with anyone, anywhere, at any time, feed billions of people, and understand our universe. The accelerating rate of development can be directly traced to the practice of science. How did science achieve so much? What allowed us to unravel the mysteries of our universe and existence? What is the essence of such a successful practice? In a word, it’s simplify! Science simplified phenomena in order to break through to understanding.

 

Science studies phenomena by simplifying them. In a good scientific experiment only one thing is studied at a time and everything else is either removed or held constant. To study gravity it must be done in a vacuum, removing the resistance to movement provided by air molecules. Other objects have to be removed so that only two objects are interacting, and all other forces have to be removed or controlled. Once, this is accomplished gravity can be studied in as pure a form as possible. This simplification is the essence of the scientific method. It successfully investigates phenomena by isolating them from the surrounding complexities.

 

Similarly, the essence of contemplative practices is to simplify. This allows us to investigate what resides at the core of our being by removing complexities or holding them as constant as possible. To achieve spiritual breakthroughs, contemplative practices, like science does to produce breakthroughs in the physical realm, removes as many distractions as possible to allow for the study of our essence in its purest form possible.

 

This is particularly clear with meditation practices. The beginner is taught to remove themselves to a quiet environment, to sit as comfortably as possible while still maintaining alertness, to quiet the mental chatter, and to concentrate on a single simple thing such as the breath or a mantra. In a body scan meditation, the concentration is on the feelings emanating solely from particular areas of the body. It is difficult to do hold the concentration required, especially for a beginner. It is the challenge of meditation. But, once achieved, even for brief periods of time, the practitioner becomes in essence a scientist of awareness. S/he becomes an explorer of the essential nature of their being. If the meditation is contemplative prayer, then the individual becomes an explorer of the nature of the Deity.

 

Similarly, mindful movement practices such as qigong or tai chi simplify by concentrating the mind on specific movements and the energetics (chi) revealed in their execution. The practitioner becomes an explorer of chi, the energy of existence. Yoga practice combines a number of these components with meditation at its core, but using body postures, asanas, as sometimes the point of concentration, sometimes the breathing, and sometimes just pure meditation. But, in essence, yoga simplifies the mind so that the core of being becomes exposed.

 

If we are successful in the practice and have simplified our mental landscape what is revealed? Once we pare away the distractions from the environment, from the thoughts, plans, and memories, from the internal speech, and from the body, what is left?  First we realize that try as we may we can never really quiet our minds. The internal chatter continues. We can quiet it for brief periods, but, not for long. This is uncomfortable for the beginning meditator who sees it as a failure. But, reflection can result in the first breakthrough; the understanding that we do not and cannot control our minds. If we can’t control it, then what is it? Is it the mind that defines us or is it simply something no different than the wind blowing, something outside of our essence that is simply there? It’s just another stimulus, just a thought arising and falling away, that only has power if we believe it comes from our essence. Only by simplifying are we able to have this breakthrough.

 

By simplifying in mindfulness practice we are able to see things as they really are, not as we think they should be, or as ideas of labels, but simply as ever changing experiences. One of the next breakthroughs is the realization of impermanence. Once simplified it is easy to see that everything is changing, increasing or decreasing, arising, or falling away, sometimes quickly and sometimes slowly, but never constant or stationary. Our minds and our sensory systems are programmed to produce constancy and only when we can eliminate these processes can we clearly see the impermanence of all things. These include our sensations, feelings, our physical body, and even thoughts. This reveals the fleeting nature of our experiences and even our lives and brings us to the realization that reality exists only in the present moment, that the past is simply a faulty memory and the future is a fanciful speculation. Only by simplifying are we able to have this breakthrough.

 

Once we have these breakthroughs and we have simplified our view of experience we are open to the next breakthrough, the realization that the only thing that is not changing, that is constant is our awareness. What is aware of impermanent reality is always aware and has always been aware, never changing, always present. Once we see that this is the only constant we can begin to understand that this is our essence, that awareness is what we are. We are not fleeting experience or a constructed sense of self, but rather that which is viewing these things, awareness. Only by simplifying are we able to have this breakthrough.

 

There are other breakthroughs that await when the process of simplification is complete. These we call awakening or enlightenment or as a teacher of mine likes to say, a moment of clarity. These like the other breakthroughs depend upon our simplifying everything so that the truth of existence can shine through.

