Improve Anxiety and Depression with an Abbreviated Mindfulness-Based Cognitive Therapy

Improve Anxiety and Depression with an Abbreviated Mindfulness-Based Cognitive Therapy

 

By John M. de Castro, Ph.D.

 

People at risk for depression are dealing with a lot of negative thoughts, feelings and beliefs about themselves and this can easily slide into a depressive relapse. MBCT helps them to recognize that’s happening, engage with it in a different way and respond to it with equanimity and compassion.” – Willem Kuyken

 

Anxiety disorders are the most common mental illness, affecting 40 million adults in the U.S., or 18% of the population. Depression affects over 6% of the population. And anxiety and depression often co-occur. Anxiety and depression are generally treated with drugs. But there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for anxiety and depression. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments.

 

Recently, it has been found that mindfulness training can be effective for anxiety disorders. Mindfulness has also been shown to be effective for depressionMindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression and has been shown to be very effective. MBCT, however, is an 8-week program delivered in relatively small groups. It is not clear if a briefer program to larger groups might also be effective.

 

In today’s Research News article “A Brief Mindfulness-Based Cognitive Therapy (MBCT) Intervention as a Population-Level Strategy for Anxiety and Depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8057287/ )  Burgess and colleagues recruited adult patients with an anxiety or mood disorders and provided them with 5 weekly 2-hour group based session of Mindfulness-Based Cognitive Therapy (MBCT) with daily home practice. The group size was larger than the typical MBCT program (i.e., 16–20 participants rather than 12 participants) and meditation practice was reduced to 10-15 minutes compared to the traditional 40 minutes. They were measured before and after training for anxiety, depression, self-compassion, perceived stress, mental well-being, and disability.

 

They found that after Mindfulness-Based Cognitive Therapy (MBCT) there was significant reductions in anxiety, depression, worry, and acute distress, and significant increases in self-compassion and mental well-being. There were large clinically significant changes such that 50% of the patients had remissions of depression and 20% had remissions of anxiety.

 

It should be noted that there was no control condition in the present study. But previous controlled studies have routinely demonstrated that Mindfulness-Based Cognitive Therapy (MBCT) produces significant improvements in anxiety, depression, worry, distress, self-compassion, and mental well-being. So, the present results are unlikely to be due to confounding factors. The present study demonstrates that the significant benefits of MBCT can be produced with an abbreviated program delivered to a large group. This reduces the amount of time clinicians have to devote to the program, thereby reducing cost. It would also be likely that the abbreviated program would improve adherence to the program requirements and reduce drop-outs. This allows more patients at lower cost to have their suffering reduced.

 

So, improve anxiety and depression with an abbreviated Mindfulness-Based Cognitive Therapy.

 

Mindfulness-Based Cognitive Therapy (MBCT) is designed to help people who suffer repeated bouts of depression and chronic unhappiness. It combines the ideas of cognitive therapy with meditative practices and attitudes based on the cultivation of mindfulness. The heart of this work lies in becoming acquainted with the modes of mind that often characterize mood disorders while simultaneously learning to develop a new relationship to them.” – MBCT.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

 

Emilee E. Burgess, Steven Selchen, Benjamin D. Diplock, Neil A. Rector. A Brief Mindfulness-Based Cognitive Therapy (MBCT) Intervention as a Population-Level Strategy for Anxiety and Depression. Int J Cogn Ther. 2021 Apr 20 : 1–19. doi: 10.1007/s41811-021-00105-x

 

Abstract

Mindfulness-based interventions (MBIs) have emerged as clinically effective interventions for anxiety and depression although there are significant barriers to their access in the general population. The present study examined the effectiveness of a 5-week abbreviated mindfulness-based cognitive therapy (MBCT) intervention for a physician-referred, treatment-seeking, community sample (N = 54) with mood and/or anxiety symptom burden. Treatment effects demonstrated significant reductions in mood and anxiety symptom severity and significant increases in general well-being. Observed effect sizes were generally large, with high response and remission rates. The present study offers preliminary support that an abbreviated MBCT protocol can offer large treatment effects for decreasing mood and anxiety symptoms and could potentially offer an effective population-level strategy to improve cost-effectiveness and access to care.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8057287/

 

Reduce Negative Moods and Depression in Healthy Individuals and Patients with Mood Disorders with Psychedelic Drugs

Reduce Negative Moods and Depression in Healthy Individuals and Patients with Mood Disorders with Psychedelic Drugs

 

By John M. de Castro, Ph.D.

 

“the therapeutic use of psychedelic drugs in psychotherapeutic settings represents a promising and integrative treatment with enduring effects for mental health patients.” – Genis Oña

 

Psychedelic substances such as peyote, mescaline, LSD, Bufotoxin, ayahuasca and psilocybin have been used almost since the beginning of recorded history to alter consciousness and produce spiritually meaningful experiences. People find these experiences extremely pleasant. eye opening, and even transformative. They often report that the experiences changed them forever. Psychedelics have also been found to be clinically useful as they markedly improve mood, increase energy and enthusiasm and greatly improve clinical depression.

 

The research on the effectiveness of psychedelic drugs on mood and clinical depression is accumulating. So, it makes sense to step back and summarize what has been learned. In today’s Research News article “Classic serotonergic psychedelics for mood and depressive symptoms: a meta-analysis of mood disorder patients and healthy participants.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7826317/ )  Galvão-Coelho and colleagues review, summarize, and perform a meta-analysis of the published research studies of the effectiveness of psychedelic drugs in improving mood and reducing depression with healthy individuals and patients with mood disorders.

