Reduce Anxiety and Improve Attention in Pre-Teens with Yogic Breathing

Reduce Anxiety and Improve Attention in Pre-Teens with Yogic Breathing

 

By John M. de Castro, Ph.D.

 

Pranayama is an incredibly effective, important tool to teach children so they can control their energy, their mood, and their impulses.” – Amanda James

 

Breathing is essential for life and generally occurs automatically. It’s easy to take for granted as it’s been there our entire lives. Nevertheless, we become more aware of it when it varies with circumstances, such as when we exercise and also in emotional states, especially fear and anxiety. But we rarely notice it during everyday ongoing life. Yet, its characteristics are associated with our state of well-being. Slow deep breathing is characteristic of a healthy relaxed state. Breathing exercises are common in yoga practices and have been found to have a number of beneficial effects.

 

The Pre-teen years are transitional between childhood and adolescence. What happens here and what is learned can have a huge impact on the child’s ability to navigate the difficult years of adolescence. It is not known whether training in yogic breathing techniques can be beneficial for pre-teens.

 

In today’s Research News article “Immediate Effect of a Yoga Breathing Practice on Attention and Anxiety in Pre-Teen Children.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6678429/), Telles and colleagues recruited healthy pre-teen children (11-12 years of age) who practiced yoga and yogic breathing exercises and randomly assigned them to one of 3 orders of 3 interventions; high frequency yogic breathing, breath awareness, and quiet sitting practiced on successive days. The breathing exercises were practiced at school for 3 3.5-minute periods followed by 1-minute rest. They were measured before and after each session for anxiety and selective attention.

 

They found that there was a significant decrease in anxiety after all 3 interventions. After high frequency yogic breathing there was a significant increase in selective attention, while after breath awareness there was a significant increase in selective attention errors.

 

The reduction in anxiety cannot be definitively ascribed to the yogic exercises as quiet sitting also reduces anxiety. Anxiety reduction may also be due to relief for having finished the task as there was a reduction regardless of task. High frequency yogic breathing is known to produce physiological activation, increasing heart rate and blood pressure. This activation may be responsible for the improved selective attention. On the other hand, breath awareness practice tends to produce relaxation. It is possible that this relaxation reduces vigilance and increases errors in selective attention.

 

There is a need for more research on yogic breathing and its effects on anxiety levels to ascertain if the reduction in anxiety are due to contaminants such as placebo effects or relaxation after task completion. It is important to reduce anxiety in pre-teens as this is a difficult time and high levels of anxiety can interfere with the child’s ability to cope with the challenges. Also, improved selective attention with high frequency yogic breathing may help the pre-teens in their academic endeavors.

 

So, reduce anxiety and improve attention in pre-teens with yogic breathing.

 

kids love working with the breath!! There is so much fun to be had with breathing exercises. They find inner strength and peace, it uplifts them, calms them, and teaches them how to focus in nerve-wracking or anxiety-inducing situations. – Joanne Moules

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Telles, S., Gupta, R. K., Gandharva, K., Vishwakarma, B., Kala, N., & Balkrishna, A. (2019). Immediate Effect of a Yoga Breathing Practice on Attention and Anxiety in Pre-Teen Children. Children (Basel, Switzerland), 6(7), 84. doi:10.3390/children6070084

 

Abstract

Pre-teen children face stressors related to their transition from childhood to adolescence, with a simultaneous increase in academic pressure. The present study compared the immediate effects of 18 min of (i) high frequency yoga breathing with (ii) yoga-based breath awareness and (iii) sitting quietly, on (a) attention and (b) anxiety, in 61 pre-teen children (aged between 11 and 12 years; 25 girls). Attention was assessed using a six letter cancellation task and Spielberger’s State Trait Anxiety Inventory STAI-S was used to measure anxiety before and after the three practices, practiced on separate days. Repeated measures ANOVA, followed by Bonferroni adjusted post-hoc analyses showed an increase in total attempts and net scores after high frequency yoga breathing (p < 0.05), while wrong attempts increased after yoga based breath awareness (p < 0.05). Anxiety decreased comparably after all three interventions. The 25 girls in the group had the same trend of results as the whole group with respect to the attention-based cancellation task, while boys showed no, how since change. For both girls and boys, anxiety decreased after all three 18min interventions. The results suggest that high frequency yoga breathing could be a short, useful school based practice to improve attention and reduce anxiety.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6678429/

 

Mindfulness Produces Long-Term Reductions in Depression and Depression Relapse

Mindfulness Produces Long-Term Reductions in Depression and Depression Relapse

 

By John M. de Castro, Ph.D.

 

“Instead of getting sucked into our emotions or our thoughts, which is what happens when we’re depressed or anxious, we see them as those thoughts again, or those feelings again, and that disempowers them.” – Daniel Goleman

 

Depression affects over 6% of the population. Depression can be difficult to treat. It is usually treated with antidepressant 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. Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering.

 

Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs failAcceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT). ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

Attention Bias Modification (ABM) involves simple computerized training to increase attention to positive stimuli. It is not known if ABM might supplement Acceptance and Commitment Therapy (ACT) to further decrease depression relapse rates. In today’s Research News article “Acceptance and Commitment Therapy Preceded by Attention Bias Modification on Residual Symptoms in Depression: A 12-Month Follow-Up.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6727662/), Østergaard and colleagues examined the combination of Acceptance and Commitment Therapy (ACT) and  Attention Bias Modification (ABM) to reduce depression relapse.

 

They recruited participants who had a history of depression but were not currently in a depressive episode. They were randomly assigned to receive a single session of either Attention Bias Modification (ABM) training or a control condition that was very similar except that attention to both positive and negative stimuli were equally reinforced. They were then assigned to either receive 8 once a week, 2.5 hour session of Acceptance and Commitment Therapy (ACT) or no treatment. Participants were measured before and after training and each month over the subsequent year for depression, depression relapse, and feasibility and acceptability of treatments.

 

They found that Attention Bias Modification (ABM) did not significantly affect depression or relapse. On the other hand, Acceptance and Commitment Therapy (ACT) with or without prior Attention Bias Modification (ABM) training produced significant reductions in both self-report and clinician reported levels of depression that continued to decline over the year follow-up period. They also found that over the 12-month follow-up 79% of the participants who received ACT training did not have another depressive episode while only 55% of the control participants did not have a relapse. Hence, ACT significantly reduces depression levels and depression relapse over a year following treatment.

 

These are impressive results. Acceptance and Commitment Therapy (ACT) is not only a safe and effective mindfulness-based treatment to reduce depression and depression relapse in people with a history of depression but also has a sustained impact lasting for at least a year following treatment. It is unusual for studies to have such long-term follow-up. It is important that ACT has such sustained benefits.

