Brain Activity Predicts the Effectiveness of Dialectical Behavior Therapy for Borderline Personality Disorder

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Brain Activity Predicts the Effectiveness of Dialectical Behavior Therapy for Borderline Personality Disorder

 

By John M. de Castro, Ph.D.

 

“Dialectical behavior therapy (DBT). . . is a type of psychotherapy, sometimes called “talk therapy,” used to treat borderline personality disorder (BPD). DBT is a form of cognitive behavioral therapy (CBT).” – Kristalyn Salters-Pedneault

 

Borderline Personality Disorder (BPD) is a very serious mental illness that is estimated to affect 1.6% of the U.S. population. It involves unstable moods, behavior, and relationships, problems with regulating emotions and thoughts, impulsive and reckless behavior, and unstable relationships. BPD is associated with high rates of co-occurring depression, anxiety disorders, substance abuse, eating disorders, self-harm, suicidal behaviors, and completed suicides. Needless to say, it is widespread and debilitating.

 

One of the few treatments that appears to be effective for Borderline Personality Disorder (BPD) is Dialectical Behavior Therapy (DBT). It is targeted at changing the problem behaviors characteristic of BPD including self-injury. 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.

 

The nervous system is a dynamic entity, constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. These changes in the brain are called neuroplasticity. It is unknown how Dialectical Behavior Therapy may interact with brain systems to improve the responsiveness of Borderline Personality Disorder (BPD) to Dialectical Behavior Therapy (DBT).

 

In today’s Research News article “Individualized treatment response prediction of dialectical behavior therapy for borderline personality disorder using multimodal magnetic resonance imaging.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6749487/), Schmitgen and colleagues recruited female patients suffering from Borderline Personality Disorder (BPD) who were treated with a 12-week program of Dialectical Behavior Therapy (DBT). They were classified into patients who had significantly benefited from treatment (responders) and those who did not (non-responders). Prior to the therapy the participants underwent functional Magnetic Resonance Imaging (fMRI) of their brains while performing cognitive reappraisal, sensory distraction and cognitive distraction tasks. They were also measured for BPD symptom severity, emotion regulation, dissociative experiences, anxiety, depression, and working memory.

 

They found that before treatment responders had significantly higher levels of borderline symptoms and borderline severity and higher anxiety levels than non-responders. They also found that activation of the amygdala and parahippocampus areas during a cognitive reappraisal task, along with borderline personality disorder severity and the gray matter volume of the amygdala produced the best predictors of responders vs. non-responders.

 

It appears that Dialectical Behavior Therapy (DBT) for Borderline Personality Disorder (BPD) works best with patients who have the most severe symptoms and whose amygdala and parahippocampus areas are largest and respond most to a cognitive reappraisal task. These areas are associated with the brain systems underlying emotion regulation. Hence, the results suggest that particularly severe borderline patients whose brains respond best to emotional stimuli are the best responders to DBT. This suggests that the patients whose brains are best able to regulate emotions respond best to DBT.

 

Hence, brain activity predicts the effectiveness of Dialectical Behavior Therapy (DBT) for Borderline Personality Disorder (BPD).

 

“one thing that has really helped in my recovery process, I would say dialectical behavior therapy. I eat, sleep and breathe DBT. I can give you a damn good crash course in mindfulness, which is a core concept in DBT. I can teach you about self-validation. I can spoon-feed you lessons and lessons on interpersonal effectiveness. DBT has truly been a gift to me.” – Borderline Beauty

 

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

 

Schmitgen, M. M., Niedtfeld, I., Schmitt, R., Mancke, F., Winter, D., Schmahl, C., & Herpertz, S. C. (2019). Individualized treatment response prediction of dialectical behavior therapy for borderline personality disorder using multimodal magnetic resonance imaging. Brain and behavior, 9(9), e01384. doi:10.1002/brb3.1384

 

Abstract

Introduction

Individualized treatment prediction is crucial for the development and selection of personalized psychiatric interventions. Here, we use random forest classification via pretreatment clinical and demographical (CD), functional, and structural magnetic resonance imaging (MRI) data from patients with borderline personality disorder (BPD) to predict individual treatment response.

Methods

Before dialectical behavior therapy (DBT), 31 female patients underwent functional (three different emotion regulation tasks) and structural MRI. DBT response was predicted using CD and MRI data in previously identified anatomical regions, which have been reported to be multimodally affected in BPD.

Results

Amygdala and parahippocampus activation during a cognitive reappraisal task (in contrasts displaying neural activation for emotional challenge and for regulation), along with severity measures of BPD psychopathology and gray matter volume of the amygdala, provided best predictive power with neuronal hyperractivities in nonresponders. All models, except one model using CD data solely, achieved significantly better accuracy (>70.25%) than a simple all‐respond model, with sensitivity and specificity of >0.7 and >0.7, as well as positive and negative likelihood ratios of >2.74 and <0.36 each. Surprisingly, a model combining all data modalities only reached rank five of seven. Among the functional tasks, only the activation elicited by a cognitive reappraisal paradigm yielded sufficient predictive power to enter the final models.

Conclusion

This proof of principle study shows that it is possible to achieve good predictions of psychotherapy outcome to find the most valid predictors among numerous variables via using a random forest classification approach.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6749487/

 

Increase Self-Compassion and Decrease Mind Wandering in Depression with Mindfulness

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Increase Self-Compassion and Decrease Mind Wandering in Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“MBCT program is a group intervention that allows participants to become aware of how conditioned patterns of mind and mood can trigger depression relapse and sustain current symptoms of depression.  Through the practice of mindful awareness, they develop the capacity to mindfully disengage from distressing moods and negative thoughts.” – Center for Mindfulness in Medicine

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. 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.