 

They identified 12 published randomized controlled trials; 8 used psilocybin, 3 LSD, and 1 ayahuasca. They report that the research found that psychedelic treatment produced significant reductions in negative moods and depression in both healthy participants and in patients with mood disorders. In mood disorder patients the improvements were still significant 2 months after treatment. It should be recognized that the application of the psychedelics in these studies occur in highly structured controlled environments. This produces few if any troubling side effects with the exception of occasional slight anxiety. The safety of these drugs in uncontrolled non-clinical settings are not known.

 

The published research is clear that psychedelic drugs are effective in improving mood and reducing depression in both healthy individuals and those with mood disorders. Mood disorders including depression are by far the most common psychological problems in humans. The research is suggesting that controlled administration of psychedelic drugs is a safe and effective treatment relieving the suffering.

 

So, reduce negative moods and depression in healthy individuals and patients with mood disorders with psychedelic drugs.

 

People who had recently used psychedelics such as psilocybin report a sustained improvement in mood and feeling closer to others after the high has worn off.” – Bill Hathaway

 

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

 

Galvão-Coelho, N. L., Marx, W., Gonzalez, M., Sinclair, J., de Manincor, M., Perkins, D., & Sarris, J. (2021). Classic serotonergic psychedelics for mood and depressive symptoms: a meta-analysis of mood disorder patients and healthy participants. Psychopharmacology, 238(2), 341–354. https://doi.org/10.1007/s00213-020-05719-1

 

Abstract

Rationale

Major depressive disorder is one of the leading global causes of disability, for which the classic serotonergic psychedelics have recently reemerged as a potential therapeutic treatment option.

Objective

We present the first meta-analytic review evaluating the clinical effects of classic serotonergic psychedelics vs placebo for mood state and symptoms of depression in both healthy and clinical populations (separately).

Results

Our search revealed 12 eligible studies (n = 257; 124 healthy participants, and 133 patients with mood disorders), with data from randomized controlled trials involving psilocybin (n = 8), lysergic acid diethylamide ([LSD]; n = 3), and ayahuasca (n = 1). The meta-analyses of acute mood outcomes (3 h to 1 day after treatment) for healthy volunteers and patients revealed improvements with moderate significant effect sizes in favor of psychedelics, as well as for the longer-term (16 to 60 days after treatments) mood state of patients. For patients with mood disorder, significant effect sizes were detected on the acute, medium (2–7 days after treatment), and longer-term outcomes favoring psychedelics on the reduction of depressive symptoms.

Conclusion

Despite the concerns over unblinding and expectancy, the strength of the effect sizes, fast onset, and enduring therapeutic effects of these psychotherapeutic agents encourage further double-blind, placebo-controlled clinical trials assessing them for management of negative mood and depressive symptoms.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7826317/

 

Increase Psychological Flexibility and Thereby Relieve Anxiety and Depression with Psychedelic Drugs

Increase Psychological Flexibility and Thereby Relieve Anxiety and Depression with Psychedelic Drugs

 

By John M. de Castro, Ph.D.

 

“psilocybin may be effective in the much wider population of patients who suffer from major depression than previously appreciated. The magnitude of the effect we saw was about four times larger than what clinical trials have shown for traditional antidepressants on the market,” – Alan Davis

 

Psychedelic substances have been used almost since the beginning of recorded history to alter consciousness and produce spiritually meaningful experiences. People find these experiences very pleasant and eye opening. They often report that the experiences changed them forever. But only very recently have these effects of psychedelic substances come under rigorous scientific scrutiny.

 

When studied in the laboratory under double blind conditions psychedelic substances have been shown to “reliably occasion deeply personally meaningful and often spiritually significant experiences (e.g. mystical-type experiences).” Psychedelic substances have also been shown to improve clinical depression. The case seems clear, but it’s important to look at the mechanism by which psychedelic substances improve depression.

 

In today’s Research News article “Psychological flexibility mediates the relations between acute psychedelic effects and subjective decreases in depression and anxiety.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7451132/ )  Davis and colleagues recruited adults who have had an experience with a single psychedelic drug. LSD was used by 42% of the respondents and psilocybin was used by 38%. The respondents completed a questionnaire measuring the drug used, when and how much; mystical experiences, acute insight, anxiety, depression, stress, and psychological flexibility.

 

They found that the greater the level of mystical experiences the greater the levels of acute insights and psychological flexibility. They also found that the greater the level of levels of acute insights and psychological flexibility the greater the decrease in anxiety and depression. A path analysis revealed that the effects of mystical experiences and acute insights on anxiety and depression were indirect by way of psychological flexibility. They increased psychological flexibility which reduced anxiety and depression.

 

These are interesting results but caution must be exercised in reaching conclusions as there was no control condition and the results are completely correlational and based upon subjective recall by the individuals. In addition, the participants volunteered by responding to recruitment materials and those who respond are likely those that benefited from the psychedelic experiences.

 

Regardless, the results replicate previous findings that psychedelic drugs increase mystical experiences and acute insights and these are associated with improved mental health. But the results suggest that these effects are completely mediated by increased psychological flexibility. In other words, mystical experiences and acute insights increase flexibility which improves anxiety and depression. “Psychological flexibility is described as an essential set of processes that help people manage stressors and engage in adaptive behaviors that promote values-driven action.”  Hence, this flexibility allows the individual to adaptively respond to events in the environment rather than internalizing them producing anxiety and depression. Psychedelic drugs appear to enhance this flexibility and thereby improve mental health.

 

So, increase psychological flexibility and thereby relieve anxiety and depression with psychedelic drugs.