 

So, produce long-term reductions in depression and depression relapse with mindfulness.

 

Mindfulness is a valuable practice for improving the cognitive symptoms of depression, such as distorted thinking and distractibility. It helps individuals recognize these more subtle symptoms, realize that thoughts are not facts and refocus their attention to the present.” –  Margarita Tartakovsky

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Tom Østergaard, Tobias Lundgren, Ingvar Rosendahl, Robert D. Zettle, Rune Jonassen, Catherine J. Harmer, Tore C. Stiles, Nils Inge Landrø, Vegard Øksendal Haaland. Acceptance and Commitment Therapy Preceded by Attention Bias Modification on Residual Symptoms in Depression: A 12-Month Follow-Up. Front Psychol. 2019; 10: 1995. Published online 2019 Aug 29. doi: 10.3389/fpsyg.2019.01995

 

Abstract

Depression is a highly recurrent disorder with limited treatment alternatives for reducing risk of subsequent episodes. Acceptance and commitment therapy (ACT) and attention bias modification (ABM) separately have shown some promise in reducing depressive symptoms. This study investigates (a) if group-based ACT had a greater impact in reducing residual symptoms of depression over a 12-month follow-up than a control condition, and (b) if preceding ACT with ABM produced added benefits. This multisite study consisted of two phases. In phase 1, participants with a history of depression, currently in remission (N = 244), were randomized to either receive 14 days of ABM or a control condition. In phase 2, a quasi- experimental design was adopted, and only phase-1 participants from the Sørlandet site (N = 124) next received an 8-week group-based ACT intervention. Self-reported and clinician-rated depression symptoms were assessed at baseline, immediately after phase 1 and at 1, 2, 6, and 12 months after the conclusion of phase 1. At 12-month follow-up, participants who received ACT exhibited fewer self-reported and clinician-rated depressive symptoms. There were no significant differences between ACT groups preceded by ABM or a control condition. There were no significant differences between ACT groups preceded by ABM or a control condition. Group-based ACT successfully decreased residual symptoms in depression over 12 months, suggesting some promise in preventing relapse.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6727662/

 

Enhance Enjoyment of the (Winter Solstice) Holidays with Mindfulness

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Enhance Enjoyment of the (Winter Solstice) Holidays with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Any picture-perfect image of the holidays we build up in our minds, filled with expectations of how life should be, rarely gets met for long..” – Mark Bertin

 

The end of December marks transitions. It marks the new year, transition from 2019 to 2020. It’s also the time of the winter solstice, the shortest day of the year, transitioning from shortening days to lengthening days. Since the beginning of recorded history, the solstice has been a time of celebration and merriment. For most of that time it was an extremely popular pagan celebration.

 

The Christians tried to suppress this pagan winter solstice celebration, but it was exceedingly popular and they were unsuccessful. So, instead they coopted it, turning it into a celebration of Jesus’ birth. There are no records of the actual date of Jesus’ birth, so any day could be chosen, and the time of the pagan solstice celebration was perfect. There are still many remnants of that pagan celebration carried into the Christmas celebration, including the tree, wreaths, mistletoe, holly, and even the name yule, the yule log, and the use of the word “jolly”.

 

The winter solstice is a reminder of the impermanence of all things. For months, the world has been becoming darker and colder. But the winter solstice marks the reversal of this trend. For the next several months the world will be becoming brighter and warmer. It’s a reminder that even the darkest moments are impermanent. This is true for all of the problems that occur in our lives. These too will pass.

 

Regardless of the purported reason, the end of December is a time of celebration. We now look on it as a time for giving, but the gifts are a relatively new addition that has been enthusiastically promoted by merchants. Should we be jaundiced about the celebration because of it’s confusing history, its crass commercialism, and varied religious meanings or should we participate with enthusiasm? Mindfulness tells us not to judge, just to experience what life has to offer in the moment. The holiday season has much to offer us. So, mindfulness would suggest that we don’t judge or criticize but engage mindfully in whatever way is appropriate for us.

 

Perhaps the greatest gift we can give to our family and friends at any time but especially during the holidays is our presence, not just our physical presence but our mindful attentive presence. We give to them when we deeply listen. So many conversations are superficial. So, engaging deeply with others is a special gift. It involves employing an underused skill of true listening with full attention to another, not listening on the surface while composing the next communication, but just listening with mindfulness. We in effect give to them our most precious gift, our fully engaged selves.

 

We may be surprised by what we now hear that we may have been missing for years, and what reactions occur to our deep listening. Just know that you’re giving what most people need most, to feel listened to, respected, valued and cared about. Deep listening is particularly valuable when the holiday conversation turns to controversial subjects such as politics. These conversations can be a mine field that can poison a holiday event. But deeply listen to what is being said is often sufficient, as the conversant often just wants to be heard. Making the effort to deeply listen, understand the other person’s point of view, and responding with compassion can quickly diffuse the situation.

 

The holidays are a time to focus on children. Here, also, mindfulness can improve the experience. If we mindfully observe and truly listen, we can see that what children desire most is our attention and love. Presents of toys and gadgets are opened with enthusiasm and glee. But the joy is short-lived. As with most things the happiness produced is fleeting. But, if you engage with the child, playing and giving your full attention to him/her the happiness is much more enduring. Doing this mindfully, without expectations or judgment will bring a joy and happiness to you that will also be enduring. Don’t engage with the child for personal gain, but enjoy the gain when it happens.

 

The holidays are also a time of revelry, with abundant parties and celebrations at work, with friends, and with family. Once again, engaging mindfully can improve the experience and help prevent excess. Being mindful can help us keep alcohol intake under control. By being aware of our state in the present moment we are better able to know when we reached our limit and especially, to know when to refrain from driving. Mindful eating can also help us enjoy all of the wonderful foods presented during the holidays while being aware of our actual physical state. It can help us to eat slowly, savoring the exquisite flavors, without overindulging. Engage socially mindfully without judging and deeply listening and you’ll enjoy the interactions all the more.

 

Mindfulness can also help with holiday depression. Because of the high expectations of what the holidays should be like in contrast to the experienced reality, many people get depressed. It is the time of the highest suicide rates of the year. Mindfulness is known to combat depression in ourselves. But, for the holidays we could use our mindfulness skills, particularly listening, to help vulnerable people deal with the holidays. Our compassion and loving kindness can go a long way toward helping people overcome negative mood states. Just a genuine smile can sometimes be a great mood enhancer. Mindfully give of yourself, without expectation of getting anything back. You’ll be amazed at how much good it does for others and at the benefit you will receive.

