Mindfulness is Associated with Better Mental Health in Firefighters

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Mindfulness is Associated with Better Mental Health in Firefighters

 

By John M. de Castro, Ph.D.

 

“mindfulness practices work at both a preventative and remedial level by assisting them to maintain higher levels of resilience to deal with their emergency responder roles and helping to reduce and cease distressing reactions after difficult personal and traumatic incidents.” – Mark Molony

 

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime with 7%-8% of the population developing Post-Traumatic Stress Disorder (PTSD). First responders such as firefighters and police experience traumatic events as part of their jobs and many develop symptoms of PTSD. This is responsible for the fact that wore firefighters and police officers die by suicide than all line-of-duty deaths combined. 103 firefighters and 140 police officers died by suicide in 2017, compared to 93 firefighter and 129 officer line-of-duty deaths.

 

Obviously, stress and trauma effects are troubling problems for firefighters that need to be addressed. There are a number of therapies that have been developed to treat PTSD. One of which, mindfulness training has been found to be particularly effective.  Indeed, mindfulness has been shown to has been shown to reduce the physiological and psychological responses to stress, to reduce suicidality and to reduce the impact of trauma on the individual. So, a firefighter’s level of mindfulness may be associated with better mental health.

 

In today’s Research News article “Mental health and mindfulness amongst Australian fire fighters.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6570940/), Counson and colleagues recruited healthy firefighters who had experienced trauma in the last 6 months. The firefighters completed measures of mindfulness, anxiety, depression, and psychological well-being.

 

They found that the higher the firefighters’ levels of mindfulness, the lower the levels of anxiety and depression and the higher the levels of psychological well-being. Hence, mindfulness was found to be associated with better mental health in these firefighters who are exposed to trauma. This study is correlational and no conclusions regarding causation can be reached. But previous research has demonstrated that mindfulness has causal effects on anxiety, depression, and psychological well-being. So, it is likely that the associations seen here were due to causal connections.

 

These results suggest that mindful firefighters are resistant to the effects of trauma. It has been shown the mindfulness is effective in treating Post-Traumatic Stress Disorder (PTSD). The present results then combined with these previous findings suggest that mindfulness may help to protect firefighters from trauma making it less likely that they’ll develop PTSD.

 

So, mindfulness is associated with better mental health in firefighters.

 

“targeted mindfulness training program increases some aspects of firefighter resilience (distress tolerance, positive adjustment, and perseverance). . . . The more lessons firefighters completed, the greater their improvements in both mindfulness and resilience.” – AMRA

 

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

 

Counson, I., Hosemans, D., Lal, T. J., Mott, B., Harvey, S. B., & Joyce, S. (2019). Mental health and mindfulness amongst Australian fire fighters. BMC psychology, 7(1), 34. doi:10.1186/s40359-019-0311-2

 

Abstract

Background

While extensive research has highlighted the positive mental health outcomes associated with mindfulness, little work has examined how mindfulness may protect the mental health of first responders exposed to trauma. This is important as there is increasing evidence that mindfulness skills, if protective, can be taught to groups of at-risk workers. The purpose of the current research was to examine the potential role mindfulness may have in supporting the mental health of Australian fire fighters.

Methods

The sample consisted of 114 professional fire fighters who completed demographic and job-related questions followed by measures of mindfulness (FMI-14), well-being (WHO-5), depression (HADS-D) and anxiety (HADS-A). Hierarchical multiple linear regressions were performed to determine whether levels of mindfulness were associated with anxiety, depression and wellbeing after accounting for age and number of years of fire service.

Results

High levels of mindfulness were associated with decreased depression (p ≤ .001) and anxiety (p ≤ .001) as well as increased psychological well-being (p ≤ .001). Measures of mindfulness were able to explain a substantial amount of the variability in well-being (26.8%), anxiety (23.6%) and depression (22.4%), regardless of age and years of fire service.

Conclusions

The present study provides evidence for robust associations between dispositional mindfulness and mental health markers of depression, anxiety and well-being in Australian fire fighters recently exposed to trauma. Mindfulness is a psychological characteristic that may be able to be modified, although further research is required to substantiate these findings and to formally test mindfulness interventions. Such studies would allow greater insight into the underlying mechanisms through which mindfulness may exert its beneficial effects.

Electronic supplementary material

The online version of this article (10.1186/s40359-019-0311-2) contains supplementary material, which is available to authorized users.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6570940/

 

Improve Depression by Modulating the Autonomic Nervous System in the Elderly with Tai Chi

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Improve Depression by Modulating the Autonomic Nervous System in the Elderly with Tai Chi

 

By John M. de Castro, Ph.D.

 

“The ancient Chinese practice of tai chi appears to relieve symptoms of depression in older people.” – Tara Parker-Pope

 

Human life is one of constant change. We revel in our increases in physical and mental capacities during development, but regret their decreases during aging. The aging process involves a systematic progressive decline in every system in the body. It is inevitable and cannot be avoided. This includes our mental abilities which decline with age including impairments in memory, attention, and problem-solving ability, and in emotion regulation. Depression is very common in the elderly. The elderly cope with increasing loss of friends and family, deteriorating health, as well as concerns regarding finances on fixed incomes. In addition, many elderly experience withdrawal and isolation from social interactions producing increased loneliness, worry and anxiety.

 

There is some hope for age related decline, however, as there is evidence that it can be slowed. There are some indications that physical and mental exercise can reduce the rate of decline. For example, contemplative practices such as meditation, yoga, and Tai Chi or qigong have all been shown to be beneficial in slowing or delaying physical and mental decline with aging and with improving depression. There is, however, been very little research on the mechanisms by which Tai Chi practice improves depression in the elderly.