 

So, simplify to break through!

 

“The ability to simplify means to eliminate the unnecessary so that the necessary may speak.” – Hans Hofmann

 

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 Attention in the Elderly with Tai Chi

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By John M. de Castro, Ph.D.

 

“A growing body of carefully conducted research is building a compelling case for tai chi as an adjunct to standard medical treatment for the prevention and rehabilitation of many conditions commonly associated with age.” – Peter Wayne

 

We all want to live longer. We celebrate the increasing longevity of the population. But, aging is a mixed blessing. The aging process involves a systematic progressive decline in every system in the body, the brain included. It cannot be avoided. Our mental abilities may also decline with age including impairments in memory, attention, and problem solving ability. These are called age related cognitive decline. This occurs to everyone as they age, but to varying degrees. Some deteriorate into a dementia, while others maintain high levels of cognitive capacity into very advanced ages. One of the key deficits that develops with age is in attention. It becomes easier to get distracted and harder to focus. This is, to some extent, responsible for some of the memory loss as the elderly person is not paying close enough attention to what’s going on to store and consolidate memories about it.

 

There is some hope for those who are prone to deterioration as there is evidence that these cognitive declines can be slowed. For example, a healthy diet and a regular program of exercise can slow the physical decline of the body with aging. Also, contemplative practices such as meditation, yoga, and tai chi or qigong have all been shown to be beneficial in slowing or delaying physical and mental decline with aging. Tai Chi is an ancient eastern practices involving slow mindful movements. It is a gentle exercise and a contemplative practice that improves mindfulness. Mindfulness practices have been shown to improve cognitive processes while Tai Chi practice has been shown to slow age related cognitive decline. It would seem reasonable to hypothesize that Tai Chi practice might decrease age related cognitive decline including deficits in attention.

 

In today’s Research News article “The mental-attention Tai Chi effect with older adults.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1282515381772385/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4886430/

Kim and colleagues recruited individuals between 50 and 80+ years of age and separated them into two groups, Chinese and non-Chinese (English speakers) samples. They had both samples practice Tai Chi twice a week for 16 weeks for 1 to 1 ½ hours per session. The participants were measured both before and after the 16 weeks of practice with three attentional tasks and a measure of fluid intelligence.

 

They found that the effects of Tai Chi practice were different for the two groups. The Chinese sample had significant improvements in attentional capacity and attentional inhibition and also in fluid intelligence, while both groups showed improvements in attentional balance. The differences in the effects of Tai Chi practice might have been due to a number of differences between the groups. The Chinese group was significantly younger, less well educated, had lower incomes, and had more prior practice with Tai Chi than the non-Chinese sample. The results were not correlated with age so it is unlikely that this is the explanation for the differences but the results were significantly correlated with education, income, and experience with Tai Chi. So, these group differences may have been responsible for the differential effects.

 

The authors interpret the differences as due to motivational differences, where the Chinese sample were more motivated to practice Tai Chi as it is common in China. The two groups did not differ in attendance to Tai Chi practice, however, indicating that they may have been equivalently motivated. It is also possible that the Chinese participants through their culture had a stronger belief that Tai Chi is effective and thus had greater expectations that Tai Chi would improve attention. There is no way to assess which of the possible explanations might be true. That will require further research.

 

Mindfulness practices, in general, have been shown to improve attention and decrease cognitive decline in the elderly. So, the fact that Tai Chi, a mindfulness practice increases attention and fluid intelligence is not surprising.  Since, Tai Chi practice is a gentle practice with no significant negative side effects, that appears to have both physical and psychological benefits, and can be implemented at a very low cost, it would appear to be an ideal practice for the elderly to slow physical and cognitive decline.

 

So, practice Tai Chi to slow age related declines in attention and fluid intelligence.

 

“Tai Chi goes to the root system of the majority of health and wellness issues by unwinding the muscular tissues and mind, aligning the spine posture and stabilizing the energy devices that run via the body, giving them with life energy.”

 

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

Kim, T. H. M., Pascual-Leone, J., Johnson, J., & Tamim, H. (2016). The mental-attention Tai Chi effect with older adults. BMC Psychology, 4, 29. http://doi.org/10.1186/s40359-016-0137-0

Abstract

Background: Tai Chi practice has some fitness, wellness, and general cognitive effects in older adults. However, benefits of Tai Chi on specific mental-attentional executive processes have not been investigated previously. We studied older Canadian adults of Chinese and non-Chinese origin and from low socioeconomic areas.