 

Finally, the underlying theme of the winter solstice and the holidays is transformation and renewal. Just as the slow decent into the short days of winter ends the slow ascent to the long days of summer begins. We can use this time to begin to transform and renew ourselves. What better way to transform ourselves than practicing mindfulness, not just on a meditation mat or in a yoga studio, but in everyday existence. Practicing mindfulness at work, while driving, while exercising, in our relationships can truly transform our lives.

 

The idea of personal transformation is reflected in the tradition of the New year’s resolution. Although this is a common tradition, few resolutions are entered into with sufficient dedication and energy to actually carry them out. We should use this holiday season to reflect mindfully on our own lives, looking deeply at what will truly help us and our families to thrive physically, emotionally, socially, and spiritually in the coming year. Then set realistic goals and concrete plans to fulfill them.

 

An excellent New Year’s resolution that can help to lead to a more fulfilling life is to simply make a commitment to be more mindful in the coming year. This should include a plan for engaging in regular practice and working to transfer mindfulness skills obtained outside of the practice. But, be realistic as to what can actually be accomplished, set small goals, and then develop a firm concrete plan to achieve them. It may be helpful to set periodic reminders in your smartphone of these plans. Pay special attention to what the effects are of engaging in the planned behaviors. It is important to recognize the progress that is being made and the positive impact that follows.

 

So, enhance the enjoyment of the (winter solstice) holidays with mindfulness.

 

“I hope that in this year to come, you make mistakes. Because if you are making mistakes, then you are making new things, trying new things, learning, living, pushing yourself, changing yourself, changing your world. You’re doing things you’ve never done before, and more importantly, you’re doing something.” – Neil Gaiman

CMCS – Center for Mindfulness and Contemplative Studies

 

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

Reduce Pain and Falls and Improve Mobility in the Elderly with Tai Chi

Reduce Pain and Falls and Improve Mobility in the Elderly with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Solid research shows that tai chi can benefit people with osteoarthritis, rheumatoid arthritis, fibromyalgia, tension headache, and other ongoing, painful conditions.” – Harvard Health

 

The process of aging affects every aspect of the physical and cognitive domains. Every system in the body deteriorates including motor function with a decline in strength, flexibility, and balance. Impaired balance is a particular problem as it can lead to falls. The elderly also frequently suffer from chronic pain.

 

Pain involves both physical and psychological issues. Physically, exercise can be helpful in strengthening the body to prevent or relieve pain. Psychologically, the stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. Indeed, mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of low back painTai Chi, Qigong, and yoga  are all exercises and mindfulness practices that have been found to be effective for pain.

 

In today’s Research News article “Tai Chi for older adults with chronic multisite pain: a randomized controlled pilot study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6126990/), You and colleagues examine the ability of Tai Chi practice to reduce chronic pain in the elderly. They recruited elderly (>65 years of age) with multisite (2 or more) musculoskeletal pain who either had 1 or more falls in the last year or used a cane or walker. They were randomly assigned to receive 12 weeks, 2 hours, twice a week of either Tai Chi or light physical exercise. They were measured before and after training for acceptability of the exercises, chronic health conditions, pain, attention, executive function, physical function, gait, falls, and fear of falling. 83% of the elderly completed the study.

 

They found that in comparison to baseline the elderly who engaged in Tai Chi had significantly lower pain and pain interference with activities, improvements in gait, including stride and swing time, and decreased gait asymmetry, and decreased fear of falling, and fewer falls over the subsequent 9 months, while the light exercise group did not.

 

These are encouraging pilot results that are similar to other findings with Tai Chi with other types of patients. Unfortunately, because this was a small pilot study there were no statistically significant differences between the Tai Chi group and the light exercise group even though the Tai Chi groups was significantly improved relative to baseline whereas the light exercise group was not. But these results provide justification for performing a future large scale randomized controlled trial.

 

It’s important to note that Tai Chi is a gentle and safe mindfulness practice. It is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It is inexpensive to administer, can be performed in groups or alone, at home or in a facility, and can be quickly learned. In addition, it can be practiced in social groups. This can make it fun, improving the likelihood of long-term engagement in the practice.

 

So, reduce pain and falls and improve mobility in the elderly with Tai Chi.

 

“Improved flexibility will reduce stiffness and help keep joints mobile. Stiffness causes pain; increase flexibility will relieve pain.  Tai Chi for Arthritis gently moves all joints, muscles and tendons throughout the body.” – Paul Lam

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

You, T., Ogawa, E. F., Thapa, S., Cai, Y., Zhang, H., Nagae, S., … Leveille, S. G. (2018). Tai Chi for older adults with chronic multisite pain: a randomized controlled pilot study. Aging clinical and experimental research, 30(11), 1335–1343. doi:10.1007/s40520-018-0922-0

 

Abstract

Background

Chronic pain is associated with poorer cognition and mobility, and fall risk in older adults.

Aims

To investigate the feasibility of a randomized trial of mind-body exercise (Tai Chi) versus light physical exercise in older adults with multisite pain.

Methods

Adults aged ≥ 65y with multisite pain who reported falling in the past year or current use of an assistive device were recruited from Boston area communities. Participants were randomized to either a Tai Chi or a light physical exercise program, offered twice weekly for 12 weeks. The primary outcomes were feasibility and acceptability. Secondary outcomes included pain characteristics, cognition, physical function, gait mobility, fear of falling, and fall frequency.

Results

Of 176 adults screened, 85 were eligible, and 54 consented and enrolled (average age 75±8y; 96.30% white; 75.93% female). The dropout rate was 18% for Tai Chi and 12% for light physical exercise. For those completing the study, exercise class attendance was 76% for Tai Chi and 82% for light physical exercise. There were no significant group differences in most secondary outcomes. Tai Chi significantly lowered pain severity (4.58±1.73 to 3.73±1.79, p<0.01) and pain interference (4.20±2.53 to 3.16±2.28, p<0.05), reduced fear of falling (90.82±9.59 to 96.84±10.67, p<0.05), and improved several single-task and dual-task gait variables, while light physical exercise did not change these measures

Discussion and Conclusions

This study demonstrated the feasibility and acceptability of conducting a larger randomized controlled trial in older adults with multisite pain. Study findings and challenges encountered will inform future research.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6126990/

 

Augment Mystical Experiences in Meditation and Long-Term Well-Being with Psilocybin

Augment Mystical Experiences in Meditation and Long-Term Well-Being with Psilocybin

 

By John M. de Castro, Ph.D.

