Improve Sleep Quality in People with Insomnia with Mindfulness

Improve Sleep Quality in People with Insomnia with Mindfulness

 

By John M. de Castro, Ph.D.

 

“If you suffer from insomnia, mindfulness helps you be more accepting of your experience when you have difficulty sleeping. It may seem paradoxical, but this willingness to accept the experience of poor sleep can lead to less anxiety and better rest.” – Polan Orzech

 

Modern society has become more around-the-clock and more complex producing considerable pressure and stress on the individual. The advent of the internet and smart phones has exacerbated the problem. The resultant stress can impair sleep. Indeed, it is estimated that over half of Americans sleep too little due to stress. As a result, people today sleep 20% less than they did 100 years ago. Not having a good night’s sleep has adverse effects upon the individual’s health, well-being, and happiness. It has been estimated that 30 to 35% of adults have brief symptoms of insomnia, 15 to 20% have a short-term insomnia disorder, and 10% have chronic insomnia

 

Insomnia is more than just an irritant. Sleep deprivation is associated with decreased alertness and a consequent reduction in performance of even simple tasks, decreased quality of life, increased difficulties with memory and problem solving, increased likelihood of accidental injury including automobile accidents, and increased risk of dementia and Alzheimer’s disease. It also can lead to anxiety about sleep itself. This is stressful and can produce even more anxiety about being able to sleep. About 4% of Americans revert to sleeping pills. But these do not always produce high quality sleep and can have problematic side effects. So, there is a need to find better methods to treat insomnia. Mindfulness-based practices have been reported to improve sleep amount and quality and help with insomnia.

 

Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT). ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. It would seem reasonable to expect that Acceptance and Commitment Therapy (ACT) might improve sleep and relieve insomnia.

 

In today’s Research News article “Acceptance and Commitment Therapy (ACT) Improves Sleep Quality, Experiential Avoidance, and Emotion Regulation in Individuals with Insomnia-Results from a Randomized Interventional Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916154/ ) Zakiei and colleagues recruited adults with clinical insomnia and randomly assigned them to receive 8 weekly sessions of 70 minutes of either Acceptance and Commitment Therapy (ACT) or group meetings to discuss daily activities and daily problems (active control condition). They were measured before and after treatment and 12 weeks later for experiential avoidance, sleep quality, sleep characteristics, dysfunctional thoughts on sleep, sleep problem acceptance, and emotion regulation.

 

They found that over training and the 12-week follow-up in comparison to the active control condition, the group that received Acceptance and Commitment Therapy (ACT) had significant reductions in experiential avoidance, dysfunctional thoughts on sleep, and significant increases in sleep quality, total sleep time, feelings of being restored by sleep, sleep problem acceptance, and emotion regulation. In addition, the greater the reduction in experiential avoidance the lower the levels of dysfunctional thoughts on sleep and the higher the levels of emotion regulation, sleep quality, and sleep problem acceptance.

 

These results demonstrate that Acceptance and Commitment Therapy (ACT) provided to patients with insomnia produces large improvements in sleep and decreases in cognitive-emotional processes related to insomnia. Although not demonstrated in the study, the results suggest that the improvements in sleep may occur due to ACT’s ability to alter dysfunctional thought processes and strengthen adaptive thinking. Mindfulness-based practices have been previously reported to improve sleep amount and quality and help with insomnia. The fact that ACT works so well for insomnia suggests that correcting dysfunctional thinking about sleep adds to the effectiveness of mindfulness in improving sleep. The effects were large, significant, and lasting suggesting that ACT should be prescribed for patients with clinical insomnia.

 

So, improve sleep quality in people with insomnia with mindfulness.

 

mindfulness improves regulation of stress and increases a sense of calm that results in a better ability to sleep.” – Melli O’Brien

 

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

Zakiei, A., Khazaie, H., Rostampour, M., Lemola, S., Esmaeili, M., Dürsteler, K., Brühl, A. B., Sadeghi-Bahmani, D., & Brand, S. (2021). Acceptance and Commitment Therapy (ACT) Improves Sleep Quality, Experiential Avoidance, and Emotion Regulation in Individuals with Insomnia-Results from a Randomized Interventional Study. Life (Basel, Switzerland), 11(2), 133. https://doi.org/10.3390/life11020133

 

Abstract

Insomnia is a common problem in the general population. To treat insomnia, medication therapies and insomnia-related cognitive-behavioral interventions are often applied. The aim of the present study was to investigate the influence of acceptance and commitment therapy (ACT) on sleep quality, dysfunctional sleep beliefs and attitudes, experiential avoidance, and acceptance of sleep problems in individuals with insomnia, compared to a control condition. A total of 35 participants with diagnosed insomnia (mean age: 41.46 years old; 62.9% females) were randomly assigned to the ACT intervention (weekly group therapy for 60–70 min) or to the active control condition (weekly group meetings for 60–70 min without interventional and psychotherapeutic character). At baseline and after eight weeks (end of the study), and again 12 weeks later at follow-up, participants completed self-rating questionnaires on sleep quality, dysfunctional beliefs and attitudes about sleep, emotion regulation, and experiential avoidance. Furthermore, participants in the intervention condition kept a weekly sleep log for eight consecutive weeks (micro-analysis). Every morning, participants completed the daily sleep log, which consisted of items regarding subjective sleep duration, sleep quality, and the feeling of being restored. Sleep quality, dysfunctional beliefs and attitudes towards sleep, emotion regulation, and experiential avoidance improved over time, but only in the ACT condition compared to the control condition. Improvements remained stable until follow-up. Improvements in experiential avoidance were related to a favorable change in sleep and cognitive-emotional processing. Micro-analyses showed that improvements occurred within the first three weeks of treatment. The pattern of results suggests that ACT appeared to have improved experiential avoidance, which in turn improved both sleep quality and sleep-related cognitive-emotional processes at longer-term in adults with insomnia.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916154/

 

Mindfulness is Associated with Improved Coping and Mental Well-Being During the Covid-19 Pandemic

Mindfulness is Associated with Improved Coping and Mental Well-Being During the Covid-19 Pandemic

 

By John M. de Castro, Ph.D.

