Relieve Depression in Latino Immigrants with Mindfulness Meditation

psyjdc Leave a comment

Relieve Depression in Latino Immigrants with Mindfulness Meditation

 

By John M. de Castro, Ph.D.

 

“with practice, meditation can help many people control how they react to the stress and anxiety that often leads to depression,” – John Denninger

 

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. Clearly, there is a need for treatment alternatives that can be effective alone or in combination with drugs.

 

A particularly vulnerable population is Latino immigrants. They experience many forms of stress while attempting to acculturate to the new culture which frequently produces depression. Mindfulness practices including meditation have been found to be effective in relieving depression and preventing its reoccurrence. There is, however, a lack of studies of the effectiveness of meditation practice on depression in stressed Latino immigrant populations.

 

In today’s Research News article “Mindfulness meditation and improvement in depressive symptoms among Spanish- and English speaking adults: A randomized, controlled, comparative efficacy trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6611613/), Lopez-Maya and colleagues recruited adult Latino immigrants who reported high levels of psychological distress and stress. They were randomly assigned to receive 6 weeks of once a week for 2 hours group-based sessions in either mindfulness meditation or health education. The mindfulness meditation program consisted of “mindful sitting meditation, mindful eating, appreciation meditation, friendly or loving-kindness meditation, mindful walking, and mindful movement.” They were measured before and after training for depression, mindfulness, and perceived stress.

 

They found that in comparison to baseline and the health education group, after mindfulness meditation training there was a significant reduction in depression with small to moderate effect size, and large significant increases in mindfulness with large effect size. Hence, the mindfulness meditation program was successful in improving mindfulness and relieving depression in a Latino immigrant population.

 

The fact that mindfulness meditation training reduced depression is not surprising as the efficacy of this training for depression has been well established with a large number of studies. What the current study establishes is that mindfulness meditation training is effective in treating depression in Latino immigrants who are stressed and are experiencing psychological distress. Immigration is difficult and challenging. The present results suggest that mindfulness meditation training is a safe and effective method to help alleviate the psychological effects of these stresses and thereby improve the well-being of the immigrants. Future studies should evaluate the long-term effectiveness of this training for depression.

 

So, relieve depression in latino immigrants with mindfulness meditation.

 

“Depression is rooted in fears about the future and regrets about the past. Focusing on the moment, not the past or the future, is the secret behind meditation’s power.” – Eoc Institute

 

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

 

Lopez-Maya, E., Olmstead, R., & Irwin, M. R. (2019). Mindfulness meditation and improvement in depressive symptoms among Spanish- and English speaking adults: A randomized, controlled, comparative efficacy trial. PloS one, 14(7), e0219425. doi:10.1371/journal.pone.0219425

 

Abstract

Objective

Latino immigrants experience acculturative stress and increased depression risk. Mindfulness meditation improves depressive symptoms, yet the vast majority of research has focused on English speaking populations.

Methods

In this randomized clinical trial with 2 parallel treatment groups, adults with moderate levels of perceived stress (n = 76) were recruited from the Los Angeles community from October 2015 to March 2016, stratified into Spanish- (n = 36) and English speaking (n = 40) language groups, and randomized for 6 weeks of treatment with standardized mindful awareness practices (MAPs) or health education (HE). Main outcome measure was depressive symptoms, measured by the Beck Depression Inventory.

Results

Using an intent-to-treat analysis, the primary outcome, depressive symptoms as indexed by the Beck Depression Inventory, showed greater improvement in MAPs vs. HE, with a between-group post-intervention mean difference of -2.2 (95% CI -4.4 – -0.07) and effect size of 0.28; similar effect sizes were found in the the Spanish- (0.29) and English speaking (0.30) groups. MAPs showed significant improvement relative to HE on secondary outcome of mindfulness with between group difference of 10.7 (95% CI4.5–16.9), but not perceived stress.

Conclusion

The comparable efficacy of Spanish and English formats of mindfulness meditation in improving depressive symptoms suggests that this community based intervention may mitigate depression risk in Latino adults who are experiencing social adversity.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6611613/

 

Change the Brain’s Electrical Activity to during Sleep and Wakefulness with Meditation

psyjdc Leave a comment

Change the Brain’s Electrical Activity to during Sleep and Wakefulness with Meditation

 

By John M. de Castro, Ph.D.

 

“Soon after beginning a meditation practice, many people report needing less sleep.” – Eoc Institute

 

We spend about a third of our lives in sleep, but we know very little about it. It is known that sleep is not a unitary phenomenon. Rather, it involves several different states that can be characterized by differences in physiological activation, neural activity, and subjective experiences. In the waking state the nervous system shows EEG activity that is termed low voltage fast activity. The electrical activity recorded from the scalp is rapidly changing but only with very small size waves. When sleep first occurs, the individual enters into a stage called slow-wave sleep, sometimes called non-REM sleep. The heart rate and blood pressure decline even further and the muscles become very soft and relaxed. In this state the EEG shows a characteristic waveform known as the theta rhythm, which is a large change in voltage recorded that oscillates at a rate of 4 to 8 cycles per second. As the individual goes even deeper into sleep something remarkable happens as the individual enters into rapid eye movement sleep (REM sleep). Here the muscles become extremely inhibited and flaccid, but the eyes move rapidly under the closed eyelids as if the individual was looking around. At the same time the heart rate and blood pressure increase and become very variable and sometimes very high.

 

It has been shown that mindfulness training, including meditation practice, affects sleep and tends to improve sleep and reduce insomnia. But there is need to further investigate the effects of meditation practice, particularly long-term meditation practice, on brain activity during sleep and wakefulness to begin to understand the mechanisms by which meditation practice affects sleep and wakefulness.