 

The idea behind psychedelic therapy is that the receptive state that the drug confers opens the door to fresh ideas about how to think about the past and future, which the therapist can reinforce.” – Paul Tullis

 

 

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

 

Davis, A. K., Barrett, F. S., & Griffiths, R. R. (2020). Psychological flexibility mediates the relations between acute psychedelic effects and subjective decreases in depression and anxiety. Journal of contextual behavioral science, 15, 39–45. https://doi.org/10.1016/j.jcbs.2019.11.004

 

Abstract

Prior research has shown that acute subjective psychedelic effects are associated with both spontaneous and intended changes in depression and anxiety. Psychedelics are also theorized to produce increases in psychological flexibility, which could explain decreases in depression and anxiety following a psychedelic experience. Therefore, the present cross-sectional survey study sought to examine whether psychological flexibility mediated the relationship between acute psychedelic experiences and spontaneous or intended changes in depression and anxiety among a large international sample of people who reported having used a psychedelic (n=985; male=71.6%; Caucasian/white=84.1%; Mage=32.2, SD=12.6). A regression analysis showed that acute effects (i.e., mystical and insightful effects) were significantly associated with decreases in depression/anxiety following a psychedelic experience. A path analysis revealed that, while controlling for age and sex, increases in psychological flexibility fully mediated the effect of mystical and insightful experiences on decreases in depression and anxiety following a psychedelic experience. This suggests that psychological flexibility may be an important mediator of the therapeutic effects of psychedelic drugs. Future prospective experimental studies should examine the effect of psychedelic drug administration on psychological flexibility in order to gain a better understanding of the psychological processes that predict therapeutic effects of psychedelics.

Highlights

  • Acute psychedelic effects are related to changes in depression/anxiety
  • Changes in psychological flexibility fully mediate this relationship
  • Psychological flexibility should be examined in clinical trials with psychedelics

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7451132/

 

Improve Anxiety Disorders in Children and Adolescents with Mindfulness

Improve Anxiety Disorders in Children and Adolescents with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The more present you are in life, the more you realize you make better decisions, manage your emotions, and are fully engaged in life.” – Stephanie Gutzmer

 

A characterizing feature of anxiety disorders is recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Anxiety often co-occurs with depression or is a precursor to bipolar disorder. Anxiety disorders and depression have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. In addition, drugs can be problematic for the developing brain. So, there is a need to develop alternative treatments particularly for children and adolescents. Mindfulness practices have been shown to be quite effective in relieving anxiety.

 

Mindfulness-Based Cognitive Therapy (MBCT) involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy That is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. MBCT has been shown to reduce anxiety. It has been proposed that intervening early may tend to mitigate or prevent future disorders So, it makes sense to examine the ability of MBCT to treat anxiety disorders in children and adolescents.

 

In today’s Research News article “Mindfulness-based cognitive therapy for children and adolescents with anxiety disorders at-risk for bipolar disorder: A psychoeducation waitlist controlled pilot trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7307795/ ) Cotton and colleagues recruited youths aged 9-18 years diagnosed with anxiety disorder and who had at least one parent diagnosed with bipolar disorder. They were assigned in an age balanced way to either a wait-list control condition or to receive 12 weekly, 75-minute Mindfulness-Based Cognitive Therapy for Children (MBCT-C) group sessions. They were measured before and after training and weekly for anxiety, clinician-rated anxiety and anxiety-related functional impairment, emotion regulation, mindfulness, and clinician-rated illness severity.

 

They found that in comparison to baseline and the wait-list control group after Mindfulness-Based Cognitive Therapy for Children (MBCT-C) there was a significant reduction in clinician-rated illness severity. They also found that during the 12 weeks of treatment, the MBCT-C group had significant reductions in anxiety. In addition, the greater the increase in mindfulness the greater the reduction in anxiety and the greater the increase in emotion regulation.

 

These are interesting results that suggest that Mindfulness-Based Cognitive Therapy (MBCT) may be effective in reducing anxiety and illness severity in children and adolescents with anxiety disorders at-risk for bipolar disorder. In some ways these results are not surprising in that MBCT has been shown to reduce anxiety in adults and mindfulness has been found to be associated with reduced anxiety and improved emotion regulation. But MBCT might be considered as too sophisticated for children and adolescents. So, it is significant that it can be successfully applied to children and adolescents. It can relieve their anxiety and decrease the intensity of their disorder.

 

So, improve anxiety disorders in children and adolescents with mindfulness.

 

Being mindful means paying attention to the present moment, exactly as it is. It is really hard to be anxious if you are completely focused on the present moment – what you are sensing and doing RIGHT NOW … and NOW … and NOW.” – Anxiety Canada

 

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

 

Cotton, S., Kraemer, K. M., Sears, R. W., Strawn, J. R., Wasson, R. S., McCune, N., Welge, J., Blom, T. J., Durling, M., & Delbello, M. P. (2020). Mindfulness-based cognitive therapy for children and adolescents with anxiety disorders at-risk for bipolar disorder: A psychoeducation waitlist controlled pilot trial. Early intervention in psychiatry, 14(2), 211–219. https://doi.org/10.1111/eip.12848

 

Abstract

Aim.

Previous studies suggest that Mindfulness-Based Cognitive Therapy for Children (MBCT-C) is feasible and may improve anxiety and emotion regulation in youth with anxiety disorders at-risk for bipolar disorder. However, controlled studies are warranted to replicate and extend these findings.

Methods.

In the current study, 24 youth with anxiety disorders who have at least one parent with bipolar disorder participated in a MBCT-C treatment period (n = 24; Mage = 13.6, 75% girls, 79% White) with a subset also participating in a prior psychoeducation waitlist control period (n = 19 Mage = 13.8, 68% girls, 84% White). Participants in both the waitlist and MBCT-C periods completed independently-rated symptom scales at each time point. Participants in the waitlist period received educational materials 12 weeks prior to the beginning of MBCT-C.

Results.

