Improve Chronic Low Back Pain with Yoga

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Improve Chronic Low Back Pain with Yoga

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

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

 

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

 

So, improve chronic low back pain with yoga.

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

Background:

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

Objective:

To determine whether yoga is noninferior to PT for cLBP.

Design:

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

Setting:

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

Participants:

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

Intervention:

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

Measurements:

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

Results:

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

Limitations:

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

Conclusion:

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

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

 

Possibly Improve Dementia Patient Caregiver Mental Health with Mindfulness

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Possibly Improve Dementia Patient Caregiver Mental Health with Mindfulness

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

Background

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

Objectives

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

Search methods

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

Selection criteria

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

Data collection and analysis

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

Main results

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

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

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

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

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

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

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

Authors’ conclusions

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

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

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

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

 

Improve Psychological Functioning with Mindfulness

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Improve Psychological Functioning with Mindfulness

 

By John M. de Castro, Ph.D.

 

” the positive potential benefits of mindfulness practice are more attentional control, more effective emotional regulation, enhanced social relationships, reduced risk for physical ailments, enhanced immune system functioning, and better sleep quality.” – Jason Linder

 

Over the last several decades, research and anecdotal experiences have accumulated an impressive evidential case that the development of mindfulness has positive benefits for the individual’s mental, physical, and spiritual life. Mindfulness appears to be beneficial both for healthy people and for people suffering from a myriad of mental and physical illnesses. It appears to be beneficial across ages, from children to the elderly. And it appears to be beneficial across genders, personalities, race, and ethnicity. The breadth and depth of benefits is unprecedented. There is no other treatment or practice that has been shown to come anyway near the range of mindfulness’ positive benefits.

 

The clustering of these benefits may supply a clue as to how mindfulness training is working to improve mental health. This can be investigated by looking at the interrelationships between the effects of mindfulness training. In today’s Research News article “Does mindfulness change the mind? A novel psychonectome perspective based on Network Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6638953/), Roca and colleagues apply network analysis to investigate the interrelationships between a large number of effects of Mindfulness-Based Stress Reduction (MBSR) training.

 

They recruited healthy adult participants in a Mindfulness-Based Stress Reduction (MBSR) program. The MBSR program consisted of 32 hours of training separated into 8 weekly group sessions involving meditation, yoga, body scan, and discussion. The patients were also encouraged to perform daily practice. They were measured before and after MBSR training for meditation experience, and psychological and physical health problems, and 5 categories of mindfulness effects; 1) Mindfulness, including five facets, decentering, non-attachment, and bodily awareness, 2) Compassion, including compassion towards oneself and others and empathy, 3) Psychological well-being, including satisfaction with life, optimism, and overall well-being, 4) Psychological distress, including anxiety, stress, and depression, and 5) Emotional and cognitive control, including emotional regulation, rumination, thought suppression and attentional control.

 

They found that after MBSR training there were significant improvements in effectively all of the five categories. This is not new as much research has demonstrated that mindfulness training produces improvements in mindfulness, compassion, psychological well-being, psychological distress, and emotional and cognitive control.

 

These data were then subjected to network analysis. Prior to MBSR training the network analysis revealed clustering in three paths “mindfulness and self-compassion; clinical symptoms and rumination; and most of FFMQ mindfulness components with attentional control measure.” After MBSR training, however, there was a network reorganization such that the three paths disappeared and were replaced by two paths, psychopathological and adaptive.

 

Centrality measures in the network analysis indicated that both prior to and after MBSR training the most central, fundamental, and interrelated components were all facets of mindfulness and all well-being measures. In addition, Community Analysis revealed that mindfulness, compassion, and emotional regulation were the most highly associated components.

 

The results are complex but suggest that Mindfulness-Based Stress Reduction (MBSR) training reorganizes the associations of psychological variables, simplifying them into two categories representing distress and adaptation. The training may help the individual see the interrelationships of the problems they have and the solutions employed. The results further suggest, not surprisingly, that mindfulness, compassion, and emotion regulation are central to the benefits of mindfulness training. Many other benefits flow from these.

 

So, improve psychological functioning with mindfulness.

 

“Mindfulness-Based Stress Reduction . . . Participants experienced significant decreases in perceived stress, depression, anxiety, emotional dysregulation, and post-traumatic stress symptoms.” – Carolyn McManus

 

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

 

Roca, P., Diez, G. G., Castellanos, N., & Vazquez, C. (2019). Does mindfulness change the mind? A novel psychonectome perspective based on Network Analysis. PloS one, 14(7), e0219793. doi:10.1371/journal.pone.0219793

 