 

In today’s Research News article “Acute effects of meditation training on the waking and sleeping brain: Is it all about homeostasis?” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534352/), Dentico and colleagues recruited long-term meditators (at least 3-years of experience) and a group of age and gender matched non-meditators. They had their overnight electroencephalograms (EEG) recorded during sleep and after waking in the lab under three conditions, baseline, after a day of intensive focused meditation, and after a day of intensive loving kindness meditation. The meditation simulated a meditation retreat format for 2 days. The non-meditators rested during similar periods. They were also measured for depression, mental health issues, sleep disorders, insomnia, fatigue, sleepiness, and common phenomenological features of meditation.

 

They found that the sleep and waking EEGs were not different between the two types of meditation, focused or loving kindness. After intensive meditation practice there were significant increases after sleep in waking slow (8 hz.) and fast (15 hz.) waves in the EEG recorded from the prefrontal and parietal cortical regions. They also reported that the greater the amount of previous meditation experience the greater the waking high frequency waveforms after a day of intensive meditation. They also found that the EEG activities in in the theta frequency range (4-8 hz.) in different brain regions were highly related during non-REM sleep in long-term meditators.

 

These results are interesting and suggest that long-term meditation changes the brains activity during both sleep and wakefulness. The regions most affected, the prefrontal and parietal cortical regions, are associated with attentional processes. So, the results suggest that long-term meditation changes the brain to improve its ability to focus attention. They also suggest that long-term meditation increases the synchronization in different brain regions of activity during non-REM sleep. This may signal deeper levels of sleep. Regardless, the results suggest that meditation experience changes the brain’s activity in sleep and wakefulness.

 

So, change the brain’s electrical activity to during sleep and wakefulness with meditation.

 

“meditation has lasting effects on the plastic brain, and that gamma activity during non-REM sleep may be a reliable marker for the extent of these changes.” – Plastic Brain

 

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

 

Dentico D, Bachhuber D, Riedner BA, Ferrarelli F, Tononi G, Davidson RJ, Lutz A. Acute effects of meditation training on the waking and sleeping brain: Is it all about homeostasis? Eur J Neurosci. 2018 Sep;48(6):2310-2321. doi: 10.1111/ejn.14131. PMID: 30144201; PMCID: PMC6534352.

 

Abstract

Our recent finding of a meditation-related increase in low-frequency NREM sleep EEG oscillatory activities peaking in the theta-alpha range (4–12 Hz) was not predicted. From a consolidated body of research on sleep homeostasis, we would expect a change peaking in slow wave activity (1–4 Hz) following an intense meditation session. Here we compared these changes in sleep with the post-meditation changes in waking rest scalp power to further characterize their functional significance. High-density EEG recordings were acquired from 27 long-term meditators (LTM) on three separate days at baseline and following two 8-hr sessions of either mindfulness or compassion-and-loving-kindness meditation. Thirty-one meditation-naïve participants (MNP) were recorded at the same time points. As a common effect of meditation practice, we found increases in low and fast waking EEG oscillations for LTM only, peaking at eight and 15 Hz respectively, over prefrontal, and left centro-parietal electrodes. Paralleling our previous findings in sleep, there was no significant difference between meditation styles in LTM as well as no difference between matched sessions in MNP. Meditation-related changes in wakefulness and NREM sleep were correlated across space and frequency. A significant correlation was found in the EEG low frequencies (<12 Hz). Since the peak of coupling was observed in the theta-alpha oscillatory range, sleep homeostatic response to meditation practice is not sufficient to explain our findings. Another likely phenomenon into play is a reverberation of meditation-related processes during subsequent sleep. Future studies should ascertain the interplay between these processes in promoting the beneficial effects of meditation practice.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534352/

 

Improve Coping with Chronic Pain with Yoga

psyjdc Leave a comment

Improve Coping with Chronic Pain with Yoga

 

By John M. de Castro, Ph.D.

 

“By first understanding chronic pain as a mind-body experience and then using yoga’s toolbox of healing practices—including breathing exercises and restorative poses—you can find true relief from pain and begin to reclaim your life.” – Kelly McGonigal

 

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.

 

Pain involves both physical and psychological issues. The stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. So, reducing the emotional reactions to pain may be helpful in pain management. There is an accumulating volume of research findings to demonstrate that mind-body therapies have highly beneficial effects on the health and well-being of humans. Mindfulness practices have been shown to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. Indeed, mindfulness practices, in general, are effective in treating pain and specific practices such as yoga can be effective for the relief of chronic pain.

 

In today’s Research News article “Yoga for People With Chronic Pain in a Community-Based Setting: A Feasibility and Pilot RCT.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6689911/), Schmid and colleagues recruited adult pain patients from a pain clinic who had chronic pain for at least 6 months. They received treatment as usual but half were randomly assigned to receive an additional program of yoga practice for 60 minutes, twice a week, for 8 weeks, including both seated and standing poses. They were measured before and after training for pain severity, pain interference with daily activities, mental and physical quality of life, self-efficacy, and body responsiveness.

 

They found that after treatment the yoga group had significant improvements in pain interference with daily activities, self-efficacy surrounding pain management, physical function, and coping with symptoms, confidence to address pain and chronic disease, and body responsiveness. Hence, it appears that yoga practice, while not altering pain severity itself, does improve the patients’ ability to manage the pain and prevent it from interfering with their daily activities and thereby improve their quality of life. Chronic pain produces suffering, which interferes with the conduct of the patients’ lives. Relief is critical. Yoga practice appears to produce a modicum of that relief.

 

So, improve coping with chronic pain with yoga.