Methods: Sixty-four adults (51–87 years old) took part in a 16-week Tai Chi program. There were two groups: Chinese-background (n = 35) and Non-Chinese-background (n = 29). They received four mental-attention executive tasks before and after the 16-week period. These tasks measured visuospatial reasoning, mental-attentional activation (working memory), attentional inhibition, and balance between these attention factors (field-dependence-independence).

Results: Chinese participants showed significant gain on Figural Intersections Task (mental-attentional capacity), Antisaccade (attentional inhibition), and Matrix Reasoning (fluid intelligence measure). Both groups evidenced gain on the Water Level Task (attentional balance).

Conclusions: These gains suggest that Tai Chi can improve mental-attentional vigilance and executive control, when practitioners are sufficiently motivated to pursue this practice, and apply themselves (as our Chinese participants seem to have done). We found that Tai Chi enhanced mental attentional executives in the Chinese sample. The largely negative results with Non-Chinese participants might be explained by less strong motivation and by the relatively short Tai Chi practice period, which contrasts with the prior familiarity with Tai Chi of the Chinese participants.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4886430/

 

Reverse Osteoporotic Bone Loss with Yoga

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By John M. de Castro, Ph.D.

 

“Yoga’s emphasis on strength-building, balance and alignment can help people with osteoporosis avoid injury. Low-impact weight-bearing yoga poses stimulate bone growth to build stronger bones. Standing poses can build strength in your hips, an area commonly affected by osteoporosis. Light back-bending back extension poses decompress the vertebrae and build spinal strength.” – Kristin Shea

 

Bone is living tissue that, like all living tissues, is constantly being broken down and replaced. Osteoporosis occurs when the creation of new bone doesn’t keep up with the removal of old bone. This results in a loss of bone mass, causing bones to become weak and brittle. It can become so brittle that a fall or even mild stresses like bending over or coughing can cause a fracture. These fractures most commonly occur in the hip, wrist or spine. Osteoporosis, particularly in its early stages, is difficult to diagnosis as there are typically no symptoms of bone loss. But once bones have been weakened, signs and symptoms may include: back pain, caused by a fractured or collapsed vertebra, loss of height over time, a stooped posture, or a bone fracture that occurs much more easily than expected.

 

Osteoporosis is estimated to affect 200 million women worldwide; approximately 10% of women aged 60, 20% of women aged 70, 40% of women aged 80 and 70% of women aged 90. In the United States 54 million adults over 50 are affected by osteoporosis and low bone mass; 16% of women and 4% of men. Worldwide, osteoporosis causes more than 8.9 million fractures annually, including 1 in 3 women and 1 in 5 men over age 50. Most fractures occur in postmenopausal women and elderly men. Osteoporosis takes a huge personal and economic toll. The disability due to osteoporosis is greater than that caused by cancers and is comparable or greater than that lost to a variety of chronic diseases, such as arthritis, asthma and high blood pressure related heart disease.

 

The most common treatments for osteoporosis are drugs which slow down the breakdown of bone, combined with exercise. The side effects of the drugs are mild, including upset stomach and heartburn. But, there is a major compliance problem as the drugs must be taken over very long periods of time. In fact, only about a third of patients continue to take their medications for at least a year. Even when drugs are taken, exercise is recommended to improve bone growth.

 

Yoga is a relatively gentle low-cost exercise that can be adjusted to the capabilities of elderly individuals. “By pitting one group of muscles against another, yoga exposes bones to greater forces and, therefore, might enhance bone mineral density more than other means.” So, it would seem reasonable to suspect that yoga practice might be effective in the treatment of osteoporosis. In today’s Research News article “Twelve-Minute Daily Yoga Regimen Reverses Osteoporotic Bone Loss.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1281868151837108/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4851231/

Lu and colleagues recruited participants over the internet who had recent bone density measures and were willing to practice yoga for 12 minutes per day. Only participants who complied and practiced yoga at least every other day were included in the final sample. In the four years prior to the study the participants lost bone density with an average loss per month of −0.0036 g/cm2 for the spine, −0.00008 g/cm2 for the hips, and −0.009 for the femora and 109 bone fractures were reported. After practicing yoga for two years the participants increased bone density with an average gain per month of 0.048, 0.088, and 0.0003 g/cm2, for spine, hips, and femora and only 19 bone fractures were reported.