 

Right now it’s very easy to let your brain spin out with the frightening possibilities. Practicing mindfulness helps bring us back to the present, and away from the brink.” – David Anderson

 

Mindfulness training has been shown to improve health and well-being in healthy individuals. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. One of the primary effects of mindfulness that may be responsible for many of its benefits is that it improves the physiological and psychological responses to stress. T

 

he COVID-19 pandemic is extremely stressful particularly during a lockdown and hence has challenged the mental and physical health of the population. It has created intense stress both for frontline workers but also for people simply isolating at home. So, mindfulness, because of its ability to improve stress responding, may be helpful in coping with the mental and physical challenges resulting from the COVID-19 pandemic.

 

In today’s Research News article “Coping with COVID-19 – Longitudinal analysis of coping strategies and the role of trait mindfulness in mental well-being.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7843110/ )  Götmann and colleagues recruited online adults during a Covid-19 lockdown in Germany. At 13 different points in time, they completed measures of mindfulness, coping strategies, well-being, savoring, resilience, and depression.

 

They found that the higher the levels of trait mindfulness the higher the levels of well-being, savoring, and problem solving coping and the lower the levels of distraction and denial and blaming coping. But of the mindfulness facets only self-regulated attention was associated with higher levels of problem solving and savoring and only orientation toward experience was associated with lower levels of distraction and denial and blaming and higher levels of well-being. Further they found that well-being was positively related to problem solving coping was negatively related to blaming.

 

Using structural equation modelling, they were able to show that mindfulness was positively related to well-being as a result of self-regulated attention which was positively related to problem solving coping and in turn well-being. On the other hand, they found that mindfulness was positively related to well-being as a result of orientation to experience being negative related to distraction and denial and blaming and in turn higher well-being.

 

These results are interesting but correlational and as such causation cannot be determined. But prior research has demonstrated that mindfulness produces higher well-being and positive coping. So, the present results are likely due to causal connections between these variables. The findings additionally suggest that mindfulness has a twofold connection with well-being via two mindfulness facets. Attention promoted a positive coping mechanism which in turn improved well-being while non-judging of experience interfered with negative coping mechanisms’ ability to detract from well-being.

 

These findings were produced by people experiencing a Covid-19 lockdown. They suggest that mindfulness is very beneficial during stressful times. It promotes the ability to cope with the situation in a constructive manner and suppresses non-constructive coping. It thus leads to better well-being in the midst of a public health crisis.

 

So, mindfulness is associated with improved coping and mental well-being during the Covid-19 pandemic.

 

“During the current pandemic, there is so much uncertainty concerning the future, and many threats to our security (physical, social, emotional, and financial). It is totally natural and normal to feel anxious, fearful, and frustrated. . . Mindfulness can help us acknowledge this situation, without allowing us to be carried away with strong emotions; it can, in turn, help bring ourselves back to a centered calm. Only then can we see more clearly what it is we have control over and what it is that we do not. “ – Michigan Medicine

 

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

 

Götmann, A., & Bechtoldt, M. N. (2021). Coping with COVID-19 – Longitudinal analysis of coping strategies and the role of trait mindfulness in mental well-being. Personality and individual differences, 175, 110695. https://doi.org/10.1016/j.paid.2021.110695

 

Abstract

Policy interventions intended to fight COVID-19 forced people to cope with several restrictions on their personal freedom. The present work addressed the question of how people dealt with stressors during a lockdown period and investigated the role of trait mindfulness and its subcomponents in coping and mental well-being. We recruited a sample of 93 participants to study coping reactions using a multi-wave study over a period of two-months with 13 measurement points. Multilevel analysis revealed that engagement-related coping such as problem-solving was positively related to well-being; the opposite was true for disengagement coping such as blaming. The mindfulness facet orientation towards experience (being open and accepting experiences without judgment) was negatively related to disengagement coping, while the facet self-regulated attention (awareness of the present moment) was positively related to engagement coping. Self-regulated attention but not orientation towards experience was associated with savoring positive aspects of COVID-related changes over time. Engagement-related coping mediated the effects of trait mindfulness on well-being. The findings point to the differential effects of subcomponents of trait mindfulness in the context of coping and mental well-being. Further implications are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7843110/

 

Mindfulness is Associated with Medication Adherence in Older Adults

Mindfulness is Associated with Medication Adherence in Older Adults

 

By John M. de Castro, Ph.D.

 

“Keep a watch…on the faults of the patients, which often make them lie about the taking of things prescribed. For through not taking disagreeable drinks, purgative or other, they sometimes die.” – Hippocrates, Decorum

 

“Integrating mindfulness into our practices may help foster the therapeutic alliance and ultimately medication adherence.” – Michael Ascher

 

In order for prescriptive medications to be effective in treating disease they must be taken. But about 50% of older patients do not take their medications as prescribed and many do not even fill their prescriptions. This is a shockingly high degree of non-compliance that can lead to poorer health and potentially death. Indeed, it has been stated that “increasing the effectiveness of adherence interventions may have a far greater impact on the health of the population than any improvement in specific medical treatments” (R. Brian Haynes). Mindfulness, on the other hand has been shown to be associated with better compliance with therapy and greater health related behaviors. So, it makes sense to study the role of mindfulness in medication adherence in older individuals.