 

“Yoga can be helpful in pain management with both physical and mental benefits, but yoga is not a quick fix solution. Yoga has many of the same benefits as mindfulness practice, due to the common focus on breath, body and present moment awareness. Because yoga is also a physical practice many people find yoga more accessible than traditional meditation practices, which are undertaken in stillness.” – PainHealth

 

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

 

Schmid, A. A., Fruhauf, C. A., Sharp, J. L., Van Puymbroeck, M., Bair, M. J., & Portz, J. D. (2019). Yoga for People With Chronic Pain in a Community-Based Setting: A Feasibility and Pilot RCT. Journal of evidence-based integrative medicine, 24, 2515690X19863763. doi:10.1177/2515690X19863763

 

Abstract

The purpose of this feasibility pilot study was to assess benefits of 8 weeks of yoga in people with chronic pain. Participants completed baseline assessments and were randomized to yoga or usual care. Yoga was offered twice a week for 8 weeks. We assessed feasibility and the Brief Pain Inventory (BPI) was the primary outcome, assessing pain-severity and pain interference on daily activities. Eighty-three people were recruited; 67 people completed the study and were included in the analyses. Average age of participants was 50.78 ± 10.43 years and most participants had pain >10 years. The intervention appeared feasible and there were significant improvements (P < .05) in multiple measures for the yoga group, including a decrease in BPI interference scores from 7.15 ± 1.70 to 6.14 ± 2.21 (P = .007). There was a significant difference in body responsiveness and pain management scores between groups at 8 weeks. It appears that yoga was feasible and positively influenced multiple outcome measures for people with chronic pain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6689911/

 

Improve Psychological Need Satisfaction in School Students with Mindfulness

psyjdc Leave a comment

Improve Psychological Need Satisfaction in School Students with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness does much more than just create a positive classroom culture. Some of the purported benefits of mindfulness include decreasing stress and anxiety, improving self-esteem and self-regulation, and increasing calm.” – Lily Jones

 

Adolescence is a time of mental, physical, social, and emotional growth. 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. The stresses can create difficulties in satisfying the adolescent’s needs and create frustration with the lack of need satisfaction.

 

Mindfulness training has been shown in adolescents to improve emotion regulation and to benefit the psychological and emotional health. Autonomy-supportive teaching involves taking students’ perspectives, offering choices to students, and providing rationales to decision making. This type of teaching may help adolescents to make better decisions and be better able to satisfy their needs. So, it would make sense to study the relationships of mindfulness and autonomy-supportive teaching on need satisfaction and frustration in adolescents.

 

In today’s Research News article “Autonomy-Supportive Teaching and Basic Psychological Need Satisfaction among School Students: The Role of Mindfulness. International journal of environmental research and public health.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6679142/), Li and colleagues recruited Chinese secondary school children (grades 7-12) and had them complete a questionnaire. They answered questions as to the autonomy-supportiveness of their Physical Education teacher, their need satisfaction, need frustration, and mindfulness.

 

They found that the higher the levels of autonomy-supportive teaching the higher the levels of mindfulness and need satisfaction and the lower the levels of need frustration. In addition, they found that the higher the levels of mindfulness the higher the levels of need satisfaction and the lower the levels of need frustration. Multiple regression analysis revealed that the relationship of autonomy-supportive teaching with higher need satisfaction and lower need frustration was greater with greater levels of mindfulness. A path analysis revealed the mindfulness was related to higher need satisfaction and lower need frustration both directly and indirectly by being associated with higher levels of autonomy-supportive teaching.

 

It should be kept in mind that the study was correlational and as such causation cannot be determined. Regardless, the study suggests that a teaching strategy of encouraging autonomy and decision making may enhance mindfulness and in turn improve ability to satisfy needs and decrease frustration. That mindfulness may enhance the influence of autonomy-supportive teaching makes sense as the development of mindfulness may provide a more accurate and non-judgmental awareness of the current environment allowing autonomous decision making to be better tailored to the current state of affairs and thereby be more effective.

 

So, improve psychological need satisfaction in school students with mindfulness.

 

“Students who received the mindfulness training reported that their stress levels went down after the training, while the students in the control group did not. Students in the mindfulness training group also reported fewer negative feelings, such as sadness or anger, after the training.” – Science Daily

 

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

 

Li, C., Kee, Y. H., Kong, L. C., Zou, L., Ng, K. L., & Li, H. (2019). Autonomy-Supportive Teaching and Basic Psychological Need Satisfaction among School Students: The Role of Mindfulness. International journal of environmental research and public health, 16(14), 2599. doi:10.3390/ijerph16142599

 

Abstract

Grounded in self-determination theory, the purpose of this study was to investigate the relationships between autonomy-supportive teaching, mindfulness, and basic psychological need satisfaction/frustration. Secondary school students (n = 390, Mage = 15) responded to a survey form measuring psychological constructs pertaining to the research purpose. A series of multiple regression analysis showed that autonomy-supportive teaching and mindfulness positively predicted need satisfaction and negatively predicted need frustration. In addition, the associations between autonomy-supportive teaching and need satisfaction/frustration were moderated by mindfulness. Students higher in mindfulness were more likely to feel need satisfaction and less likely to experience need frustration, even in a low autonomy-supportive teaching environment. These results speak to the relevance of creating autonomy-supportive teaching environments and highlight mindfulness as a potential pathway to basic psychological need satisfaction in educational settings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6679142/

 

Improve the Psychological Well-Being of Lupus Patients with Mindfulness

psyjdc Leave a comment

Improve the Psychological Well-Being of Lupus Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“For someone with lupus who suffers from persistent joint or muscular pain, the struggle to find relief can be stressful and exhausting. But mindfulness meditation is not about fighting. It’s all about acceptance. And once you have achieved calm, it can help you regain a much-needed sense of control when your disease brings you discomfort.” – Lupus Foundation

 

Autoimmune diseases occur when the body’s systems that are designed to ward off infection attack the individual’s own tissues. Lupus is an autoimmune disease that affects a variety of organ systems including kidneys, joints, skin, blood, brain, heart and lungs. Lupus can produce fever, joint pain, stiffness and swelling, butterfly-shaped rash on the face or rashes elsewhere on the body, skin lesions that appear or worsen with sun exposure, fingers and toes that turn white or blue when exposed to cold or during stressful periods, shortness of breath, chest pain, dry eyes, headaches, confusion and memory loss. Lupus strikes between 10 to 25 people per 100,000, or about 322,000 cases in the U.S.