 

Mindfulness-Based Cognitive Therapy (MBCT) is an alternative treatment to drugs that was specifically developed to treat depression. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior. MBCT has been found to be effective in treating depression. The exact mechanisms by which MBCT improves depression need exploration.

 

In today’s Research News article “Compassionate Hearts Protect Against Wandering Minds: Self-compassion Moderates the Effect of Mind-Wandering on Depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6426326/), Greenberg and colleagues recruited depressed adults and randomly assigned them to receive either 8 weekly 2-hour sessions of Mindfulness-Based Cognitive Therapy (MBCT) or to a wait list control condition. MBCT participants were also asked to practice at home. All participants continued to receive their usual treatments. They were measured before and after treatment for depression, self-compassion, and mind wandering.

 

They found that prior to treatment the higher the levels of depression, the higher the levels of mind wandering and the lower the levels of self-compassion and that the higher the levels of self-compassion the lower the levels of mind wandering. They also found that participants who were low in mind wandering were significantly lower in depression, but only for participants who were also low in self-compassion. For those high in self-compassion there was no relationship between mind wandering and depression. Only those participants who were both low in self-compassion and high in mind wandering were depression scores high.

 

Compared to baseline and the wait-list controls, participants who received Mindfulness-Based Cognitive Therapy (MBCT) had significantly greater reductions in depression and mind wandering and increases in self-compassion.  They also found that the higher the levels of self-compassion at the beginning of training the larger the improvement in depression produced by MBCT. The improvements in depression were also associated with improvements in mind wandering.

 

The study reveals that self-compassion moderates the relationship of mind wandering with depression such that mind wandering is only associated with depression when self-compassion is low. In other words, when a participant has low levels of compassion for themselves they are vulnerable to the ability of a wandering mind to make depression worse. Mindfulness-Based Cognitive Therapy (MBCT) was shown to improve depression, mind wandering, and self-compassion and the degree of impact of MBCT on depression was dependent on the levels of self-compassion, with high self-compassion associated with greater improvement.

 

So, self-compassion appears to be a critical variable in the relationship of mind wandering with depression and the effectiveness of MBCT on depression. This further suggests that training in self-compassion may be able to help reduce depression and improve the impact of mindfulness-based treatments on depression.

 

So, increase self-compassion and decrease mind wandering in depression with mindfulness.

 

“ When you’re struggling with depression, the last thing you want to do is be self-compassionate. But this is precisely what can help.” – 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

 

Greenberg, J., Datta, T., Shapero, B. G., Sevinc, G., Mischoulon, D., & Lazar, S. W. (2018). Compassionate Hearts Protect Against Wandering Minds: Self-compassion Moderates the Effect of Mind-Wandering on Depression. Spirituality in clinical practice (Washington, D.C.), 5(3), 155–169. doi:10.1037/scp0000168

 

Abstract

Depression is associated with high levels of mind-wandering and low levels of self-compassion. However, little is known about whether and how these two factors interact with one another to influence depressive symptoms. The current study examined the interaction between mind-wandering, self-compassion and depressive symptoms in a depressed sample and tested the effects of an eight-week Mindfulness Based Cognitive Therapy (MBCT) program on these constructs. At baseline, mind-wandering was associated with higher depressive symptoms only among individuals with low self-compassion. Self-compassion additionally predicted depressive improvement. As expected, MBCT increased self-compassion and reduced mind-wandering compared to a treatment-as-usual control group. Overall, longitudinal changes in self-compassion produced a moderation effect similar to the one at baseline so that increases in mind-wandering were associated with increases in depressive symptoms only among those who decreased in self-compassion. Results provide the first evidence that self-compassion can protect against the deleterious effects of mind-wandering among depressed participants, both at baseline and longitudinally. Findings also suggest that self-compassion is an effective predictor of depressive improvement. Finally, MBCT is effective not only at reducing depressive symptoms, but also at targeting protective and risk factors associated with depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6426326/

 

Secret of Happiness

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Nunchi

 

I read a wonderful article in the New York Times by Euny Hong entitled “The Korean Secret to Happiness and Success” (https://www.nytimes.com/2019/11/02/opinion/sunday/nunchi.html). It emphasizes the impact of the Korean word “nunchi” on their world view and their way of life. “Nunchi” is literally translated as “eye measure.” It suggests that every situation should be seen as a whole and the individual’s actions should be appropriate for the entire human context.

 

The fact is that most human behavior is affected mainly by a few aspects of the situation that the individual deems particularly salient and important. These might be people who are particularly important, or special friends or family, or enemies. Although this to some extent makes sense, it results in relegating everything and everyone else to the background. The totality of the situation is lost.

 

To students of mindfulness, it should be apparent that “nunchi” is the same as present moment awareness. It is being totally conscious of what is going on in the immediate environment. It is also non-judgmental, perceiving everything just as it is. But it is more in that the interrelationships of all things, what the Buddha called “interdependent co-arising” has to be seen, “eye measured.” It involves seeing the total picture as a gestalt, with not only the immediate components but also how they all interrelate.