 

In today’s Research News article “The Effects of Tai Chi on Heart Rate Variability in Older Chinese Individuals with Depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313592/), Liu and colleagues recruited elderly (aged 60 and older) who were not taking antidepressant medications or drinking alcohol, but who scored as having mild depression on an elderly depression scale. They were randomly assigned to either receive Tai Chi training for 60 minutes, 3 times per week for 24 weeks, or to a no-treatment control condition. The elderly were measured before and after treatment for depression, and heart rate variability, a measure of autonomic nervous system activity.

 

They found that in comparison to baseline and the control group the Tai Chi participants had significantly decreased levels of depression and significant decreases in low frequency heart rate variability and significant increases in high frequency heart rate variability. The higher the levels of high frequency heart rate variability the lower the levels of depression and the lower the levels of low frequency heart rate variability the lower the levels of depression.

 

These findings are interesting and suggest that Tai Chi training reduces depression in the elderly. The results further suggest that Tai Chi training may do so by creating balance between the sympathetic and parasympathetic nervous systems. High frequency heart rate variability is suggestive of parasympathetic (relaxation) activity and this was increased by Tai Chi training while low frequency heart rate variability is suggestive of sympathetic (activation) activity and this was decreased by Tai Chi training. Hence, the results suggest that Tai Chi training may lead to less activation and greater relaxation and this may counter depression.

 

So, improve depression by modulating the autonomic nervous system in the elderly with Tai Chi

 

 “Tai chi has many physical and emotional benefits. Some of the benefits of tai chi include decreased anxiety and depression and improvements in cognition. It may also help you manage symptoms of some chronic diseases.” – Healthline

 

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, J., Xie, H., Liu, M., Wang, Z., Zou, L., Yeung, A. S., … Yang, Q. (2018). The Effects of Tai Chi on Heart Rate Variability in Older Chinese Individuals with Depression. International journal of environmental research and public health, 15(12), 2771. doi:10.3390/ijerph15122771

 

Abstract

Background Very little research has been done to simultaneously investigate the effects of Tai Chi (TC) on depression and heart rate variability (HRV). This study, therefore, attempted to explore the effects of TC on depression and on HRV parameters. Methods Sixty older individuals with depression score of 10 or above (the Geriatric Depression Scale, GDS) were randomly assigned into two groups: TC (n = 30) and control group (n = 30). Participants in the experimental group participated in a 24-week TC training program (three 60-min sessions per week), whereas individuals in the control group maintained their unaltered lifestyle. Depression and HRV were measured using the GDS and digital electrocardiogram at baseline and after the 24-week intervention. Results The TC had produced significant positive chances in depression and some HRV parameters (mean heart rate, RMSSD, HF, LFnorm, and HFnorm) (p < 0.05), whereas these positive results were not observed in the control group. Conclusions The results of this study indicated that TC may alleviate depression of the elderly through modulating autonomous nervous system or HRV parameters. This study adds to a growing body of research showing that TC may be effective in treating depression of the elderly. Tai Chi as a mild to moderate mind-body exercise is suitable for older individuals who suffer from depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313592/

 

Improve the Psychological Well-Being of the Chronically Ill with Yoga

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Improve the Psychological Well-Being of the Chronically Ill with Yoga

 

By John M. de Castro, Ph.D.

 

“Yoga can reduce stress, anxiety, and fatigue in people living with chronic illness, and it can improve immune function. Yoga can also stimulate the parasympathetic nervous system (the part of the nervous system that helps you to rest and heal).” – Kayla Kurin

 

Chronic diseases are long-term illnesses that last more than a year, limit the individual’s ability to conduct their lives, and require medical attention. These include cancer, cardiovascular diseases, digestive diseases, skin diseases, diabetes, pulmonary diseases, neurological diseases, arthritis, chronic pain, obesity, and mental illness. Chronic diseases affect approximately 40% of the total adult population. As such they put a tremendous strain on the medical systems not to mention on individuals and families.

 

People with chronic diseases often also suffer from chronic fatigue, pain, stress, and mood disorders especially depression. They also have difficulty working and have a decreased quality of life. So, it is very important to find effective means of treating patients with chronic illnesses. Yoga practice has been found to be helpful for patients with many of these illnesses. But it is important to further study the effectiveness of yoga practice for patients with chronic illnesses.

 

In today’s Research News article “Mental Wellbeing, Quality of Life, and Perception of Chronic Illness in Yoga-Experienced Compared with Yoga-Naïve Patients.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6542302/), Telles and colleagues recruited patients with chronic noncommunicable diseases and asked if they practiced yoga. They were measured for their perception of their disease, mental well-being, and quality of life, including psychological, environmental, and total facets.

 

They found that the experienced yoga practitioners had significantly greater mental well-being, perceived control over their illnesses, and in their psychological, environmental, and total quality of life. They also found that the longer that the patients had been practicing yoga the higher the scores on perception of their illness, mental well-being, and quality of life.

 

These findings are not due to active manipulation and it is possible that patients who chose to practice yoga are characteristically different from patients who do not. These findings need to be replicated in a randomized controlled trial. With this caveat in mind the results suggest that yoga practice is beneficial for patients with chronic noncommunicable diseases, improving their perception of their illness, mental well-being and quality of life. Chronic diseases are difficult to deal with. So, it is important to find the potential of yoga practice to help relieve at least some of their suffering.