Abstract

If the brain is a complex network of functionally specialized areas, it might be expected that mental representations could also behave in a similar way. We propose the concept of ‘psychonectome’ to formalize the idea of psychological constructs forming a dynamic network of mutually dependent elements. As a proof-of-concept of the psychonectome, networks analysis (NA) was used to explore structural changes in the network of constructs resulting from a psychological intervention. NA was applied to explore the effects of an 8-week Mindfulness-Based Stress Reduction (MBSR) program in healthy participants (N = 182). Psychological functioning was measured by questionnaires assessing five key domains related to MBSR: mindfulness, compassion, psychological well-being, psychological distress and emotional-cognitive control. A total of 25 variables, covering the five constructs, were considered as nodes in the NA. Participants significantly improved in most of the psychological questionnaires. More interesting from a network perspective, there were also significant changes in the topological relationships among the elements. Expected influence and strength centrality indexes revealed that mindfulness and well-being measures were the most central nodes in the networks. The nodes with highest topological change after the MBSR were attentional control, compassion measures, depression and thought suppression. Also, cognitive appraisal, an adaptive emotion regulation strategy, was associated to rumination before the MBSR program but became related to mindfulness and well-being measures after the program. Community analysis revealed a strong topological association between mindfulness, compassion, and emotional regulation, which supports the key role of compassion in mindfulness training. These results highlight the importance of exploring psychological changes from a network perspective and support the conceptual advantage of considering the interconnectedness of psychological constructs in terms of a ‘psychonectome’ as it may reveal ways of functioning that cannot be analyzed through conventional analytic methods.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6638953/

 

Treat Depression with Tai Chi

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Treat Depression with Tai Chi

 

By John M. de Castro, Ph.D.

 

“A 12-week program of instruction and practice of the Chinese martial art tai chi led to significantly reduced symptoms of depression in Chinese Americans not receiving any other treatments.” – Science Daily

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. Depression can be difficult to treat and is usually treated with anti-depressive medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression. Even after remission some symptoms of depression may still be present (residual symptoms).

 

Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering. Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail.  Mindful Movement practices such as Qigong and Tai Chi have been found to be effective for depression. Research has been accumulating. So, it is important to step back and examine what has been learned regarding the application of Tai Chi practice for depression.

 

In today’s Research News article “Treating Depression With Tai Chi: State of the Art and Future Perspectives.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6474282/), Kong and colleagues review and summarize the published research on the effectiveness of Tai Chi practice for depression. They report that the published research has demonstrated that Tai Chi practice significantly decreases depression levels in a variety of groups including adults, the elderly, pregnant women, patients taking antidepressant drugs or not, and those with a variety of diseases including fibromyalgia, arthritis, multiple sclerosis, heart failure, mild dementia, and cerebrovascular disorder.

 

They report that the published research indicates that Tai Chi practice may lower depression by producing neuroplastic changes in the nervous system, particularly the brain’s Default Mode Network that’s known to be involved in self-referential thinking which is prevalent in depression. Another possible mechanism is indicated by the research demonstrating that Tai Chi reduces the physiological and psychological responses to stress, that are known to exacerbate depression. Tai Chi is also known to reduce the inflammatory response that is heightened in depression. In addition, Tai Chi is a mild exercise and exercise has been shown to reduce depression. Finally, Tai Chi practice appears to relax the autonomic component of the peripheral nervous system

 

The results of the published research suggests that Tai Chi  practice should be prescribed for depression. 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, treat depression with Tai Chi.

 

“A 12-week program of instruction and practice of the Chinese martial art tai chi led to significantly reduced symptoms of depression in Chinese Americans not receiving any other treatments.” – Mayo Clinic

 

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

 

Kong, J., Wilson, G., Park, J., Pereira, K., Walpole, C., & Yeung, A. (2019). Treating Depression With Tai Chi: State of the Art and Future Perspectives. Frontiers in psychiatry, 10, 237. doi:10.3389/fpsyt.2019.00237

 

Abstract

Major depressive disorder (MDD) is one of the most prevalent mental illnesses in America. Current treatments for MDD are unsatisfactory given high non-response rates, high relapse rates, and undesirable side effects. Accumulating evidence suggests that Tai Chi, a popular mind–body intervention that originated as a martial art, can significantly regulate emotion and relieve the symptoms of mood disorders. In addition, the availability of instructional videos and the development of more simplified and less structured Tai Chi has made it a promising low-intensity mind-body exercise. In this article, we first examine a number of clinical trials that implemented Tai Chi as a treatment for depression. Then, we explore several mechanisms by which Tai Chi may alleviate depressive symptoms, hypothesizing that the intervention may modulate the activity and connectivity of key brain regions involved in mood regulation, reduce neuro-inflammatory sensitization, modulate the autonomic nervous system, and regulate hippocampal neurogenesis. Finally, we discuss common challenges of the intervention and possible ways to address them. Specifically, we pose developing a simplified and tailored Tai Chi protocol for patients with depression, comparatively investigating Tai Chi with other mind–body interventions such as yoga and Baduanjin, and developing new mind–body interventions that merge the advantages of multiple mind–body exercises.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6474282/

 

Increase Social Contact and Reduce Loneliness with A Mindfulness Smartphone App

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Increase Social Contact and Reduce Loneliness with A Mindfulness Smartphone App

 

By John M. de Castro, Ph.D.