 

In today’s Research News article “Selected psychological predictors of medication adherence in the older adults with chronic diseases.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7729554/ ) Gruszczyńska and colleagues recruited older adults, over 60 year of age, who were diagnosed with a chronic disease. They completed measures of medication adherence, health locus of control, stress coping, and mindfulness.

 

They found that the higher the levels of medication adherence, the higher the levels of internal locus of control, influence of others locus of control, and mindfulness and the lower the levels of emotion-oriented coping and distraction seeking. Regression analysis revealed that the strongest positive predictors of medication adherence were influence of others locus of control, and mindfulness while the most powerful negative predictor was emotion-oriented coping.

 

It should be recognized that this study is correlational and as such causation cannot be determined. But these results make sense as ascribing the control of one’s health to other powerful people would suggest that the individual would be more likely to follow the direction of a physician and comply with the medicinal directions. That people who cope with stress emotionally would not adhere to medicinal directions also make sense as the invocation of strong emotions associated with the stress of the disease would be aversive and lead to avoidding or ignoring medicines associated with the source of stress.

 

Finally, mindfulness was found to be influential on medication adherence. Being more aware of and attentive to the needs of the body should lead to tending to those needs and taking prescribed medications to help. Indeed, mindfulness tends to promote health related behaviors in general. In other words, mindful people tend to do things that are beneficial for their health including taking prescribed medications as directed.

 

Since elderly people taking prescribed medications is one of the single most important contributors to their overall health and longevity, improving adherence is extremely important. Perhaps if training in mindfulness was prescribed along with medications, medication adherence may be improved leading to better health outcomes.

 

So, mindfulness is associated with medication adherence in older adults.

 

“Mindfulness interventions have been proven effective on several predictors of poor adherence (i.e., sleep, cognitive impairment, depression, and stress) and thus hold great potential to improve medication adherence.“ – Elena Salmoirago-Blotcher

 

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

 

Gruszczyńska, M., Wyszomirska, J., Daniel-Sielańczyk, A., & Bąk-Sosnowska, M. (2020). Selected psychological predictors of medication adherence in the older adults with chronic diseases. Nursing open, 8(1), 317–326. https://doi.org/10.1002/nop2.632

 

Abstract

Aim

The main goal of the study was to assess the significance of selected psychological factors related to the adherence to medication recommendations among the older adults with chronic diseases.

Design

It was designed as a cross‐sectional study, aimed at assessing the importance of selected psychological factors in complying with medication recommendations among older adults.

Methods

The study involved 345 older adults with chronic diseases, assessed the importance of selected psychological factors, such as: health locus of control, stress coping and mindfulness in adhering to medication recommendations older persons. To answer the research questions, we performed frequency analyses, basic descriptive statistics analyses together with the Kolmogorov–Smirnov test, Student’s t tests for independent samples, monofactorial analysis of variance in the intergroup diagram, analysis correlation with the Pearson correlation coefficient, Spearman’s rank correlation ρ analysis and stepwise linear regression analysis.

Results

The study identified psychological predictors of medication adherence, which explained 12% of the variability. An emotion‐oriented coping proved to be the most important factor. Additionally, powerful other health locus of control and mindful attention were shown to have a positive effect.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7729554/

 

Lower Stress and Improve the Psychological Health of Healthcare Workers with Mind-Body Practices

Lower Stress and Improve the Psychological Health of Healthcare Workers with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

mind-body programs. . . emphasize the importance of mindfulness, getting more sleep and reducing stress. Not long ago, those life strategies were viewed as irrelevant to a person’s health care. But these are all things that boost one’s mood. An added bonus? They make a huge difference in improving physical health.” – Hal Paz

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. These stressors have been vastly amplified during the Covid-19 pandemic. Improving the psychological health of health care professionals, then, has to be a priority.

 

Contemplative practices have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnoutincreasing resilience, and improving sleep.  Hence, it is reasonable to examine the ability of mind-body practices as a means to improve the well-being of healthcare professionals.

 

In today’s Research News article “Long-term beneficial effects of an online mind-body training program on stress and psychological outcomes in female healthcare providers: A non-randomized controlled study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7593019/ ) Lee and colleagues recruited female healthcare workers and randomly assigned them to a wait-list control condition or to receive an 8-week online program of mind-body training. The participants practiced at home for 10 minutes, 5 days per week, for 8 weeks. The training included relaxation training, breathing exercises, and meditation. The participants were measured before and after training and 4 weeks later for occupational stress, stress responses, emotional intelligence, resilience, coping strategies, positive and negative emotions, and anxiety.

 

They found that in comparison to baseline and the wait-list control group, the mind-body training group had significant reduction in overall stress levels, anger, and depression and a significant increase in a social support coping strategy that were maintained 4 weeks after the end of training. They also found that the mind-body group had a significant increase in emotion regulation, a problem-solving coping strategy ,and resilience and a significant decrease in negative emotions at the end of training but these improvements were no longer significant 4 weeks later.

 

This is an interesting study but conclusions must be tempered by the fact that the comparison condition was passive, leaving open the possibility for contaminants such as experimenter bias or participant expectancy, or attentional effects as alternative explanations. But the results are similar to other controlled studies that mindfulness training decreases stress, anger, negative emotions. and depression and increases emotion regulation and adaptive coping. So, it would appear that the mind-body training improves the psychological health of female healthcare workers with lasting improvements in stress levels, anger, depression and social support coping but transitory improvements in emotion regulation, resilience, negative emotions and problem-solving coping.

 

An important characteristic of the mind-body training in the present study was that it was provided online and only involved 10 minutes of daily practice. This type of program is convenient and doesn’t add a major time commitment to the healthcare workers’ already very busy schedule. So, it is easy to inexpensively and conveniently provide it to large numbers of healthcare workers without adding extra stress. Such a program, then, can improve the well-being of these stressed workers, potentially reducing burnout and improving job effectiveness. This is particularly important during the Covid-19 pandemic.

