Improve Psychiatric Problems among Veterans with Mindfulness

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Improve Psychiatric Problems among Veterans with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness-based interventions show promise in helping soldiers reduce symptoms of PTS and depression as well as experience improvements in various psychosocial domains.” – Adam Clark

 

There are vast numbers of people worldwide who suffer with mental or physical illnesses. Mindfulness practices have been found to be helpful with coping with these illnesses and in many cases reducing the symptoms of the diseases. Mindfulness-Based Cognitive Therapy (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 a wide range of psychological issues. Military veterans are highly susceptible to psychiatric illnesses. So, it would make sense to investigate the effectiveness of MBCT for treating the psychiatric problems of military veterans

 

In today’s Research News article “Treatment Engagement and Outcomes of Mindfulness-Based Cognitive Therapy for Veterans with Psychiatric Disorders.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6748402/), Marchand and colleagues examined the medical records of veterans who had undergone Mindfulness-Based Cognitive Therapy (MBCT) therapy for psychiatric illnesses. MBCT was provided in 8 weeks of once a week 2-hour sessions. Their conditions included psychiatric disorders such as anxiety and depression, substance abuse, and ADHD, and medical disorders such as diabetes, hypertension, and chronic pain.

 

They found that only 67% of the veterans completed the Mindfulness-Based Cognitive Therapy (MBCT)  program. The greater the number of emergency room visits and psychiatric admission prior to the study significantly predicted the likelihood of completion of the MBCT program. This suggests that veterans who have a history of seeking treatment are more likely to complete therapy. Importantly, they found that following the MBCT program there was a significant decrease in psychiatric admission with large effect size.

 

These are interesting findings that suggest that the Mindfulness-Based Cognitive Therapy (MBCT)  program is effective in treating a variety of psychiatric conditions in military veterans. There appears to be a problem, however, with veterans who don’t have a history of seeking treatment completing the therapeutic program. This may signal the need for further study of what can be done to improve participation in this group. It is also possible that prior care with these particular veterans has not been effective and their dropping out of therapy may reflect the lack of success for them with the MBCT program. It is clear nonetheless that when the veterans complete the program it is highly effective in treating their conditions.

 

So, improve psychiatric problems among veterans with mindfulness.

 

“We now have a lot of evidence that mindfulness meditation is helpful for a range of different conditions, including depression, anxiety, substance problems and chronic pain.” – Joseph Wielgosz

 

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

 

Marchand, W. R., Yabko, B., Herrmann, T., Curtis, H., & Lackner, R. (2019). Treatment Engagement and Outcomes of Mindfulness-Based Cognitive Therapy for Veterans with Psychiatric Disorders. Journal of alternative and complementary medicine (New York, N.Y.), 25(9), 902–909. doi:10.1089/acm.2018.0511

 

Abstract

Objectives: The aim of this study was to evaluate utilization and outcomes of mindfulness-based cognitive therapy (MBCT) provided to veterans with psychiatric disorders.

Design: Retrospective chart review.

Settings: Veterans Administration Medical Center (VAMC).

Subjects: Ninety-eight veterans with psychiatric illness who were enrolled in an MBCT class between May of 2012 and January of 2016. Subjects were predominately white (95%), male (81%), and >50 years old (74%). The most common psychiatric conditions were any mood disorder (82%) and post-traumatic stress disorder (54%).

Intervention: Eight-week MBCT class.

Outcome measures: Session attendance and pre- to postintervention changes in numbers of emergency department (ED) visits and psychiatric hospitalizations.

Results: The average number of sessions attended was 4.87 of 8 and only 16% were present for all sessions. Veteran demographic variables did not predict the number of MBCT sessions attended. However, both greater numbers of pre-MBCT ED visits (p = 0.004) and psychiatric admissions (p = 0.031) were associated with attending fewer sessions. Among patients who experienced at least one pre- or post-treatment psychiatric admission in the 2 years pre- or postintervention (N = 26, 27%), there was a significant reduction in psychiatric admissions from pre to post (p = 0.002). There was no significant change in ED visits (p = 0.535).

Conclusions: MBCT may be challenging to implement for veterans with psychiatric illness in, at least some, outpatient VAMC settings due to a high attrition rate. Possible mediation approaches include development of methods to screen for high dropout risk and/or development of shorter mindfulness-based interventions (MBIs) and/or coupling MBIs with pleasurable activities. The finding of a significant decrease in psychiatric hospitalizations from pre- to post-MBCT suggests that prospective studies are warranted utilizing MBCT for veterans at high risk for psychiatric hospitalization.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6748402/

 

Improve Personal Growth in Cancer Survivors with Mindfulness and Spirituality

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Improve Personal Growth in Cancer Survivors with Mindfulness and Spirituality

 

By John M. de Castro, Ph.D.

 

“religion and spirituality can help cancer patients find meaning in their illness and provide comfort in the face of fear.” – American Cancer Society

 

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. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, 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.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatigue, stress,  sleep disturbance, and anxiety and depression. In addition, religion and spirituality become much more important to people when they’re diagnosed with cancer or when living with cancer. It is thought that people take comfort in the spiritual when facing mortality. Hence, spirituality and mindfulness may be useful tools for the survivors of cancer to cope with their illness. Thus, there is a need to study the relationships of spirituality and mindfulness on the ability of cancer survivors to positively adjust to their situation.

 

In today’s Research News article “Spiritual coping, perceived growth, and the moderating role of spiritual mindfulness in cancer survivors.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6340393/), Rudaz and colleagues recruited cancer survivors and had them complete questionnaires measuring spiritual coping (using spirituality as a comfort during difficulties), spiritual mindfulness, personal growth, and positive reinterpretation (interpreting stressful events in a positive way).