 

“Loneliness and social isolation are among the most robust known risk factors for poor health and early death. . . Our research shows that a 14-day smartphone-based mindfulness program can target both, and that practice in welcoming and opening to all of our inner experiences—good or bad—is the key ingredient for these effects,” – Emily Lindsay

 

Humans are social animals. We are generally happiest when we’re with family and friends. Conversely, being without close social contact makes us miserable. It’s the close relationship that is so important as we can be around people all day at work and still feel deep loneliness. These contacts are frequently superficial and do not satisfy our deepest need. It is sometimes said that we live in “the age of loneliness.” It is estimated that 20% of Americans suffer from persistent loneliness. This even when we are more connected than ever with the internet, text messaging, social media, etc. But these create the kinds of superficial contacts that we think should be satisfying, but are generally not. This has led to the counterintuitive findings that young adults, 18-34, have greater concerns with loneliness than the elderly.

 

The consequences of loneliness are dire. It has been estimated that being socially isolated increases mortality by 14%. This is twice the elevation produced by obesity. Even worse, for people over 60, loneliness increases their risk of death by 45%. When a spouse loses a marital partner there’s a 30% increase in mortality in the 6-months following the death. Hence, loneliness is not only an uncomfortable and unhappy state, but it is also a threat to health and longevity. It is clear that this epidemic of loneliness needs to be addressed.

 

In today’s Research News article “Mindfulness training reduces loneliness and increases social contact in a randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6397548/), Lindsay and colleagues recruited stressed but otherwise healthy adults and randomly assigned them to a 14 lesson smartphone app with one of three conditions; monitoring present moment experience, monitoring present moment experience plus accepting the experience, or reappraisal and coping strategies). They reported daily on their smartphones their level of loneliness, social contacts, and social support for three days before and 3 days after training with the App.

 

They found that after the intervention the monitoring present moment experience plus accepting the experience group had significantly lower levels of loneliness than prior to training and significantly greater number of social contacts, while neither the monitoring present moment experience or reappraisal and coping strategies groups had significant improvements.

 

These are interesting and potentially important results. Training to monitor present moment experience is not enough by itself to improve loneliness or increase social contact. It requires additional training in acceptance of experience. Many mindfulness training programs, such as Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT),  Mindfulness-Based Relapse Prevention (MBRP), Mindfulness-Oriented Recovery Enhancement (MORE), and Acceptance and Commitment Therapy (ACT) already include both present moment and acceptance training. In fact, most meditation trainings emphasize both present moment and acceptance. So, it would be un usual for a training program not to have both components. But the present results suggest that is important to have both components to produce benefits.

 

The study did not have an acceptance alone condition. So, it cannot be determined if acceptance training also requires present moment training to produce benefits or if acceptance training alone can. Nevertheless, it is clear that the combination is a safe and effective means to reduce loneliness and enhance social contact. It is not clear whether the enhanced social contact was responsible for the reduced loneliness or that reducing loneliness encourages more social contact or that these two effects are produced separately by training.

 

Regardless, reducing loneliness is very important for the physical and psychological health and well-being of adults and mindfulness plus acceptance training is capable of doing just that. The fact that the training can occur without therapist contact with a smartphone App is important as this means that the treatment is scalable and can be implemented conveniently and at low cost.

 

So, increase social contact and reduce loneliness with a mindfulness smartphone App.

 

“In Unified Mindfulness terms, it appears that equanimity (acceptance) combines with concentration and sensory clarity to reduce loneliness and social isolation.” – Unmindfulness.com

 

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

 

Lindsay, E. K., Young, S., Brown, K. W., Smyth, J. M., & Creswell, J. D. (2019). Mindfulness training reduces loneliness and increases social contact in a randomized controlled trial. Proceedings of the National Academy of Sciences of the United States of America, 116(9), 3488–3493. doi:10.1073/pnas.1813588116

 

SIGNIFICANCE

Loneliness (i.e., feeling alone) and social isolation (i.e., being alone) are among the most robust known risk factors for poor health and accelerated mortality. Yet mitigating these social risk factors is challenging, as few interventions have been effective for both reducing loneliness and increasing social contact. Mindfulness interventions, which train skills in monitoring present-moment experiences with an orientation of acceptance, have shown promise for improving social-relationship processes. This study demonstrates the efficacy of a 2-wk smartphone-based mindfulness training for reducing loneliness and increasing social contact in daily life. Importantly, this study shows that developing an orientation of acceptance toward present-moment experiences is a critical mechanism for mitigating these social risk factors.

Loneliness (i.e., feeling alone) and social isolation (i.e., being alone) are among the most robust known risk factors for poor health and accelerated mortality. Yet mitigating these social risk factors is challenging, as few interventions have been effective for both reducing loneliness and increasing social contact. Mindfulness interventions, which train skills in monitoring present-moment experiences with an orientation of acceptance, have shown promise for improving social-relationship processes. This study demonstrates the efficacy of a 2-wk smartphone-based mindfulness training for reducing loneliness and increasing social contact in daily life. Importantly, this study shows that developing an orientation of acceptance toward present-moment experiences is a critical mechanism for mitigating these social risk factors.