 

So, lower stress and improve the psychological health of healthcare workers with min-body practices.

 

Mind-body therapies are safe, noninvasive techniques that have been shown to reduce stress and anxiety . . . Furthermore, they have demonstrated preliminary effects in improving psychological outcomes in physicians and health-care providers.” – Ting Bao

 

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

 

Lee, D., Lee, W. J., Choi, S. H., Jang, J. H., & Kang, D. H. (2020). Long-term beneficial effects of an online mind-body training program on stress and psychological outcomes in female healthcare providers: A non-randomized controlled study. Medicine, 99(32), e21027. https://doi.org/10.1097/MD.0000000000021027

 

Abstract

Mind-body training (MBT) programs are effective interventions for relieving stress and improving psychological capabilities. To expand our previous study which demonstrated the short-term effects of an 8-week online MBT program, the present study investigated whether those short-term effects persist up to a month after the end of the intervention.

Among previous participants, 56 (64%) participated in this follow-up study, 25 in the MBT group and 31 in the control group. Outcome measures included the stress response, emotional intelligence, resilience, coping strategies, positive and negative affect, and anger expression of both groups at baseline, at 8 weeks (right after the training or waiting period), and at 12 weeks (a month after the training or waiting period).

The MBT group showed a greater decrease in stress response at 8 weeks, and this reduction remained a month after the end of the intervention. The effect of MBT on resilience and effective coping strategies was also significant at 8 weeks and remained constant a month later. However, the improvement to emotional intelligence and negative affect did not persist a month after training.

These findings suggest that the beneficial short-term effects of MBT may last beyond the training period even without continuous practice, but the retention of these benefits seems to depend on the outcome variables. Through a convenient, affordable, and easily accessible online format, MBT may provide cost-effective solutions for employees at worksites.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7593019/

 

Improve Refractory Depression with Mindfulness

Improve Refractory Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

Mindfulness and other meditations, particularly combined with cognitive therapy, work just as well for anxiety or depression as the medications do, but they don’t have those side effects,” – Daniel Goleman

 

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 do not respond to treatment. This is called refractory depression.

 

Mindfulness training has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs failDialectical Behavior Therapy (DBT)  is a mindfulness-based therapeutic technique that produces behavior change by focusing on changing the thoughts and emotions that precede problem behaviors, as well as by solving the problems faced by individuals that contribute to problematic thoughts, feelings and behaviors. In DBT five core skills are practiced; mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness. DBT has been shown to be effective in treating depression. So, it makes sense, then, to study the effectiveness of Dialectical Behavior Therapy (DBT) for refractory depression.

 

In today’s Research News article “Refractory depression – mechanisms and efficacy of radically open dialectical behaviour therapy (RefraMED): findings of a randomised trial on benefits and harms.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282863/ ) Lynch and colleagues recruited adults with refractory major depressive disorder and randomly assigned them to either treatment as usual or to receive 29 weekly 1 hour sessions of Dialectical Behavior Therapy (DBT). They were measured before and after treatment and 5 months and 11 months later for depressive symptoms, psychosocial functioning, suicidal ideation, psychological inflexibility, emotional coping, and social support.

 

They found that compared to baseline both groups continuously improved with reduced depressive symptoms, but the group that received Dialectical Behavior Therapy (DBT) demonstrated significantly greater reductions but they were only statistically significant immediately after treatment but not at the 5 and 11 month follow ups. Also remission rates were higher in the DBT group. In addition, the DBT group had significantly greater psychological flexibility, emotional coping after treatment and all follow-up measurements.

 

These are interesting results that suggest that Dialectical Behavior Therapy (DBT) is an effective treatment for refractory major depressive disorder. In other words, it helps the patients who are not helped by any other treatments; the most difficult to treat patients. The fact that the relief of depressive symptoms is not significantly different from the treatment as usual group at the 5 and 11-month follow ups suggests that booster session may be necessary. But it should be recognized that the patients were markedly improved relative to their baselines. It was just that the treatment as usual group improved as well. So, the DBT produced a large and sustained reduction in depression in these refractory patients.

 

So, improve refractory depression with mindfulness.

 

Meditation helped me realize that the misery I feel is temporary. It sucks, but if I can wade my way through it, I know I’ll probably have a better day tomorrow.” – Stacey Neglia

 

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

 

Lynch, T. R., Hempel, R. J., Whalley, B., Byford, S., Chamba, R., Clarke, P., Clarke, S., Kingdon, D. G., O’Mahen, H., Remington, B., Rushbrook, S. C., Shearer, J., Stanton, M., Swales, M., Watkins, A., & Russell, I. T. (2020). Refractory depression – mechanisms and efficacy of radically open dialectical behaviour therapy (RefraMED): findings of a randomised trial on benefits and harms. The British journal of psychiatry : the journal of mental science, 216(4), 204–212. https://doi.org/10.1192/bjp.2019.53

 

Abstract

Background

Individuals with depression often do not respond to medication or psychotherapy. Radically open dialectical behaviour therapy (RO DBT) is a new treatment targeting overcontrolled personality, common in refractory depression.

Aims

To compare RO DBT plus treatment as usual (TAU) for refractory depression with TAU alone (trial registration: ISRCTN 85784627).

Method

RO DBT comprised 29 therapy sessions and 27 skills classes over 6 months. Our completed randomised trial evaluated RO DBT for refractory depression over 18 months in three British secondary care centres. Of 250 adult participants, we randomised 162 (65%) to RO DBT. The primary outcome was the Hamilton Rating Scale for Depression (HRSD), assessed masked and analysed by treatment allocated.