 

The symptoms of Lupus can look like a number of other diseases so it is hard to diagnose lupus. It is tipped off in many patients by the distinctive facial rash. There are no known cures for lupus and treatment is targeted at symptom relief. Drug treatments include pain relievers, corticosteroids, immunosuppressants, and even antimalarial drugs. Mindfulness practices have been shown to be effective for a wide variety of illnesses and to improve the immune system. So, it is possible that mindfulness training could improve Lupus and its symptoms.

 

Acceptance 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.

 

In today’s Research News article “Efficacy of Acceptance and Commitment Therapy in Reducing Disappointment, Psychological Distress, and Psychasthenia among Systemic Lupus Erythematosus (SLE) Patients.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6702277/), Sahebari and colleagues recruited female lupus patients and were randomly assigned to receive 8 weekly sessions of Acceptance and Commitment Therapy (ACT) or treatment as usual. They were measured before and after treatment for depression, psychological distress, fatigue, disappointment, and psychasthenia.

 

They found that in comparison to baseline and the treatment as usual control condition, the lupus patients who received Acceptance and Commitment Therapy (ACT) had significantly lower levels of psychological distress, psychasthenia, and disappointment with large effect sizes. psychasthenia is a psychological disorder characterized by phobias, obsessions, compulsions, or excessive anxiety. Hence, ACT appears to be effective in improving the psychological state of lupus patients. It can be speculated that ACT has its benefits for lupus patients by increasing mindfulness and the patients’ ability to accept their situation without judgement.

 

So, improve the psychological well-being of lupus patients with mindfulness.

 

“Improvement was observed in several areas: patients’ increased ability to differentiate between themselves and the disease; increased ability to accept, rather than to actively fight the fact that one must live with the disease; and decreased behavioral avoidance. These observations speak to the significant therapeutic potential of mindfulness practice among SLE patients” – Danny Horash

 

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

 

Sahebari, M., Asghari Ebrahimabad, M. J., Ahmadi Shoraketokanlo, A., Aghamohammadian Sharbaf, H., & Khodashahi, M. (2019). Efficacy of Acceptance and Commitment Therapy in Reducing Disappointment, Psychological Distress, and Psychasthenia among Systemic Lupus Erythematosus (SLE) Patients. Iranian Journal of Psychiatry, 14(2), 130–136.

 

Abstract

Objective: The aim of this study was to evaluate the efficacy of acceptance and commitment therapy (ACT) in the reduction of disappointment, psychological distress, and psychasthenia among patients with systemic lupus erythematosus (SLE).

Method : This quasi-experimental study was conducted on 24 females with lupus who referred to the Rheumatoid Disease Research Center (RDRC) of Ghaem hospital in Mashhad, Iran. This study had a pretest-posttest control group design. The participants were randomly assigned into 2 groups of experimental and control. The experimental group was treated with ACT. Data were collected using the Beck’s Hopelessness Scale, Kessler’s Psychological Distress Inventory, and Krupp’s Psychasthenia Inventory.

Results: Mean age and mean duration of illness were 37.25±4.61 and 5.12±2.33 years, respectively. The mean disappointment score and psychological distress in the experimental group were lower compared to those in control group at the post experimental stage (P<0.001). Moreover, there was a significant difference between the experimental and control groups in the mean scores of psychasthenia in the posttest stage (P<0.001).

Conclusion: According to the obtained results of this study, the enhancement of psychological flexibility based on ACT positively affected disappointment, psychological distress, and psychasthenia among the lupus patients. Therefore, it can be concluded that this therapeutic approach could reduce psychasthenia in patients through clarification of the values.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6702277/

 

Treat Cancer with Mindfulness

psyjdc Leave a comment

By John M. de Castro, Ph.D.

 

“A cancer diagnosis brings an awareness of the preciousness of life,” Fine explains. “And mindfulness can help us to experience that precious life with greater clarity, balance, and gratitude, one moment at a time.” – Micki Fine

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. Coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis. In addition, cancer patients are often challenged with a wide range of residual issues including chronic pain, sleep disturbance, sexual problems, loss of appetite, and chronic fatigue. Cancer survivors are also at greater risk for developing second cancers and other health conditions.

 

But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. It is estimated that 15 million adults and children with a history of cancer are alive in the United States today. Hence there is a need to identify safe and effective treatments for the physical, emotional, and financial hardships that can persist for years after diagnosis and treatment.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. The evidence is rapidly accumulating, so it makes sense to step back and summarize what has been learned.

 

In today’s Research News article “Evidence for the Role of Mindfulness in Cancer: Benefits and Techniques.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6623989/), Mehta and colleagues review and summarize the published research literature on the effectiveness of mindfulness practice to relieve the physical and psychological suffering of cancer patients. They identified 124 published research studies using a variety of mindfulness training programs, most of which involved either the Mindfulness-Based Stress Reduction (MBSR) program or Mindfulness-Based Cognitive Therapy (MBCT) or versions of MBSR. or MBCT that were modified for the needs of cancer patients.

 

They report that the published research finds that mindfulness training is safe, resulting in few if any negative effects and effective, producing significant improvements in cancer-related stress, depression, pain intensity, fatigue, loss of appetite and weight loss, insomnia, immune responses, and psychological responses to chemotherapy. Mindfulness training also improved the ability of caregivers for cancer patients to deal with the psychological stresses. They also report that studies indicate that mindfulness training is cost effective in treating cancer patients compared to other approaches. Hence, the research to date suggests that mindfulness training is a safe, effective, and cost effective treatment for a variety of cancer-related problems in cancer survivors and their caregivers.

 

So, treat cancer with mindfulness.