Keywords: mindfulness, social relationships, loneliness, acceptance, ambulatory assessment

ABSTRACT

Loneliness and social isolation are a growing public health concern, yet there are few evidence-based interventions for mitigating these social risk factors. Accumulating evidence suggests that mindfulness interventions can improve social-relationship processes. However, the active ingredients of mindfulness training underlying these improvements are unclear. Developing mindfulness-specific skills—namely, (i) monitoring present-moment experiences with (ii) an orientation of acceptance—may change the way people perceive and relate toward others. We predicted that developing openness and acceptance toward present experiences is critical for reducing loneliness and increasing social contact and that removing acceptance-skills training from a mindfulness intervention would eliminate these benefits. In this dismantling trial, 153 community adults were randomly assigned to a 14-lesson smartphone-based intervention: (i) training in both monitoring and acceptance (Monitor+Accept), (ii) training in monitoring only (Monitor Only), or (iii) active control training. For 3 d before and after the intervention, ambulatory assessments were used to measure loneliness and social contact in daily life. Consistent with predictions, Monitor+Accept training reduced daily-life loneliness by 22% (d = 0.44, P = 0.0001) and increased social contact by two more interactions each day (d = 0.47, P = 0.001) and one more person each day (d = 0.39, P= 0.004), compared with both Monitor Only and control trainings. These findings describe a behavioral therapeutic target for improving social-relationship functioning; by fostering equanimity with feelings of loneliness and social disconnect, acceptance-skills training may allow loneliness to dissipate and encourage greater engagement with others in daily life.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6397548/Loneliness and social isolation are a growing public health concern, yet there are few evidence-based interventions for mitigating these social risk factors. Accumulating evidence suggests that mindfulness interventions can improve social-relationship processes. However, the active ingredients of mindfulness training underlying these improvements are unclear. Developing mindfulness-specific skills—namely, (i) monitoring present-moment experiences with (ii) an orientation of acceptance—may change the way people perceive and relate toward others. We predicted that developing openness and acceptance toward present experiences is critical for reducing loneliness and increasing social contact and that removing acceptance-skills training from a mindfulness intervention would eliminate these benefits. In this dismantling trial, 153 community adults were randomly assigned to a 14-lesson smartphone-based intervention: (i) training in both monitoring and acceptance (Monitor+Accept), (ii) training in monitoring only (Monitor Only), or (iii) active control training. For 3 d before and after the intervention, ambulatory assessments were used to measure loneliness and social contact in daily life. Consistent with predictions, Monitor+Accept training reduced daily-life loneliness by 22% (d = 0.44, P = 0.0001) and increased social contact by two more interactions each day (d = 0.47, P = 0.001) and one more person each day (d = 0.39, P= 0.004), compared with both Monitor Only and control trainings. These findings describe a behavioral therapeutic target for improving social-relationship functioning; by fostering equanimity with feelings of loneliness and social disconnect, acceptance-skills training may allow loneliness to dissipate and encourage greater engagement with others in daily life.

 

Mindfulness Training can Produce Harm but Much can be Avoided

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Mindfulness Training can Produce Harm but Much can be Avoided

 

By John M. de Castro, Ph.D.

 

“meditation was designed not to make us happier, but to radically change our sense of self and perception of the world. Given this, it is perhaps not surprising that some will experience negative effects such as dissociation, anxiety and depression.” – Hackspirit

 

People begin meditation with the misconception that meditation will help them escape from their problems. Nothing could be further from the truth. In fact, meditation does the exact opposite, forcing the meditator to confront their issues. In meditation, the practitioner tries to quiet the mind. But, in that relaxed quiet state, powerful, highly emotionally charged thoughts and memories are likely to emerge. The strength here is that meditation is a wonderful occasion to begin to deal with these issues. But often the thoughts or memories are overwhelming. At times, professional therapeutic intervention may be needed.

 

Many practitioners never experience these negative experiences or only experience very mild states. There are, however, few systematic studies of the extent of negative experiences. In general, the research has reported that unwanted (negative) experiences are quite common with meditators, but for the most part, are short-lived and mild. There is, however, a great need for more research into the nature of the experiences that occur during meditation.

 

In today’s Research News article “Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6575147/), Baer and colleagues review what little research there is regarding negative experiences with mindfulness training. They report that negative experiences and harm are relatively common and occur with a variety of physical and psychological therapies, drug treatments, exercise, and also with mindfulness-based practices. Most people practicing meditation have emotional or challenging experiences arise, including troubling thoughts, anxiety, depression, confusion, depersonalization and alienation. These tend to be short-lived and often are thought to be part of the therapeutic process and lead to healthy outcomes. Only a small percentage of participants (1% to 7%) experience severe negative experiences such as psychotic symptoms, disorientation, and depression at a severe enough level to prompt cessation of meditation.

 

The authors identify three categories of potential sources of adverse events, program factors, participant factors, and teacher/clinician factors. In terms of program factors the most significant appears to be the intensity of the practice with a large percentage of adverse events occurring on retreats. In terms of participant factors, prior psychiatric and/or traumatic issues appear to be risk factors for adverse events. In terms of teacher/clinician factors, it appears that teacher ability and competence is important including “empathy, understanding of the client’s problems, communication about the nature of the program, skillful implementation of the program, managing difficulties that arise, and encouraging adherence to recommended practice.” Harm avoidance emphasizes taking these factors into consideration at the outset and monitoring for participant discomfort with appropriate intervention when needed.