Results

After 7 months, immediately following therapy, RO DBT had significantly reduced depressive symptoms by 5.40 points on the HRSD relative to TAU (95% CI 0.94–9.85). After 12 months (primary end-point), the difference of 2.15 points on the HRSD in favour of RO DBT was not significant (95% CI –2.28 to 6.59); nor was that of 1.69 points on the HRSD at 18 months (95% CI –2.84 to 6.22). Throughout RO DBT participants reported significantly better psychological flexibility and emotional coping than controls. However, they reported eight possible serious adverse reactions compared with none in the control group.

Conclusions

The RO DBT group reported significantly lower HRSD scores than the control group after 7 months, but not thereafter. The imbalance in serious adverse reactions was probably because of the controls’ limited opportunities to report these.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282863/

 

Improve Psychological Well-Being, Sleep, and Performance in College Athletes with Mindfulness

Improve Psychological Well-Being, Sleep, and Performance in College Athletes with Mindfulness.

By John M. de Castro, Ph.D.

 

How much time do you spend training your body, getting to peak performance?  With mindfulness training you can now train your mind. Learn how to focus more effectively, worry less, be more present and increase your ability to respond and react quickly.” – Blair Bowker

 

Athletic performance requires the harmony of mind and body. Excellence is in part physical and in part psychological. That is why an entire profession of Sports Psychology has developed. “In sport psychology, competitive athletes are taught psychological strategies to better cope with a number of demanding challenges related to psychological functioning.” They use a number of techniques to enhance performance including mindfulness training. It has been shown to improve attention and concentration and emotion regulation and reduces anxiety and worry and rumination, and the physiological and psychological responses to stress. As a result, mindfulness training has been employed by athletes and even by entire teams to enhance their performance.

 

In today’s Research News article “Mindfulness-Based Stress Reduction Benefits Psychological Well-Being, Sleep Quality, and Athletic Performance in Female Collegiate Rowers.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2020.572980/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1437459_69_Psycho_20200922_arts_A ) Jones and colleagues recruited women members of a college rowing team and randomly assigned them to a no-treatment control condition or to receive 8 weekly 75 minutes group sessions of Mindfulness-Based Stress Reduction (MBSR). This training includes meditation, body scan, yoga, and discussion with daily home practice. They were measured before and after training for athletic coping skills, anxiety, depression, perceived stress, mindfulness, sleepiness, sleep quality, activity during sleep, rumination, and psychological well-being. They were also measured before the treatment and 6 weeks into the 8-week program for rowing performance.

 

They found that in comparison to baseline and the control group, after Mindfulness-Based Stress Reduction (MBSR) training there were significant increases in mindfulness, psychological well-being, sleep quality, activity during sleep, athletic coping skills, and rowing performance and significant decreases in daytime sleepiness. In addition, they report that the greater the increase in mindfulness the greater the increase in psychological well-being, sleep quality, and athletic coping skills and the greater the decrease in daytime sleepiness.

 

These are interesting results suggesting that mindfulness training improves the psychological well-being and athletic performance in athletes. But the comparison to a no-treatment condition leaves open alternative interpretations of participant expectancy effects, experimenter bias, attentional effects, etc. In addition, only female athletes were included in the study. Future research should include male athletes and employ an active control comparison condition such as group discussions of college life without mindfulness training.

 

The results from  previous studies have demonstrated that mindfulness training improves the psychological well-being and athletic performance in athletes. So, it is likely that the improvements seen in the present study were also due to the mindfulness training. In addition, the fact that in the group that received Mindfulness-Based Stress Reduction (MBSR) training that the amount of increase in mindfulness was associated with the degree of improvement in the psychological well-being and athletic performance, suggests that mindfulness was the key determinant of the improvements. So, it would appear likely that increasing mindfulness is of great benefit to athletes.

 

So, improve psychological well-being, sleep, and performance in college athletes with mindfulness.

 

mindfulness meditation for athletes can help them control negative thoughts and sports anxiety which allows them to focus on their skills in the present moment and perform better.’ – Ertheo

 

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

 

Jones BJ, Kaur S, Miller M and Spencer RMC (2020) Mindfulness-Based Stress Reduction Benefits Psychological Well-Being, Sleep Quality, and Athletic Performance in Female Collegiate Rowers. Front. Psychol. 11:572980. doi: 10.3389/fpsyg.2020.572980

 

Factors such as psychological well-being, sleep quality, and athletic coping skills can influence athletic performance. Mindfulness-based interventions, including mindfulness-based stress reduction (MBSR), have been shown to benefit these factors, suggesting they may, at least indirectly, benefit athletic performance. Moreover, while mindfulness training has been linked to better accuracy in some high-precision sports, whether it can improve non-precision elements of athletic performance is unclear. The objective of this study was to investigate the influence of MBSR on psychological well-being, sleep, athletic coping skills, and rowing performance in collegiate rowers in a controlled experimental design. Members of a Division I NCAA Women’s Rowing team completed either an 8-week MBSR course along with their regular athletic training program (Intervention group) or the athletic training program alone (Control group). Measurements of interest were taken at baseline and again either during or shortly following the intervention. In contrast to the Control group, the Intervention group showed improvements in psychological well-being, subjective and objective sleep quality, athletic coping skills, and rowing performance as measured by a 6,000-m ergometer test. Improvements in athletic coping skills, psychological well-being, and subjective sleep quality were all correlated with increases in mindfulness in the Intervention group. These results suggest that mindfulness training may benefit non-precision aspects of athletic performance. Incorporating mindfulness training into athletic training programs may benefit quality of life and performance in student athletes.

https://www.frontiersin.org/articles/10.3389/fpsyg.2020.572980/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1437459_69_Psycho_20200922_arts_A

 

Improve Depression in International Students with Positive Coping with Mindfulness

Improve Depression in International Students with Positive Coping with Mindfulness

 

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

 

By John M. de Castro, Ph.D.