 

So, improve the psychological well-being of the chronically ill with yoga.

 

“a consistent practice of yoga and meditation often helps people who are dealing with illness by reducing stress, alleviating symptoms of the disease and side effects of medication, boosting the immune system, and increasing overall comfort.” – Julie Eisenberg

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Telles, S., Gupta, R. K., Kumar, A., Pal, D. K., Tyagi, D., & Balkrishna, A. (2019). Mental Wellbeing, Quality of Life, and Perception of Chronic Illness in Yoga-Experienced Compared with Yoga-Naïve Patients. Medical science monitor basic research, 25, 153–163. doi:10.12659/MSMBR.914663

 

Abstract

Background

Perception of chronic illness and a positive outlook improve recovery, and yoga can improve wellbeing. This study aimed to compare perception, mental wellbeing, and quality of life in yoga-experienced compared with yoga-naïve patients with chronic illness and to determine whether the duration of yoga practice in the yoga-experienced group had any correlation with the perception of illness, mental wellbeing, and quality of life.

Material/Methods

A cross-sectional comparative study recruited 419 patients with chronic non-communicable disease. Yoga-experienced patients (n=150) (mean age, 41.9±13.6 years) and yoga-naïve patients (n=269) (mean age, 41.2±12.6 years) were assessed for the perception of their illness, mental wellbeing, and quality of life using the Warwick-Edinburgh mental wellbeing scale (WEMWBS) and the World Health Organization quality of life (WHOQOL-BREF) self-reporting questionnaire.

Results

The yoga-experienced group had significantly increased mental wellbeing, personal control as a dimension of their perception of illness, and psychological and environmental quality of life compared with the yoga-naïve group (all, p<0.05), when comparisons were made using the Mann-Whitney U test. The duration of yoga practised in months was positively-correlated with mental wellbeing and different aspects of quality of life. There was a negative correlation with the perception of illness suggesting that the illness was perceived to be less severe (all, p<0.05) when correlations were made using Spearman’s rank correlation coefficient.

Conclusions

In patients with chronic illness, yoga improved mental wellbeing, aspects of quality of life, and resulted in a positive perception of illness.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6542302/

 

Improve Empathy, Compassion, and Prosocial Behaviors with Meditation

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Improve Empathy, Compassion, and Prosocial Behaviors with Meditation

 

By John M. de Castro, Ph.D.

 

“From the philosophical and religious traditions from which mindfulness comes, it’s been long understood that practicing meditation, and cultivating mindfulness, in particular, can conduce to virtuous action.” – Daniel Berry

 

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

 

Mindfulness has been found to increase prosocial emotions such as compassion, and empathy and prosocial behaviors such as altruism. These changes in turn reduce antisocial behaviors such as violence and aggression. The research findings on the effectiveness of meditation practice in developing prosocial attitudes and behaviors is accumulating. So, it makes sense to take a step back and summarize what’s been learned.

 

In today’s Research News article “A Systematic Review and Meta-analysis of the Effects of Meditation on Empathy, Compassion, and Prosocial Behaviors.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6081743/), Luberto and colleagues review, summarize, and perform a meta-analysis on the effects of meditation practice on procociality; “empathy, compassion, sympathy, love, altruism, and kindness.” They discovered 26 studies, 22 examined adults while 4 examined children.

 

They report that the published studies found that meditation practices produced significant increases in empathy, compassion, and prosocial behaviors. Mediation analyses suggest that meditation practice improves social-emotional functioning that in turn improves prosocial behaviors. It also suggests that this is in part due to meditation practice producing a physical and psychological relaxation response that counters stress effects. Regardless the published research literature makes it clear that meditation practice improves social emotions and behaviors. This may lead to a smoother and more effectively functioning society and to greater social cohesion and happiness.

 

So, improve empathy, compassion, and prosocial behaviors with meditation.

 

“the research shows that mindfulness increases empathy and compassion for others and for oneself, and that such attitudes are good for you.” – Shauna Shapiro

 

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

 

Luberto, C. M., Shinday, N., Song, R., Philpotts, L. L., Park, E. R., Fricchione, G. L., & Yeh, G. Y. (2018). A Systematic Review and Meta-analysis of the Effects of Meditation on Empathy, Compassion, and Prosocial Behaviors. Mindfulness, 9(3), 708–724. doi:10.1007/s12671-017-0841-8

 

Abstract

Increased attention has focused on methods to increase empathy, compassion, and pro-social behavior. Meditation practices have traditionally been used to cultivate pro-social outcomes, and recently investigations have sought to evaluate their efficacy for these outcomes. We conducted a systematic review and meta-analysis of meditation for pro-social emotions and behavior. A literature search was conducted in PubMed, MEDLINE, PsycINFO, CINAHL, Embase, and Cochrane databases (inception-April 2016) using the search terms: mindfulness, meditation, mind-body therapies, tai chi, yoga, MBSR, MBCT, empathy, compassion, love, altruism, sympathy, or kindness. Randomized controlled trials in any population were included (26 studies with 1,714 subjects). Most were conducted among healthy adults (n=11) using compassion or loving kindness meditation (n=18) over 8–12weeks (n=12) in a group format (n=17). Most control groups were wait-list or no-treatment (n=15). Outcome measures included self-reported emotions (e.g., composite scores, validated measures) and observed behavioral outcomes (e.g., helping behavior in real-world and simulated settings). Many studies showed a low risk of bias. Results demonstrated small to medium effects of meditation on self-reported (SMD = .40, p < .001) and observable outcomes (SMD = .45, p < .001) and suggest psychosocial and neurophysiological mechanisms of action. Subgroup analyses also supported small to medium effects of meditation even when compared to active control groups. Clinicians and meditation teachers should be aware that meditation can improve positive pro-social emotions and behaviors.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6081743/

 

Improve Attentional Monitoring of Others Emotions with Mindfulness

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Improve Attentional Monitoring of Others Emotions with Mindfulness

 

By John M. de Castro, Ph.D.