There were significantly greater improvements in overall clinical severity in the MBCT-C period compared to the waitlist period, but not in clinician- and child-rated anxiety, emotion regulation or mindfulness. However, increases in mindfulness were associated with improvements in anxiety and emotion regulation in the MBCT-C period, but not the waitlist period.

Conclusions.

Findings suggest that MBCT-C may be effective for improving overall clinical severity in youth with anxiety disorders who are at-risk for bipolar disorder. However, waitlist controlled designs may inflate effect sizes so interpret with caution. Larger studies utilizing prospective randomized controlled designs are warranted.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7307795/

 

Yoga Improves Resident Physician Psychological Health But Doesn’t Appear to be Feasible and Acceptable.

Yoga Improves Resident Physician Psychological Health But Doesn’t Appear to be Feasible and Acceptable.

 

By John M. de Castro, Ph.D.

 

Slammed by long and unpredictable hours, heavy clinical workloads, fatigue and limited professional control, many medical residents experience stress and even burnout. And surveys indicate this burnout can seriously impact physician well-being and patient care outcomes.” – Jennifer Huber

 

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. It is estimated that over 45% of healthcare workers experience burnout. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout, in fact, it is a threat to the entire healthcare system. Currently, over a third of healthcare workers report that they are looking for a new job. Hence, burnout contributes to the shortage of doctors and nurses.

 

Preventing burnout has to be a priority. Unfortunately, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout. So, it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices have been shown to reduce the psychological and physiological responses to stress and improve well-being. Indeed, mindfulness has been shown to be helpful in treating and preventing burnoutincreasing resilience, and improving sleep. Yoga is a mind-body practice that includes mindfulness and exercise. Yoga practice has been shown to improve the symptoms of burnout. But it is unclear whether it would be feasible and effective for resident physicians.

 

In today’s Research News article “Evaluation of a Yoga-Based Mind-Body Intervention for Resident Physicians: A Randomized Clinical Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7961714/ ) Loewenthal and colleagues recruited resident physicians and randomly assigned them to a wait-list control condition or to receive 1-hour, once a week for 6-weeks yoga training with daily home practice. They completed a questionnaire regarding the feasibility of the program. They were also measured before and after training and 2-months later for psychological health, including mindfulness, resilience, perceived stress, professional fulfillment, depression, anxiety, sleep disturbance, and resident well-being.

 

The participants rated the feasibility and acceptability of the program as low and they averaged attending only 1.93 of the 6 sessions with no one completing all 6 sessions. They found that the yoga group had significant increases in mindfulness, resilience, professional fulfillment, and resident well-being and significant decreases in anxiety, perceived stress, and sleep disturbance. While the wait-list group did not.

 

These efficacy findings are similar to those reported in other studies that yoga training results in increases in mindfulness, resilience, and well-being and significant decreases in anxiety, perceived stress, and sleep disturbance. But the program was very disappointing in feasibility and acceptability. Resident physicians are pressed for time and stressed and may not have the time too attend classes and practice yoga. Other mindfulness programs, particularly those implemented online have been found to be feasible, acceptable, and effective for health care workers. They would appear to be preferable to yoga for resident physicians.

 

So, yoga improves resident physician psychological health but doesn’t appear to be feasible and acceptable.

 

So often we treat others’ bodies and minds, yet often neglect our own. While we encourage our patients to roll out their mats and settle into their asanas, we can remember to do it ourselves. When we treat our stress and anxiety, we will be better able to treat our patients.” – Julia Michie Bruckner,

 

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

 

Loewenthal, J., Dyer, N. L., Lipsyc-Sharf, M., Borden, S., Mehta, D. H., Dusek, J. A., & Khalsa, S. (2021). Evaluation of a Yoga-Based Mind-Body Intervention for Resident Physicians: A Randomized Clinical Trial. Global advances in health and medicine10, 21649561211001038. https://doi.org/10.1177/21649561211001038

 

Abstract

Background and Objective

Mind-body interventions (MBIs) have been shown to be effective individual-level interventions for mitigating physician burnout, but there are no controlled studies of yoga-based MBIs in resident physicians. We assessed the feasibility of a yoga-based MBI called RISE (resilience, integration, self-awareness, engagement) for residents among multiple specialties and academic medical centers.

Methods

We conducted a waitlist controlled randomized clinical trial of the RISE program with residents from multiple specialty departments at three academic medical centers. The RISE program consisted of six weekly sessions with suggested home practice. Feasibility was assessed across six domains: demand, implementation, practicality, acceptability, adaptation, and integration. Self-reported measures of psychological health were collected at baseline, post-program, and two-month follow-up.

Results

Among 2,000 residents contacted, 75 were assessed for eligibility and 56 were enrolled. Forty-four participants completed the study and were included in analysis. On average, participants attended two of six sessions. Feasibility of in-person attendance was rated as 28.9 (SD 25.6) on a 100-point visual analogue scale. Participants rated feasibility as 69.2 (SD 26.0) if the program was offered virtually. Those who received RISE reported improvements in mindfulness, stress, burnout, and physician well-being from baseline to post-program, which were sustained at two-month follow-up.

Conclusion

This is the first controlled study of a yoga-based MBI in residents. While the program was not feasible as delivered in this pilot study, initial analyses showed improvement in multiple measures of psychological health. Residents reported that virtual delivery would increase feasibility.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7961714/

 

Improve Pain, Sleep, and the Mental Health of Chronic Pain Patients with Internet Mindfulness Training

Improve Pain, Sleep, and the Mental Health of Chronic Pain Patients with Internet Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“In the context of chronic pain . . . meditation can help you to stop your mind wandering back to your pain when you are trying to focus on something else, therefore improving your ability to give your entire attention to the task at hand and in turn, improve your level of functioning. It gives you the power to take your mind off your pain and refocus it, therefore aiding you in replacing unhelpful, behaviours with healthy ones which can reduce your pain and allow you to take better care of your health.” – Ann-Marie D’arcy-Sharpe

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain.