 

One of the key judgements to be made is the cost/benefit analysis. Mindfulness training produces major physical, psychological, and spiritual benefits and these must be weighed against potential harm. It is generally true that the benefits are substantial and long lasting while the adverse events are mild and short-lived. But for a fraction of participants the harm is so debilitating to make the practice totally ineffective. It is incumbent on mindfulness teachers and clinicians to carefully assess potential risk factors and screen out particularly vulnerable participants and to rigorously monitor participant distress during the training to intervene or stop training when necessary to prevent harm.

 

“Mindfulness can have negative effects for some people, even if you’re doing it for only 20 minutes a day. It’s difficult to tell how common [negative] experiences are, because mindfulness researchers have failed to measure them, and may even have discouraged participants from reporting them by attributing the blame to them.” – Miguel Farias

 

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

 

Baer, R., Crane, C., Miller, E., & Kuyken, W. (2019). Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings. Clinical psychology review, 71, 101–114. doi:10.1016/j.cpr.2019.01.001

 

Abstract

The benefits of empirically supported mindfulness-based programs (MBPs) are well documented, but the potential for harm has not been comprehensively studied. The available literature, although too small for a systematic review, suggests that the question of harm in MBPs needs careful attention. We argue that greater conceptual clarity will facilitate more systematic research and enable interpretation of existing findings. After summarizing how mindfulness, mindfulness practices, and MBPs are defined in the evidence-based context, we examine how harm is understood and studied in related approaches to physical or psychological health and wellbeing, including psychotherapy, pharmacotherapy, and physical exercise. We also review research on harmful effects of meditation in contemplative traditions. These bodies of literature provide helpful parallels for understanding potential harm in MBPs and suggest three interrelated types of factors that may contribute to harm and require further study: program-related factors, participant-related factors, and clinician- or teacher-related factors. We discuss conceptual issues and empirical findings related to these factors and end with recommendations for future research and for protecting participants in MBPs from harm.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6575147/

 

Less Complex Brain Activity Characterizes Meditation by Experienced Meditators.

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Less Complex Brain Activity Characterizes Meditation by Experienced Meditators.

 

By John M. de Castro, Ph.D.

 

“Using modern technology like fMRI scans, scientists have developed a more thorough understanding of what’s taking place in our brains when we meditate. The overall difference is that our brains stop processing information as actively as they normally would.” – Belle Beth Cooper

 

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

 

It is important to understand what are the exact changes in the brain that are produced by meditation. In today’s Research News article “Characterizing the Dynamical Complexity Underlying Meditation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6637306/), Escrichs and colleagues recruited experienced adult meditators with at least 1000 hours of meditation experience and an ongoing practice and a matched group of non-meditators. They underwent functional Magnetic Resonance Imaging (fMRI) at rest and again when performing breath focused meditation. The scans were then analyzed with Intrinsic Ignition Framework that measures the degree of elicited whole-brain integration of spontaneously occurring events across time, in other words the complexity of information processing going on in the nervous system.

 

They found that at rest, the meditators had higher Intrinsic-Driven Mean Integration (IDMI) than controls but during meditation they had significantly lower IDMI than the controls. The meditators also had significantly higher metastability during rest than controls but that metastability significantly declined during meditation. These results are complex but indicate that meditators have greater levels of information moving around the brain and greater complexity of information processing over time at rest but during meditation move to a state where there is less information moving around and less complexity of processing.

 

The results suggest that meditators have more complicated information processing going on in their nervous systems at rest but during meditation greatly simplify that activity. It would appear that this takes practice as the non-meditators did not have comparable activities during meditation. This suggests that meditation experience over time produces neuroplastic alterations of the brain that increase the ability of the brain to process information normally and to become quieter during meditation.

 

“Nondirective meditation yields more marked changes in electrical brain wave activity associated with wakeful, relaxed attention, than just resting without any specific mental technique.” – ScienceDaily

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

 

Escrichs, A., Sanjuán, A., Atasoy, S., López-González, A., Garrido, C., Càmara, E., & Deco, G. (2019). Characterizing the Dynamical Complexity Underlying Meditation. Frontiers in systems neuroscience, 13, 27. doi:10.3389/fnsys.2019.00027

 

Abstract

Over the past 2,500 years, contemplative traditions have explored the nature of the mind using meditation. More recently, neuroimaging research on meditation has revealed differences in brain function and structure in meditators. Nevertheless, the underlying neural mechanisms are still unclear. In order to understand how meditation shapes global activity through the brain, we investigated the spatiotemporal dynamics across the whole-brain functional network using the Intrinsic Ignition Framework. Recent neuroimaging studies have demonstrated that different states of consciousness differ in their underlying dynamical complexity, i.e., how the broadness of communication is elicited and distributed through the brain over time and space. In this work, controls and experienced meditators were scanned using functional magnetic resonance imaging (fMRI) during resting-state and meditation (focused attention on breathing). Our results evidenced that the dynamical complexity underlying meditation shows less complexity than during resting-state in the meditator group but not in the control group. Furthermore, we report that during resting-state, the brain activity of experienced meditators showed higher metastability (i.e., a wider dynamical regime over time) than the one observed in the control group. Overall, these results indicate that the meditation state operates in a different dynamical regime compared to the resting-state.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6637306/

 

Facilitate Stroke Rehabilitation with Tai Chi Practice

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Facilitate Stroke Rehabilitation with Tai Chi Practice

 

By John M. de Castro, Ph.D.