 

“results show promise for mindfulness-based interventions to treat common psychological problems such as anxiety, stress, and depression in cancer survivors and to improve overall quality of life.” – Linda Carlson

 

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

 

Mehta, R., Sharma, K., Potters, L., Wernicke, A. G., & Parashar, B. (2019). Evidence for the Role of Mindfulness in Cancer: Benefits and Techniques. Cureus, 11(5), e4629. doi:10.7759/cureus.4629

 

Abstract

Mindfulness is being used increasingly in various aspects of cancer management. Benefits of mindfulness practices are being observed to manage the adverse effects of treatment, symptoms from cancer progression, and the cost-effectiveness compared to conventional contemporary management strategies. In this review article, we present clinical trial data showing the benefits of mindfulness in various aspects of cancer management as well as techniques that have been commonly used in this practice.

Conclusions

Mindfulness-based practices are being increasingly utilized in various aspects of cancer management. It has shown utility in multiple prospective trials and continues to be explored. Most of the evidence of the benefit of mindfulness in cancer is to reduce toxicity and stress. There is a need for more prospective trials exploring its use in reducing cancer incidence or preventing its recurrence.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6623989/

 

Improve Tinnitus by Changing the Brain with Mindfulness

psyjdc Leave a comment

Improve Tinnitus by Changing the Brain with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The mindfulness approach is radically different from what most tinnitus sufferers have tried before, and it may not be right for everyone. We are confident, however, that the growing research base has demonstrated how it can offer an exciting new treatment to people who may have found that traditional treatment has not been able to help them yet.” – Liz Marks

 

Tinnitus is one of the most common symptoms to affect humanity. People with tinnitus live with a phantom noise that can range from a low hiss or ringing to a loud roar or squeal which can be present constantly or intermittently. It can have a significant impact on people’s ability to hear, concentrate, or even participate in everyday activities. Approximately 25 million to 50 million people in the United States experience it to some degree. Approximately 16 million people seek medical attention for their tinnitus, and for up to two million patients, debilitating tinnitus interferes with their daily lives.

 

There are a number of treatments for tinnitus including, counseling, sound therapy, drugs, and even brain stimulation. Unfortunately, none of these treatments is very effective. Mindfulness practices have been shown to be effective in treating Tinnitus. 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 mindfulness practices may change the brain to improve tinnitus.

 

In today’s Research News article “Functional Brain Changes During Mindfulness-Based Cognitive Therapy Associated With Tinnitus Severity.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6667657/), Zimmerman and colleagues recruited adult participants in an 8-week Mindfulness-Based Cognitive Therapy (MBCT) program consisting of 2-hour weekly sessions and 40-60 minutes daily home practice. The MBCT program consists of mindfulness training and Cognitive Behavioral Therapy (CBT). During therapy the patient is trained to investigate and alter aberrant thought patterns underlying their reactions to tinnitus symptoms. The participants brains were scanned before and after the MBCT program, and at follow-up 8 weeks later with functional Magnetic resonance Imaging (fMRI) and were measured for tinnitus, anxiety, depression, and mindfulness.

 

They found that the MBCT program produced a significant reduction in tinnitus symptoms that were maintained at the 8-week follow-up. With the fMRI scans they found widespread changes in brain functional connectivity following the MBCT program. Significantly, they found a reduced connectivity between the amygdala and parietal cortex that was negatively correlated with the reduction in tinnitus symptoms. In other words, the greater the decrease in functional connectivity, the greater the reductions in tinnitus symptoms. It will require further research to determine how this connectivity change might be related to tinnitus symptoms.

 

The study demonstrated that the Mindfulness-Based Cognitive Therapy (MBCT) program reduces the symptoms of tinnitus in a lasting way. The brain scan results suggest that alterations of the functional connectivity of brain areas may underlie the symptom improvements. It will require considerably more research to determine the exact nature of the changes and their relationship to tinnitus. But the study is a good first start.

 

So, improve tinnitus by changing the brain with mindfulness.

 

“Mindfulness is a special kind of awareness: it . . . frees you to be more present in your immediate experience, so that you can wake up to the wonder of the one life you are given. Others have found that cultivating this practice has helped reduce the negative impact of tinnitus on their lives. The more open you can be to whatever you are experiencing at any moment, the more awake, alive, happy, and balanced you can be.” – Jennifer Gans

“

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

 

Zimmerman, B., Finnegan, M., Paul, S., Schmidt, S., Tai, Y., Roth, K., … Husain, F. T. (2019). Functional Brain Changes During Mindfulness-Based Cognitive Therapy Associated With Tinnitus Severity. Frontiers in Neuroscience, 13, 747. doi:10.3389/fnins.2019.00747

 

Abstract

Mindfulness-based therapies have been introduced as a treatment option to reduce the psychological severity of tinnitus, a currently incurable chronic condition. This pilot study of twelve subjects with chronic tinnitus investigates the relationship between measures of both task-based and resting state functional magnetic resonance imaging (fMRI) and measures of tinnitus severity, assessed with the Tinnitus Functional Index (TFI). MRI was measured at three time points: before, after, and at follow-up of an 8-week long mindfulness-based cognitive therapy intervention. During the task-based fMRI with affective sounds, no significant changes were observed between sessions, nor was the activation to emotionally salient compared to neutral stimuli significantly predictive of TFI. Significant results were found using resting state fMRI. There were significant decreases in functional connectivity among the default mode network, cingulo-opercular network, and amygdala across the intervention, but no differences were seen in connectivity with seeds in the dorsal attention network (DAN) or fronto-parietal network and the rest of the brain. Further, only resting state connectivity between the brain and the amygdala, DAN, and fronto-parietal network significantly predicted TFI. These results point to a mostly differentiated landscape of functional brain measures related to tinnitus severity on one hand and mindfulness-based therapy on the other. However, overlapping results of decreased amygdala connectivity with parietal areas and the negative correlation between amygdala-parietal connectivity and TFI is suggestive of a brain imaging marker of successful treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6667657/

 

Therapeutic Alliance is Important for Success in Treating Cancer Patients with Mindfulness

psyjdc Leave a comment

 

Therapeutic Alliance is Important for Success in Treating Cancer Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Compared with [treatment as usual], MBCT and eMBCT were similarly effective in reducing psychological distress in a sample of distressed heterogeneous patients with cancer.” – Felix Compen

 

Receiving a diagnosis of cancer has a huge impact on most people. Coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. It is estimated that 15 million adults and children with a history of cancer are alive in the United States today. But, surviving cancer carries with it a number of problems. “Physical, emotional, and financial hardships often persist for years after diagnosis and treatment. Cancer survivors are also at greater risk for developing second cancers and other health conditions.” National Cancer Survivors Day.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. Mindfulness-Based Cognitive Therapy (MBCT) consists of mindfulness training and Cognitive Behavioral Therapy (CBT). During therapy the patient is trained to investigate and alter aberrant thought patterns underlying their reactions to cancer. So, it would make sense to study the effectiveness of MBCT and the characteristics of the therapy the psychological distress of cancer patients.