 

“Trying to harness the mind in meditation is a bit like holding a water wiggly—those tubular, slippery, jelly-filled toys that leap out of your hand whenever you try to hold onto them. With the addition of a psychedelic state of mind, it could be like grasping with a greased hand.” – Paul Austin

 

Psychedelic substances have been used almost since the beginning of recorded history to alter consciousness and produce spiritually meaningful experiences. Psychedelics produce effects that are similar to those that are reported in spiritual awakenings. They report a loss of the personal self. They experience what they used to refer to as the self as just a part of an integrated whole. They report feeling interconnected with everything else in a sense of oneness with all things. They experience a feeling of timelessness where time seems to stop and everything is taking place in a single present moment. They experience ineffability, being unable to express in words what they are experiencing and as a result sometimes producing paradoxical statements. And they experience a positive mood, with renewed energy and enthusiasm.

 

It is easy to see why people find these experiences so pleasant and eye opening. They often report that the experiences changed them forever. Even though the effects of psychedelic substances have been experienced and reported on for centuries, only very recently have these effects come under rigorous scientific scrutiny.

 

Psilocybin is a psychedelic substance that is found naturally in a number of varieties of mushrooms. It has been used for centuries particularly by Native Americans for their spiritual practices. When studied in the laboratory under double blind conditions, Psilocybin has been shown to “reliably occasion deeply personally meaningful and often spiritually significant experiences (e.g. mystical-type experiences).” Since the effects of meditation and psilocybin appear similar, it’s important to look at the effects of the combination of meditation with psilocybin.

 

In today’s Research News article “.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6813317/ ), Smigielski and colleagues recruited experienced adult meditators participating in a 5-day meditation retreat and randomly assigned them to receive either a high dose of psilocybin or a placebo. The participants were matched for age, gender, mindfulness level, and meditation experience. They were administered psilocybin or placebo on the fourth day of the retreat. Before and after and on each day of the retreat they were measured for mindfulness and meditation depth. Six hours after psilocybin or placebo administration they were measured for altered states of consciousness and mystical experiences. Four months after the retreat they were evaluated for changes in behavior by self-report and that of a significant other. They did not observe any adverse events associated with psilocybin administration.

 

They found that on the day of administration the psilocybin group had significantly greater depth of meditation and after the retreat significantly higher mindfulness. While the drugs were in effect the psilocybin group had large significant increases in altered states of consciousness, including unity, spiritual experience, blissfulness, insightfulness, and disembodiment and large significant increases in mystical experiences, including complex imagery, elementary imagery, audiovisual synesthesia, and changed meaning of percepts. Four months after the retreat the participants who were administered psilocybin had significant changes in behavior documented by themselves and a significant other including significantly greater appreciation for life, self-acceptance, quest for meaning/sense of purpose, and appreciation of death.

 

Meditation retreats have been shown to increase meditation depth, mindfulness, mystical experiences, and to produce changes in consciousness. The present results suggest that psilocybin administration produces large and significant amplifications of these effects. In fact, the participants who received psilocybin reported that the experience was equivalent to the greatest mystical experiences that they have ever had. Remarkably, the effects of the single administration were enduring, altering and deepening their acceptance of themselves as they are, their appreciation of life and death, and their sense of meaning and purpose. These results suggest that the combination of meditation with psilocybin may be a safe and effective means to improve psychological and spiritual health and well-being.

 

So, augment mystical experiences in meditation and long-term well-being with psilocybin.

 

“After the retreat, mushroom-assisted meditators reported less self-consciousness and more illusions and hallucinations than the control group. What’s more, their brains showed alterations in the functioning of the default mode network—a group of interacting brain regions linked to self-awareness and rumination—during open awareness meditation. . . . What is even more remarkable is that experienced meditators in the psilocybin group reported better social functioning four months later.” – Grace Bullock

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Smigielski, L., Kometer, M., Scheidegger, M., Krähenmann, R., Huber, T., & Vollenweider, F. X. (2019). Characterization and prediction of acute and sustained response to psychedelic psilocybin in a mindfulness group retreat. Scientific reports, 9(1), 14914. doi:10.1038/s41598-019-50612-3

 

Abstract

Meditation and psychedelics have played key roles in humankind’s search for self-transcendence and personal change. However, neither their possible synergistic effects, nor related state and trait predictors have been experimentally studied. To elucidate these issues, we administered double-blind the model psychedelic drug psilocybin (315 μg/kg PO) or placebo to meditators (n = 39) during a 5-day mindfulness group retreat. Psilocybin increased meditation depth and incidence of positively experienced self-dissolution along the perception-hallucination continuum, without concomitant anxiety. Openness, optimism, and emotional reappraisal were predictors of the acute response. Compared with placebo, psilocybin enhanced post-intervention mindfulness and produced larger positive changes in psychosocial functioning at a 4-month follow-up, which were corroborated by external ratings, and associated with magnitude of acute self-dissolution experience. Meditation seems to enhance psilocybin’s positive effects while counteracting possible dysphoric responses. These findings highlight the interactions between non-pharmacological and pharmacological factors, and the role of emotion/attention regulation in shaping the experiential quality of psychedelic states, as well as the experience of selflessness as a modulator of behavior and attitudes. A better comprehension of mechanisms underlying most beneficial psychedelic experiences may guide therapeutic interventions across numerous mental conditions in the form of psychedelic-assisted applications.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6813317/

 

Mindfulness Reduces Addiction by Improving Pleasure Appreciation in Opioid Users

Mindfulness Reduces Addiction by Improving Pleasure Appreciation in Opioid Users

 

By John M. de Castro, Ph.D.

 

“mindfulness-based interventions could help people dependent on opioids increase their self-awareness and self-control over cravings and be less reactive to emotional and physical pain. Individuals with an opioid addiction could also be taught to change their negative thoughts and savor pleasant events, which may help them to regulate their emotions and experience more enjoyment.” – Science News

 

Substance abuse and addiction is a terrible problem, especially opioid pain relievers. Opioid addiction has become epidemic and is rapidly increasing affecting more than 2 million Americans and an estimated 15 million people worldwide. In the U.S more than 20,000 deaths yearly were attributed to an overdose of prescription opioids, and another 13,000 deaths from heroin overdose. These statistics, although startling are only the tip of the iceberg. Drug use is associated with suicide, homicide, motor-vehicle injury, HIV infection, pneumonia, violence, mental illness, and hepatitis. It can render the individual ineffective at work, it tears apart families, it makes the individual dangerous both driving and not.

 

An effective treatment for addiction has been elusive. Most programs and therapies to treat addictions have poor success rates. Recent research is indicating that mindfulness has been found to be effective in treating addictionsMindfulness-Oriented Recovery Enhancement (MORE) was specifically developed to employ mindfulness training along with other proven methods to assist addicts in remaining off of drugs. MORE involves mindful breathing and body scan meditations, cognitive reappraisal to decrease negative emotions and craving, and savoring to augment natural reward processing and positive emotion.