 

There is an accumulating volume of research findings that demonstrate that mindfulness practices, in general, are effective in treating pain. A therapeutic technique that contains mindfulness training and Cognitive Behavioral Therapy (CBT) is Acceptance and Commitment Therapy (ACT). It 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.

 

Acceptance and Commitment Therapy (ACT) requires a scheduled program of sessions with a trained therapist. This results in costs that many clients 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, mindfulness training over the internet 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. In addition, research has indicated that mindfulness training online can be effective for improving the health and well-being of the participants.

 

In today’s Research News article “Internet‐delivered acceptance and commitment therapy as microlearning for chronic pain: A randomized controlled trial with 1‐year follow‐up.” (See summary below or view the full text of the study at: https://onlinelibrary.wiley.com/doi/10.1002/ejp.1723 ) Rickardsson and colleagues recruited adult chronic pain patients and randomly assigned them to either a wait-list control condition or to receive an 8-week program of Acceptance and Commitment Therapy (ACT) delivered over the internet. ACT was delivered in daily microlearning short learning interactions. There was a 74% completion rate of the modules. The participants were measured before and after training and at 3-, 6-, and 12-month follow-ups for psychiatric problems, pain interference, pain intensity, anxiety, depression, psychological inflexibility, values, and health-related quality of life.

 

They found that compared to baseline and the wait-list control group, the group that received internet-delivered Acceptance and Commitment Therapy (ACT) had significant decreases in pain interference, pain intensity, anxiety, depression, psychological inflexibility, value obstruction, and insomnia. These improvements were long-lasting as they were maintained at the 12-month follow-up.

 

These are impressive improvements in the pain and psychological health of these diverse chronic pain patients. These results correspond with the frequent prior observations that mindfulness training produces reductions in pain, anxiety, depression, psychological inflexibility, and insomnia in a wide range of patient types and normal individuals. These results are particularly impressive as Acceptance and Commitment Therapy (ACT) was delivered over the internet. in daily microlearning short learning interactions. This was very convenient for the patients and required only 12.4 minutes per week of therapist time per week and was thus very inexpensive to deliver. Yet ACT was highly effective and lasting in relieving the suffering of these chronic pain patients.

 

So, improve pain, sleep, and the mental health of chronic pain patients with internet mindfulness training.

 

What we want to do as best as we can is to engage with the pain just as it is. It’s not about achieving a certain goal – like minimizing pain – but learning to relate to your pain differently.” – Elisha Goldstein

 

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

 

Jenny Rickardsson, Charlotte Gentili, Linda Holmström, Vendela Zetterqvist, Erik Andersson, Jan Persson, Mats Lekander, Brjánn Ljótsson, Rikard K. Wicksell. Internet‐delivered acceptance and commitment therapy as microlearning for chronic pain: A randomized controlled trial with 1‐year follow‐up, European Journal of Pain, 2021;00:1–19, https://doi.org/10.1002/ejp.1723

 

Abstract

Background

Studies of Internet‐delivered acceptance and commitment therapy (ACT) for chronic pain have shown small to moderate positive effects for pain interference and pain acceptance. Effects on pain intensity, depression, anxiety and quality of life (QoL) have been less favourable, and improvements for values and sleep are lacking. In this randomized controlled trial iACT – a novel format of Internet‐ACT using daily microlearning exercises – was examined for efficacy compared to a waitlist condition.

Methods

Adult participants (mean age 49.5 years, pain duration 18.1 years) with diverse chronic pain conditions were recruited via self‐referral, and randomized to iACT (n = 57) or waitlist (n = 56). The primary outcome was pain interference. The secondary outcomes were QoL, depression, anxiety, insomnia and pain intensity. The process variables included psychological inflexibility and values. Post‐assessments were completed by 88% (n = 100) of participants. Twelve‐month follow‐up assessments were completed by 65% (iACT only, n = 37). Treatment efficacy was analysed using linear mixed models and an intention‐to‐treat‐approach.

Results

Significant improvements in favour of iACT were seen for pain interference, depression, anxiety, pain intensity and insomnia, as well as process variables psychological inflexibility and values. Between‐group effect sizes were large for pain interference (d = 0.99) and pain intensity (d = 1.2), moderate for anxiety and depressive symptoms and small for QoL and insomnia. For the process variables, the between‐group effect size was large for psychological inflexibility (d = 1.0) and moderate for values. All improvements were maintained at 1‐year follow‐up.

Conclusions

Internet‐ACT as microlearning may improve a broad range of outcomes in chronic pain.

Significance

The study evaluates a novel behavioral treatment with positive results on pain interference, mood as well as pain intensity for longtime chronic pain sufferers. The innovative format of a digital ACT intervention delivered in short and experiential daily learnings may be a promising way forward.

https://onlinelibrary.wiley.com/doi/10.1002/ejp.1723

 

jenny.rickardsson@ki.se

 

Improve Psychological Well-Being in Covid-19 Lockdown with Online Mindfulness Training

Improve Psychological Well-Being in Covid-19 Lockdown with Online Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“mindfulness is one tool that can help promote mental wellness throughout the COVID-19 pandemic and beyond.” – Julie Dunn

 

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. The COVID-19 pandemic 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. Mindfulness is known to decrease the psychological and physical responses to stress. So, mindfulness training may be helpful in coping with the mental and physical challenges resulting from the COVID-19 pandemic.