 

In today’s Research News article “Therapeutic alliance-not therapist competence or group cohesion-contributes to reduction of psychological distress in group-based mindfulness-based cognitive therapy for cancer patients.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6680267/ ), Bisseling and colleagues recruited cancer patients who were high in anxiety and depression and randomly assigned them to receive Mindfulness-Based Cognitive Therapy (MBCT) delivered either face-to-face in groups or online or to continue receiving treatment as usual. MBCT was delivered in 8 weekly 2.5 hour sessions along with audio guided home practice. They were measured before and after treatment for psychological distress, group cohesion, therapeutic alliance, and therapist competence.

 

Only the data from patients who had completed therapy were included in the analysis. They found that following treatment there was a significant decrease in anxiety and depression (psychological distress). They also found that the higher the levels of therapeutic alliance the greater the reduction in psychological distress. This was not true for either the group cohesion or the therapist competence.

 

Therapeutic alliance consists of “how closely client and therapist agree on and are mutually engaged in the goals of treatment; how closely client and therapist agree on how to reach the treatment goals; and the degree of mutual trust, acceptance, and confidence between client and therapist.” So, the results suggest that this relationship between patient and therapist is an important factor in the effectiveness of mindfulness treatment to improve the psychological distress of cancer patients. It is not how good the therapist is, but how well they create a mutual agreement regarding the therapy that is important for the effectiveness of the therapy.

 

This agreement may signal a buy-in by the patient to the efficacy of the therapy. This, in turn, can drive a positive expectation for therapeutic success both from the patient and the therapist. It has been demonstrated that the beliefs of the patient and the therapist have powerful effects on the outcome. So, it is possible that the therapeutic alliance is simply a measure of the power of those expectations and, in turn, the effectiveness of the program.

 

“Mindfulness-based cognitive therapy (MBCT) and individual Internet-based MBCT (eMBCT) had comparable efficacy in improving psychological distress among patients with cancer.” – James Nam

 

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

 

Bisseling, E. M., Schellekens, M., Spinhoven, P., Compen, F. R., Speckens, A., & van der Lee, M. L. (2019). Therapeutic alliance-not therapist competence or group cohesion-contributes to reduction of psychological distress in group-based mindfulness-based cognitive therapy for cancer patients. Clinical psychology & psychotherapy, 26(3), 309–318. doi:10.1002/cpp.2352

 

Abstract

Mindfulness‐based cognitive therapy (MBCT) is an innovative evidence‐based intervention in mental and somatic health care. Gaining knowledge of therapeutic factors associated with treatment outcome can improve MBCT. This study focused on predictors of treatment outcome of MBCT for cancer patients and examined whether group cohesion, therapeutic alliance, and therapist competence predicted reduction of psychological distress after MBCT for cancer patients. Moreover, it was examined whether therapist competence facilitated therapeutic alliance or group cohesion. Multilevel analyses were conducted on a subsample of patients collected in a larger randomized controlled trial on individual internet‐based versus group‐based MBCT versus treatment as usual in distressed cancer patients. The current analyses included the 84 patients who completed group‐based MBCT out of 120 patients who were randomized to group‐based MBCT. Group cohesion and therapist competence did not predict reduction in psychological distress, whereas therapeutic alliance did. In addition, therapist competence did not predict therapeutic alliance but was associated with reduced group cohesion. Our findings revealed that therapeutic alliance significantly contributed to reduction of psychological distress in MBCT for cancer patients. Elaborating the clinical implications of the predictive significance of therapeutic alliance might be of added value to enhance the potential effect of MBCT.

Key Practitioner Message

  • Mindfulness‐based cognitive therapy (MBCT) is an innovative evidence‐based intervention in mental and somatic health care and has been increasingly applied in oncology to reduce psychological distress.
  • Therapeutic alliance predicts reduction in psychological distress after MBCT for cancer patients, whereas group cohesion and therapist competence did not.
  • Therapist competence did not appear to be a precondition for a good therapeutic alliance and high group cohesion.
  • Contrary to expectation, we found competence to be negatively related to group cohesion.
  • Elaborating the clinical implications of the predictive significance of therapeutic alliance might be of added value to enhance the potential effect of MBCT for cancer patients.
  • The current findings should be taken into account in the training of MBCT therapists.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6680267/

 

Improve Chronic Low Back Pain with Yoga

psyjdc Leave a comment

Improve Chronic Low Back Pain with Yoga

 

By John M. de Castro, Ph.D.

 

“Yoga is great for working on flexibility and core stability, correcting posture, and breathing—all of which are necessary for a healthy back.” – Sasha Cyrelson

 

Low Back Pain is the leading cause of disability worldwide and affects between 6% to 15% of the population. It is estimated, however, that 80% of the population will experience back pain sometime during their lives. There are varied treatments for low back pain including chiropractic care, acupuncture, biofeedback, physical therapy, cognitive behavioral therapy, massage, surgery, opiate pain killing drugs, steroid injections, and muscle relaxant drugs. These therapies are sometimes effective particularly for acute back pain. But, for chronic conditions the treatments are less effective and often require continuing treatment for years and opiate pain killers are dangerous and can lead to abuse, addiction, and fatal overdoses. Obviously, there is a need for safe and effective treatments for low back pain that are low cost and don’t have troublesome side effects.