 

“implementing the ancient Chinese art of tai chi into one’s routine may produce strong results of increased stability and functionality, leading to an overall sense of well being for the stroke survivor.” – Saebo

 

Every year, more than 795,000 people in the United States have a stroke and it is the third leading cause of death, killing around 140,000 Americans each year. A stroke results from an interruption of the blood supply to the brain, depriving it of needed oxygen and nutrients. This can result in the death of brain cells and depending on the extent of the damage produce profound loss of function. Even after recovery from stroke patients can experience residual symptoms. Problems with balance and falling are very common.

 

It is clear that basic physical fitness and exercise are excellent for stroke prevention and rehabilitation. Yoga practice is an exercise that can be adapted to the needs and limitations of stroke victims. The ancient mindful movement technique Tai Chi and Qigong are very safe forms of gentle exercise that appears to be beneficial for stroke victims including improving balance. It is difficult to get stroke survivors to engage in exercise. Perhaps the practice of Tai Chi, since it is adaptable, very gentle, and fun, might be acceptable and effective in the treatment of stroke survivors.

 

In today’s Research News article “The effect of Tai Chi exercise on motor function and sleep quality in patients with stroke: A meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6626210/), Li and colleagues review, summarize, and perform a meta-analysis of the published research literature on the effectiveness of Tai Chi practice for the rehabilitation of patients who have survived strokes. They identified 17 published randomized controlled trials.

 

They report that the published studies found that Tai Chi practice produced a significant improvement in balance and ability to perform daily activities in the stroke survivors. There were no significant improvements in either sleep quality or walking ability.

 

The results of the published research to date suggest that Tai Chi practice is a safe and effective treatment to improve stroke survivors ability to perform daily activities. This is important for improving the independence of the survivors and for their quality of life. The studies also found that Tai Chi practice improved balance. This is very important as this would reduce the likelihood of falls which are a real threat to the health and even longevity of stroke survivors. So, Tai Chi practice produces important benefits for the health and well-being of stroke survivors.

 

So, facilitate stroke rehabilitation with Tai Chi practice.

 

“The benefits of tai chi for stroke patients may come from the unique combination of slow, controlled movements coupled with relaxation. In one study on tai chi for stroke recovery, patients who didn’t participated in tai chi sustained 5 times more falls than those who did.” – Flint Rehab

 

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, Y., Zhang, Y., Cui, C., Liu, Y., Lei, M., Liu, T., … Jin, C. (2017). The effect of Tai Chi exercise on motor function and sleep quality in patients with stroke: A meta-analysis. International Journal of Nursing Sciences, 4(3), 314–321. doi:10.1016/j.ijnss.2017.06.001

 

Abstract

Objective

The meta-analysis is to objectively evaluate the efficacy of Tai Chi exercise for motor function and sleep quality in patients with stroke.

Methods

Randomized controlled trials(RCTs) about the effects of Tai Chi versus a non-exercise or conventional rehabilitation exercise control group on motor function and sleep quality in patients with stroke were searched from multiple electronic databases(PubMed, Web of Science, the Cochrane Library, EMBASE, AMED, CBM, CNKI, Wanfang and VIP) until August 2016. Two investigators independently screened eligible studies, extracted data, and assessed the methodological quality by using the quality evaluation criteria for RCTs recommended by Cochrane Handbook. Then meta-analysis was performed by RevMan5.3 software.

Results

A total of 17 RCTs with 1209 participants were included. The meta-analysis indicated that there was a significant difference on improving the balance function(P < 0.001) and ability of daily activity (P = 0.0003) of patients with stroke between Tai Chi group and control group. However, no significant effect was found on Tai Chi for walking function and sleep quality(P > 0.05).

Conclusion

Tai Chi exercise can significantly improve the balance function and ability of daily activities of patients with stroke, and there are no significant differences in walking function and sleep quality. Therefore, lots of multicenter, large-sample, higher quality randomized controlled trials are needed to verify the effects of Tai Chi exercise in improving walking function and sleep quality for patients with stroke.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6626210/

 

Improve the Psychological and Physical Health of Myeloproliferative Neoplasm Patients with a Smartphone Mindfulness App

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Improve the Psychological and Physical Health of Myeloproliferative Neoplasm Patients with a Smartphone Mindfulness App

 

By John M. de Castro, Ph.D.