 

In today’s Research News article “A Brief Online Mindfulness-Based Group Intervention for Psychological Distress Among Chinese Residents During COVID-19: a Pilot Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972025/ ) Zhang and colleagues recruited online Chinese adults who were staying at home during the Covid-19 lockdown. They were randomly assigned to a wait-list control condition or to receive online mindfulness training with an abbreviated group version of Mindfulness-Based Stress Reduction (MBSR). The training consisted of a 2-hour training followed by 13 days of 1.5 hours per day of practice separated into 3 30-minute sessions. Once training was complete for the mindfulness group, the wait-list group received the same 2-week mindfulness training. They were measured before and after the training for mindfulness and psychological distress, including somatization, depression, and anxiety.

 

They found that in comparison to baseline and the wait-list control group, the mindfulness training produced significantly higher mindfulness levels and significantly lower levels of psychological distress, including somatization, depression, and anxiety levels. The wait-list group after they received the mindfulness training had similar significant improvements in their psychological well-being.

 

These results are consistent with previous findings that mindfulness training produces decreases in distress, including somatization, depression, and anxiety. But the present study demonstrates that online mindfulness training can produce similar benefits for individuals locked down during a pandemic. Since the training is online, it could be made available to widespread individuals at low cost and thus would be ideal for maintaining the psychological health of people in lock down.

 

So, improve psychological well-being in covid-19 lockdown with online mindfulness training.

 

In many ways, COVID-19 has shown us just how connected and how much the same we really are. All of us—and some of us more than others—are vulnerable to getting sick and none of us wants to become ill. Viewed through the lens of interconnectedness, practicing mindfulness as the coronavirus spreads is not only a way to care for ourselves but a way to care for everyone around us.” – Kelly Barron

 

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

 

Hui Zhang, Anao Zhang, Chengbin Liu, Jian Xiao, Kaipeng Wang. A Brief Online Mindfulness-Based Group Intervention for Psychological Distress Among Chinese Residents During COVID-19: a Pilot Randomized Controlled Trial, Mindfulness (N Y) 2021 Mar 18 : 1–11. doi: 10.1007/s12671-021-01618-4

 

Abstract

Objectives

The coronavirus (COVID-19) global pandemic has increased psychological distress among the general population. The objective of this study is to evaluate a mindfulness-based intervention for psychological distress among Chinese residents during COVID-19.

Methods

This study used a switching replications design to test the feasibility and efficacy of a brief online mindfulness-based intervention for Chinese residents’ psychological distress. Fifty-one residents in the Hubei province were randomly allocated to two groups (experimental group and waitlist control group) with three waves of measurement at time 1, time 2, and time 3 for changes in mindfulness and psychological distress.

Results

In addition to significant within-group improvements over time for both groups, OLS linear regression with full information likelihood estimation revealed statistically significant between-group treatment effects across outcome domains, including mindfulness awareness, b = 2.84, p < 0.001, g = 6.92, psychological distress, b = −21.33, p < 0.001, g = 6.62, somatic symptoms, b = −6.22, p < 0.001, g = 4.42, depressive symptoms, b = −7.16, p < 0.001, g = 5.07, and anxiety symptoms, b = −8.09, p < 0.001, g = 6.84.

Conclusions

Results suggest that a brief online mindfulness-based intervention can be a feasible and promising intervention for improving mindfulness and decreasing psychological distress among Chinese residents staying at home during the COVID-19 outbreak. The study used a small convenience sample which led to a concern of external generalizability and with limited evaluation of long-term change.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972025/

 

Reduce Stress and Improve Healthcare Worker Well-Being with Mindfulness

Reduce Stress and Improve Healthcare Worker Well-Being with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The therapeutic applications of mindfulness are considerable and its impact on clinical practice itself appears to be profound. Indeed, several commentators characterize mindfulness as inciting nothing short of a revolution in the way we conduct our mental lives both within the clinic and without.” – Matias P. Raski

 

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. It is estimated that over 45% of healthcare workers experience burnout. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout, in fact, it is a threat to the entire healthcare system. Currently, over a third of healthcare workers report that they are looking for a new job. Hence, burnout contributes to the shortage of doctors and nurses.

 

Preventing burnout has to be a priority. Unfortunately, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout. So, it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices have been shown to reduce the psychological and physiological responses to stress and improve well-being. Indeed, mindfulness has been shown to be helpful in treating and preventing burnoutincreasing resilience, improving sleep and reduce stress.

 

In today’s Research News article “Reducing stress and promoting well-being in healthcare workers using mindfulness-based cognitive therapy for life.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903308/ ) Strauss and colleagues recruited healthy adult healthcare workers and randomly assigned them to either a wait-list control condition or to receive 8 weekly 2-hour group sessions of Mindfulness-Based Cognitive Therapy (MBCT) along with 40 minutes of daily practice.  MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior. MBCT was developed specifically to treat depression. For this study it was modified to be more appropriate for the general population. The participants were measured before and after training for attendance and practice amounts, stress, anxiety, depression, mental well-being, burnout, presenteeism, compassion, and mindfulness.

 

They found that in comparison to baseline and the wait-list control group after Mindfulness-Based Cognitive Therapy (MBCT) there were significant increases in mindfulness, mental well-being, and self-compassion, and significant decreases in anxiety, depression, and stress. They also found that the greater the increases in mindfulness and self-compassion produced by MBCT the greater the increase in mental well-being and the decrease in stress.

 

These findings are similar to those found in previous research with different groups that Mindfulness training increases well-being and self-compassion, and decreases anxiety, depression, and stress. Hence, mindfulness training improves the psychological well-being of healthcare workers. This should help protect them against burnout and increase their resilience in the face of high workplace stress.

 

So, reduce stress and improve healthcare worker well-being with mindfulness.