 

“experience with mindfulness meditation is associated with distinct reactions to emotional provocations in attention and social decision-making tasks, and have implications for understanding the relationship between mindfulness meditation and emotion regulation.” – Deidre Reis

 

Mindfulness practice has been shown to improve emotion regulation. Practitioners demonstrate the ability to fully sense and experience emotions, but respond to them in more 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.

 

There is evidence that mindfulness training improves emotion regulation by altering the brain. A common method to study the activity of the nervous system is to measure the electrical signal at the scalp above brain regions. Changes in this activity are measurable with mindfulness training. One method to observe emotional processing in the brain is to measure the changes in the electrical activity that occur in response to specific emotional stimuli. These are called event-related potentials or ERPs. The signal following a stimulus changes over time.

 

The fluctuations of the signal after specific periods of time are thought to measure different aspects of the nervous system’s processing of the stimulus. The N200 response in the evoked potential (ERP) is a negative going electrical response occurring between a 2.0 to 3.5 tenths of a second following the target stimulus presentation. The N200 component is thought to reflect attentional monitoring of conflict. The P300 response in the evoked potential (ERP) is a positive going electrical response occurring between a 3.5 to 6.0 tenths of a second following the target stimulus presentation. The P300 component is thought to reflect inhibitory processes.

 

In today’s Research News article “Brief mindfulness training enhances cognitive control in socioemotional contexts: Behavioral and neural evidence.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6641506/), Quaglia and colleagues recruited healthy adults and randomly assigned them to receive 4 20-minute sessions of either mindfulness training or book listening. They were measured before and after training for mindfulness and were tested with an emotional go no-go task in which they were asked to press a button when a picture of a face was presented that expressed a particular emotion and not respond to faces with other emotions. The pictures were of faces expression either anger, happiness, or neutral emotions. During the task the brain electrical activity was recorded with an electroencephalograph (EEG).

 

They found, as expected, that the group receiving mindfulness training, in comparison to the book listening group, had significantly higher mindfulness following training. They found that the mindfulness group, after training had significantly better scores, including both speed and accuracy, for facial emotion discrimination than the control group. With the evoked potentials, they found that on no-go trials, trials where the target facial emotion was not present. The mindfulness trained participants had significantly larger N200 amplitudes than the controls.

 

These results suggest that mindfulness training makes the individual more sensitive to emotional expressions by others. The evoked potentials in the EEGs suggest that mindfulness training did this by enhancing the brain’s ability to pay attention and monitor conflict allowing the individual to better withhold responses when appropriate. This could, in part, explain the improvement of emotion regulation with mindfulness training and may be the basis for the prior findings that mindfulness training improves responding in social contexts.

 

So, improve attentional monitoring of others emotions with mindfulness.

 

“our cognitive structures, as a developmental system, have the capacity to advance to a higher (more accurate) level of understanding about social and psychological reality, as the result of learning from the interacting experiences.” – Key Sun

 

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

 

Quaglia, J. T., Zeidan, F., Grossenbacher, P. G., Freeman, S. P., Braun, S. E., Martelli, A., … Brown, K. W. (2019). Brief mindfulness training enhances cognitive control in socioemotional contexts: Behavioral and neural evidence. PloS one, 14(7), e0219862. doi:10.1371/journal.pone.0219862

 

Abstract

In social contexts, the dynamic nature of others’ emotions places unique demands on attention and emotion regulation. Mindfulness, characterized by heightened and receptive moment-to-moment attending, may be well-suited to meet these demands. In particular, mindfulness may support more effective cognitive control in social situations via efficient deployment of top-down attention. To test this, a randomized controlled study examined effects of mindfulness training (MT) on behavioral and neural (event-related potentials [ERPs]) responses during an emotional go/no-go task that tested cognitive control in the context of emotional facial expressions that tend to elicit approach or avoidance behavior. Participants (N = 66) were randomly assigned to four brief (20 min) MT sessions or to structurally equivalent book learning control sessions. Relative to the control group, MT led to improved discrimination of facial expressions, as indexed by d-prime, as well as more efficient cognitive control, as indexed by response time and accuracy, and particularly for those evidencing poorer discrimination and cognitive control at baseline. MT also produced better conflict monitoring of behavioral goal-prepotent response tendencies, as indexed by larger No-Go N200 ERP amplitudes, and particularly so for those with smaller No-Go amplitude at baseline. Overall, findings are consistent with MT’s potential to enhance deployment of early top-down attention to better meet the unique cognitive and emotional demands of socioemotional contexts, particularly for those with greater opportunity for change. Findings also suggest that early top-down attention deployment could be a cognitive mechanism correspondent to the present-oriented attention commonly used to explain regulatory benefits of mindfulness more broadly.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6641506/

 

Improve Chronic Low Back Pain with Mindful Movement Practices

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Improve Chronic Low Back Pain with Mindful Movement Practices

 

By John M. de Castro, Ph.D.

 

“Tai chi helps with back pain in several ways. It strengthens the muscles in your abdomen and pelvic area that are crucial to supporting the lower back; it improves your balance and flexibility; and it makes you more aware of your posture when you sit, stand, and walk.” – Benjamin Kligler

 

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. The pain interferes with daily living and with work, interfering with productivity and creating absences. 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.