 

“Even with an app, mindfulness takes practice. Like playing an instrument or a sport, the more you practice, the better you get and the more you get out of it. . . Whatever you try, mindfulness training is considered very safe, and has a good chance of increasing your happiness and peacefulness, and reducing your depression, anxiety, and stress.” – James Cartreine

 

“Myeloproliferative Neoplasms (MPNs) are blood cancers that occur when the body makes too many white or red blood cells, or platelets” (Cancer Support Community). It typically occurs in older adults and is fairly rare (1-2 cases/100,000 per year) and has a very high survival rate. It produces a variety of psychological and physical symptoms including fatigue, anxiety, depression, pain, and sleep disturbance, reduced physical, social, and cognitive functioning resulting in a reduced quality of life.

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health including fatigue, anxiety, depression, pain, and sleep disturbance, and improves physical, social, and cognitive functioning as well as quality of life in cancer patients. The vast majority of the mindfulness training techniques, however, require a trained therapist. This results in costs that many patients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient.

 

As an alternative, Apps for smartphones have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. But the question arises as to the effectiveness of these Apps in relieving the psychological and physical symptoms of cancer and improving their quality of life.

 

In today’s Research News article “Smartphone-Based Meditation for c: Feasibility Study to Inform Future Trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6658299/), Huberty and colleagues recruited Myeloproliferative Neoplasm Patients and randomly assigned them to either to receive 4 weeks of mindfulness training including 10 minutes of meditation per day via a smartphone app (“Calm”) followed by mindfulness training via another smartphone app (“10% Happier App”), the 2 apps in reverse order, education about Myeloproliferative Neoplasm followed by “10% Happier App”, or education followed by “Calm” app. They were measured before and after training and for Myeloproliferative Neoplasm symptoms, fatigue, anxiety, depression, pain, sleep disturbance, sexual function, health, and quality of life.

 

They found that the participants used the “Calm” App to a significantly greater extent and enjoyed it more than the “10% Happier” App. But following mindfulness training with both apps there were significant improvements. For the “10% Happier” App after training there were significant increases in health, and mental health and decreases in fatigue, anxiety, depression, and sleep disturbance. For the “Calm” App after training there were significant increases in health, and decreases in Myeloproliferative Neoplasm symptoms, fatigue, depression, vaginal discomfort, and sleep disturbance.

 

This was a relatively small pilot study that demonstrated the feasibility and efficacy of mindfulness training smartphone apps for the treatment of Myeloproliferative Neoplasm patients. It would appear that the “Calm” App is the preferred app. But both were effective in producing benefits. The improvements were significant and helpful in relieving the suffering of the patients. This is important as the use of smartphone apps makes it easier, more convenient, and more cost effective to provide mindfulness training to a wide swath of Myeloproliferative Neoplasm patients thus maximizing the utilization of mindfulness training for the improvement of the symptoms of patients with Myeloproliferative Neoplasm.

 

So, improve the psychological and physical health of myeloproliferative neoplasm patients with a smartphone mindfulness app.

 

“So how can this practice of mindfulness help people with cancer? . . . Routinely, we see large and meaningful improvements in mood, stress levels, depression, anger, worry, and rumination. We also see people having an increased sense of meaning and purpose in life, better sleep, and more energy, as well as displaying biological changes like a healthier pattern of stress hormones and less inflammation in the immune system.” – Linda Carlson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Jennifer Huberty, Ryan Eckert, Linda Larkey, Jonathan Kurka, Sue A Rodríguez De Jesús, Wonsuk Yoo, Ruben Mesa. Smartphone-Based Meditation for Myeloproliferative Neoplasm Patients: Feasibility Study to Inform Future Trials. JMIR Form Res. 2019 Apr-Jun; 3(2): e12662. Published online 2019 Apr 29. doi: 10.2196/12662

 

 

Abstract

Background

Myeloproliferative neoplasm (MPN) patients often report high symptom burden that persists despite the best available pharmacologic therapy. Meditation has gained popularity in recent decades as a way to manage cancer patient symptoms.

Objective

The aim of this study was to examine the feasibility of 2 different consumer-based meditation smartphone apps in MPN patients and to examine the limited efficacy of smartphone-based meditation on symptoms compared with an educational control group.

Methods

Patients (n=128) were recruited nationally through organizational partners and social media. Eligible and consented patients were enrolled into 1 of 4 groups, 2 of which received varying orders of 2 consumer-based apps (10% Happier and Calm) and 2 that received one of the apps alone for the second 4 weeks of the 8-week intervention after an educational control condition. Participants were asked to perform 10 min of meditation per day irrespective of the app and the order in which they received the apps. Feasibility outcomes were measured at weeks 5 and 9 with a Web-based survey. Feasibility outcomes were acceptability, demand, and limited efficacy for depression, anxiety, pain intensity, sleep disturbance, sexual function, quality of life, global health, and total symptom burden.