 

There’s a Korean saying that “half of social life is nunchi.” This implies that seeing the entire social context in total in the present moment is extremely important to successfully navigating the social situation. When apprising a room full of people, the practice of “nunchi” would dictate taking in the whole scene and feeling the mood of the entire room, be it celebratory, somber, gleeful, sad, angry, etc.. Each individual in the room is then seen within the context. If there’s an angry sense to the room, the behavior of each person is seen against that backdrop. If one individual is neutral, they will actually be viewed as positive, as neutral is in the positive direction from angry. This better allows the individual to react and interact with the person with greater understanding and a more accurate interpretation of the behavior, which, in turn, allows for more calibrated and effective responses. Others tend to like better and interact more with people who practice “nunchi.”

 

In the process of “eye measuring” there is little opportunity for talking. So, “nunchi” usually involves more listening and less talking. It’s been said that we learn nothing new when we’re speaking. So, by practicing “nunchi” and listening more we have the opportunity to learn and be better positioned for future interactions. People respond very positively when they feel that they are being heard. Listening is a rare yet extremely valuable skill that is promoted by the practice of “nunchi.”

 

“Nunchi” allows for better identification of what can be controlled and what can’t. Seeing things and people as they are and as a whole should make it clear what kinds of impacts our behavior can have and what are the likely consequences of those behaviors. In other words, being completely in the present moment strengthens the ability to intervene for the good.

 

The Korean’s clearly understand the importance of present moment awareness and by making it an important word in the language, “nunchi”, make it front and center in their minds. They have long recognized it importance for effective interactions. The mindfulness revolution in the western world is simply helping us catch up.

 

So, practice “nunchi”, being mindful and aware, and be happier.

 

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

 

Reduce the Complexity of Brain Activity with Meditation

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Reduce the Complexity of Brain Activity with Meditation

 

By John M. de Castro, Ph.D.

 

“intensive and continued meditation practice is associated with enduring improvements in sustained attention.” – Anthony Zanesco

 

There has accumulated a large amount of research demonstrating that meditation practice has significant benefits for psychological, physical, and spiritual wellbeing. One way that meditation practices may produce these benefits is by altering the brain. The nervous system is a dynamic entity, constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. These changes in the brain are called neuroplasticity. Over the last decade neuroscience has been studying the effects of contemplative practices on the brain and has identified neuroplastic changes in widespread areas. In other words, meditation practice appears to mold and change the brain, producing psychological, physical, and spiritual benefits.

 

It is important to understand what are the exact changes in the brain that are produced by meditation. Studies of changes in brain activity with meditation suggest that meditators have more complicated information processing going on in their nervous systems at rest but during meditation greatly simplify that activity. But there are, a wide variety of meditation techniques that may have different consequences for brain changes. One category of these techniques is focused attention meditation, where the individual practices paying attention to a single meditation object, learns to filter out distracting stimuli, including thoughts, and learns to stay focused on the present moment, filtering out thoughts centered around the past or future.

 

In today’s Research News article “Controlling the Temporal Structure of Brain Oscillations by Focused Attention Meditation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6585826/), Irrmischer and colleagues examine the changes in brain activity with focused meditation. They recruited experienced meditators (> 5 years of experience) and meditation naïve control participants. They measured their brain activity with an Electroencephalogram (EEG) after eye closed rest and after 5 minutes of focused meditation. In a second study they recruited experienced meditators and healthy control participants. They again measured their brain activity with an Electroencephalogram (EEG) during and after eye closed rest and during and after 5 minutes of focused meditation.

 

In study 1, compared to after a rest condition, after focused meditation there were significant changes in cognitive content with a reduction in theory of mind, planning, sleepiness, verbal thought, health concerns, and discontinuity of mind, and increase in somatic awareness. Also, in comparison to baseline and the control participants, during focused meditation there was a reduction in the complexity of the brain activity with a reduction in long-range temporal correlations across every frequency band and across brain areas. These differences in the EEG were confirmed in study 2 and they found that after 1 year of meditation training there was a further significant reduction in the complexity of brain activity with a reduction in long-range temporal correlations. These differences were also present after eyes closed rest without meditation suggesting that there was an overall reduction in neural activity complexity.

 

These results are interesting and suggest that meditation changes the brain over time to produce less complexity in brain activity. This is similar to previous findings using a different analytic technique that meditation reduces the complexity of neural processing. It is not known but this decrease in complexity of brain activity may be reflective of the ability of meditation practice to increase attention and decrease mind wandering. Greater focus with less distraction would reduce the complexity of brain activity. This would make the brain more efficient and better able to carry out its important cognitive functions. These cognitive changes were reflected in the cognitive contents after meditation.

 

So, reduce the complexity of brain activity with meditation.