 

As we become more adept at dwelling in the living presence of our own experience, we begin to connect more deeply with patients, as well as co-workers and family members. Mindfulness practice provides a simple and practical way to recapture the calling of healing.” – Penn 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

 

Strauss, C., Gu, J., Montero-Marin, J., Whittington, A., Chapman, C., & Kuyken, W. (2021). Reducing stress and promoting well-being in healthcare workers using mindfulness-based cognitive therapy for life. International journal of clinical and health psychology : IJCHP, 21(2), 100227. https://doi.org/10.1016/j.ijchp.2021.100227

 

Background/Objective

Healthcare workers play a critical role in the health of a nation, yet rates of healthcare worker stress are disproportionately high. We evaluated whether mindfulness-based cognitive therapy for life (MBCT-L), could reduce stress in healthcare workers and target a range of secondary outcomes. Method: This is the first parallel randomised controlled trial of MBCT-L. Participants were NHS workers, who were randomly assigned (1:1) to receive either MBCT-L or wait-list. The primary outcome was self-reported stress at post-intervention. Secondary variables were well-being, depression, anxiety, and work-related outcomes. Mixed regressions were used. Mindfulness and self/other-compassion were explored as potential mechanisms of effects on stress and wellbeing. Results: We assigned 234 participants to MBCT-L (n = 115) or to wait-list (n = 119). 168 (72%) participants completed the primary outcome and of those who started the MBCT-L 73.40% (n = 69) attended the majority of the sessions. MBCT-L ameliorated stress compared with controls (B = 2.60, 95% CI = 1.63‒3.56; d = -0.72; p < .0001). Effects were also found for well-being, depression and anxiety, but not for work-related outcomes. Mindfulness and self-compassion mediated effects on stress and wellbeing. Conclusions: MBCT-L could be an effective and acceptable part of a wider healthcare workers well-being and mental health strategy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903308/

 

The Well-Being and Quality of Life in Cancer Patients are Related to Spirituality

The Well-Being and Quality of Life in Cancer Patients are Related to Spirituality

 

By John M. de Castro, Ph.D.

 

“Many patients with cancer rely on spiritual or religious beliefs and practices to help them cope with their disease. This is called spiritual coping.” – National Cancer Institute

 

A cancer diagnosis has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing experience. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotions and stress of a surviving cancer is a challenge and there are no simple treatments for these psychological sequelae of cancer.

 

Religion and spirituality become much more important to people when they survive cancer. It is thought that people take comfort in the spiritual when facing mortality. Hence, spirituality may be useful for cancer patients to cope with their illness and the psychological difficulties resulting from the disease. Thus, there is a need to study the relationships of spirituality on the well-being and quality of life of cancer patients.

 

In today’s Research News article “Association between spiritual well-being, quality of life, anxiety and depression in patients with gynecological cancer in China.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7793354/) Chen and colleagues recruited women with primary gynecological cancer and had them complete measures of quality of life with cancer, global health, spiritual well-being, anxiety, and depression.

 

They found that the higher the levels of spiritual well-being the higher the levels of global health and quality of life and the lower the levels of depression and anxiety. Multiple regression analysis revealed that religion, depression, anxiety and quality of life were the strongest predictors of spiritual well-being.

 

These findings are correlational and as a result causation cannot be determined. Regardless, the results clearly show that spiritual well-being is significantly related to better health and quality of life and lower psychological problems in women with primary gynecological cancer. These findings are similar to those seen with other forms of cancer that spirituality is associated with the patient’s quality of life and well-being. This raises the possibility that promoting spirituality in cancer patients may improve their physical and psychological well-being. It remains for future research to explore this possibility.

 

So, the well-being and quality of life in cancer patients are related to spirituality.

 

Consistent associations between spirituality, spiritual well-being, and health outcomes found in published studies highlight the importance of providing spiritual care to enhance cancer patients’ spiritual well-being and address their spiritual needs.” – Yi-Hui Lee

 

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

 

Chen, J., You, H., Liu, Y., Kong, Q., Lei, A., & Guo, X. (2021). Association between spiritual well-being, quality of life, anxiety and depression in patients with gynaecological cancer in China. Medicine, 100(1), e24264. https://doi.org/10.1097/MD.0000000000024264

 

Abstract

The physical and psychological condition of patients with gynaecological cancer has received much attention, but there is little research on spirituality in palliative care. This study aimed to investigate spiritual well-being and its association with quality of life, anxiety and depression in patients with gynaecological cancer. A cross-sectional study was conducted in China in 2019 with 705 patients diagnosed with primary gynaecological cancer. European Organisation for Research and Treatment of Cancer quality of life instruments (EORTC QLQ-SWB32 and EORTC QLQ-C30) and the Hospital Anxiety and Depression Scale were used to measure spiritual well-being, quality of life, anxiety and depression. Univariate and multiple linear regression analyses were performed to examine associations between spiritual well-being, quality of life, anxiety and depression. Functioning scales and global health status were positively correlated with spiritual well-being (P < .05). Anxiety and depression were negatively correlated with spiritual well-being (P < .05). Depression (−0.362, P < .001) was the strongest predictor of Existential score. Anxiety (−0.522, P < .001) was the only predictor of Relationship with self. Depression (−0.350, P < .001) and Global health (0.099, P = .011) were the strongest predictors of Relationship with others. Religion (−0.204, P < .001) and Depression (−0.196, P < .001) were the strongest predictors of Relationship with someone or something greater. Global health (0.337, P < .001) and Depression (−0.144, P < .001) were the strongest predictors of Global-SWB. Well spiritual well-being is associated with lower anxiety and depression, and better quality of life. Health providers should provide more spiritual care for non-religious patients and combine spiritual care with psychological counselling to help patients with gynaecological cancer, especially those who have low quality of life or severe symptoms, or experience anxiety or depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7793354/

 

Improve the Psychological Well-Being of Police with Mindfulness

Improve the Psychological Well-Being of Police with Mindfulness

 

By John M. de Castro, Ph.D.