 

Depression affects over 6% of the population. It is common in college students. There is a lot of pressure on college students to excel so that they can get the best jobs after graduation. This can lead to stress, anxiety and depression which can impede the student’s physical and mental health, well-being, and school performance. International students face the additional stress of being immersed in an alien culture and being separated from family and friends. 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. It is important to determine if mindfulness training can help to relieve depression in international college students.

 

In today’s Research News article “The Mediating Effects of Coping Style on the Effects of Breath Count Mindfulness Training on Depressive Symptoms among International Students in China.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7474765/ ) Gu and colleagues recruited foreign college students in china and randomly assigned them to receive no treatment, but encouraged to exercise, or 8-weeks for 2-hours per week of either normal college counseling or Mindfulness-Based Cognitive Therapy (MBCT) program that emphasized attention to the breath. They were measured before and after training for depression, life events including family life, work and study life, and family and friends’ life, and positive and negative coping. In addition, saliva samples were taken and assayed for cortisol levels.

 

They found that in general international college students had mild levels of depression and that the higher the levels of depression the greater the problems with life events and the lower the coping ability. They found that both mindfulness training and normal counseling, but not exercise, resulted in significant reductions in depression and cortisol levels. In addition, those students who had positive coping styles had greater reductions in depression after mindfulness training than either of the other groups.

 

That mindfulness training can reduce depression, especially with or Mindfulness-Based Cognitive Therapy (MBCT) has been well documented in prior research. Additionally, it found that students with positive coping styles benefited the most from the therapy. Additionally, it found that students with positive coping styles benefited the most from the therapy. In addition, mindfulness training reduced cortisol levels suggesting a reduction in stress levels in these students. Again, mindfulness training has been previously been shown to reduce cortisol levels and stress. The contribution of the present study is that it demonstrates that mindfulness training is effective in reducing stress and depression in international students.

 

It is interesting that MBCT training was no more effective than traditional college counseling. MBCT training was specifically developed to treat depression. So, it is surprising that it was not superior to normal counselling. It is possible that since the students were only mildly depressed in the first place there was limited ability to show improvement creating a floor effect. Indeed, depression index levels at the end of training indicated no depression was present at all following training. Perhaps if the students were more depressed to start with, MBCT training would have a greater opportunity to demonstrate superiority. Nevertheless, it is clear that mindfulness training can reduce the depression found in international students especially in students who have strong positive coping ability.

 

So, improve depression in international students with positive coping with mindfulness.

 

Depression makes someone more likely to react to life’s setbacks with negative, judgmental thinking, which can lower their mood and trigger a new episode. Mindfulness helps create mental space around these thoughts, enabling people at risk to observe, with kindness, the patterns of the mind that might otherwise drag them down.” – Ed Halliwell

 

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

 

Gu, S., Li, Y., Liang, F., Feng, R., Zeng, Z., & Wang, F. (2020). The Mediating Effects of Coping Style on the Effects of Breath Count Mindfulness Training on Depressive Symptoms among International Students in China. Neural plasticity, 2020, 8859251. https://doi.org/10.1155/2020/8859251

 

Abstract

Mindfulness training has gained popularity in the scientific field and has been proposed as an efficient way for emotional regulation. Mindfulness-based cognitive therapy (MBCT) is designed especially for depressive people in reducing risk of depression relapse and is recommended in national guidelines as a treatment choice for relapse prevention in recurrent depression. The aim of the current study was to investigate the effects of mindfulness training on depressive symptoms of international students and probe into the mediating role of mindfulness in stressful events and depression. In addition, we introduced a new kind of mindfulness training, the breathing exercise-based mindfulness training, which is based on the integration of Buddhism and Daoism. Self-report questionnaires assessing the coping style, abnormal depressive behavior, and stressful live events were completed in 260 international students in China (mean age = 21.4 years). The results showed that (1) many international students showed depression symptoms, (2) stressful life events play a completely mediating role in the initiation of depression and anxiety, and (3) mindfulness training for 8 weeks significantly reduced the depressive symptoms, and it was also related to a positive coping style. This study has certain theoretical significance in exploring the mechanism of the occurrence and development of depression among international students and provides useful tools for this special group of international students. In addition, the international students can also learn Chinese culture through the training. These findings indicate that mindfulness training and positive coping style are interrelated with treating depressive symptoms for international students.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7474765/

 

Improve College Student Adjustment with Mindfulness

Improve College Student Adjustment with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness and meditation are both great ways for students to improve their health. And the benefits of these practices can also trickle into their academic lives.” – Kenya McCullum

 

In the modern world education is a key for success. Where a high school education was sufficient in previous generations, a college degree is now required to succeed in the new knowledge-based economies. There is a lot of pressure on university students to excel so that they can get the best jobs after graduation. This stress might in fact be counterproductive as the increased pressure can actually lead to stress and anxiety which can impede the student’s physical and mental health, well-being, and school performance.

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with reducing the physical and psychological reactions to stress and increasing resilience in the face of stress. Indeed, these practices have been found to reduce stress and improve psychological health in college students. So, mindfulness may be an important tool to enhance student’s well-being and adjustment to college.

 

In today’s Research News article “The Differential Role of Coping, Physical Activity, and Mindfulness in College Student Adjustment.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2020.01858/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1401267_69_Psycho_20200811_arts_A) Moeller and colleagues recruited undergraduate students and had them complete measures of anxiety, depression, loneliness, perceived stress, coping strategies, self-esteem, physical activity, and mindfulness. These data were then analyzed with regression analysis.