 

These are exciting results and suggest that the practice of yoga has long-term benefits for bone health. These results suggest that osteoporotic bone loss can be reversed with yoga. The people studied were from all over the world, making the results highly generalizable to disparate populations. Also, yoga practice has many additional benefits for psychological and physical health and it is safe, low-cost, and can be adapted for individuals at varying ages and physical conditions.

 

Hence, practice yoga for bone health.

 

”yoga poses, have improved bone strength and mineral density significantly. . . .They showed a dramatic rise in the bone mineral density of those that practiced yoga. The people that did not do any yoga had the expected modest fall in their bone mineral density.” – Lauren Fishman

 

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

Lu, Y.-H., Rosner, B., Chang, G., & Fishman, L. M. (2016). Twelve-Minute Daily Yoga Regimen Reverses Osteoporotic Bone Loss. Topics in Geriatric Rehabilitation, 32(2), 81–87. http://doi.org/10.1097/TGR.0000000000000085

 

Abstract

Objective:

Assess the effectiveness of selected yoga postures in raising bone mineral density (BMD).

Methods:

Ten-year study of 741 Internet-recruited volunteers comparing preyoga BMD changes with postyoga BMD changes.

Outcome Measures:

Dual-energy x-ray absorptiometric scans. Optional radiographs of hips and spine and bone quality study (7 Tesla).

Results:

Bone mineral density improved in spine, hips, and femur of the 227 moderately and fully compliant patients. Monthly gain in BMD was significant in spine (0.0029 g/cm2, P = .005) and femur (0.00022 g/cm2, P = .053), but in 1 cohort, although mean gain in hip BMD was 50%, large individual differences raised the confidence interval and the gain was not significant for total hip (0.000357 g/cm2). No yoga-related serious injuries were imaged or reported. Bone quality appeared qualitatively improved in yoga practitioners.

Conclusion:

Yoga appears to raise BMD in the spine and the femur safely.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4851231/

 

Build a Cooperative Brain with Mindfulness

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By John M. de Castro, Ph.D.

 

“With mindfulness, we learn to truly stand in our own shoes. From this perspective, mindfulness is a practice of self–empathy. This kind of self-awareness allows us to develop empathic connections to others. As we experience the landscape of our inner life with more detail and richness, our ability to understand the inner lives of others expands.” – Matthew Brensilver

 

Humans are social animals. This is a great asset for the species as the effort of the individual is amplified by cooperation. In primitive times, this cooperation was essential for survival. But in modern times it is also essential, not for survival but rather for making a living and for the happiness of the individual. This ability to cooperate is so essential to human flourishing that it is built deep into our DNA and is reflected in the structure of the human nervous system.

 

This cooperation is reflected in the modern workplace where the enterprise is founded on a large number of employees each playing their individual role in the totality of the business. Complex organizations such as modern corporations produce interpersonal challenges and stresses on the individual. Fortunately, the human has considerable social skills including the abilities to be compassionate and understanding of others, helping to cope with these challenges. This involves a considerable ability to regulate emotions, to not react to the individual’s momentary emotions to consider the greater good.

 

Mindfulness may be of great assistance. It is known to produce better emotion regulation and to promote compassion and empathy. Hence, mindfulness improves the individual’s ability to work cooperatively with others. As a result, mindfulness training has been shown to improve performance and satisfaction in the workplace. In today’s Research News article “Mindfulness training increases cooperative decision making in economic exchanges: Evidence from fMRI.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1281180551905868/?type=3&theater

or below, Kirk and colleagues explore the effects of mindfulness training on economic cooperation and the underlying neural systems. They recruited adults to participate in a stress reduction program. They were randomly assigned either to an 8-week Mindfulness Based Stress Reduction (MBSR) program or an 8-week progressive muscle relaxation program. All participants were measured before and after training for mindfulness and mood states. They also played an “Ultimatum Game” in which they were asked to accept or reject offers of splits of $20 all of which produced a gain for participants but varied in fairness of the split. Surprisingly participants frequently reject unfair offers even when it is in their best interest to accept all non-zero offers. Finally, participants’ brains were scanned with functional Magnetic Resonance Imaging (fMRI) while playing the game.