 

Pain involves both physical and psychological issues. Physically, exercise can be helpful in strengthening the back to prevent or relieve pain. Psychologically, 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. Mindfulness practices have been shown to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. Indeed, mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of low back pain. Tai Chi, Qigong, and yoga  are both exercises and mindfulness practices that have been found to be effective for back pain. There is accumulating evidence. So, it is useful to take a step back and summarize what has been found.

 

In today’s Research News article “Are Mindful Exercises Safe and Beneficial for Treating Chronic Lower Back Pain? A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6571780/), Zou and colleagues review, summarize, and perform a meta-analysis of the effects of the mindful movement practices of Tai Chi, Qigong, and yoga on chronic low back pain. The identified 17 randomized controlled trials that included a total of 2022 participants.

 

They report that the published research found that both Tai Chi and yoga practices produced significant reductions in pain intensity and back specific disability in patients with chronic low back pain. There were no reported adverse events with Tai Chi practice but there were a few adverse events reported with yoga practice. So, although both are effective in treating chronic low back pain, more care must be taken with yoga practice to protect against injury.

 

The results of the published research strongly suggests that Tai Chi  practice should be prescribed for chronic low back pain, reducing pain and disability. In addition, Tai Chi is a gentle and safe mindfulness practice. It is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It is inexpensive to administer, can be performed in groups or alone, at home or in a facility, and can be quickly learned. In addition, it can be practiced in social groups. This can make it fun, improving the likelihood of long-term engagement in the practice. So, Tai Chi practice would appear to be an excellent gentle practice to chronic low back pain.

 

So, improve chronic low back pain with mindful movement practices.

 

“On the physical side, tai chi supports or improves balance, coordination, flexibility, muscle strength, and stamina. On the mental side, tai chi helps relieve stress, improves body awareness and, when done in a group setting, reduces social isolation.” – Harvard Health

 

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

 

Zou, L., Zhang, Y., Yang, L., Loprinzi, P. D., Yeung, A. S., Kong, J., … Li, H. (2019). Are Mindful Exercises Safe and Beneficial for Treating Chronic Lower Back Pain? A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of clinical medicine, 8(5), 628. doi:10.3390/jcm8050628

 

Abstract

Background: Chronic low back pain (CLBP) is a common health issue worldwide. Tai Chi, Qigong, and Yoga, as the most widely practiced mindful exercises, have promising effects for CLBP-specific symptoms. Objective: We therefore conducted a comprehensive review investigating the effects of mindful exercises versus active and/or non-active controls while evaluating the safety and pain-related effects of mindful exercises in adults with CLBP. Methods: We searched five databases (MEDLINE, EMBASE, SCOPUS, Web of Science, and Cochrane Library) from inception to February 2019. Two investigators independently selected 17 eligible randomized controlled trials (RCT) against inclusion and exclusion criteria, followed by data extraction and study quality assessment. Standardized mean difference (SMD) was used to determine the magnitude of mindful exercises versus controls on pain- and disease-specific outcome measures. Results: As compared to control groups, we observed significantly favorable effects of mindful exercises on reducing pain intensity (SMD = −0.37, 95% CI −0.5 to −0.23, p < 0.001, I2 = 45.9 %) and disability (SMD = −0.39, 95% CI −0.49 to −0.28, p < 0.001, I2 = 0 %). When compared with active control alone, mindful exercises showed significantly reduced pain intensity (SMD = −0.40, p < 0.001). Furthermore, of the three mindful exercises, Tai Chi has a significantly superior effect on pain management (SMD= −0.75, 95% CI −1.05 to −0.46, p < 0.001), whereas Yoga-related adverse events were reported in five studies. Conclusion: Findings of our systematic review suggest that mindful exercises (Tai Chi and Qigong) may be beneficial for CLBP symptomatic management. In particular, Tai Chi appears to have a superior effect in reducing pain intensity irrespective of non-control comparison or active control comparison (conventional exercises, core training, and physical therapy programs). Importantly, training in these mindful exercises should be implemented with certified instructors to ensure quality of movement and injury prevention.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6571780/

 

Improve Adolescent Emotion Regulation and Mental Health with Mindfulness

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Improve Adolescent Emotion Regulation and Mental Health with Mindfulness

 

By John M. de Castro, Ph.D.

 

“But a growing body of evidence suggests that mindfulness practice could be beneficial to teens, helping them cultivate empathy, as well as skills for concentration and impulse control. In short, mindfulness can help adolescents navigate the challenges of adolescence.” – Sarah Rudell Beach

 

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.

 

Mindfulness training in adults has been shown to reduce anxiety, depression, and perceived stress levels and improve emotional regulation. In addition, in adolescents it has been shown to improve emotion regulation and to benefit the psychological and emotional health. There is a need to explore the relationship between these effects of mindfulness training in adolescents.

 

In today’s Research News article “Adolescents’ Mindfulness and Psychological Distress: The Mediating Role of Emotion Regulation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567674/), Ma and Fang recruited middle school students between the ages of 12-18 years and had them complete scales measuring mindfulness, anxiety, depression, perceived stress, difficulties with emotion regulation, and emotion regulation.