 

“bringing attention back to the breath each time you feel your mind wandering during meditation helps strengthen the brain’s neural circuitry for focus.” – Nicole Bayes-Fleming

 

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

 

Irrmischer, M., Houtman, S. J., Mansvelder, H. D., Tremmel, M., Ott, U., & Linkenkaer-Hansen, K. (2018). Controlling the Temporal Structure of Brain Oscillations by Focused Attention Meditation. Human brain mapping, 39(4), 1825–1838. doi:10.1002/hbm.23971

 

Abstract

Our focus of attention naturally fluctuates between different sources of information even when we desire to focus on a single object. Focused attention (FA) meditation is associated with greater control over this process, yet the neuronal mechanisms underlying this ability are not entirely understood. Here, we hypothesize that the capacity of attention to transiently focus and swiftly change relates to the critical dynamics emerging when neuronal systems balance at a point of instability between order and disorder. In FA meditation, however, the ability to stay focused is trained, which may be associated with a more homogeneous brain state. To test this hypothesis, we applied analytical tools from criticality theory to EEG in meditation practitioners and meditation‐naïve participants from two independent labs. We show that in practitioners—but not in controls—FA meditation strongly suppressed long‐range temporal correlations (LRTC) of neuronal oscillations relative to eyes‐closed rest with remarkable consistency across frequency bands and scalp locations. The ability to reduce LRTC during meditation increased after one year of additional training and was associated with the subjective experience of fully engaging one’s attentional resources, also known as absorption. Sustained practice also affected normal waking brain dynamics as reflected in increased LRTC during an eyes‐closed rest state, indicating that brain dynamics are altered beyond the meditative state. Taken together, our findings suggest that the framework of critical brain dynamics is promising for understanding neuronal mechanisms of meditative states and, specifically, we have identified a clear electrophysiological correlate of the FA meditation state.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6585826/

 

Meditation Practice is Growing Rapidly Among Children and Adolescents

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Meditation Practice is Growing Rapidly Among Children and Adolescents

 

By John M. de Castro, Ph.D.

 

“It’s almost as though meditation was designed for kids. They just ‘get it’ – there is this elasticity and freedom in their minds which allows them to be present in the moment and free from any external thoughts or pressures.” – Andy Puddicombe

 

Childhood is a miraculous period during which the child is dynamically absorbing information from every aspect of its environment. This occurs almost without any intervention from the adults as the child appears to be programmed to learn. It is here that behaviors, knowledge, skills, and attitudes are developed that shape the individual. Adolescence is a time of mental, physical, social, and emotional growth. It is during this time that higher levels of thinking, sometimes called executive function, develops.

 

Childhood and adolescence can be difficult times, fraught with challenges. During this time the child transitions to young adulthood; including the development of intellectual, psychological, physical, and social abilities and characteristics. There are so many changes occurring during this time that the child or adolescent can feel overwhelmed and unable to cope with all that is required.

 

Mindfulness training for children and adolescents has been shown to have very positive effects. These include academic, cognitive, psychological, and social domains. Mindfulness training has been shown to improve emotion regulation and to benefit the psychological and emotional health of adolescents. Importantly, mindfulness training with children and adolescents appears to improve the self-concept, improves attentional ability and reduces stress. These benefits are becoming more widely appreciated and should have led to greater numbers of children and adolescents practicing meditation.

 

In today’s Research News article “Prevalence, patterns, and predictors of meditation use among U.S. children: Results from the National Health Interview Survey.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6502253/), Wang and Gaylord analyzed the data from the 2017 National Health Interview Survey, separating that  obtained from children and adolescents. They recorded meditation use, health records, and health care utilization.

 

They found that 7.4% of the children and adolescents practiced meditation. This was a very large increase from the 1.6% that was found in 2012. 1.0% of the children and adolescents used mantra meditation, 1.6% used mindfulness meditation, 4.0% used spiritual meditation, and 3.0% practiced meditation as part of yoga, tai chi, or qigong. They also found that meditation was more likely to be used by youths whose parent completed some college, had headaches, depression, or a respiratory allergy, and who lived in the western U.S. Children or adolescents who had medical conditions were more likely to use mindfulness meditation. Surprisingly, neither age, gender, race, nor socioeconomic status was associated with different frequencies of meditation use.

 

These results are interesting and document the tremendous increase in the acceptability and utilization of meditation practice by children and adolescents over the last 5 years. This has probably occurred due to the increased recognition of the benefits of mindfulness practices for the physical and psychological health of children and adolescents and it’s increased practice in schools. It will be interesting to see if this trend continues over the next 5 years.

 

“Our kids’ brains are tired, and children of all ages really need opportunities where they can take time out each day “unplugged” to relax and focus. Meditation offers this break and helps kids function more effectively and clearly.” – Healthy Children

 

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

 

Wang, C., Li, K., & Gaylord, S. (2019). Prevalence, patterns, and predictors of meditation use among U.S. children: Results from the National Health Interview Survey. Complementary therapies in medicine, 43, 271–276. doi:10.1016/j.ctim.2019.02.004

 

Abstract

Objectives:

The purpose of the study is to examine the characteristics of various types of meditation use (i.e., mantra, mindful, and spiritual meditation) among U.S. children.

Methods:

Using 2017 National Health Interview Survey, we examined the prevalence, patterns, and potential predictors of meditation use among U.S. children aged 4 to 17 years. Descriptive statistics, Wald F chi-square test, and multivariable logistic regression were used for data analysis (n = 6925).

Results:

Overall meditation use has increased substantially from 1.6% in 2012 to 7.4% in 2017 among children in the US. Children with chronic medical conditions were more likely to use mindful meditation (Adjusted Odds Ratio (AOR) = 1.9–3.6, 95% CI [1.0–7.4]). Regularly taking prescription medication had an inverse relation with mantra meditation use (AOR = 0.4, 95% CI [0.2–0.9]). Children with delayed medical care due to access difficulties were more likely to use spiritual meditation, compared to those who did not (AOR = 1.7, 95% CI [1.1–2.6]).