 

They found that mindfulness training significantly increased the acceptance of splits particularly with the most unfair but profitable splits, increasing from 24% to 44% after training. This resulted in a significant increase in the total distribution of money to both the participant and their supposed partner. Hence, mindfulness training produced greater profit for both. There was no change for the relaxation group. Both groups increased in mindfulness and the greater the increase in mindfulness, the greater the acceptance rates of the offers. In terms of the nervous system activity they found that pre-training unfair offers led to increased activity of the Insula, but this activity was lower after mindfulness training. In addition, in the mindfulness trained participants, cooperation led to increased activity of the Septum. Mindfulness training was also found to increase the functional connectivity between the Insula and the Septum.

 

These results suggest that mindfulness training produces greater cooperation to the benefit of all participants and that these changes are reflected in changes in neural processing. Why would mindfulness training increase cooperation in the “Ultimatum Game.” Rejecting any off in the game actually reduces the gain for everyone including the participant. So, it is an irrational action. The offers that are rejected are those that are seen to gain more for another than the participant, to be unfair. So, it is this emotional reaction to the perceived unfairness that prompts the counterproductive action of rejecting the offer. Mindfulness training is known to improve emotion regulation, making the individual better able to respond adaptively to emotions. This is probably what made the mindfulness trained group better at cooperation in the face of perceived unfairness, responding rationally and adaptively, increasing profit for all. These effects of mindfulness training are reflected in changes in the brain.

 

So, build a cooperative brain with mindfulness.

 

“We are emotional beings and we can’t help but be affected by the varying moods and interactions we have with others. Life is always changing and this constant change can create difficult thoughts and emotions, which can flow into the workplace. The silver lining is that if we can meet suffering at work with concern and care, compassion naturally arises. Work environments that cultivate compassion create a much more positive and productive place to work.” –  Carley Hauck

 

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

Kirk U, Gu X, Sharp C, Hula A, Fonagy P, Montague PR. Mindfulness training increases cooperative decision making in economic exchanges: Evidence from fMRI. Neuroimage. 2016 Jun 4. pii: S1053-8119(16)30189-6. doi: 10.1016/j.neuroimage.2016.05.075

 

Abstract

Emotions have been shown to exert influences on decision making during economic exchanges. Here we investigate the underlying neural mechanisms of a training regimen which is hypothesized to promote emotional awareness, specifically mindfulness training (MT). We test the hypothesis that MT increases cooperative economic decision making using fMRI in a randomized longitudinal design involving 8 weeks of either MT or active control training (CT). We find that MT results in an increased willingness to cooperate indexed by higher acceptance rates to unfair monetary offers in the Ultimatum Game. While controlling for acceptance rates of monetary offers between intervention groups, subjects in the MT and CT groups show differential brain activation patterns. Specifically, a subset of more cooperative MT subjects displays increased activation in the septal region, an area linked to social attachment, which may drive the increased willingness to express cooperative behavior in the MT cohort. Furthermore, MT resulted in attenuated activity in anterior insula compared with the CT group in response to unfair monetary offers post-training, which may suggest that MT enables greater ability to effectively regulate the anterior insula and thereby promotes social cooperation. Finally, functional connectivity analyses show a coupling between the septal region and posterior insula in the MT group, suggesting an integration of interoceptive inputs. Together, these results highlight that MT may be employed in contexts where emotional regulation is required to promote social cooperation.

 

Tamp Down Impulsivity and Aggression in Youth with Mindfulness

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“When you are angry, when you feel despair, you practice mindful breathing, mindful walking, to generate the energy of mindfulness. This energy allows you to recognize and embrace your painful feelings.“ – Thich Nhat Hahn

 

By John M. de Castro, Ph.D.