 

They found that the higher the levels of mindful awareness and non-judgement the lower the levels of anxiety, depression, loneliness, perceived stress, and disengaged coping and the higher the levels of self-esteem. Regression models predicting the student’s stress levels and their anxiety levels revealed that they were associated with disengaged coping and negatively associated with mindfulness. A regression model predicting the student’s depression levels revealed that they were associated with disengaged coping and negatively associated with engagement coping, physical activity, and mindfulness. A regression model predicting the student’s loneliness levels revealed that they were associated with disengaged coping and negatively associated with engagement coping, physical activity, and mindfulness. Finally, a regression model predicting the student’s self-esteem levels revealed that they were associated positively associated with engagement coping, physical activity, and mindfulness and negatively with disengaged coping.

 

These findings are correlational and as such causation cannot be determined. But the findings highlight the importance of mindfulness with the psychological well-being of undergraduate students. As has been seen in other studies with a variety of different participants mindfulness is associated with lower levels of negative emotional states such as anxiety, depression, perceived stress, and loneliness and higher levels of self-esteem. In other words, mindfulness in college students is a predictor of better mental health and well-being. This should allow the students to better adjust to college and be more successful in their studies.

 

So, improve college student adjustment with mindfulness.

 

mindfulness is not something to do just because you “should” or “to be healthy”; rather, the benefits enable students to become more effective leaders who can fully enjoy their lives.” – Priya Thomas

 

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

 

Moeller RW, Seehuus M, Simonds J, Lorton E, Randle TS, Richter C and Peisch V (2020) The Differential Role of Coping, Physical Activity, and Mindfulness in College Student Adjustment. Front. Psychol. 11:1858. doi: 10.3389/fpsyg.2020.01858

 

Research has examined the function of stress management techniques, including coping, physical activity, and mindfulness on college students’ adjustment. The present study examined the differential contributions of three stress management techniques to students’ maladaptation (perceived stress, depression, anxiety, and loneliness) and adaptation (self-esteem). Undergraduate students (N = 1185) responded to an online survey. Hierarchical linear regression results indicated that all three stress management techniques – coping, physical activity, and mindfulness – were related to the five outcomes as predicted. Higher levels of disengagement coping strategies were related to higher perceived stress, anxiety, and depression. Components of mindfulness emerged as a strong predictor of adaptation.

https://www.frontiersin.org/articles/10.3389/fpsyg.2020.01858/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1401267_69_Psycho_20200811_arts_A

 

Mindfulness is Associated with Lower Impact of Fibromyalgia and Greater Well-Being

Mindfulness is Associated with Lower Impact of Fibromyalgia and Greater Well-Being

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

In today’s Research News article “Mindfulness is associated with psychological health and moderates the impact of fibromyalgia.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6545163/) Pleman and colleagues recruited adult patients diagnosed with fibromyalgia and had them complete measures of mindfulness, fibromyalgia impact, pain interference, symptom severity, anxiety, depression, perceived stress, coping strategies, health-related quality of life, self-efficacy, and walking ability.

 

They found that the higher the levels of mindfulness the lower the levels of fibromyalgia impact, pain interference, symptom severity, anxiety, depression, and perceived stress, and the higher the mental health related quality of life, coping, and self-efficacy. This was true also for the individual mindfulness facets of describing, acting-with-awareness, and non-judging. Hence, mindfulness was associated with better psychological health and lower overall impact of fibromyalgia.

 

These findings are correlational and as such causation cannot be determined. But prior research has shown that mindfulness training causes improvements in fibromyalgia. So, the present findings are probably due to a causal effect of being mindful on the psychological and physical impact of fibromyalgia and the quality of life of the patients. Hence, mindfulness can go a long way toward relieving the suffering of patients with fibromyalgia.

 

So, mindfulness is associated with lower impact of fibromyalgia and greater well-being.

 

“Often, individuals with fibromyalgia demonstrate a series of maladaptive coping strategies which in turn can lead to poor mental health; however mindfulness meditation has been shown to significantly improve this.” – Breathworks

 

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

 

Pleman, B., Park, M., Han, X., Price, L. L., Bannuru, R. R., Harvey, W. F., Driban, J. B., & Wang, C. (2019). Mindfulness is associated with psychological health and moderates the impact of fibromyalgia. Clinical rheumatology, 38(6), 1737–1745. https://doi.org/10.1007/s10067-019-04436-1

 

Abstract

Objective

Previous studies suggest mindfulness is associated with pain and depression. However, its impact in individuals with fibromyalgia remains unclear. We examined associations between mindfulness and physical and psychological symptoms, pain interference, and quality of life in fibromyalgia patients.

Methods

We performed a cross-sectional analysis on baseline data from a fibromyalgia clinical trial. Mindfulness was assessed using the Five Facet Mindfulness Questionnaire (FFMQ). Pearson’s correlations and multivariable linear regression models were used to evaluate associations between mindfulness and fibromyalgia impact, pain interference, physical function, depression, anxiety, stress, self-efficacy, and health-related quality of life. We also examined whether mindfulness moderated associations between fibromyalgia impact and psychological outcomes.

Results

A total of 177 participants (age 52.0±12.2 (SD) years; 93.2% women; 58.8% white; body mass index 30.1±6.7 kg/m2; FFMQ score 131.3±20.7; Revised Fibromyalgia Impact Questionnaire score 57.0±19.4) were included. Higher total mindfulness was significantly associated with lower fibromyalgia impact (r=−0.25), pain interference (r=−0.31), stress (r=−0.56), anxiety (r=−0.58), depression (r=−0.54), and better mental health-related quality of life (r=0.57). Describing, Acting-with-awareness, and Non-judging facets of mindfulness were also associated with these outcomes. Mindfulness moderated the effect of fibromyalgia impact on anxiety (interaction P=0.01).