Conclusions:

Meditation use has rapidly increased among U.S. children within the past few years. Future studies should explore the underlying reasons for this increase and its potential benefits for pediatric meditators.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6502253/

 

Spirituality is Associated with Lower Suicidality in Adolescents

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Spirituality is Associated with Lower Suicidality in Adolescents

 

By John M. de Castro, Ph.D.

 

“suicide is never the right answer. The more we can nurture a sense of connectedness and purpose in our lives (of “spirituality”), the less likely people will be tempted to “end it all.” – Eben Alexander

 

After cancer and heart disease, suicide accounts for more years of life lost than any other cause. Around 43,000 people take their own lives each year in the US. Someone dies from suicide every 12.3 minutes. It is estimated that worldwide about a million people die by suicide every year. 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.

 

Depression and other mood disorders are the number-one risk factor for suicide. More than 90% of people who kill themselves have a mental disorder, whether depression, bipolar disorder or some other diagnosis. So, the best way to prevent suicide may be to treat the underlying cause. For many this means treating depression. Spirituality may help to provide meaning and prevent suicide. But there is scant research on the relationship of spirituality and religiosity and suicide.

 

In today’s Research News article “The role of social support and spiritual wellbeing in predicting suicidal ideation among marginalized adolescents in Malaysia.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6565529/), Ibrahim and colleagues recruited adolescents from low income families and measured them for suicide ideation, social support, and spiritual well-being.

 

They found that the higher the levels of social support, and spiritual well-being the lower the levels of suicide ideation. It should be recognized that this study was correlational and as such no conclusions regarding causation can be reached. The results suggest clear negative relationships between spirituality and social support and suicide ideation in adolescents from low income families. Being spiritual and having social support are related to having few, if any, thoughts regarding suicide. It remains for future research to establish whether improving spirituality and/or social support would result in fewer thoughts about suicide.

 

So, spirituality is associated with lower suicidality in adolescents.

 

“I personally think spirituality is a part of each of our beings. It has been the difference in my life and has walked me back from the place where I thought suicide was my only option. Maybe spirituality can be the difference in someone else’s life, too.” – Kelli Evans

 

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

 

Ibrahim, N., Che Din, N., Ahmad, M., Amit, N., Ghazali, S. E., Wahab, S., … A Halim, M. (2019). The role of social support and spiritual wellbeing in predicting suicidal ideation among marginalized adolescents in Malaysia. BMC public health, 19(Suppl 4), 553. doi:10.1186/s12889-019-6861-7

 

Abstract

Background

The high number of adolescents and young adults harbouring suicidal ideation, as reported by the Ministry of Health Malaysia, is alarming. This cross-sectional study aims to examine the association between social support and spiritual wellbeing in predicting suicidal ideation among Malaysian adolescents.

Methods

A total of 176 adolescents in selected urban areas in the states of Wilayah Persekutuan and Selangor were selected. The Suicide Ideation Scale (SIS) was used to measure the level of severity or tendency of suicidal ideation. The Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure the perceived social support received by the respondent while the Spiritual Wellbeing Scale (SWBS) was used to measure the religious wellbeing (RWB), the existential wellbeing (EWB) and the overall score of spiritual wellbeing (SWB).

Results

The study found that both RWB and EWB showed significant negative correlation with suicidal ideation. Similarly, support from family and friends also showed a negative correlation with suicidal ideation. Further analysis using multiple regressions showed that RWB and SWB, and family support predict suicidal ideation in adolescents.

Conclusion

Spiritual wellbeing in combination with family support plays a major role in predicting suicidal ideation. Therefore, intervention for encompassing spirituality and family support may contribute to a more positive outcome in suicidal adolescents.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6565529/

 

Improve Physical and Mental Health in Trauma Victims with Bikram Yoga

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Improve Physical and Mental Health in Trauma Victims with Bikram Yoga

 

By John M. de Castro, Ph.D.

 

“The steamy temps “allow you to increase their range of motion and stretch deeper within each pose,” since heat makes muscles more pliable, says Numbers. Unlike stretching it out in a standard cool yoga studio, the heat will have you feeling like a pro and extending further than you thought you could.” – Aryelle Siclait

 

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime. Trauma can produce troubling physical and psychological symptoms that need to be addressed. There are a number of therapies that have been developed to treat the effects of trauma. One of which, mindfulness training has been found to be particularly effective. Yoga practice is a mindfulness practice that has been shown to be helpful for trauma survivors.

 

Yoga is a mindfulness practice that has been shown to improve physical well-being and cardiovascular health. Bikram Yoga is somewhat unique yoga practice as it employs a set sequence of 26 poses (asanas) and two breathing exercises. It is practiced in a heated environment (105°F, 40.6°C, 40% humidity) and there is a unique programmed instructional dialogue. The hot environment is thought to soften the muscles making them more pliable and loosen the joints making them more flexible allowing the practitioner to go deeper into poses. The sweating that occurs is thought to help remove toxins and impurities.

 

In today’s Research News article “#MindinBody – feasibility of vigorous exercise (Bikram yoga versus high intensity interval training) to improve persistent pain in women with a history of trauma: a pilot randomized control trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6714085/), Flehr and colleagues recruited adult pre-menopausal women who had persistent pain and who had experienced trauma. They were randomly assigned to receive 8 weeks of 3 sessions per week of Bikram Yoga (90 minutes) or High Intensity Interval Training (45 minutes). The women were measured before and after training for pain severity, pain interference with quality of life, health, anxiety, depression, perceived stress, disorders of extreme stress, self-efficacy, life stressors, mindfulness, body size, and electrocardiogram (EKG) measures.