 

One method to observe reward processing in the brain is to measure the changes in the electrical activity that occur in response to specific reward related stimuli. These are called event-related potentials or ERPs. The signal following a stimulus changes over time. The fluctuations of the signal after specific periods of time are thought to measure different aspects of the nervous system’s processing of the stimulus. The Late Positive Potential (LPP) response in the evoked potential (ERP) is a positive going electrical response occurring between a 4 to 8 tenths of a second following the target stimulus presentation. The LPP is thought to reflect attention to the emotional features of a stimulus.

 

In today’s Research News article “Mindfulness-Oriented Recovery Enhancement remediates hedonic dysregulation in opioid users: Neural and affective evidence of target engagement.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6795512/), Garland and colleagues recruited chronic pain patients who were opioid users. They were randomly assigned to receive 8 weeks of either Mindfulness-Oriented Recovery Enhancement (MORE) or a therapist led support group. They were measured for brain activity with an electroencephalogram (EEG) before and after treatment and opioid use at 3-month follow-up. In one experiment they measure the EEG response (Late Positive Potential (LPP)) while being presented with opioid cues (pictures of pills and pill bottles) or a neutral picture either normally or while attempting to not react or judge the stimuli. In a separate experiment with a similar procedure except that the participants were presented with natural reward pictures (e.g., social affiliation, natural beauty, and athletic victories) or neutral pictures.

 

They found that before treatment opioid and natural reward stimuli reliably produced significantly larger Late Positive Potentials (LPP) indicating that the LPP reflected emotional responses to rewards. After treatment the group that received Mindfulness-Oriented Recovery Enhancement (MORE) had significantly smaller LPP responses to opioid related cues than the support group. When the participants were asked to not react or judge the stimuli the MORE group had significantly greater reductions in the LPP. Importantly, the participants in the MORE group had a significantly larger LPPs to natural reward stimuli and when the participants were asked to not react or judge the natural reward stimuli the MORE group had a significantly larger increases in the LPP.

 

They also investigated the subjective emotional responses of the participants to the opioid and natural reward stimuli and found that after Mindfulness-Oriented Recovery Enhancement (MORE) the participants had larger increases in response to natural reward stimuli and smaller responses to opioid related stimuli. At the 3 month follow-up they found that MORE reduced the use of opioids to a greater extent than the support group and that it did so directly and also indirectly by increasing natural reward responses which, in turn, reduced opioid use.

 

These results suggest that responses to the rewarding aspects of stimuli is important in opioid addiction and that Mindfulness-Oriented Recovery Enhancement (MORE) reduces opioid use in addicted individuals they demonstrate that MORE reduces emotional responses to opioid cues while amplifying responses to natural rewards. This suggests that mindfulness treatment reduces opioid use by altering the addict’s responses to stimuli related to the addiction and naturally rewarding stimuli; amplifying natural reward while suppressing opioid rewards. This makes opioids less rewarding and natural stimuli more rewarding.

 

So, mindfulness reduces addiction by altering pleasure appreciation in opioid users.

 

Mindfulness-Oriented Recovery Enhancement (MORE), increases the brain’s response to natural, healthy rewards while also decreasing the brain’s response to opioid-related cues.” – University of Utah

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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Study Summary

 

Garland, E. L., Atchley, R. M., Hanley, A. W., Zubieta, J. K., & Froeliger, B. (2019). Mindfulness-Oriented Recovery Enhancement remediates hedonic dysregulation in opioid users: Neural and affective evidence of target engagement. Science advances, 5(10), eaax1569. doi:10.1126/sciadv.aax1569

 

Abstract

Addiction neuroscience models posit that recurrent drug use increases reactivity to drug-related cues and blunts responsiveness to natural rewards, propelling a cycle of hedonic dysregulation that drives addictive behavior. Here, we assessed whether a cognitive intervention for addiction, Mindfulness-Oriented Recovery Enhancement (MORE), could restructure reward responsiveness from valuation of drug-related reward back to valuation of natural reward. Before and after 8 weeks of MORE or a support group control, prescription opioid users (N = 135) viewed opioid and natural reward cues while an electroencephalogram biomarker of target engagement was assessed. MORE was associated with decreased opioid cue-reactivity and enhanced capacity to regulate responses to opioid and natural reward cues. Increased positive affective responses to natural reward cues were associated with decreased craving and mediated MORE’s therapeutic effects on opioid misuse. This series of randomized experiments provide the first neurophysiological evidence that an integrative behavioral treatment can remediate hedonic dysregulation among chronic opioid users.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6795512/

 

Change the Brain to Reduce Chronic Pain with Mindfulness

Change the Brain to Reduce Chronic Pain with Mindfulness

 

By John M. de Castro, Ph.D.

 

While many experts recommend mindfulness-based practices to manage pain, the goal of those practices is typically not to remove pain entirely, but to change your relationship with it so that you are able to experience relief and healing in the middle of uncomfortable physical sensations.” – Jon Kabat-Zinn

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain.

 

There is an accumulating volume of research findings to demonstrate that mindfulness practices, in general, are effective in treating pain. Pain experiences are processed in the nervous system. So, it’s likely that mindfulness practices somehow alter the brain’s processing of pain. In today’s Research News article “The neural mechanisms of mindfulness-based pain relief: a functional magnetic resonance imaging-based review and primer.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6728003/), Zeidan and colleagues review and summarize the published research studies on the changes in the brain that accompany the relief of chronic pain by mindfulness-based treatments.

 

They report that mindfulness appears to reduce pain by increasing attention to the present moment. High levels of mindfulness are associated with lower pain experiences with chronic conditions and that these levels are associated with less activity in the, so called, default mode network in the brain (consisting of the medial prefrontal cortex, posterior cingulate cortex/precuneus, inferior, and lateral temporal cortices). The default mode network is thought to underlie self-referential thinking and mind wandering.

 

The research also reports that short-term meditation reduces chronic pain and increases communications between cortical areas and the thalamus suggesting top down control of pain sensitivity. On the other hand, long-term meditation practice reduces chronic pain by deactivating prefrontal cortical areas and activating somatosensory cortical regions. This suggests that long-term meditation reduces cognitive appraisals of arising sensory events. Finally, the research suggests that the neural mechanisms of mindfulness-based pain relief are different than opioid pain relief suggesting that there are different mechanisms involved.

 

Obviously, much more research is needed. But there is an evolving picture of the changes in the brain that occur with mindfulness practices that produce relief of chronic pain. It is different from that of opioid pain relievers and primarily involves high level, cortical, neural systems associated with attention to stimuli and the thought processes that arise evaluating those stimuli. In other words, mindfulness-based practices affect pain processing at the highest levels of attention and thinking.

 

So, change the brain to reduce chronic pain with mindfulness.