 

Mindfulness practices have been found to be effective in treating pain and have been shown to be safe and effective in the management of low back pain. Yoga practice has been shown to have a myriad of health benefits. These include relief of chronic pain. Yoga practice has also been shown to be effective for the relief of chronic low-back pain.  Many forms of yoga focus on the proper alignment of the spine, which could directly address the source of back and neck pain for many individuals. So, it makes sense to further explore the effectiveness of yoga practice for chronic low back pain.

 

In today’s Research News article “Yoga, Physical Therapy, or Education for Chronic Low Back Pain: A Randomized Noninferiority Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6392183/), Saper and colleagues recruited adult patients with low back pain lasting at least 12 weeks and randomly assigned them to receive yoga, physical therapy, or education. Yoga training consisted of 12 weekly, 75 minute classes with 30 minutes of daily practice at home including relaxation, breathing exercises, meditation, and poses. Drop-in yoga classes were available during the subsequent 40 weeks. Physical therapy occurred in 15 60-minute session of graded exercise over 12 weeks. Booster classes were offered during the subsequent 40 weeks. Education included information on chronic low back pain self-management, stretching, strengthening, and the role of emotions and fear avoidance. They were measured before and after training and at 14, 28, and 40 weeks later for back-related function, pain intensity, global improvement, patient satisfaction, and health related quality of life.

 

They found that in comparison to baseline both the yoga and physical therapy groups had improvements in back-related function and pain intensity and were less likely to use pain medication at the end of training. These improvements were maintained 40 weeks later. Hence, both yoga practice and physical therapy were equivalently safe and effective treatments for low back pain and the improvements produced were enduring.

 

So, improve chronic low back pain with yoga.

 

“Yoga is one of the more effective tools for helping soothe low back pain. The practice helps to stretch and strengthen muscles that support the back and spine, such as the paraspinal muscles that help you bend your spine, the multifidus muscles that stabilize your vertebrae, and the transverse abdominis in the abdomen, which also helps stabilize your spine.” – Matthew Solan

 

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

 

Saper, R. B., Lemaster, C., Delitto, A., Sherman, K. J., Herman, P. M., Sadikova, E., … Weinberg, J. (2017). Yoga, Physical Therapy, or Education for Chronic Low Back Pain: A Randomized Noninferiority Trial. Annals of internal medicine, 167(2), 85–94. doi:10.7326/M16-2579

 

Abstract

Background:

Yoga is effective for mild to moderate chronic low back pain (cLBP), but its comparative effectiveness with physical therapy (PT) is unknown. Moreover, little is known about yoga’s effectiveness in underserved patients with more severe functional disability and pain.

Objective:

To determine whether yoga is noninferior to PT for cLBP.

Design:

12-week, single-blind, 3-group randomized noninferiority trial and subsequent 40-week maintenance phase. (ClinicalTrials.gov: NCT01343927)

Setting:

Academic safety-net hospital and 7 affiliated community health centers.

Participants:

320 predominantly low-income, racially diverse adults with nonspecific cLBP.

Intervention:

Participants received 12 weekly yoga classes, 15 PT visits, or an educational book and newsletters. The maintenance phase compared yoga drop-in classes versus home practice and PT booster sessions versus home practice.

Measurements:

Primary outcomes were back-related function, measured by the Roland Morris Disability Questionnaire (RMDQ), and pain, measured by an 11-point scale, at 12 weeks. Prespecified noninferiority margins were 1.5 (RMDQ) and 1.0 (pain). Secondary outcomes included pain medication use, global improvement, satisfaction with intervention, and health-related quality of life.

Results:

One-sided 95% lower confidence limits were 0.83 (RMDQ) and 0.97 (pain), demonstrating noninferiority of yoga to PT. However, yoga was not superior to education for either outcome. Yoga and PT were similar for most secondary outcomes. Yoga and PT participants were 21 and 22 percentage points less likely, respectively, than education participants to use pain medication at 12 weeks. Improvements in yoga and PT groups were maintained at 1 year with no differences between maintenance strategies. Frequency of adverse events, mostly mild self-limited joint and back pain, did not differ between yoga and PT.

Limitations:

Participants were not blinded to treatment assignment. The PT group had disproportionate loss to follow-up.

Conclusion:

A manualized yoga program for nonspecific cLBP was noninferior to PT for function and pain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6392183/

 

Possibly Improve Dementia Patient Caregiver Mental Health with Mindfulness

psyjdc Leave a comment

Possibly Improve Dementia Patient Caregiver Mental Health with Mindfulness

 

By John M. de Castro, Ph.D.

 

“One of the major difficulties that individuals with dementia and their family members encounter is that there is a need for new ways of communicating due to the memory loss and other changes in thinking and abilities. The practice of mindfulness places both participants in the present and focuses on positive features of the interaction, allowing for a type of connection that may substitute for the more complex ways of communicating in the past. It is a good way to address stress.” – Sandra Weintraub

 

Dementia is a progressive loss of mental function produced by degenerative diseases of the brain. Dementia patients require caregiving particularly in the later stages of the disease. Caregiving for dementia patients is a daunting intense experience that can go on for four to eight years with increasing responsibilities as the loved one deteriorates. This places tremendous psychological and financial stress on the caregiver. Hence, there is a need to both care for the dementia patients and also for the caregivers. Mindfulness practice for caregivers has been shown to help them cope with the physical and psychological demands of caregiving. In addition, mindfulness training has been found to help protect aging individuals from physical and cognitive declines.