 

They found that for the cancer survivors, the greater the levels of mindfulness, the greater the levels of personal growth and the greater the levels of positive reinterpretation. Hence mindfulness was associated with positive adjustments to their illness. Further they found that higher levels of spiritual coping were associated with higher levels of personal growth and higher levels of positive reinterpretation only when mindfulness was high. No relationship was present when mindfulness was low. Younger participants and those with higher levels of education had significantly higher levels of personal growth.

 

It has to be kept in mind that the study was correlational and as such no conclusions about causation can be reached. But the results suggest that spiritual mindfulness is associated with two positive characteristics in cancer survivors, personal growth and positive reinterpretation. In other words, being mindful was associated with an ability to interpret the illness in a positive way and use it as a springboard for greater personal growth. Being able to take solace in spirituality (spiritual coping) was only an effective strategy when the cancer survivors had high levels of mindfulness. Hence, mindfulness is an important characteristic on its own but also one that allows for spirituality to be associated with growth. They appear to have to work together.

 

So, improve personal growth in cancer survivors with mindfulness and spirituality.

 

“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 E. 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

 

Rudaz, M., Ledermann, T., & Grzywacz, J. G. (2018). Spiritual coping, perceived growth, and the moderating role of spiritual mindfulness in cancer survivors. Journal of psychosocial oncology, 36(5), 609–623. doi:10.1080/07347332.2018.1464091

 

Abstract

Purpose.

This study examined the moderating role of spiritual mindfulness on the association between spiritual coping and perceived growth in individuals with and without current treatment for cancer.

Design/Sample.

Adults with a cancer history (N = 534) from the Midlife in the United States study completed a telephone interview and self-administered questionnaires.

Methods/Findings.

Moderated regression analyses, controlled for age and educational attainment, showed that mindfulness moderated the effect of spiritual coping on personal growth and on positive reinterpretation. High mindfulness amplified the effect of spiritual coping on both personal growth and positive reinterpretation. Further, this moderating effect was significantly different for adults with versus without current treatment for cancer for positive reinterpretation but not for personal growth.

Conclusions/Implications.

These findings highlight the potential amplifying effect of spiritual mindfulness on the effect of spiritual coping on perceived growth in cancer survivors.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6340393/

 

Improve Emotion Regulation with Exercise and Mindfulness

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Improve Emotion Regulation with Exercise and Mindfulness

 

By John M. de Castro, Ph.D.

 

“When we engage in mindful practices, we can bring greater awareness, clarity, and equanimity to our day to day experiences. This leads to greater balance and less of the intense swings in mood that can throw us off kilter for days at a time.” – Sean Fargo

 

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. Aerobic exercise can also improve emotions and their regulation. So, it makes sense to study the relationship between exercise and mindfulness in effecting emotion regulation.

 

In today’s Research News article “How Does Exercise Improve Implicit Emotion Regulation Ability: Preliminary Evidence of Mind-Body Exercise Intervention Combined With Aerobic Jogging and Mindfulness-Based Yoga.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6718717/), Zhang and colleagues recruited healthy female postgraduate students who did not have meditation experience and who did not engage in exercise. They were randomly assigned to a wait-list control condition or to engage in exercise 3 times per week over 8 weeks. The exercise alternated between jogging for 40 minutes and yoga practice for 60 minutes. The yoga practice consisted of postures, breathing exercises, and meditation. They were measured before and after the intervention for emotion regulation, negative emotions, aerobic fitness, and mindfulness.

 

They found that in comparison to baseline and the wait-list control group, the aerobic exercise and yoga group had significant increases in emotion regulation, aerobic fitness, and mindfulness and decreases in negative emotions. They also found that increases in aerobic fitness were associated with increases in emotion regulation. But this association was only significant with participants who had high or moderate increases in their levels of mindfulness. At low levels of improvements in mindfulness there was no significant relationship between aerobic fitness and emotion regulation.

 

These findings are interesting and suggest that aerobic exercise and yoga improves the individual’s ability to regulate their emotions. But mindfulness is required for aerobic exercise to be effective. The increases in mindfulness would be expected as the exercise intervention contained yoga and meditation components. Aerobic exercise is known to improve mood. It is new to show that it also improves emotion regulation. Perhaps that’s the reason for the improvements in mood. But in order for the emotion regulation to be improved by exercise, it must be accompanied by improvements in mindfulness. This suggests that the ability to pay attention in the present moment nonjudgmentally to one’s emotions is required for the exercise to affect the ability to regulate the emotions. Here mindfulness plays a permissive role allowing the exercise to have its effect on the participants ability to regulate their emotions.

 

So, Improve Emotion Regulation with Exercise and Mindfulness.

 

“By acting mindfully, people are not only aware of their own feelings but become able to distance from it, avoiding feeling overpowered and acting out.” – Joan Swart

 

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, Y., Fu, R., Sun, L., Gong, Y., & Tang, D. (2019). How Does Exercise Improve Implicit Emotion Regulation Ability: Preliminary Evidence of Mind-Body Exercise Intervention Combined With Aerobic Jogging and Mindfulness-Based Yoga. Frontiers in psychology, 10, 1888. doi:10.3389/fpsyg.2019.01888

 

Abstract

Purpose: The primary aim of the present study is to examine the effect of 8-week mind-body exercise intervention combining aerobic jogging and mindfulness-based yoga on implicit emotion regulation ability. The secondary aim is to explore the specific potential pathways by which the mind-body exercise intervention fosters implicit emotion regulation. This may help us to understand how the key components of exercise intervention contribute to emotional benefits.

Methods: Sixty participants were randomly allocated to one of two parallel groups: (1) the intervention group (n = 29) and (2) the waitlist control group (n = 31). Participants were asked to fill out scales measuring mindfulness and instructed to complete an emotion regulation task to assess implicit emotion regulation ability as well as the PWC 170 Test to evaluate aerobic fitness before and after the intervention.

Results: The results of the two-way repeated ANOVA revealed that 8 weeks of intervention improved implicit emotion regulation, mindfulness, and aerobic fitness levels. Path analysis showed that only improved aerobic fitness mediated the intervention effect on implicit emotion regulation ability, controlling for change in negative affect. Notably, the relationship between the effects on implicit emotion regulation ability and aerobic fitness was moderated by improved mindfulness.