 

They found that the higher the levels of mindfulness, the lower the levels of anxiety, depression, perceived stress, and difficulties with emotion regulation, including all subscales; “lack of emotional clarity (Clarity), difficulty in engaging in goal-directed behavior under negative emotions (Goals), loss of control under negative emotions (Impulse), limited strategies for emotion regulation (Strategies), and non-acceptance of emotional responses (Non-acceptance).” Using a mediation model, they found that high levels of mindfulness were related to lower levels of anxiety, depression, and perceived stress directly and indirectly as a results of mindfulness’ negative relationship with difficulties with emotion regulation. In other words, mindfulness was directly related to lower levels of psychological distress and also indirectly by its relationship with lower levels of difficulties with emotion regulation which were in turn related to less psychological distress.

 

The study is correlational and as such causation cannot be concluded. But prior research has demonstrated that mindfulness causes reductions in anxiety, depression, perceived stress, and difficulties with emotional regulation. Hence, it would be reasonable to conclude that the present findings were also due to the effects of mindfulness on psychological health.

 

Adolescence is a time of strong emotions that the adolescents have not yet learned how to effectively regulate. This makes this period of life very difficult with high levels of emotional distress. The finding though indicate that mindfulness may be a way to mitigate the emotional upheavals of adolescence of improve the psychological health of the teens by improving their ability to deal with their emotions.

 

So, improve adolescent emotion regulation and mental health with mindfulness.

 

“Mindfulness teaches teenagers to recognize the downward spiral of thoughts before it gets out of hand, perhaps learning to label it as simply “worrying.” They can acknowledge the anxiety without getting caught up in it, without it leading to the rumination that ultimately ruins their mood.” – Sarah Rudell Beach

 

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

 

Ma, Y., & Fang, S. (2019). Adolescents’ Mindfulness and Psychological Distress: The Mediating Role of Emotion Regulation. Frontiers in psychology, 10, 1358. doi:10.3389/fpsyg.2019.01358

 

Abstract

Mindfulness has been widely linked with psychological well-being in general population. There are emerging studies supporting the relationship between adolescents’ mindfulness and their mental health. However, the mechanisms through which mindfulness may influence adolescents’ psychological distress have only recently been explored, and more related research is still needed. This study investigated the relationship between adolescents’ dispositional mindfulness and psychological symptoms of depression, anxiety and stress. The mediating variables were also explored in perspective of two common emotion regulation theories, which were measured through Difficulties in Emotion Regulation Scale (DERS) and Emotion Regulation Questionnaire (ERQ). DERS has been used as a comprehensive assessment of emotion regulation difficulties. ERQ is also widely accepted to measure the emotion regulation process including dimensions of cognitive reappraisal and expressive suppression. Measures assessing mindfulness, emotion regulation, and psychological distress were administered to 1067 adolescents in mainland China. The results confirmed that adolescents’ dispositional mindfulness was negatively associated with depression, anxiety, and stress. DERS, especially the sub-dimensions of Acceptance and Strategies, significantly mediated the relationship between mindfulness and symptoms of depression, anxiety and stress. Whereas, ERQ including subscales of cognitive reappraisal and expressive suppression exerted limited mediating effect. These findings provided insights for the potential underlying mechanism between adolescents’ mindfulness and psychological distress, demonstrating that DERS might be more pervasive than ERQ. Further research was suggested to explore other mediating variables underlying mindfulness and psychological distress among adolescents and develop mindfulness-based programs to improve adolescents’ mindfulness and emotion regulation ability.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567674/

 

Different Activity of the Brain is Associated with Meditation

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Different Activity of the Brain is Associated with Meditation

 

By John M. de Castro, Ph.D.

 

“Backed by 1000’s of studies, meditation is the neuroscientific community’s most proven way to upgrade the human brain.” – EOC Institute

 

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

 

In today’s Research News article “Mindfulness Meditation Is Related to Long-Lasting Changes in Hippocampal Functional Topology during Resting State: A Magnetoencephalography Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312586/), Lardone and colleagues recruited healthy adult participants who had practiced Vipassana meditation for at least one year and participants who had never meditated. They recorded functional connectivity of brain regions with magnetoencephalography, a technique to record brain activity.

 

They found that in comparison to non-meditators, the meditators had increased activity in the Amygdala in the gamma frequency band (25-100 hz), the Hippocampus, the Caudate and the Cingulum in the Theta frequency band (4-8 hz), and the prefrontal cortex in the alpha frequency band (8-12 hz). Hence, there were significant differences in neural activity in the brains of meditators vs. non-meditators.

 

This study is correlative and causation cannot be determined. Meditation may cause these brain activity changes, or people with these kinds of brain activity are likely to engage in meditation, or some third factor may cause them both to covary. Nevertheless, it is clear that meditation practice is associated with different brain activity. This may be the physiological process that underlies some or all of the widespread psychological and physical benefits of meditation practice.

 

“Meditation provides experiences that the mind can achieve no other way, such as inner silence and expanded awareness. And as the mind gains experience, the brain shows physical activity as well—sometimes profound changes.” – Deepak Chopra

 

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

 

Lardone, A., Liparoti, M., Sorrentino, P., Rucco, R., Jacini, F., Polverino, A., … Mandolesi, L. (2018). Mindfulness Meditation Is Related to Long-Lasting Changes in Hippocampal Functional Topology during Resting State: A Magnetoencephalography Study. Neural plasticity, 2018, 5340717. doi:10.1155/2018/5340717

 