 

It is a sad fact that late adolescence and young adulthood are dangerous times in life. The body is either fully developed or close to it, but the brain lags behind, especially the frontal areas that inhibit and control basic instincts and reactions. As a result, youth often react aggressively and impulsively without higher level control of these behaviors. This is responsible for some troubling statistics. Young people ages 15-24 represent only 14% of the U.S. population, but they account for 30% of the total costs of motor vehicle injuries among males. Regarding youth violence and aggression, 46% of males, and 26% of females reported they had been in physical fights, one million U.S. students took guns to school and six thousand were kicked out of school for packing weapons, the annual death toll from school shootings has more than doubled, the youth homicide rate increased by 168 percent, and juvenile arrest for possession of weapons, aggravated assault, robbery, and murder have risen more than 50 percent.

 

It is important for society to control violent and aggressive behavior and late adolescence and young adulthood are periods when the likelihood is high. Mindfulness has been shown to reduce violence and aggression in adults. So, it would seem reasonable to investigate whether mindfulness may be effective in helping to control the aggressive tendencies of youth. In today’s Research News article “Mindfulness-Based Program for Management of Aggression Among Youth: A Follow-up Study.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1280433211980602/?type=3&theater

or below, Sharma and colleagues investigate this idea. They provided training in mindfulness meditation to youth who were having difficulty controlling aggression. Prior to the training 22% involved themselves in physical violence, 12% also used weapons during aggression, and 14.2% had experienced injuries due to fights. They found that after the training, there were significant decreases in physical aggression, verbal aggression, anger, hostility, rumination, and a decrease in urges to smoke, and significant increases in physical and environmental quality of life, well-being, relaxation, and interpersonal interactions.

 

These results are encouraging that meditation training can help in controlling hostility and aggression in difficult youth. But, without a control comparison condition, the findings have to be viewed cautiously. There is a need for a randomized controlled clinical trial to provide unambiguous evidence that meditation practice can reduce aggressive and impulsive tendencies in youth. It makes sense that mindfulness could do this as it’s been demonstrated that mindfulness training improves executive function and frontal lobe activity which are deficient in youth. The results of this study, although flawed, make a compelling case that further research is warranted.

 

So, tamp down impulsivity and aggression in youth with mindfulness.

 

“After 20 years of working with mindfulness I’ve begun to notice that aggression and reactivity still arise.  Yay.  The difference? Practising the practice has given me the little bit of gap I need to see my desire to jump down someone’s throat, before I actually do it.” – Elaine Smookler

 

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

Sharma, M. K., Sharma, M. P., & Marimuthu, P. (2016). Mindfulness-Based Program for Management of Aggression Among Youth: A Follow-up Study. Indian Journal of Psychological Medicine, 38(3), 213–216. http://doi.org.ezproxy.shsu.edu/10.4103/0253-7176.183087

 

Abstract

Background: Youth have shown indulgence in various high-risk behaviors and violent activities. Yoga-based approaches have been used for the management of psychological problems. The present work explores the role of mindfulness-based program in the management of aggression among youth.

Materials and Methods: Sociodemographic information schedule, Buss-Perry Aggression Questionnaire, and World Health Organization quality of life were administered on 50 subjects in the age range of 18-25 years at pre- and post-mindfulness-based program level.

Results: It revealed the presence of feeling of well-being and ability to relax themselves; changes in score of anger, hostility, physical, and verbal aggression; and enhancement of quality of life in the physical and environment domains at 1 month follow-up.

Conclusions: Mindfulness-based program has shown changes in aggression expression/control and implies integration of it in available program for the management of aggression among youth.

 

Improve Self-Control and Emotionality with Mindfulness

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By John M. de Castro, Ph.D.

 

“I noticed that people who have addictions and those who teach mindfulness speak the same language. Mindfulness teachers will tell you that stress is caused by craving. If you can let go of that craving, then your stress will dissolve, and practicing mindfulness is the way to do that.” – Judson Brewer

 

There are many addictions, from exercise, to alcohol, to sex, to drugs, to gambling, to cigarettes. There are a number of differences produced by the specific nature of each addiction. But, there are also some general features. The core components of addiction include an enhanced incentive for the activity or substance (craving), impaired self-control (impulsivity and compulsivity), emotional dysregulation (negative mood) and increased reactivity to stress.

 

Mindfulness training has been shown to be helpful with each of these components, decreasing cravings, impulsiveness, and psychological and physiological responses to stress, and increasing emotion regulation.  It is no wonder then that mindfulness training has been found to be effective for the treatment of a variety of addictions.  Addictions appear to act via changes to the brain systems affecting self-control; activity in the Anterior Cingulate Cortex (ACC) and adjacent medial Prefrontal Cortex (mPFC). Mindfulness training has also been shown to alter the activity of these structures in the opposite direction through a process called neuroplasticity. This makes a case that mindfulness acts to help in the treatment of addictions by altering the same structures involved in addictions.