Conclusion: Eight weeks of mind-body exercise intervention improves implicit emotion regulation ability. The aerobic fitness may be an essential pathway which mediates the efficacy on implicit emotion regulation ability. Furthermore, different components, such as aerobic fitness and mindfulness, may interactively contribute to such emotional benefits.

Keywords: mind-body exercise, aerobic jogging, mindfulness-based yoga, implicit emotion regulation ability, aerobic fitness, mindfulness, potential pathway

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6718717/

 

Improve Fibromyalgia Symptoms with Mindfulness

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Improve Fibromyalgia Symptoms with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness training is a low-cost, side-effect-free addition to fibromyalgia treatment that almost anyone can try — research suggests it helps you improve negative emotions surrounding fibromyalgia pain and, over time, change the way you respond to and think about your fibromyalgia symptoms.” – Madeline Vann

 

Fibromyalgia is a mysterious disorder whose causes are unknown. It is very common affecting over 5 million people in the U.S., about 2% of the population with about 7 times more women affected than men. It is characterized by widespread pain, abnormal pain processing, sleep disturbance, and fatigue that lead to psychological distress. Fibromyalgia may also have morning stiffness, tingling or numbness in hands and feet, headaches, including migraines, irritable bowel syndrome, sleep disturbances, thinking and memory problems, and painful menstrual periods. The symptoms are so severe and debilitating that about half the patients are unable to perform routine daily functions and about a third have to stop work. Although it is not itself fatal, suicide rates are higher in fibromyalgia sufferers.

 

There are no completely effective treatments for fibromyalgia. Symptoms are generally treated with pain relievers, antidepressant drugs and exercise. But these only reduce the severity of the symptoms and do not treat the disease directly. Mindfulness practices have also been shown to be effective in reducing pain from fibromyalgia. Some of the effects of mindfulness practices are to alter thought processes, changing what is thought about. In terms of pain, mindfulness training, by focusing attention on the present moment has been shown to reduce worry and catastrophizing. Pain is increased by worry about the pain and the expectation of greater pain in the future. The studies are accumulating, so, it would make sense to pause and summarize what has been learned.

 

In today’s Research News article “Mindfulness- and acceptance-based interventions for patients with fibromyalgia – A systematic review and meta-analyses.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6719827/), Haugmark and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials exploring the effectiveness of mindfulness- and acceptance-based interventions in the treatment of fibromyalgia. They found 9 published randomized controlled trials employing Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), or Acceptance and Commitment Therapy (ACT).

 

They found that the published research studies report that the mindfulness- and acceptance-based interventions produced small to moderate but significant improvements in the fibromyalgia patients’ levels of pain, depression, anxiety, sleep quality, health-related quality of life, and mindfulness. These benefits were sustained at follow-up but were diminished in magnitude. Hence, these interventions were safe and effective treatments for the suffering and psychological well-being of patients with fibromyalgia.

 

Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), and Acceptance and Commitment Therapy (ACT) are quite different therapies with some vastly different therapeutic techniques. But they all have in common, mindfulness training. So, it would appear that mindfulness training was the critical component responsible for the benefits. This should not be surprising as mindfulness has been shown in many studies of various healthy and distressed groups to improve pain, depression, anxiety, sleep quality, and health-related quality of life. But fibromyalgia has no cure and causes great suffering in its victims. It is very comforting to see that mindfulness training can, at least, mitigate the suffering.

 

So, improve fibromyalgia symptoms with mindfulness.

 

“people with fibromyalgia may have what’s called an “attentional bias” toward negative information that appeared to be linked to pain severity. Researchers suggested that mindfulness training may help manage this trait and therefore reduce pain.” – Adrienne Dellwo

 

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

 

Haugmark, T., Hagen, K. B., Smedslund, G., & Zangi, H. A. (2019). Mindfulness- and acceptance-based interventions for patients with fibromyalgia – A systematic review and meta-analyses. PloS one, 14(9), e0221897. doi:10.1371/journal.pone.0221897

 

Abstract

Objectives

To analyze health effects of mindfulness- and acceptance-based interventions, including mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT) and acceptance and commitment therapy (ACT). Additionally, we aimed to explore content and delivery components in terms of procedure, instructors, mode, length, fidelity and adherence in the included interventions.

Methods

We performed a systematic literature search in the databases MEDLINE, PsychINFO, CINAHL, EMBASE, Cochrane Central and AMED from 1990 to January 2019. We included randomized and quasi-randomized controlled trials analyzing health effects of mindfulness- and acceptance-based interventions for patients with fibromyalgia compared to no intervention, wait-list control, treatment as usual, or active interventions. MBSR combined with other treatments were included. Predefined outcomes were pain, fatigue, sleep quality, psychological distress, depression, anxiety, mindfulness, health-related quality of life and work ability. The Template for Intervention Description and Replication (TIDieR) checklist and guide was used to explore content and delivery components in the interventions. Meta-analyses were performed, and GRADE was used to assess the certainty in the evidence.

Results

The search identified 4430 records, of which nine original trials were included. The vast majority of the participants were women. The analyses showed small to moderate effects in favor of mindfulness- and acceptance-based interventions compared to controls in pain (SMD -0.46 [95% CI -0.75, -0.17]), depression (SMD -0.49 [95% CI -0.85, -0.12]), anxiety (SMD -0.37 [95% CI -0.71, -0.02]), mindfulness (SMD -0.40 [-0.69, -0.11]), sleep quality (SMD -0.33 [-0.70, 0.04]) and health-related quality of life (SMD -0.74 [95% CI -2.02, 0.54]) at end of treatment. The effects are uncertain due to individual study limitations, inconsistent results and imprecision.