 

“self-reported mindfulness to be associated with increased resilience and emotional intelligence and decreased negative health outcomes among police officers.” – John H. Kim

 

Policing is a very stressful occupation. Stress in police can result from role conflicts between serving the public, enforcing the law, and upholding ethical standards and personal responsibilities as spouse, parent, and friend. Stress also results from, threats to health and safety, boredom, responsibility for protecting the lives of others, continual exposure to people in pain or distress, the need to control emotions even when provoked, the presence of a gun, even during off-duty hours, and the fragmented nature of police work, with only rare opportunities to follow cases to conclusion or even to obtain feedback or follow-up information.

 

This stress can have serious consequences for the individual and in turn for society. Police officers have one of the highest suicide rates in the nation, possibly the highest. They have a high divorce rate, about second in the nation. They are problem drinkers about twice as often as the general population. This is a major problem as stress and the resultant complications can impact job performance, which sometimes involve life or death situations.

 

Mindfulness training has been shown to improve the physiological and psychological responses to stress and it has been found to reduce burnout in first responders. So, it is likely that mindfulness training with police can help them cope with the stress and thereby improve their quality of life and psychological well-being.

 

In today’s Research News article “Mindfulness Training Improves Quality of Life and Reduces Depression and Anxiety Symptoms Among Police Officers: Results From the POLICE Study-A Multicenter Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7952984/ ) Trombka and colleagues recruited active police officers and randomly assigned them to a wait list control condition or to receive 8 weekly sessions of Mindfulness-Based Health Promotion (MBHP) which is based on Mindfulness-Based Stress Reduction (MBSR) program. It includes mindful movements, meditation, body scan, and breathing practices along with teachings on mindfulness and self-compassion and discussion. They were measured 2 weeks before and 2 weeks after training and 6 months later for quality of life, anxiety, depression, religiosity, mindfulness, self-compassion, and quality of life domains of spirituality, religiosity, and personal beliefs.

 

They found that in comparison to baseline and the wait-list control group, the group that received Mindfulness-Based Health Promotion (MBHP) had significantly greater quality of life, including physical health, psychological, social relationships, and environment, overall quality of life and general health facets. These improvements remained significant 6 months after the conclusion of treatment. In addition, the MBHP group had significant reductions in anxiety and depression and significant increases in self-compassion which were also still present at the 6-month follow-up. A mediation analysis revealed that MBHP improved all facets of quality of life directly and also indirectly by improving self-compassion which in turn improved the various facets of quality of life.

 

These are clear and important results. Mindfulness-Based Health Promotion (MBHP) produced significant improvements in the psychological well-being of the police. Mindfulness training has been previously shown to improve quality of life and self-compassion. The present study replicates these finding but also demonstrates that the improvement in self-compassion is in part responsible for the improvements in quality of life. Self-compassion involves kindness toward oneself in the face of one’s personal failings. This is important for psychological well-being especially for police who are often dealing with difficult and stressful situations. Recognizing their own imperfect humanness with kindness greatly reduce self-criticism and blame allowing them to being OK with doing the best they can,

 

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

 

The science is validating that mindfulness has the potential to increase fair and impartial policing, because we are open to recognizing our responses to a stimulus, to an event, to a person,” – Sylvia Moir

 

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

 

Trombka, M., Demarzo, M., Campos, D., Antonio, S. B., Cicuto, K., Walcher, A. L., García-Campayo, J., Schuman-Olivier, Z., & Rocha, N. S. (2021). Mindfulness Training Improves Quality of Life and Reduces Depression and Anxiety Symptoms Among Police Officers: Results From the POLICE Study-A Multicenter Randomized Controlled Trial. Frontiers in psychiatry, 12, 624876. https://doi.org/10.3389/fpsyt.2021.624876

 

Abstract

Background: Police officers’ high-stress levels and its deleterious consequences are raising awareness to an epidemic of mental health problems and quality of life (QoL) impairment. There is a growing evidence that mindfulness-based interventions are efficacious to promote mental health and well-being among high-stress occupations.

Methods: The POLICE study is a multicenter randomized controlled trial (RCT) with three assessment points (baseline, post-intervention, and 6-month follow-up) where police officers were randomized to mindfulness-based health promotion (MBHP) (n = 88) or a waiting list (n = 82). This article focuses on QoL, depression and anxiety symptoms, and religiosity outcomes. Mechanisms of change and MBHP feasibility were evaluated.

Results: Significant group × time interaction was found for QoL, depression and anxiety symptoms, and non-organizational religiosity. Between-group analysis showed that MBHP group exhibited greater improvements in QoL, and depression and anxiety symptoms at both post-intervention (QoL d = 0.69 to 1.01; depression d = 0.97; anxiety d = 0.73) and 6-month follow-up (QoL d = 0.41 to 0.74; depression d = 0.60; anxiety d = 0.51), in addition to increasing non-organizational religiosity at post-intervention (d = 0.31). Changes on self-compassion mediated the relationship between group and pre-to-post changes for all QoL domains and facets. Group effect on QoL overall health facet at post-intervention was moderated by mindfulness trait and spirituality changes.

Conclusion: MBHP is feasible and efficacious to improve QoL, and depression and anxiety symptoms among Brazilian officers. Results were maintained after 6 months. MBHP increased non-organizational religiosity, although the effect was not sustained 6 months later. To our knowledge, this is the first mindfulness-based intervention RCT to empirically demonstrate these effects among police officers. Self-compassion, mindfulness trait, and spirituality mechanisms of change are examined.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7952984/