Conclusion

Higher mindfulness is associated with less pain interference, lower impact of fibromyalgia, and better psychological health and quality of life in people with fibromyalgia. Mindfulness moderates the influence of fibromyalgia impact on anxiety, suggesting mindfulness may alter how patients cope with fibromyalgia. Future studies should assess how mind-body therapies aiming to cultivate mindfulness may impact the well-being of patients with fibromyalgia.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6545163/

 

Improve Borderline Personality Disorder with Mindfulness

Improve Borderline Personality Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

Mindfulness meditation training may help individuals with BPD be more effective in applying healthy coping skills in the midst of emotional pain. Mindfulness skills allow you to get just a little bit of space to be able to notice the emotion and be more strategic in terms of how you will act in the face of the emotion.” – Kristalyn Salters-Pedneault

 

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

 

One of the few treatments that appears to be effective for Borderline Personality Disorder (BPD) is Dialectical Behavior Therapy (DBT). It is targeted at changing the problem behaviors characteristic of BPD through focusing on changing the thoughts and emotions that precede problem behaviors, as well as by solving the problems faced by individuals that contribute to problematic thoughts, feelings and behaviors. In DBT five core skills are practiced; mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness.

 

It is not known if Dialectical Behavior Therapy (DBT) is effective for a subset of patients with Borderline Personality Disorder (BPD) who are not suicidal or self-harming. In today’s Research News article “Dialectical behaviour therapy skills reconsidered: applying skills training to emotionally dysregulated individuals who do not engage in suicidal and self-harming behaviours.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6993331/), Kells and colleagues recruited patients with Borderline Personality Disorder (BPD) who had never attempted suicide or engaged in any self-harming and who had high levels of emotional dysregulation. They received a 24-week Dialectical Behavior Therapy (DBT) program that met once a week for 2.5 hours. They were measured before, during, and after treatment and 6 months later for emotion regulation, mindfulness, and DBT skills.

 

There was a 49% drop-out rate. They found that for those that completed the program at each time point during and after treatment including the 6-month follow-up there were significant reductions in dysfunctional coping and increases in emotion regulation, mindfulness, and DBT skills. The effects were quite large with changes of 22% to 50% from baseline.

 

The study has a number of interpretive problems as there wasn’t a control condition. Previous controlled research, however, has demonstrated that Dialectical Behavior Therapy (DBT) is effective for the treatment of Borderline Personality Disorder (BPD). So. the present results were probably due to the treatment and not a confounding influence. The drop-out rate in this study was very high. BPD is a very difficult condition to treat and high drop-out rates are common. Hence it is reasonable to conclude that the present study successfully demonstrated that DBT is an effective treatment for BPD in patients without a history of suicide attempts or self-harming behaviors.

 

These findings suggest that Dialectical Behavior Therapy (DBT) affects a core symptom of Borderline Personality Disorder (BPD), an inability to cope with and regulate emotions. The patients improved markedly in their ability to regulate their emotions and cope with them. It is possible that the observed improvements in mindfulness may have been responsible for the improvements as mindfulness has been shown repeatedly to improve emotion regulation and coping behavior. It remains for future research to investigate this idea.

 

So, improve Borderline Personality Disorder with mindfulness.

 

Strong emotions disrupt a person’s ability to think and to be mindful. This is true for all of us. An inability to think can lead to even stronger and more dysregulated emotions. This is of particular concern in people with BPD, who often experience strong and difficult to control emotions.” = Blaise Aguirre

 

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

 

Kells, M., Joyce, M., Flynn, D., Spillane, A., & Hayes, A. (2020). Dialectical behaviour therapy skills reconsidered: applying skills training to emotionally dysregulated individuals who do not engage in suicidal and self-harming behaviours. Borderline personality disorder and emotion dysregulation, 7, 3. https://doi.org/10.1186/s40479-020-0119-y

 

Abstract

Background

Dialectical behaviour therapy (DBT) is an evidence-based intervention for borderline personality disorder (BPD) but is an intensive treatment with significant health service costs. Access to DBT can sometimes be restricted due to limited resources. Positive results have been reported for the use of DBT skills training (DBT-ST), one of the four modes of standard DBT, in the treatment of individuals with BPD who self-harm. This study evaluates DBT-ST for a subgroup of individuals attending community mental health services who may have a diagnosis of BPD (or emerging BPD traits) but who are not actively self-harming.

Methods

Participants in this study were 100 adults attending community mental health services with a diagnosis of BPD, emerging BPD traits or emotion dysregulation who were not actively self-harming. The majority of participants were female (71%), aged 25–34 years (32%), single (48%) and unemployed (34%). Participants partook in a 24-week DBT-ST intervention delivered by DBT therapists. Outcome measures included the Difficulties in Emotion Regulation Scale (DERS), the DBT Ways of Coping Checklist (DBT-WCCL) and the Five Facet Mindfulness Questionnaire (FFMQ). Measures were administered at pre-intervention, at the end of each skills module, and at post-intervention.

Results

Significant reductions in emotion dysregulation (DERS) and dysfunctional coping (DBT-WCCL) scores were reported from pre- to post-intervention (p < .001). A significant increase in mindfulness scores (FFMQ) and DBT skill use (DBT-WCCL) was also observed (p < .001). However, the drop-out rate was high (49% at post-intervention).

Discussion

The results of this uncontrolled study suggest that a standalone 24-week DBT-ST intervention may have a beneficial impact in terms of a reduction in emotion dysregulation and dysfunctional coping, and an increase in mindfulness and DBT skills use in patients with BPD/ emerging BPD traits who are not currently engaging in self-harm. Adequately powered randomised controlled trials are required to determine treatment efficacy in comparison to standard DBT for this population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6993331/