 

They found that pain significantly decreased for both groups. On the other hand, Bikram Yoga produced significantly greater improvements in physical functioning, mental health, and heart rate variability with moderate to large effect sizes. No intervention related injuries were reported. Heart rate variability has been shown to measure greater parasympathetic nervous system activity reflecting better overall health.

 

The results suggest that although both programs produced decreased pain intensity, Bikram Yoga was superior to a comparable high intensity exercise in improving the physical and mental health of trauma survivors with persistent pain. A strength of the study is that the Bikram Yoga intervention was compared to another high intensity exercise program, thus reducing the likelihood of participant expectancy effects. Hence Bikram Yoga appears to be a safe and effective treatment for women who have experienced trauma. It would be interesting in the future to compare the Bikram Yoga program to a comparable yoga program practiced at room temperature.

 

So, improve physical and mental health in trauma victims with Bikram Yoga.

 

“Hot yoga addresses all aspects of physical fitness including muscular strength, endurance, flexibility and weight loss. . . . There is no other style of yoga that addresses the overall health of the body in such a comprehensive way.” – Peter Mason

 

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

 

Flehr, A., Barton, C., Coles, J., Gibson, S. J., Lambert, G. W., Lambert, E. A., … Dixon, J. B. (2019). #MindinBody – feasibility of vigorous exercise (Bikram yoga versus high intensity interval training) to improve persistent pain in women with a history of trauma: a pilot randomized control trial. BMC complementary and alternative medicine, 19(1), 234. doi:10.1186/s12906-019-2642-1

 

Abstract

Background

The neurobiology of persistent pain shares common underlying psychobiology with that of traumatic stress. Modern treatments for traumatic stress often involve bottom-up sensorimotor retraining/exposure therapies, where breath, movement, balance and mindfulness, are used to target underlying psychobiology. Vigorous exercise, in particular Bikram yoga, combines many of these sensorimotor/exposure therapeutic features. However, there is very little research investigating the feasibility and efficacy of such treatments for targeting the underlying psychobiology of persistent pain.

Methods

This study was a randomized controlled trail (RCT) comparing the efficacy of Bikram yoga versus high intensity interval training (HIIT), for improving persistent pain in women aged 20 to 50 years. The participants were 1:1 randomized to attend their assigned intervention, 3 times per week, for 8 weeks. The primary outcome measure was the Brief Pain Inventory (BPI) and further pain related biopsychosocial secondary outcomes, including SF-36 Medical Outcomes and heart rate variability (HRV), were also explored. Data was collected pre (t0) and post (t1) intervention via an online questionnaire and physiological testing.

Results

A total of 34 women were recruited from the community. Analyses using ANCOVA demonstrated no significant difference in BPI (severity plus interference) scores between the Bikram yoga (n = 17) and the HIIT (n = 15). Women in the Bikram yoga group demonstrated significantly improved SF-36 subscale physical functioning: [ANCOVA: F(1, 29) = 6.17, p = .019, partial eta-squared effect size (ηp2) = .175 and mental health: F(1, 29) = 9.09, p = .005, ηp2 = .239; and increased heart rate variability (SDNN): F(1, 29) = 5.12, p = .013, ηp2 = .150, scores compared to the HIIT group. Across both groups, pain was shown to decrease, no injuries were experienced and retention rates were 94% for Bikram yoga and 75% for HIIT .

Conclusions

Bikram yoga does not appear a superior exercise compared to HIIT for persistent pain. However, imporvements in quality of life measures and indicator of better health were seen in the Bikram yoga group. The outcomes of the present study suggest vigorous exercise interventions in persistent pain cohorts are feasible.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6714085/

 

High Frequency of Yoga Practice Produces Greater Benefits

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High Frequency of Yoga Practice Produces Greater Benefits

 

By John M. de Castro, Ph.D.

 

“Regular yoga practice creates mental clarity and calmness; increases body awareness; relieves chronic stress patterns; relaxes the mind; centers attention; and sharpens concentration. Body- and self-awareness are particularly beneficial, because they can help with early detection of physical problems and allow for early preventive action.” – Natalie Nevins

 

Yoga practice has been shown to have a myriad of benefits for psychological and physical health, social, and spiritual well-being. It is both an exercise and a mind-body practice that stresses both mental attention to present moment movements, breath control, and flexibility, range of motion, and balance. There has, however, not been much attention paid to the characteristics of practice that are important for producing maximum benefits.

 

In today’s Research News article “Effects of Yoga Asana Practice Approach on Types of Benefits Experienced.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746050/), Wiese and colleagues emailed a questionnaire to a large sample of yoga practitioners. They were asked for demographic information and to describe their yoga practice and physical, mental, emotional, spiritual, and relational benefits of yoga.

 

They found that the higher the frequency of practice the greater the physical, mental, emotional, spiritual, and relational benefits. Weaker relationships were found between consistency of practice, teaching yoga, and teacher experience and the benefits. In addition, there was a relationship between the frequency of practice without a teacher and self-confidence. Evening practice was found to be a negative predictor of benefits.