 

Chronic pain is frustrating and debilitating. The last thing we want to do is pay more attention to our pain. But that’s the premise behind mindfulness, a highly effective practice for chronic pain.” – Margarita Tartakovsky,

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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Study Summary

 

Zeidan, F., Baumgartner, J. N., & Coghill, R. C. (2019). The neural mechanisms of mindfulness-based pain relief: a functional magnetic resonance imaging-based review and primer. Pain reports, 4(4), e759. doi:10.1097/PR9.0000000000000759

 

Abstract

The advent of neuroimaging methodologies, such as functional magnetic resonance imaging (fMRI), has significantly advanced our understanding of the neurophysiological processes supporting a wide spectrum of mind–body approaches to treat pain. A promising self-regulatory practice, mindfulness meditation, reliably alleviates experimentally induced and clinical pain. Yet, the neural mechanisms supporting mindfulness-based pain relief remain poorly characterized. The present review delineates evidence from a spectrum of fMRI studies showing that the neural mechanisms supporting mindfulness-induced pain attenuation differ across varying levels of meditative experience. After brief mindfulness-based mental training (ie, less than 10 hours of practice), mindfulness-based pain relief is associated with higher order (orbitofrontal cortex and rostral anterior cingulate cortex) regulation of low-level nociceptive neural targets (thalamus and primary somatosensory cortex), suggesting an engagement of unique, reappraisal mechanisms. By contrast, mindfulness-based pain relief after extensive training (greater than 1000 hours of practice) is associated with deactivation of prefrontal and greater activation of somatosensory cortical regions, demonstrating an ability to reduce appraisals of arising sensory events. We also describe recent findings showing that higher levels of dispositional mindfulness, in meditation-naïve individuals, are associated with lower pain and greater deactivation of the posterior cingulate cortex, a neural mechanism implicated in self-referential processes. A brief fMRI primer is presented describing appropriate steps and considerations to conduct studies combining mindfulness, pain, and fMRI. We postulate that the identification of the active analgesic neural substrates involved in mindfulness can be used to inform the development and optimization of behavioral therapies to specifically target pain, an important consideration for the ongoing opioid and chronic pain epidemic.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6728003/

 

Yoga Practice May Help Prevent the Development of Type II Diabetes

Yoga Practice May Help Prevent the Development of Type II Diabetes

 

By John M. de Castro, Ph.D.

 

“Yoga can do more than just relax your body in mind — especially if you’re living with diabetes. Certain poses may help lower blood pressure and blood sugar levels while also improving circulation, leading many experts to recommend yoga for diabetes management.” – Healthline

 

Diabetes is a major health issue. It is estimated that 30 million people in the United States and nearly 600 million people worldwide have diabetes and the numbers are growing. Type II Diabetes results from a resistance of tissues, especially fat tissues, to the ability of insulin to promote the uptake of glucose from the blood. As a result, blood sugar levels rise producing hyperglycemia. Diabetes is heavily associated with other diseases such as cardiovascular disease, heart attacks, stroke, blindness, kidney disease, and circulatory problems leading to amputations. As a result, diabetes doubles the risk of death of any cause compared to individuals of the same age without diabetes.

 

Type 2 diabetes is a common and increasingly prevalent illness that is largely preventable. One of the reasons for the increasing incidence of Type 2 Diabetes is its association with overweight and obesity which is becoming epidemic in the industrialized world. A leading cause of this is a sedentary life style. Unlike Type I Diabetes, Type II does not require insulin injections. Instead, the treatment and prevention of Type 2 Diabetes focuses on diet, exercise, and weight control. Recently, mindfulness practices have been shown to be helpful in managing diabetes. A mindfulness practice that combines mindfulness with exercise is yoga and it has been shown to be helpful in the treatment of Type II Diabetes. Prevention is always better than treatments. So, it is important to investigate the ability of yoga practice to prevent Type II diabetes in at risk individuals.

 

In today’s Research News article “.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6795440/), Ramamoorthi and colleagues reviewed, summarized, and performed a meta-analysis of the published controlled research studies of the effectiveness of yoga practice in improving prediabetic symptoms. The found 14 published studies with a total of 834 participants.

 

They report that the published research found that yoga practice significantly improved prediabetic symptoms. They included a significant reduction in fasting blood glucose levels and systolic blood pressure, and improved blood lipid profiles including low density lipoproteins, cholesterol, and triglycerides.

 

This meta-analysis suggests that yoga practice is a safe and effective practice that improves the metabolic signs predictive of future Type II diabetes. It appears to improve glycemic control, blood lipid profiles, and blood pressure. These are very encouraging results. It will be important to follow-up over the long-term to see if these improvements are lasting and if they reduce the transition from then prediabetic state to Type II diabetes.

 

So, yoga practice may help prevent the development of Type II Diabetes.

 

yoga for diabetes provides unique benefits that can effectively restore the body to a state of natural health and proper function.” – Yoga U

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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Study Summary

 

Ramamoorthi, R., Gahreman, D., Skinner, T., & Moss, S. (2019). The effect of yoga practice on glycemic control and other health parameters in the prediabetic state: A systematic review and meta-analysis. PloS one, 14(10), e0221067. doi:10.1371/journal.pone.0221067

 

Abstract

A systematic review and meta-analysis was conducted to investigate the effects of yoga on glycemic control, lipid profiles, body composition and blood pressure in people in the pre-diabetic state. Studies on the effectiveness of yoga on population groups under high risk for diabetes, called prediabetic or suffering from metabolic syndromes were extracted from a thorough search of PubMed, Scopus, Cochrane Library, EBSCO and IndMED databases. Both Randomised Controlled Trial (RCT) and non-RCT studies were included in the systematic review and meta-analysis. Studies published between Jan 2002 and Dec 2018 were included. Studies were considered for evaluation if they investigated a yoga intervention to prevent T2DM, against a control group, while also reporting glycemic control and other health parameters of T2DM management. Summary effect sizes and 95% confidence intervals (CI) were calculated using the Comprehensive Meta-Analysis software in addition to publication bias. Of the 46,500 identified studies, 14 studies with 834 participants of whom were 50% women, were found to be eligible for inclusion in our systematic review. Our quantitative synthesis included 12 randomized control trials and 2 non-randomized control trials, with the follow-up period ranging from 4 to 52 weeks. Compared to controls, yoga intervention improved fasting blood glucose (FBG) [Standard Mean Difference (SMD -0.064 mg/dL (95% CI -0.201 to 0.074)]; low density lipoprotein (LDL) [SMD-0.090 mg/dL (95% CI -0.270 to 0.090)]; triglycerides [SMD -0.148 mg/dL (95% CI -0.285 to -0.012)]; total cholesterol [SMD -0.058 mg/dL (95% CI -0.220 to 0.104)] and systolic blood pressure [SMD -0.058 mm Hg (95% CI -0.168 to 0.053)]. This meta-analysis uncovered clinically improved effects of yoga intervention on glycemic control, lipid profiles and other parameters of T2DM management in prediabetic population. These results suggest that yoga intervention may be considered as a comprehensive and alternative approach to preventing T2DM. Further adequately powered, well designed RCTs are needed to support our findings and investigate the long-term effects of yoga in T2DM patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6795440/

 

Improve Attention Deficit Hyperactivity Disorder (ADHD) Symptoms in Children with Yoga

Improve Attention Deficit Hyperactivity Disorder (ADHD) Symptoms in Children with Yoga

 

By John M. de Castro, Ph.D.