Conclusion

Health effects of mindfulness- and acceptance-based interventions for patients with fibromyalgia are promising but uncertain. Future trials should consider investigating whether strategies to improve adherence and fidelity of mindfulness- and acceptance-based interventions can improve health outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6719827/

 

Improve the Psychological Health of Cancer Patients with Psilocybin

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Improve the Psychological Health of Cancer Patients with Psilocybin

 

By John M. de Castro, Ph.D.

 

“Our research has shown that, in a medically controlled setting with expert screening and preparation, psilocybin can relieve the symptoms of anxiety and depression often found in patients with a cancer diagnosis.” – Heffter Research Institute

 

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

 

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

 

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

 

In today’s Research News article “Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367557/), Griffiths and colleagues recruited patients with a potentially life threatening cancer diagnosis and high levels of anxiety and/or a mood disorder. They were randomly assigned to receive psilocybin in the lab in a living room type highly supportive environment with either a low dose in the first session and the high dose in the second 5 weeks later or in reverse order with the high dose first followed by low dose. Doses were administered double blind.

 

They were measured during the session for heart rate and respiration and ratings by attending monitors. After the drug effects subsided (7 hours after administration) they were measured for hallucinogen ratings, altered states of consciousness, mystical experiences, states of consciousness, and mysticism. They were also measured at baseline and five weeks after each session and 6 months later for anxiety, depression, mood, psychiatric symptoms, quality of life, optimism, spirituality, death acceptance, death transcendence, purpose in life, life coherence, and persisting effects of psilocybin. Family friends, and co-workers were also asked to rate the participant’s behavior and attitudes.

 

After the sessions no continuing adverse events were detected. During the sessions there were significant dose dependent increases in heart rate, blood pressure, joy and happiness, and visual experiences, and all ratings by the session monitors of behavior and mood. These effects all dissipated by the end of the session.

 

In comparison to baseline at all time points after psilocybin administration there were clinically significant decreases in anxiety, depression, psychiatric symptoms and significant increases in mood, quality of life, optimism, spirituality, death acceptance, death transcendence, purpose in life, and life coherence. Family friends, and co-workers also reported significant improvements in mood and behavior in the cancer patients. They also found that the greater the mystical experiences that the cancer patients had during the sessions the greater the levels of meaningfulness, spiritual significance, increased life satisfaction, meaningful existence, death acceptance, death transcendence, purpose in life, and coherence and the lower the levels of anxiety and depression.

 

The results suggest that psilocybin administration to patients with life threatening cancer diagnoses who also had high levels of anxiety and/or mood disturbance produced large and clinically significant improvements in their psychological and spiritual well-being. These benefits were observed by clinicians, session monitors, family, friend, and co-workers, and the patients themselves. These results are remarkable particularly due to the magnitude of the effects, the breadth of the benefits, their obviousness to all concerned, and the persistence of the effects, generally still large and significant 6 months after the session. This suggests that psilocybin treatment may be greatly beneficial to relieve the psychological suffering and the spiritual difficulties precipitated by cancer diagnosis.

 

So, improve the psychological health of cancer patients with psilocybin.

 

“a substantial majority of people suffering cancer-related anxiety or depression found considerable relief for up to six months from a single large dose of psilocybin — the active compound in hallucinogenic “magic mushrooms.” – Vanessa McMains

 

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

 

Griffiths, R. R., Johnson, M. W., Carducci, M. A., Umbricht, A., Richards, W. A., Richards, B. D., … Klinedinst, M. A. (2016). Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. Journal of psychopharmacology (Oxford, England), 30(12), 1181–1197. doi:10.1177/0269881116675513

 

Abstract

Cancer patients often develop chronic, clinically significant symptoms of depression and anxiety. Previous studies suggest that psilocybin may decrease depression and anxiety in cancer patients. The effects of psilocybin were studied in 51 cancer patients with life-threatening diagnoses and symptoms of depression and/or anxiety. This randomized, double-blind, cross-over trial investigated the effects of a very low (placebo-like) dose (1 or 3 mg/70 kg) vs. a high dose (22 or 30 mg/70 kg) of psilocybin administered in counterbalanced sequence with 5 weeks between sessions and a 6-month follow-up. Instructions to participants and staff minimized expectancy effects. Participants, staff, and community observers rated participant moods, attitudes, and behaviors throughout the study. High-dose psilocybin produced large decreases in clinician- and self-rated measures of depressed mood and anxiety, along with increases in quality of life, life meaning, and optimism, and decreases in death anxiety. At 6-month follow-up, these changes were sustained, with about 80% of participants continuing to show clinically significant decreases in depressed mood and anxiety. Participants attributed improvements in attitudes about life/self, mood, relationships, and spirituality to the high-dose experience, with >80% endorsing moderately or greater increased well-being/life satisfaction. Community observer ratings showed corresponding changes. Mystical-type psilocybin experience on session day mediated the effect of psilocybin dose on therapeutic outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367557/

 

Reduce Suicide with Mindfulness

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Reduce Suicide with Mindfulness

 

By John M. de Castro, Ph.D.

 

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

 

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

 

Mindfulness training has been shown to reduce suicidality. Dialectical Behavior Therapy (DBT) is a mindfulness-based therapy targeted at changing the problem behaviors including self-injury and suicide. Behavior change is accomplished through focusing on changing the thoughts and emotions that precede problem behaviors, as well as by solving the problems faced by individuals that contribute to problematic thoughts, feelings and behaviors. In DBT five core skills are practiced; mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness. Hence it makes sense to further study the ability of DBT to reduce suicides in adolescents.

 

In today’s Research News article “Efficacy of Dialectical Behavior Therapy for Adolescents at High Risk for Suicide: A Randomized Clinical Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6584278/), McCauley and colleagues recruited adolescents (12-18 years of age) with at least one suicide attempt, elevated suicide ideation, a history of self-harm, and symptoms of Borderline Personality Disorder (BPD). They were randomly assigned to receive 6 months of individualized group therapy either of Dialectical Behavior Therapy (DBT) or individual and group non-directive supportive therapy. They were measured before, midway and after treatment and 3 and 6 months later for suicides, suicide ideation, self-harm, mood, anxiety, psychosis, eating disorders, Borderline Personality Disorder (BPD), substance abuse, and externalizing symptoms.