 

These findings suggest, as has been previously reported, that yoga practice produces myriad of benefits for psychological and physical health, social, and spiritual well-being. The characteristic of practice that was most highly related to these benefits was how many times per week yoga was practiced, particularly when the practice occurred 5 or more times per week; the more practice, the greater the benefits. Also associated with benefits were consistency of practice, teaching yoga, and teacher experience, while evening practice was associated with less benefit.

 

It should be noted that these results are correlations and caution must be exercised in assigning causation. But the findings are consistent with finding from controlled studies, suggesting that yoga practice produces great benefit.

 

So, practice frequently to obtain the greatest benefits from yoga practice.

 

“Multiple studies have confirmed the many mental and physical benefits of yoga. Incorporating it into your routine can help enhance your health, increase strength and flexibility and reduce symptoms of stress, depression and anxiety. Finding the time to practice yoga just a few times per week may be enough to make a noticeable difference when it comes to your health.” – Rachel Link

 

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

 

Wiese, C., Keil, D., Rasmussen, A. S., & Olesen, R. (2019). Effects of Yoga Asana Practice Approach on Types of Benefits Experienced. International journal of yoga, 12(3), 218–225. doi:10.4103/ijoy.IJOY_81_18

 

Abstract

Context:

Modern science and the classic text on hatha yoga, Hatha Yoga Pradipika, report physical, mental, emotional, spiritual, and relational benefits of yoga practice. While all have specific suggestions for how to practice, little research has been done to ascertain whether specific practice approaches impact the benefits experienced by practitioners.

Aims:

Our aim was to relate the experience level of the practitioner, the context of practice approaches (time of day, duration of practice, frequency of practice, etc.), and experience level of the teacher, to the likelihood of reporting particular benefits of yoga.

Methods:

We conducted a cross-sectional descriptive survey of yoga practitioners across levels and styles of practice. Data were compiled from a large voluntary convenience sample (n = 2620) regarding respondents’ methods of practice, yoga experience levels, and benefits experienced. Multiple logistic regression was used to identify approaches to yoga practice that positively predicted particular benefits.

Results:

Frequency of practice, either with or without a teacher, was a positive predictor of reporting nearly all benefits of yoga, with an increased likelihood of experiencing most benefits when the practitioner did yoga five or more days per week. Other aspects of practice approach, experience level of the practitioner, and the experience level of the teacher, had less effect on the benefits reported.

Conclusions:

Practice frequency of at least 5 days per week will provide practitioners with the greatest amount of benefit across all categories of benefits. Other practice approaches can vary more widely without having a marked impact on most benefits experienced.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746050/

 

Improve Adolescent Psychological Health with Mindfulness

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Improve Adolescent Psychological Health with Mindfulness

 

By John M. de Castro, Ph.D.

 

“It may be that mindfulness leads to an increase in self-compassion and a decrease in experiential avoidance. It may be selective attention — if you focus on your breath, you have less bandwidth to ruminate. There are a lot of factors that are operative and we’re just beginning to tease out and deconstruct them. It’s like tasting a soup with 10 spices. Is there one main ingredient or is the flavor a combination of things?” – Stuart Eisendrath

 

Adolescence is a time of mental, physical, social, and emotional growth. It is during this time that higher levels of thinking, sometimes called executive function, develops. But adolescence can be a difficult time, fraught with challenges. During this time the child transitions to young adulthood; including the development of intellectual, psychological, physical, and social abilities and characteristics. There are so many changes occurring during this time that the child can feel overwhelmed and unable to cope with all that is required.

 

Indeed, up to a quarter of adolescents suffer from depression or anxiety disorders, and an even larger proportion struggle with subclinical symptoms. Mindfulness training in adults has been shown to reduce anxiety and depression levels and improve emotional regulation. In addition, in adolescents it has been shown to improve emotion regulation and to benefit the psychological and emotional health.

 

In today’s Research News article “Effects Of Modified Mindfulness-Based Stress Reduction (MBSR) On The Psychological Health Of Adolescents With Subthreshold Depression: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6758632/), Zhang and colleagues recruited university students (aged 18-22 years) who scored high in depression but were not at clinically diagnosable levels. They were randomly assigned to receive either an 8-week Mindfulness-Based Stress Reduction (MBSR) program or to a no-treatment control condition. They were measured before and after training for depression, mindfulness, and rumination.

 

The MBSR program consists of 8 weekly 1-hour group sessions involving meditation, yoga, body scan, and discussion. The participants are also encouraged to perform daily practice. The program was modified to be better targeted at adolescents. It instructed the adolescents on the application of mindfulness practices to everyday life, including experiencing the pleasant/sad moments in life, walking, sleeping, eating, breathing and exercising to keep the attitude of “mindfulness”.

 

They found that in comparison to baseline and the no-treatment control condition the Mindfulness-Based Stress Reduction (MBSR) program produced large and significant decreases in depression and rumination and increases in mindfulness. Hence, the study demonstrated that a Mindfulness-Based Stress Reduction (MBSR) modified for adolescents is a safe and effective treatment to improve the psychological health of adolescents who had subclinical levels of depression.

 

It should be mentioned that the control condition did not include any activities and thus leaves open the possibilities of confounding by experimenter or participant bias or placebo effects. Also, the lack of a standard MBSR program for comparison to the modified program does not allow for a conclusion that the modifications produced an improved program. Nevertheless the results are encouraging that the modified MBSR program may be useful in relieving the suffering of the large numbers of adolescents with sub-clinical depression.

 

So, improve adolescent psychological health with mindfulness.