 

research reports that yoga may help relieve attention-deficit hyperactivity disorder (ADHD) in children.” – Elaine Gavalas

 

Attention Deficit Hyperactivity Disorder (ADHD) is most commonly found in children, but for about half it persists into adulthood. It’s estimated that about 5% of the adult population has ADHD. Hence, this is a very large problem that can produce inattention, impulsivity, hyperactivity, and emotional issues, and reduce quality of life. The most common treatment is drugs, like methylphenidate, Ritalin, which helps reducing symptoms in about 30% of the people with ADHD. Unfortunately, the effectiveness of the drugs appears to be markedly reduced after the first year. In addition, the drugs often have troublesome side effects, can be addictive, and can readily be abused. So, drugs, at present, do not appear to be a good solution, only affecting some, only for a short time, and with unwanted side effects.

 

There are indications that mindfulness training may be an effective treatment for ADHD. It makes sense that it should be, as the skills and abilities strengthened by mindfulness training are identical to those that are defective in ADHD,  attentionimpulse controlexecutive functionemotion control, and mood improvement. In addition, unlike drugs, it is a relatively safe intervention that has minimal troublesome side effects. Yoga is both an exercise and a mindfulness practice. This could be particularly attractive for kids with ADHD.

 

In today’s Research News article “Effects of Yoga on Attention, Impulsivity, and Hyperactivity in Preschool-Aged Children with Attention-Deficit Hyperactivity Disorder Symptoms.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871620/), Cohen and colleagues recruited preschool children (3-5 years of age) who had at least 4 symptoms of Attention Deficit Hyperactivity Disorder (ADHD). They were randomly assigned to either 6 weeks of Yoga practice or a wait-list control condition. Yoga practice consisted of breathing exercises and poses and occurred twice a week at school in a group setting for 30 minutes and on other days at home guided by a DVD. Before and after the intervention and 6 weeks and 3 months later the parents and teachers completed measures of the children’s ADHD symptoms, emotional symptoms, conduct problems, peer problems, hyperactivity/inattention and prosocial behaviors. The children were also directly measured for attention in a computer-based test and for heart rate variability.

 

They found that for children with high Attention Deficit Hyperactivity Disorder (ADHD) symptom scores, yoga practice produced significant reductions in inattention and hyperactivity/inattention ratings by the parents. On the attention task, after the yoga intervention the children had significantly improved attention but also significantly higher distractibility. These findings were maintained at follow-up.

 

The results suggest that yoga practice is particularly beneficial for children who are high in Attention Deficit Hyperactivity Disorder (ADHD) symptoms improving their attentional ability and hyperactivity. These findings require further investigation to look closer at students with lower ADHD scores. But, they suggest that yoga practice may be beneficial in treating ADHD  in preschool children. Intervening this early in development may help to prevent ADHD development and/or prevent its transition into adulthood.

 

So, improve attention deficit hyperactivity disorder (ADHD) symptoms in children with yoga.

 

Pairing a hyperactive child with a quiet, slow form of exercise may sound counterintuitive and even disastrous, but it turns out yoga can be incredibly helpful for children with attention deficit hyperactivity disorder (ADHD).” – Dennis Thompson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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Study Summary

 

Cohen, S., Harvey, D. J., Shields, R. H., Shields, G. S., Rashedi, R. N., Tancredi, D. J., … Schweitzer, J. B. (2018). Effects of Yoga on Attention, Impulsivity, and Hyperactivity in Preschool-Aged Children with Attention-Deficit Hyperactivity Disorder Symptoms. Journal of developmental and behavioral pediatrics : JDBP, 39(3), 200–209. doi:10.1097/DBP.0000000000000552

 

Abstract

Objective

Behavioral therapies are first line treatments for preschoolers with ADHD. Studies support yoga as an intervention for school age children with ADHD; this study evaluated the effects of yoga in preschoolers on parent and teacher rated attention/challenging behaviors; attentional control (KiTAP); and heart rate variability (HRV).

Methods

This randomized waitlist-controlled trial tested a 6-week yoga intervention in preschoolers with ≥ 4 ADHD symptoms on the ADHD Rating Scale-IV Preschool Version. Group 1 (n=12) practiced yoga first; Group 2 (n=11) practiced yoga second. We collected data at four time points: baseline, T1 (6 wk), T2 (12 wk), follow-up (3 mo after T2).

Results

At baseline, there were no significant differences between Group 1 and 2 on any measure. At T1, Group 1 had faster reaction times on the KiTAP Go/No go task (p=.01, 95% CI: −371.1, −59.1, d=−1.7), fewer Distractibility errors of omission (p=.009, 95% CI: −14.2, −2.3, d=−1.5), but more commission errors (p=.02, 95% CI:1.4, 14.8, d=1.3) than Group 2. Children in Group 1 with more severe symptoms at baseline showed improvement at T1 not seen in Group 2 on parent-rated Strengths and Difficulties Questionnaire hyperactivity-inattention (β=−2.1, p=.04, 95% CI: −4.0, −0.1) and inattention on the ADHD Rating Scale (β=−4.4, p=.02, 95% CI: −7.9, −0.9). HRV measures did not differ between groups.

Conclusions

Yoga was associated with modest improvements on an objective measure of attention (KiTAP) and selective improvements on parent ratings. Yoga may be a promising treatment for ADHD symptoms in preschoolers.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871620/

 

Adolescent Characteristics that Predict Success of Mindfulness Therapy to Reduce Self-Harm and Suicidality

Adolescent Characteristics that Predict Success of Mindfulness Therapy to Reduce Self-Harm and Suicidality

 

By John M. de Castro, Ph.D.