 

They found that in comparison to individual and group non-directive supportive therapy, the participants in Dialectical Behavior Therapy (DBT) attended more sessions, remained in treatment longer, and had higher completing rates. Importantly, after treatment, the group receiving Dialectical Behavior Therapy (DBT) had significantly fewer suicide attempts, less self-harm, and significantly higher rates of clinical change.

 

These are important results that suggests that Dialectical Behavior Therapy (DBT) is an effective treatment for adolescents with a history of suicide attempts and self-harm. Since compliance and completion rates were high, it suggests that the treatment was acceptable to the youths. The fact that DBT was compared to another therapy is important as it demonstrates that participant expectancy effects or placebo effects cannot account for the findings. They are also important as they suggest that DBT may help save adolescent lives in a very vulnerable population or at the very least help to relieve their suffering.

 

So, reduce suicide with mindfulness.

 

“In general, the practice of mindfulness involves observing your thoughts without buying into them. You label your thoughts as just that – thoughts. Not necessarily truth. Not necessarily a call to action. If you have the thought, “I should kill myself,” you can then observe, “I just had the thought that I should kill myself.” – Stephanie Freedenthal

 

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

 

McCauley, E., Berk, M. S., Asarnow, J. R., Adrian, M., Cohen, J., Korslund, K., … Linehan, M. M. (2018). Efficacy of Dialectical Behavior Therapy for Adolescents at High Risk for Suicide: A Randomized Clinical Trial. JAMA psychiatry, 75(8), 777–785. doi:10.1001/jamapsychiatry.2018.1109

 

Key Points

Question

Is dialectical behavior therapy more effective than individual and group supportive therapy in reducing suicide attempts and nonsuicidal self-injury in suicidal adolescents?

Findings

This multisite randomized clinical trial of 173 adolescents indicated a significant advantage for dialectical behavior therapy compared with individual and group supportive therapy for reducing repeat suicide attempts, nonsuicidal self-injury, and total self-harm after treatment. Although the dialectical behavior therapy advantage weakened over time, secondary analyses indicated that youths receiving dialectical behavior therapy were more likely to respond to treatment, indexed by the absence of any self-harm, after treatment and at 12-month follow-up.

Meaning

Dialectical behavior therapy is effective for reducing repeat suicide attempts among highly suicidal adolescents, underscoring the value of dialectical behavior therapy in suicide prevention initiatives.

Abstract

Importance

Suicide is a leading cause of death among 10- to 24-year-old individuals in the United States; evidence on effective treatment for adolescents who engage in suicidal and self-harm behaviors is limited.

Objective

To evaluate the efficacy of dialectical behavior therapy (DBT) compared with individual and group supportive therapy (IGST) for reducing suicide attempts, nonsuicidal self-injury, and overall self-harm among high-risk youths.

Design, Setting, and Participants

This randomized clinical trial was conducted from January 1, 2012, through August 31, 2014, at 4 academic medical centers. A total of 173 participants (pool of 195; 22 withdrew or were excluded) 12 to 18 years of age with a prior lifetime suicide attempt (≥3 prior self-harm episodes, suicidal ideation, or emotional dysregulation) were studied. Adaptive randomization balanced participants across conditions within sites based on age, number of prior suicide attempts, and psychotropic medication use. Participants were followed up for 1 year.

Interventions

Study participants were randomly assigned to DBT or IGST. Treatment duration was 6 months. Both groups had weekly individual and group psychotherapy, therapist consultation meetings, and parent contact as needed.

Main Outcomes and Measures

A priori planned outcomes were suicide attempts, nonsuicidal self-injury, and total self-harm assessed using the Suicide Attempt Self-Injury Interview.

Results

A total of 173 adolescents (163 [94.8%] female and 97 [56.4%] white; mean [SD] age, 14.89 [1.47] years) were studied. Significant advantages were found for DBT on all primary outcomes after treatment: suicide attempts (65 [90.3%] of 72 receiving DBT vs 51 [78.9%] of 65 receiving IGST with no suicide attempts; odds ratio [OR], 0.30; 95% CI, 0.10-0.91), nonsuicidal self-injury (41 [56.9%] of 72 receiving DBT vs 26 [40.0%] of 65 receiving IGST with no self-injury; OR, 0.32; 95% CI, 0.13-0.70), and self-harm (39 [54.2%] of 72 receiving DBT vs 24 [36.9%] of 65 receiving IGST with no self-harm; OR, 0.33; 95% CI, 0.14-0.78). Rates of self-harm decreased through 1-year follow-up. The advantage of DBT decreased, with no statistically significant between-group differences from 6 to 12 months (OR, 0.65; 95% CI, 0.12-3.36; P = .61). Treatment completion rates were higher for DBT (75.6%) than for IGST (55.2%), but pattern-mixture models indicated that this difference did not informatively affect outcomes.

Conclusions and Relevance

The results of this trial support the efficacy of DBT for reducing self-harm and suicide attempts in highly suicidal self-harming adolescents. On the basis of the criteria of 2 independent trials supporting efficacy, results support DBT as the first well-established, empirically supported treatment for decreasing repeated suicide attempts and self-harm in youths.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6584278/Importance

 

Better Mental Health During Pregnancy is Associated with Mindfulness

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Better Mental Health During Pregnancy is Associated with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness is a seriously beneficial practice during pregnancy, too? Simply tuning in and being aware can be a powerful tool to lessen stress, calm anxiety, and help you feel more connected during those long nine months.” – Carrie Murphy

 

The period of pregnancy is a time of intense physiological and psychological change. Anxiety, depression, and fear are quite common during pregnancy. More than 20 percent of pregnant women have an anxiety disorder, depressive symptoms, or both during pregnancy. A debilitating childbirth fear has been estimated to affect about 6% or pregnant women and 13% are sufficiently afraid to postpone pregnancy. It is difficult to deal with these emotions under the best of conditions but in combinations with the stresses of pregnancy can turn what could be a joyous experience of creating a human life into a horrible worrisome, torment.