 

There has accumulated a considerable body of research on the effectiveness of mindfulness to improve the psychological health of caregivers for dementia patients. In today’s Research News article “Mindfulness-based stress reduction for family carers of people with dementia.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6513415/), Liu and colleagues review, summarize, and perform a meta-analysis of the published research studies on the effectiveness of Mindfulness-Based Stress Reduction (MBSR) training for the relief of the psychological distress produced by caring for a patient with dementia. The MBSR program generally consisted of 8 weekly group sessions involving meditation, yoga, body scan, and discussion. The patients were also encouraged to perform daily practice.

 

They found and included 5 controlled research studies containing a total of 201 caregivers. They report that the published research was generally of low quality with great concerns regarding the precision of measurements. Ignoring these concerns the studies that Mindfulness-Based Stress Reduction (MBSR) training in comparison to active control conditions produced small reductions in caregivers levels of depression and anxiety.

 

In general, there are indications that the MBSR program produces small improvements in caregivers’ levels of anxiety and depression but the quality of the evidence is low. This is an important area as caregiving for dementia patients is needed but difficult and exacts a toll on the caregiver. So, relieving the caregivers suffering is very important. Hence, the review identified a great need for more better designed and executed research.

 

So, possibly improve dementia patient caregiver mental health with mindfulness.

 

“In regard to dementia care, mindfulness is not just a stress-reduction tool. It can also help with another critical aspect of dementia caregiving: the need to meet the person in the present moment, where they are most likely to reside and engage due to the dementia.” – Marguerite Manteau-Rao

 

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

 

Liu, Z., Sun, Y. Y., & Zhong, B. L. (2018). Mindfulness-based stress reduction for family carers of people with dementia. The Cochrane database of systematic reviews, 8(8), CD012791. doi:10.1002/14651858.CD012791.pub2

 

Abstract

Background

Caring for people with dementia is highly challenging, and family carers are recognised as being at increased risk of physical and mental ill‐health. Most current interventions have limited success in reducing stress among carers of people with dementia. Mindfulness‐based stress reduction (MBSR) draws on a range of practices and may be a promising approach to helping carers of people with dementia.

Objectives

To assess the effectiveness of MBSR in reducing the stress of family carers of people with dementia.

Search methods

We searched ALOIS ‐ the Cochrane Dementia and Cognitive Improvement Group’s Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (all years to Issue 9 of 12, 2017), MEDLINE (Ovid SP 1950 to September 2017), Embase (Ovid SP 1974 to Sepetmber 2017), Web of Science (ISI Web of Science 1945 to September 2017), PsycINFO (Ovid SP 1806 to September 2017), CINAHL (all dates to September 2017), LILACS (all dates to September 2017), World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov, and Dissertation Abstracts International (DAI) up to 6 September 2017, with no language restrictions.

Selection criteria

Randomised controlled trials (RCTs) of MBSR for family carers of people with dementia.

Data collection and analysis

Two review authors independently screened references for inclusion criteria, extracted data, assessed the risk of bias of trials with the Cochrane ‘Risk of bias’ tool, and evaluated the quality of the evidence using the GRADE instrument. We contacted study authors for additional information, then conducted meta‐analyses, or reported results narratively in the case of insufficient data. We used standard methodological procedures expected by Cochrane.

Main results

We included five RCTs involving 201 carers assessing the effectiveness of MBSR. Controls used in included studies varied in structure and content. Mindfulness‐based stress reduction programmes were compared with either active controls (those matched for time and attention with MBSR, i.e. education, social support, or progressive muscle relaxation), or inactive controls (those not matched for time and attention with MBSR, i.e. self help education or respite care). One trial used both active and inactive comparisons with MBSR. All studies were at high risk of bias in terms of blinding of outcome assessment. Most studies provided no information about selective reporting, incomplete outcome data, or allocation concealment.

  1. Compared with active controls, MBSR may reduce depressive symptoms of carers at the end of the intervention (3 trials, 135 participants; standardised mean difference (SMD) ‐0.63, 95% confidence interval (CI) ‐0.98 to ‐0.28; P<0.001; low‐quality evidence). We could not be certain of any effect on clinically significant depressive symptoms (very low‐quality evidence).

Mindfulness‐based stress reduction compared with active control may decrease carer anxiety at the end of the intervention (1 trial, 78 participants; mean difference (MD) ‐7.50, 95% CI ‐13.11 to ‐1.89; P<0.001; low‐quality evidence) and may slightly increase carer burden (3 trials, 135 participants; SMD 0.24, 95% CI ‐0.11 to 0.58; P=0.18; low‐quality evidence), although both results were imprecise, and we could not exclude little or no effect. Due to the very low quality of the evidence, we could not be sure of any effect on carers’ coping style, nor could we determine whether carers were more or less likely to drop out of treatment.

  1. Compared with inactive controls, MBSR showed no clear evidence of any effect on depressive symptoms (2 trials, 50 participants; MD ‐1.97, 95% CI ‐6.89 to 2.95; P=0.43; low‐quality evidence). We could not be certain of any effect on clinically significant depressive symptoms (very low‐quality evidence).

In this comparison, MBSR may also reduce carer anxiety at the end of the intervention (1 trial, 33 participants; MD ‐7.27, 95% CI ‐14.92 to 0.38; P=0.06; low‐quality evidence), although we were unable to exclude little or no effect. Due to the very low quality of the evidence, we could not be certain of any effects of MBSR on carer burden, the use of positive coping strategies, or dropout rates.

We found no studies that looked at quality of life of carers or care‐recipients, or institutionalisation.

Only one included study reported on adverse events, noting a single adverse event related to yoga practices at home

Authors’ conclusions

After accounting for non‐specific effects of the intervention (i.e. comparing it with an active control), low‐quality evidence suggests that MBSR may reduce carers’ depressive symptoms and anxiety, at least in the short term.

There are significant limitations to the evidence base on MBSR in this population. Our GRADE assessment of the evidence was low to very low quality. We downgraded the quality of the evidence primarily because of high risk of detection or performance bias, and imprecision.

In conclusion, MBSR has the potential to meet some important needs of the carer, but more high‐quality studies in this field are needed to confirm its efficacy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6513415/