Abstract

It has been suggested that the practice of meditation is associated to neuroplasticity phenomena, reducing age-related brain degeneration and improving cognitive functions. Neuroimaging studies have shown that the brain connectivity changes in meditators. In the present work, we aim to describe the possible long-term effects of meditation on the brain networks. To this aim, we used magnetoencephalography to study functional resting-state brain networks in Vipassana meditators. We observed topological modifications in the brain network in meditators compared to controls. More specifically, in the theta band, the meditators showed statistically significant (p corrected = 0.009) higher degree (a centrality index that represents the number of connections incident upon a given node) in the right hippocampus as compared to controls. Taking into account the role of the hippocampus in memory processes, and in the pathophysiology of Alzheimer’s disease, meditation might have a potential role in a panel of preventive strategies.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312586/

 

Improve Mental Health Postpartum with Perinatal Mindfulness Training

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Improve Mental Health Postpartum with Perinatal Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“the ideal treatment plan for perinatal depression and anxiety often includes mindfulness techniques. Exercises such as deep breathing, progressive muscle relaxation, and meditation, for example, have been shown to reduce blood pressure and promote recovery from many illnesses.” – Edith Gettes

 

The birth of a child is most often a joyous occasion. But often the joy turns to misery. Immediately after birth it is common for the mother to experience mood swings including what has been termed “baby blues,” a sadness that may last for as much as a couple of weeks. But some women experience a more intense and long-lasting negative mood called postpartum depression. This occurs usually 4-6 weeks after birth in about 15% of births; about 600,000 women in the U.S. every year. For 50% of the women the depression lasts for about a year while about 30% are still depressed 3 years later.

 

Mindfulness training has been shown to improve anxiety and depression in general and to relieve maternal anxiety and depression during pregnancy. But it is not known if the effectiveness of mindfulness training during the perinatal period carries over to the postpartum period. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression and consists of mindfulness training and Cognitive Behavioral Therapy (CBT). During therapy the patient is trained to investigate and alter aberrant thought patterns underlying depression. So, it would make sense to study the effectiveness of MBCT administered during the perinatal period on postpartum mental health issues.

 

In today’s Research News article “Postpartum Outcomes and Formal Mindfulness Practice in Mindfulness-Based Cognitive Therapy for Perinatal Women.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6070304/), Luberto and colleagues recruited pregnant women (average of 15.5 weeks pregnant) and provide them with an 8-week program of Mindfulness-Based Cognitive Therapy (MBCT). They were measured before and after training and 3 months postpartum for anxiety, depression, worry, mindfulness, self-compassion, meditation frequency, and home practice.

 

They found that after treatment there were significant increases in mindfulness and self-compassion and significant decreases in anxiety, depression, and worry. These improvements were maintained at 3-months postpartum except for depression that had a further significant decline. After the intervention 91% of the women continued to practice meditation and 65% continued practicing yoga. During the postpartum period 55% of the women continued to practice meditation and 25% continued practicing yoga. There were no significant differences in the outcomes for women who continued to practice versus those that didn’t.

 

These results are important in that they demonstrate that Mindfulness-Based Cognitive Therapy (MBCT)  produces important benefits for the mental health of pregnant women that endure into the postpartum period. This is important as “baby blues” and postpartum depression are frequent and difficult consequences of childbirth. The findings suggest that MBCT training during pregnancy may help to prevent “baby blues” and postpartum depression. Hence, MBCT the produces lasting improvements in the psychological state of women during both the perinatal and postpartum periods.

 

So, improve mental health postpartum with perinatal mindfulness training.

 

“By paying attention, by being mindful, I was able to accept things that spun me out previously. I still had low points, but I was better equipped to manage and accept them as feelings and moments, and move on. . . . What I thought was caused by hormone fluctuations and “baby blues” was actually much more severe.” – Kristi Pahr

 

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

 

Luberto, C. M., Park, E. R., & Goodman, J. H. (2018). Postpartum Outcomes and Formal Mindfulness Practice in Mindfulness-Based Cognitive Therapy for Perinatal Women. Mindfulness, 9(3), 850–859. doi:10.1007/s12671-017-0825-8

 

Abstract

Anxiety is common during pregnancy and associated with poorer outcomes for mother and child. Our single-arm pilot study of an eight-week Mindfulness-Based Cognitive Therapy (MBCT) intervention for pregnant women with elevated anxiety showed significant pre- to post-intervention improvements in anxiety, depression, worry, mindfulness, and self-compassion. It remains unclear whether these improvements are maintained post-partum and whether amount of formal mindfulness practice is correlated with outcomes. The current study examined whether 1) improvements in psychosocial outcomes were maintained three months postpartum; 2) women were adherent to formal practice recommendations; and 3) amount of mindfulness practice was correlated with outcomes. Twenty-three pregnant women (Mage=33.5, SD=4.40; 75% White; 71% with Generalized Anxiety Disorder) completed home practice logs throughout the intervention, and self-report measures before and after the intervention and three months postpartum. Results indicated that previously reported post-intervention improvements in anxiety, worry, mindfulness, and self-compassion were maintained postpartum (p’s<.05), and reductions in depression further improved (p<.001). Participants were generally adherent to mindfulness practice recommendations during the intervention (54%-80% weekly adherence; M=17.31 total practice hours [SD=7.45]), and many continued practicing one-week post-intervention (91%) and postpartum (55%). Mindfulness practice during the intervention was not significantly correlated with any outcome at post-intervention or postpartum. Mindfulness practice postpartum was only marginally related to improved worry postpartum (p=.05). MBCT may be associated with maintained improvements in psychosocial outcomes for women during pregnancy and postpartum, but the role of mindfulness practice is unclear. Research using larger samples and randomized controlled designs is needed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6070304/

 

Improve Children and Adolescents Mental Health with Mindfulness

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Improve Children and Adolescents Mental Health with Mindfulness

 

By John M. de Castro, Ph.D.