 

The psychological health of pregnant women has consequences for fetal development, birthing, and consequently, child outcomes. Depression during pregnancy is associated with premature delivery and low birth weight. Hence, it is clear that there is a need for methods to treat depression, and anxiety during pregnancy. Since the fetus can be negatively impacted by drugs, it would be preferable to find a treatment that did not require drugs. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy.

 

In today’s Research News article “An investigation of dispositional mindfulness and mood during pregnancy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676599/), Krusche and colleagues recruited pregnant women and had them complete measures of mindfulness, anxiety, depression, perceived stress, pregnancy distress, worries about labor, prenatal distress, pregnancy related discomforts, and pregnancy expectancies.

 

They found that the higher the levels of mindfulness, the lower the levels of anxiety, depression, perceived stress, worries about labor, pregnancy distress, prenatal distress, first and second trimester discomfort, and frequency and intensity of negative pregnancy experiences, and greater frequency and intensity of positive pregnancy experiences.

 

This study was correlational, so no conclusions can be reached about causation. But the results are striking that mindfulness is associated with better pregnancy related experiences, mood, and mental health. This portends well for the outcome of pregnancy and the health of the child. Future research should attempt to investigate the effects of mindfulness training during pregnancy on the mood, experiences, and mental health of the women.

 

So, better mental health during pregnancy is associated with mindfulness.

 

“cultivating moment-to-moment awareness of thoughts and surroundings seem to help pregnant women keep their stress down and their spirits up. . . it may also lead to healthier newborns with fewer developmental problems down the line.” – Kira Newman

 

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

 

Krusche, A., Crane, C., & Dymond, M. (2019). An investigation of dispositional mindfulness and mood during pregnancy. BMC pregnancy and childbirth, 19(1), 273. doi:10.1186/s12884-019-2416-2

 

Abstract

Background

Mindfulness courses are being offered to numerous groups and while a large body of research has investigated links between dispositional mindfulness and mood, few studies have reported this relationship during pregnancy. The aim of this study was to investigate this relationship in pregnant women to offer insight into whether an intervention which may plausibly increase dispositional mindfulness would be beneficial for this population.

Methods

A cross-sectional analysis was conducted to explore potential relationships between measures of mindfulness and general and pregnancy-specific mood. A sample of pregnant women (n = 363) was recruited using online advertising and community-based recruitment and asked to complete a number of questionnaires online.

Results

Overall, higher levels of mindfulness were associated with improved levels of general and pregnancy-related mood in pregnant women. Controlling for general stress and anxiety, higher scores for mindfulness in (psychologically) healthy women were associated with lower levels of pregnancy-related depression, distress and labour worry but this relationship was not apparent in those with current mental health problems. In participants without children, higher mindfulness levels were related to lower levels of pregnancy-related distress.

Conclusions

These results suggest a promising relationship between dispositional mindfulness and mood though it varies depending on background and current problems. More research is needed, but this paper represents a first step in examining the potential of mindfulness courses for pregnant women. Increasing mindfulness, and therefore completing mindfulness-based courses, is potentially beneficial for improvements in mood during pregnancy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676599/

 

Improve Emotions and Thinking with Mindfulness

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Improve Emotions and Thinking with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Through mindfulness you can learn to turn your negative emotions into your greatest teachers and sources of strength. . . Instead of ‘turning away’ from pain in avoidance we can learn to gently ‘turn towards’ what we’re experiencing. We can bring a caring open attention towards the wounded parts of ourselves and make wise choices about how to respond to ourselves and to life.” – Melli O’Brien

 

Mindfulness is the ability to focus on what is transpiring in the present moment. It involves a greater emphasis on attention to the immediate stimulus environment. Mindful people generally have better attentional abilities and have fewer intrusive thoughts and less mind wandering. As a result, mindfulness has been shown to be associated with improved cognition (thinking). In addition, 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.

 

Most of the research studying the effects of mindfulness on emotions and thinking have been conducted with western participants. It is important to assess the generalizability of these findings to eastern populations. In today’s Research News article “Can Mindfulness-Based Training Improve Positive Emotion and Cognitive Ability in Chinese Non-clinical Population? A Pilot Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6619344/), Zhu and colleagues recruited healthy Chinese college students who never participated in mindfulness practices. They were randomly assigned to receive either a 12 week Mindfulness-Based Stress Reduction (MBSR) training or no treatment. The MBSR program met for 2.5 hours once a week along with 30-45 minutes of daily home practice and consisted of discussion, meditation, yoga, and body scan practices. They were measured before, during, and after training for mindfulness, emotions, attention with a Continuous Performance Task, and executive function with a Stroop task.

 

They found that in comparison to the no-treatment control group, after training the Mindfulness-Based Stress Reduction (MBSR) group had significantly higher mindfulness and positive emotions. They had faster responses on the Continuous Performance Task, suggesting better sustained attention.  They further found that the greater the increase in mindfulness, the greater the increases in positive emotions and sustained attention, suggesting that the training effected mindfulness which, in turn, affected emotions and attention.

 

It has been well established that mindfulness trainings, such as Mindfulness-Based Stress Reduction (MBSR) are effective in improving emotions, attention, and mindfulness in western participants. The present study demonstrates that similar effects occur in eastern participants. This expands the generalizability of the findings, suggesting that MBSR training is effective regardless of race and culture.

 

So, improve emotions and thinking with mindfulness.