 

The pain of depression is quite unimaginable to those who have not suffered it,  and it kills in many instances because its anguish can no longer be borne.
The prevention of many suicides will continue to be hindered until there is a general awareness of the nature of this pain.” – William Styron

 

Around 43,000 people take their own lives each year in the US. Someone dies from suicide every 12.3 minutes. Worldwide over 800,000 people die by suicide every year. (Suicide Awareness Voices of Education). It is much more prevalent with males who account for 79% of suicides. The problem is far worse than these statistics suggest as it has been estimated that for every completed suicide there were 12 unsuccessful attempts. In other words, about a half a million people in the U.S. attempt suicide each year. Yet compared with other life-threatening conditions there has been scant research on how to identify potential suicide attempters, intervene, and reduce suicidality.

 

Mindfulness training has been shown to reduce suicidality. Dialectical Behavior Therapy (DBT) is a mindfulness-based therapy targeted at changing the problem behaviors including self-injury and suicide. Behavior change is accomplished through focusing on changing the thoughts and emotions that precede problem behaviors, as well as by solving the problems faced by individuals that contribute to problematic thoughts, feelings and behaviors. In DBT five core skills are practiced; mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness. It is important to identify the characteristics of adolescents who are most likely to benefit from DBT for the reduction of suicide.

 

In today’s Research News article “Predictors and moderators of recurring self‐harm in adolescents participating in a comparative treatment trial of psychological interventions.” (See summary below or view the full text of the study at: https://onlinelibrary.wiley.com/doi/full/10.1111/jcpp.13099), Adrian and colleagues recruited adolescents with previous lifetime suicide attempt, repetitive self‐harm in the past 12 weeks, borderline personality disorder (BPD) characteristics, and clinically significant suicidal ideation. They were randomly assigned to receive 6-months of either Dialectical Behavior Therapy (DBT) or individual/group supportive therapy. They were measured before and after treatment and at the midpoint of treatment for suicide attempts, non-suicidal self-injuries, self-harm, prior self-harm severity, externalizing symptoms, other psychiatric disorders, substance abuse, PTSD symptoms, borderline personality disorder (BPD) symptoms, adolescent-parent conflict, and emotional dysregulation. In addition, their parents were measured for emotional distress and adolescent-parent conflict.

 

They found that non-white adolescents had a greater response to treatment than white adolescents in the reduction in suicide ideation. The adolescent’s pre-treatment history also affected the response to treatment with adolescents with greater levels of family conflict, more extensive self‐harm histories, and more externalizing problems having a greater reduction in self-harm. They also found that Dialectical Behavior Therapy (DBT) was more effective for adolescents who were high in emotional dysregulation and whose parents had greater psychopathology and emotional dysregulation.

 

These results are interesting and suggest that certain adolescents are more responsive to treatment than others. Non-white (particularly Latino) youths, adolescents with greater levels of family conflict, more extensive self‐harm histories, more externalizing problems, higher in emotional dysregulation and whose parents had greater psychopathology and emotional dysregulation had more positive changes produced by therapy. These factors may be used to triage which youths would be most likely to benefit from different therapies and thus may potentiate therapeutic benefits.

 

Suicide is a major problem for adolescents and self-harm, self-injury, suicide ideation, and suicide attempts are all indicators of potential lethal outcomes. So, treatment is extremely important. Dialectical Behavior Therapy (DBT) appears to be effective but it is particularly effective for certain youths. Knowing this can help target and refine therapy to improve therapeutic effectiveness in reducing suicides in adolescents.

 

So, reduce suicidality in certain adolescents with mindfulness.

 

“Being curious about your suicidal thoughts is another part of mindful observation. If you have the thought, “I should kill myself,” how does it affect the thought’s meaning to then tell yourself, “Hmm, I wonder why I just had the thought that I should kill myself?” – Stacey Freedenthal

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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Study Summary

 

Molly Adrian, Elizabeth McCauley, Michele S. Berk, Joan R. Asarnow, Kathryn Korslund, Claudia Avina, Robert Gallop, Marsha M. Linehan. Predictors and moderators of recurring self‐harm in adolescents participating in a comparative treatment trial of psychological interventions. Journal of Child Psychology and Psychiatry, 30 July 2019, 60(10), 1123-1132, https://doi.org/10.1111/jcpp.13099

 

Key points

  • Adolescent prior self‐harm, externalizing problems, and reported family conflict were significant predictors of change in self‐harm, NSSI, and suicidal ideation, where adolescents with higher family conflict and less severe self‐harm history produced on average more reduction in SH from baseline to post‐treatment.
  • DBT produced better rate of improvement compared to IGST for adolescents who were emotionally dysregulation and whose parents had higher baseline emotion dysregulation and psychopathology.
  • Clinicians could consider either IGST or DBT for adolescents with self‐harm histories whose parents are well regulated and do not have impairing psychopathology. Adolescents with emotional dysregulation and parents with psychopathology and emotion dysregulation may benefit more from DBT than IGST.

Abstract

Background

In primary analyses, dialectical behavior therapy (DBT) was associated with greater reduction in self‐harm during treatment than individual/group supportive therapy (IGST). The objective of this paper was to examine predictors and moderators of treatment outcomes for suicidal adolescents who participated in a randomized controlled trial evaluating DBT and IGST.

Methods

Adolescents (N = 173) were included in the intent‐to‐treat sample and randomized to receive 6 months of DBT or IGST. Potential baseline predictors and moderators were identified within four categories: demographics, severity markers, parental psychopathology, and psychosocial variables. Primary outcomes were suicide attempts (SA) and nonsuicidal self‐injury evaluated at baseline, midtreatment (3 months), and end of treatment (6 months) via the Suicide Attempt and Self‐Injury Interview (Psychological Assessment, 18, 2006, 303). For each moderator or predictor, a generalized linear mixed model was conducted to examine main and interactive effects of treatment and the candidate variable on outcomes.

Results

Adolescents with higher family conflict, more extensive self‐harm histories, and more externalizing problems produced on average more reduction on SH frequency from baseline to post‐treatment. Adolescents meeting BPD diagnosis were more likely to have high SH frequency at post‐treatment. Analyses indicated significant moderation effects for emotion dysregulation on NSSI and SH. DBT was associated with better rates of improvement compared to IGST for adolescents with higher baseline emotion dysregulation and those whose parents reported greater psychopathology and emotion dysregulation. A significant moderation effect for ethnicity on SA over the treatment period was observed, where DBT produced better rate of improvement compared to IGST for Hispanic/Latino individuals.

Conclusions

These findings may help to inform salient treatment targets and guide treatment planning. Adolescents that have high levels of family conflict, externalizing problems, and increased level of severity markers demonstrated the most change in self‐harm behaviors over the course of treatment and benefitted from both treatment interventions. Those with higher levels of emotion dysregulation and parent psychopathology may benefit more from the DBT.

https://onlinelibrary.wiley.com/doi/full/10.1111/jcpp.13099