 

In today’s Research News article “Mindfulness meditation improves emotion regulation and reduces drug abuse.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1279737795383477/?type=3&theater

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

http://www.drugandalcoholdependence.com/article/S0376-8716(16)00117-4/fulltext

Tang and colleagues review a number of their studies on the relationships between mindfulness, the psychological properties of addictions, and the neural systems underlying self-control and addiction. They employed a mindfulness meditation training technique called integrative body–mind training (IBMT) and found that it improved executive function, emotions, and responsiveness to stress.

 

In other studies, they investigated the brain’s response to IBMT and found that it increased activity in the Anterior Cingulate Cortex (ACC) which is known to be involved in emotion regulation and the activity of the parasympathetic nervous system, that is known to be an antidote to stress responses. These results strongly suggest that mindfulness training (IBMT) acts in ways that would tend to counteract the effects of addictions including self-control and stress responsiveness. Tang and colleagues went on to test IBMT on students who were addicted to cigarettes (nicotine). They found that smokers had lower activity in Anterior Cingulate Cortex (ACC) and the medial Prefrontal Cortex (mPFC). But, IBMT training significantly reduced cigarette smoking and increased both ACC and mPFC activity.

 

These results suggest that mindfulness meditation increases activity in ACC and mPFC which are involved in emotion regulation and self-control. The improvements in these areas, in turn, assist in the prevention and treatment of addictions. These studies have produced an integrated theory of how mindfulness effects addiction by altering the nervous system in such a way as to counteract the psychological issues that underlie addictions. These studies are leading to a better understanding of how mindfulness training produces improvements in addictions.

 

So, improve self-control and emotionality with mindfulness and reduce addictions.

 

“mindfulness is likely an effective tool in helping people with addiction because it’s a single, simple skill that a person can practice multiple times throughout their day, every day, regardless of the life challenges that arise. With so much opportunity for practice—rather than, say, only practicing when someone offers them a cigarette—people can learn that skill deeply.” –  James Davis

 

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

Tang YY, Tang R, Posner MI. Mindfulness meditation improves emotion regulation and reduces drug abuse. Drug Alcohol Depend. 2016 Jun 1;163 Suppl 1:S13-8. doi: 10.1016/j.drugalcdep.2015.11.041

 

Highlights

  • We review the effects of mindfulness meditation on emotion regulation and addiction.
  • We propose the brain mechanism of mindfulness meditation.
  • We examine addiction treatment using mindfulness meditation.

Abstract

BACKGROUND: The core clinical symptoms of addiction include an enhanced incentive for drug taking (craving), impaired self-control (impulsivity and compulsivity), emotional dysregulation (negative mood) and increased stress reactivity. Symptoms related to impaired self-control involve reduced activity in anterior cingulate cortex (ACC), adjacent prefrontal cortex (mPFC) and other brain areas. Behavioral training such asmindfulness meditation can increase the function of control networks including those leading to improved emotion regulation and thus may be a promising approach for the treatment of addiction.

METHODS: In a series of randomized controlled trials (RCTs), we tested whether increased ACC/mPFC activity is related to better self-control abilities in executive functions, emotion regulation and stress response in healthy and addicted populations. After a brief mindfulness training (Integrative Body-Mind Training, IBMT), we used the Positive and Negative Affect Schedule (PANAS) and Profile of Mood States (POMS) to measure emotion regulation, salivary cortisol for the stress response and fMRI for brain functional and DTI structural changes. Relaxation training was used to serve as an active control.

RESULTS: In both smokers and nonsmokers, improved self-control abilities in emotion regulation and stress reduction were found after training and these changes were related to increased ACC/mPFC activity following training. Compared with nonsmokers, smokers showed reduced ACC/mPFC activity in the self-control network before training, and these deficits were ameliorated after training.

CONCLUSIONS: These results indicate that promoting emotion regulation and improving ACC/mPFC brain activity can help for addiction prevention and treatment.

http://www.drugandalcoholdependence.com/article/S0376-8716(16)00117-4/fulltext