 

“Flexing your ability to think about your thinking and practicing brief bouts of daily meditation is good for your health and has an endless list of psychological and physical benefits for your well-being.” – Christopher Bergland

 

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

 

Zhu, T., Xue, J., Montuclard, A., Jiang, Y., Weng, W., & Chen, S. (2019). Can Mindfulness-Based Training Improve Positive Emotion and Cognitive Ability in Chinese Non-clinical Population? A Pilot Study. Frontiers in psychology, 10, 1549. doi:10.3389/fpsyg.2019.01549

 

Abstract

Objective

Based on eastern philosophy, mindfulness is becoming popular for human being’s mental health and well-being in western countries. In this study, we proposed to explore the effectiveness and potential pathway of mindfulness-based training (MBT) on Chinese Non-clinical higher education students’ cognition and emotion.

Methods

A paired control design was used. 48 higher education students (24 in MBT group, 24 in control group) were recruited in the study. The MBT group engaged in a 12-week MBT. A package of measurements, including sustained attention tasks (The Continuous Performance Test, CPT), executive function task (Stroop) for cognitive functions, the self-reported mindfulness levels (The Mindful Attention Awareness Scale, MAAS) and emotion (The Profile of Mood States, POMS), were apply for all participants at baseline and every 4 weeks during next 12 weeks.

Results

There were no differences in baseline demographic variables between two groups. Over the 12-week training, participants assigned to MBT group had a significantly greater reduction in CPT reaction time (Cohen’s d 0.72), significantly greater improvement in positive emotion (Vigor-Activity, VA) (Cohen’s d 1.08) and in MAAS (Cohen’s d 0.49) than those assigned to control group. And, MAAS at 4th week could significantly predict the CPT RT and VA at 8th week in the MBT group. VA at 4th week could significantly predict the CPT RT at 8th week (B = 4.88, t = 2.21, p = 0.034, R2= 0.35).

Conclusion

This study shows the efficiency of 12-week MBT on Chinese Non-clinical students’ cognition and emotion. Mindfulness training may impact cognition and emotion through the improvement in mindfulness level, and may impact cognition through the improvement in positive emotion.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6619344/

 

Spirituality is Associated with Better Psychological Well-Being but also Cognitive Distortions

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Spirituality is Associated with Better Psychological Well-Being but also Cognitive Distortions

 

By John M. de Castro, Ph.D.

 

“No causal link has been established, but higher levels of spirituality have been linked to increased compassion, strengthened relationships, and improved self-esteem.” – Psychology Today

 

Spirituality is defined as “one’s personal affirmation of and relationship to a higher power or to the sacred. There have been a number of studies of the influence of spirituality on the physical and psychological well-being of practitioners mostly showing positive benefits, with spirituality encouraging personal growth and mental health. Hence, it makes sense to study the relationships of spirituality with the individual’s characteristics to better understand how spirituality might influence psychological well-being.

 

In today’s Research News article “Spirituality, dimensional autism, and schizotypal traits: The search for meaning.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6407781/), Crespi and colleagues recruited undergraduate students and had them complete questionnaires measuring spirituality including subscales measuring belief in God, search for meaning, mindfulness, and security, and also autism traits including social skills, communication, attention to detail, attention switching, and imagination subscales, and also schizotypal traits including constricted affect, social anxiety, magical thinking, unusual perceptions, ideas of reference, eccentric behavior, and odd speech.

 

They found that the higher the total levels of spirituality the lower the levels of autism traits and the higher the levels of positive schizotypal traits. Of the spirituality subscales they found that the higher the belief in God the higher the levels of positive schizotypal traits, including magical thinking and unusual perceptions. Of the spirituality subscales they found that the higher the search for meaning the lower the levels of autism traits and the higher the levels of positive schizotypal traits, including magical thinking and unusual perceptions. Of the spirituality subscales they found that the higher the mindfulness the lower the levels of autism traits.

 

It should be kept in mind that the results are correlational and as such causation cannot be determined. The findings suggest that spirituality, especially search for meaning and mindfulness, is associated with less autism traits suggesting healthier personalities. But they also suggest that spirituality, especially belief in God and search for meaning, is associated with greater positive schizotypal traits, particularly with magical thinking and unusual perceptions. These findings suggest that belief in God and search for meaning are associated with distorted cognitive processes.

 

In total, the findings suggest that spirituality is associated with some strengths in the personality but also with cognitive distortions. It is possible that adherence to particular religions (religiosity) may be the reason for the opposing findings. Indeed, this idea is supported by the fact that belief in God was associated with the cognitive distortions. Unfortunately, the present study did not measure religiosity. Hopefully, future research will include measurement of religiosity.

 

So, spirituality is associated with better psychological well-being but also cognitive distortions.

 

“There’s a lot of research linking health and more contentment with life, and having a regular spiritual practice. I personally can’t imagine getting through each day without connecting with my spiritual self, especially when life feels overwhelming or when I’m feeling a bit lost.” – Cara Howell

 

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

 

Crespi, B., Dinsdale, N., Read, S., & Hurd, P. (2019). Spirituality, dimensional autism, and schizotypal traits: The search for meaning. PloS one, 14(3), e0213456. doi:10.1371/journal.pone.0213456

 

Abstract

The relationships of spirituality with human social cognition, as exemplified in autism spectrum and schizophrenia spectrum cognitive variation, remain largely unstudied. We quantified non-clinical levels of autism spectrum and schizotypal spectrum traits (using the Autism Quotient and the Schizotypal Personality Questionnaire-Brief Revised) and dimensions of spirituality (using the Hardt Spirituality Questionnaire) in a large sample of undergraduate students. We tested in particular the hypothesis, based on the diametrical model of autism and psychosis, that autism should be negatively associated, and positive schizotypal traits should be positively associated, with spirituality. Our primary findings were threefold. First, in support of the diametric model, total Spirituality score was significantly negatively correlated with total Autism Quotient score, and significantly positively correlated with Positive Schizotypal traits (the Schizotypal Personality Cognitive-Perceptual subscale), as predicted. Second, these associations were driven mainly by opposite patterns regarding the Search for Meaning Spirituality subscale, which was the only subscale that was significantly negatively associated with autism, and significantly positively associated with Positive Schizotypal traits. Third, Belief in God was positively correlated with Positive Schizotypal traits, but was uncorrelated with autism traits. The opposite findings for Search for Meaning can be interpreted in the contexts of well-supported cognitive models for understanding autism in terms of weak central coherence, and understanding Positive Schizotypal traits in terms of enhanced salience.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6407781/

 

Tai Chi Practice is a Cost-Effective Treatment to Reduce Falls in Older Adults

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Tai Chi Practice is a Cost-Effective Treatment to Reduce Falls in Older Adults

 

By John M. de Castro, Ph.D.