Results

A total of 128 patients were enrolled across all 4 groups, with 73.4% (94/128) patients completing the intervention. Of the participants who completed the 10% Happier app, 61% (46/76) enjoyed it, 66% (50/76) were satisfied with the content, and 77% (59/76) would recommend to others. Of those who completed the Calm app, 83% (56/68) enjoyed it, 84% (57/68) were satisfied with the content, and 97% (66/68) would recommend to others. Of those who completed the educational control, 91% (56/61) read it, 87% (53/61) enjoyed it, and 71% (43/61) learned something. Participants who completed the 10% Happierapp averaged 31 (SD 33) min/week; patients completing the Calm app averaged 71 (SD 74) min/week. 10% Happier app participants saw small effects on anxiety (P<.001 d=−0.43), depression (P=.02; d=−0.38), sleep disturbance (P=.01; d=−0.40), total symptom burden (P=.13; d=−0.27), and fatigue (P=.06; d=−0.30), and moderate effects on physical health (P<.001; d=0.52). Calm app participants saw small effects on anxiety (P=.29; d=−0.22), depression (P=.09; d=−0.29), sleep disturbance (P=.002; d=−0.47), physical health (P=.005; d=0.44), total symptom burden (P=.13; d=−0.27), and fatigue (P=.13; d=−0.27). Educational control participants (n=61) did not have effects on any patient-reported outcome except for a moderate effect on physical health (P<.001; d=0.77).

Conclusions

Delivering meditation via the Calm app is feasible and scored higher in terms of feasibility when compared with the 10% Happier app. The Calm app will be used to implement a randomized controlled trial, testing the effects of meditation on symptom burden in MPNs.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6658299/

Structural and Functional Changes in the Brain Produced by Meditation Training

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Structural and Functional Changes in the Brain Produced by Meditation Training

 

By John M. de Castro, Ph.D.

 

“Measurable changes in brain regions associated with memory, sense of self, empathy, and stress start to appear in subjects who practice mindfulness meditation for only eight weeks.” – Deepak Chopra

 

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.

 

Although, these changes have been documented, there is scant evidence regarding the temporal course of the neural changes with increasing experience with meditation. In today’s Research News article “Alterations in Brain Structure and Amplitude of Low-frequency after 8 weeks of Mindfulness Meditation Training in Meditation-Naïve Subjects.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6662752/), Yang and colleagues recruited meditation naïve college students and provided them with a 8 week meditation training program. They met for 1.5 hours once a week and were requested to meditate at home for 45 minutes daily. They were measured before and after the meditation program for mindfulness, anxiety, depression, and mood, including anger, fatigue, tension, depression, vigour and friendliness. In addition, their brains were measured with functional Magnetic Resonance Imaging (fMRI) before and after training.

 

They found that after meditation training there were significant decreases in anxiety and depression and significant increases in the non-reactivity facet of mindfulness. Cortical thickness significantly increased over training in the precuneus and superior parietal lobule while local brain activity fluctuations decreased in the precuneus and inferior parietal lobule. The parietal cortex is associated with bodily sensation and self-referential thinking while the precuneus is associated with the default mode network involved in mind wandering and self-referential thought.

 

The study did not contain a control condition. So, conclusion must be reached carefully. But the results suggest that mindfulness meditation training decreases anxiety and depression, which has been previously well documented. The neural findings that meditation training resulted in decreased brain activity fluctuations in the precuneus and inferior parietal lobule suggests that the training reduces activity in brain regions associated with mind wandering and self-referential thinking, which have also been well documented previously. Focusing on the present moment as is trained in mindfulness meditation cannot coexist with mind wandering and self-referential thinking. So, it is not surprising that there’s reduced activity in the brain regions underlying these functions.

 

All of this suggests that mindfulness meditation training changes the brain in ways that reflect greater present moment awareness and less daydreaming and discursive thinking.

 

“as the popularity of mindfulness grows, brain imaging techniques are revealing that this ancient practice can profoundly change the way different regions of the brain communicate with each other – and therefore how we think – permanently.” – Tom Ireland

 

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

 

Chuan-Chih Yang, Alfonso Barrós-Loscertales, Meng Li, Daniel Pinazo, Viola Borchardt, César Ávila, Martin Walter. Alterations in Brain Structure and Amplitude of Low-frequency after 8 weeks of Mindfulness Meditation Training in Meditation-Naïve Subjects. Sci Rep. 2019; 9: 10977. Published online 2019 Jul 29. doi: 10.1038/s41598-019-47470-4

 

Abstract

Increasing neuroimaging evidence suggests that mindfulness meditation expertise is related to different functional and structural configurations of the default mode network (DMN), the salience network (SN) and the executive network at rest. However, longitudinal studies observing resting network plasticity effects in brains of novices who started to practice meditation are scarce and generally related to one dimension, such as structural or functional effects. The purpose of this study was to investigate structural and functional brain network changes (e.g. DMN) after 40 days of mindfulness meditation training in novices and set these in the context of potentially altered depression symptomatology and anxiety. We found overlapping structural and functional effects in precuneus, a posterior DMN region, where cortical thickness increased and low-frequency amplitudes (ALFF) decreased, while decreased ALFF in left precuneus/posterior cingulate cortex correlates with the reduction of (CES-D) depression scores. In conclusion, regional overlapping of structural and functional changes in precuneus may capture different components of the complex changes of mindfulness meditation training.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6662752/