 

“It is well-documented that mindfulness helps to relieve depression and anxiety in adults.1-4 A small but growing body of research shows that it may also improve adolescent resilience to stress through improved cognitive performance and emotional regulation.” – Malka Main

 

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

 

Zhang, J. Y., Ji, X. Z., Meng, L. N., & Cai, Y. J. (2019). Effects Of Modified Mindfulness-Based Stress Reduction (MBSR) On The Psychological Health Of Adolescents With Subthreshold Depression: A Randomized Controlled Trial. Neuropsychiatric disease and treatment, 15, 2695–2704. doi:10.2147/NDT.S216401

 

Abstract

Background

Sub-threshold depression (SD) has been associated with impairments in adolescent health which increase the rate of major depression. Researchers have shown the effectiveness of mindfulness on mental health, however whether the traditional mindful skills were suitable for youngsters, it was not clear. This study investigated the effects of a tailed Mindfulness-based stress reduction (MBSR) on their psychological state.

Methods

A double-blind, randomized controlled trial was carried out. 56 participants who met the inclusion criteria agreed to be arranged randomly to either the MBSR group (n=28) or the control group (n=28). Participants in MBSR group received a tailored 8-week, one time per week, one hour each time group intervention. The effectiveness of intervention was measured using validated scales, which including BDI-II, MAAS, RRS at three times (T1-before intervention; T2-after intervention; T3-three months after intervention). A repeated-measures analysis of variance model was used to analyze the data.

Results

The results showed significant improvements in MBSR group comparing with control group that depression level decreased after the 8-week intervention and the follow up (F =17.721, p < 0.00). At the same time, RRS score was significantly decreased at T2 and T3(F= 28.277, p < 0.00). The results also showed that MBSR promoted the level of mindfulness and the effect persisted for three months after intervention (F=13.489, p < 0.00).

Conclusion

A tailored MBSR intervention has positive effects on psychology health among SD youngsters, including decrease depression and rumination level, cultivate mindfulness.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6758632/

 

Mindfulness and Sense of Control are Independently Associated with Emotions

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Mindfulness and Sense of Control are Independently Associated with Emotions

 

By John M. de Castro, Ph.D.

 

“the truth is that meditation does not eradicate mental and emotional turmoil. Rather, it cultivates the space and gentleness that allow us intimacy with our experiences so that we can relate quite differently to our cascade of emotions and thoughts. That different relationship is where freedom lies.” – Sharon Salzburg

 

Mindfulness practice has been shown to improve emotions and their regulation. Practitioners demonstrate more positive and less negative emotions and the ability to fully sense and experience emotions, while responding to them in appropriate and adaptive ways. In other words, mindful people are better able to experience yet control their responses to emotions. The ability of mindfulness training to improve emotion regulation is thought to be the basis for a wide variety of benefits that mindfulness provides to mental health and the treatment of mental illness especially depression and anxiety disorders.

 

This may indicate that mindfulness training improves the sense of control over our inner life.

In today’s Research News article “The Associations Between Dispositional Mindfulness, Sense of Control, and Affect in a National Sample of Adults.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093486/), Imel and colleagues examine the relationship of sense of control with mindfulness’ ability to improve emotions. They recruited a large sample of adults (from 28 to 84 years of age) and had them complete measures of mindfulness, sense of control, positive and negative emotions, religiousness and spirituality, neuroticism, openness to experience, and extraversion.

 

Employing a moderation analysis, they demonstrated that the sense of control was strongly positively associated with positive emotions and negatively associated with negative emotions. In addition, mindfulness was also associated with positive and negative emotions. But mindfulness was not associated with sense of control. These results are interesting and suggest that mindfulness did not affect emotions by altering the individuals’ sense that they were in control of themselves. Rather, it would appear that mindfulness and sense of control are independently associated with emotions.

 

Thus, mindfulness and sense of control are independently associated with emotions.

 

“The key to overcoming these difficult emotions is mindfulness! Practicing mindfulness enables you to calm down and soothe yourself. In this state, you have space to reflect and thoughtfully respond, rather than react.” – Toni Parker

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

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

 

Study Summary

 

Imel, J. L., & Dautovich, N. D. (2018). The Associations Between Dispositional Mindfulness, Sense of Control, and Affect in a National Sample of Adults. The journals of gerontology. Series B, Psychological sciences and social sciences, 73(6), 996–1005. doi:10.1093/geronb/gbw092

 

Abstract

Objectives

The present study examined factors associated with better affective experiences across the life span, extending existing research to older adults. Specifically, we investigated dispositional mindfulness and sense of control as predictors of affect and sense of control as a potential mediator of the mindfulness—affect associations.

Method

We hypothesized that dispositional mindfulness mediated by sense of control would predict affective outcomes. An archival analysis of a sample of 4,962 adults, aged 28 to 84 years, was conducted using the Midlife in the U.S. national survey (MIDUS-II). Exploratory analyses were conducted with age as a moderator in all associations.

Results

Greater dispositional mindfulness predicted more positive and negative affect irrespective of age. Dispositional mindfulness did not predict sense of control. Greater sense of control predicted more positive and less negative affect, and these associations were significantly moderated by age. Sense of control did not mediate the dispositional mindfulness—affect associations.

Discussion

The present study extends existing research on the dispositional mindfulness—positive affect association to older ages. The sense of control and positive and negative affect associations are enhanced and buffered, respectively, at older ages, indicating that the association between control and affect differs by age.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093486/