 

“Across multiple studies, Tai chi appears to reduce risk of falling by 20 to 45 percent and is considered one of the best exercises available for ambulatory older adults with balance concerns.” – Peter Wayne

 

The process of aging affects every aspect of the physical and cognitive domains. Every system in the body deteriorates including motor function with a decline in strength, flexibility, and balance. Impaired balance is a particular problem as it can lead to falls. In the U.S. one third of people over 65 fall each year and 2.5 million are treated in emergency rooms for injuries produced by falls. About 1% of falls result in deaths making it the leading cause of death due to injury among the elderly.

 

Falls, with or without injury, also carry a heavy quality of life impact. A growing number of older adults, fear falling and, as a result, limit their activities and social engagements. This can result in further physical decline, depression, social isolation, and feelings of helplessness. It is obviously important to discover methods to improve balance and decrease the number of falls in the elderly.

 

Tai Chi training is designed to enhance and regulate the functional activities of the body through regulated breathing, mindful concentration, and gentle movements. It includes balance training and has been shown to improve balance and coordination. Indeed, Tai Chi training has been shown to reduce the frequency of falls in the elderly. It is not known, however, if Tai Chi training is more or less cost-effective than other exercises for reducing falls in the elderly.

 

In today’s Research News article “Cost-Effectiveness of a Therapeutic Tai Ji Quan Fall Prevention Intervention for Older Adults at High Risk of Falling.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6696718/), Li and colleagues recruited community-based elderly individuals (over 70 years of age) who had experienced at least one fall in the last year and randomly assigned them to one of three conditions; Tai Chi practice, multimodal (mixed) exercises, or stretching. The exercises occurred in twice weekly, 60-minute sessions, for 24 weeks. They were measured before and after training for falls, health related quality of life, health index, quality-adjusted life-years (QALYs), and health-related service utilization expenses.

 

They found that Tai Chi practice resulted in significantly greater reduction in falls and increase in quality-adjusted life-years (QALYs) than either the multimodal or stretching exercises. The costs of implementing the 3 programs were equivalent. The total health-related utilization cost was $1,958 per participant for Tai Chi, compared with $2,583 for multimodal and $2,131 for stretching. Tai Chi produced greater reductions in falls at a lower cost and resulted in lower health care costs results in in incremental costs of $850 per additional fall prevented and $27,614 per additional QALY gained.

 

These results suggest that Tai Chi practice is a safe, effective, and cost-effective means of reducing falls in the elderly. Falls when they occur in the elderly can be quite devastating and can produce major injuries that can even lead to death. So, their prevention is very important not just for reducing health care costs but for the longevity and quality of life of the individual.

 

So, Tai Chi practice is a cost-effective treatment to reduce falls in older adults.

 

“Falling in adults age 65 and older is significantly associated with loss of independence, premature mortality and big health care costs.” – Peter Harmer

 

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, F., Harmer, P., Eckstrom, E., Fitzgerald, K., Akers, L., Chou, L. S., … Winters-Stone, K. (2019). Cost-Effectiveness of a Therapeutic Tai Ji Quan Fall Prevention Intervention for Older Adults at High Risk of Falling. The journals of gerontology. Series A, Biological sciences and medical sciences, 74(9), 1504–1510. doi:10.1093/gerona/glz008

 

Abstract

Background

Data on the cost-effectiveness of proven fall prevention exercise interventions are limited. We aimed to establish the cost-effectiveness of Tai Ji Quan: Moving for Better Balance (TJQMBB) compared with a conventional exercise intervention for older adults at high risk of falling.

Methods

We conducted a trial-based cost-effectiveness analysis involving 670 older adults who had a history of falling or impaired mobility. Participants received one of three interventions—TJQMBB, multimodal exercise, or stretching exercise (control)—each of which was implemented twice weekly for 24 weeks. The primary cost-effectiveness measure was the incremental cost per additional fall prevented, comparing TJQMBB and multimodal exercise to Stretching and TJQMBB to multimodal exercise, with a secondary measure of incremental cost per additional quality-adjusted life-year (QALY) gained. The intervention was conducted between February 2015 and January 2018, and cost-effectiveness was estimated from a health care system perspective over a 6-month time horizon.

Results

The total cost to deliver the TJQMBB intervention was $202,949 (an average of $906 per participant); for multimodal exercise, it was $223,849 ($1,004 per participant); and for Stretching, it was $210,468 ($903 per participant). Incremental cost-effectiveness ratios showed that the multimodal exercise was cost-effective ($850 per additional fall prevented; $27,614 per additional QALY gained) relative to Stretching; however, TJQMBB was the most economically dominant strategy (ie, having lower cost and being clinically more efficacious) compared with multimodal and stretching exercises with regard to cost per additional fall prevented and per additional QALY gained. TJQMBB had a 100% probability of being cost-effective, relative to Stretching, at a threshold of $500 per each additional fall prevented and $10,000 per additional QALY gained. Sensitivity analyses showed the robustness of the results when extreme cases, medical costs only, and missing data were considered.

Conclusions

Among community-dwelling older adults at high risk for falls, TJQMBB is a cost-effective means of reducing falls compared with conventional exercise approaches.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6696718/