 

“In the last few years mindfulness has emerged as a way of treating children and adolescents with conditions ranging from ADHD to anxiety, autism spectrum disorders, depression and stress. And the benefits are proving to be tremendous.” – Julianne Garey

 

Childhood is a miraculous period during which the child is dynamically absorbing information from every aspect of its environment. This occurs almost without any intervention from the adults as the child appears to be programmed to learn. It is here that behaviors, knowledge, skills, and attitudes are developed that shape the individual.

 

Adolescence is a time of mental, physical, social, and emotional growth. It is during this time that higher levels of thinking, sometimes called executive function, develops. 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.

 

Mindfulness training for children and adolescents has been shown to have very positive effects. These include academic, cognitive, psychological, and social domains. Mindfulness training has been shown to improve emotion regulation and to benefit the psychological and emotional health of adolescents. Importantly, mindfulness training with children and adolescents appears to improve the self-concept, improves attentional ability and reduces stress. The research findings and evidence are accumulating. So, it makes sense to step back and review and summarize what has been learned regarding the effectiveness of mindfulness training for the cognitive growth and mental health and well-being of children and adolescents.

 

In today’s Research News article “Research Review: The effects of mindfulness-based interventions on cognition and mental health in children and adolescents – a meta-analysis of randomized controlled trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6546608/), Dunning and colleagues review, summarize and perform a meta-analysis of randomized controlled trials of the effects of mindfulness training on the cognitive ability, psychological health, and well-being of children and adolescents. They identified 33 published randomized controlled trials, 17 of which had active control conditions.

 

They found that over all published studies, mindfulness training resulted in improved cognition and executive function, with larger effects for older children and adolescents. Mindfulness training also produced significantly increased mindfulness and decreased negative behaviors, stress, anxiety and depression. increased mindfulness and decreased stress, anxiety and depression were still significant. But when mindfulness practices were compared to active control conditions cognitive improvements were no longer significant but there were still significant increases in mindfulness and decreases in stress, anxiety and depression.

 

These results are interesting and suggest that mindfulness training produces significant improvements in the mental health of children and adolescents. The results, however, suggest that reported improvements in cognition and behavior may be due to placebo or experimenter bias effects as these same improvements occurred with active control conditions. The improvements in cognitive ability appears to be maximized in adolescents when high level executive functions are developing. The lack of significant effects in studies with active control conditions may have been due to the small number of studies, 7, that had active controls and studied cognition.

 

Regardless, the accumulated research suggests that training children and adolescents in mindfulness may help them navigate the difficult emotional challenges confronting them during development.

 

So, improve children and adolescents’ mental health with mindfulness.

 

“For children, mindfulness can offer relief from whatever difficulties they might be encountering in life. It also gives them the beauty of being in the present moment.” – Annaka Harris

 

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

 

Dunning, D. L., Griffiths, K., Kuyken, W., Crane, C., Foulkes, L., Parker, J., & Dalgleish, T. (2019). Research Review: The effects of mindfulness-based interventions on cognition and mental health in children and adolescents – a meta-analysis of randomized controlled trials. Journal of child psychology and psychiatry, and allied disciplines, 60(3), 244–258. doi:10.1111/jcpp.12980

 

Abstract

Background

Mindfulness based interventions (MBIs) are an increasingly popular way of attempting to improve the behavioural, cognitive and mental health outcomes of children and adolescents, though there is a suggestion that enthusiasm has moved ahead of the evidence base. Most evaluations of MBIs are either uncontrolled or nonrandomized trials. This meta-analysis aims to establish the efficacy of MBIs for children and adolescents in studies that have adopted a randomized, controlled trial (RCT) design.

Methods

A systematic literature search of RCTs of MBIs was conducted up to October 2017. Thirty-three independent studies including 3,666 children and adolescents were included in random effects meta-analyses with outcome measures categorized into cognitive, behavioural and emotional factors. Separate random effects meta-analyses were completed for the seventeen studies (n = 1,762) that used an RCT design with an active control condition.

Results

Across all RCTs we found significant positive effects of MBIs, relative to controls, for the outcome categories of Mindfulness, Executive Functioning, Attention, Depression, Anxiety/Stress and Negative Behaviours, with small effect sizes (Cohen’s d), ranging from .16 to .30. However, when considering only those RCTs with active control groups, significant benefits of an MBI were restricted to the outcomes of Mindfulness (d = .42), Depression (d = .47) and Anxiety/Stress (d = .18) only.

Conclusions

This meta-analysis reinforces the efficacy of using MBIs for improving the mental health and wellbeing of youth as assessed using the gold standard RCT methodology. Future RCT evaluations should incorporate scaled-up definitive trial designs to further evaluate the robustness of MBIs in youth, with an embedded focus on mechanisms of action.

Key points

  • Mindfulness based interventions (MBIs) are a popular way of attempting to improve the mental and physical health outcomes of children and adolescents.
  • This is the first meta-analysis of MBIs with youth composed exclusively of randomized controlled trials (RCTs) including RCTs with active control groups – the gold standard in intervention studies.
  • When using the gold standard research design results showed that MBIs are useful in improving Depression and Anxiety outcomes, but not behavioural or cognitive outcomes,
  • The meta-analysis advocates the use of MBIs for improving mental health in young people.
  • Future RCT evaluations should incorporate scaled-up definitive trial designs to further evaluate the robustness of MBIs in youth, with an embedded focus on mechanisms of action.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6546608/