Improve the Psychological Well-Being of Medical Students with Mindfulness

Improve the Psychological Well-Being of Medical Students with Mindfulness

 

By John M. de Castro, Ph.D.

 

Medical students are being trained to have 100 things on their mind at all times. It’s harder and harder to focus on one thing explicitly. [Mindfulness] gives you that skill to know that you can focus on everything at once, but when you need to focus on one thing, you can be present with it.” – Chloe Zimmerman

 

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. Currently, over a third of healthcare workers report that they are looking for a new job. 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 as it contributes to the shortage of doctors and nurses.

 

Preventing burnout 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. It would be best to provide techniques to combat burnout early in a medical career. Studying medicine can be extremely stressful and many students show distress and express burnout symptoms. The undergraduate medical student level may be an ideal time to intervene.

 

In today’s Research News article “Mindfulness-based stress reduction for medical students: a narrative review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8105581/ )  Polle and colleagues review and summarize the published research on the effectiveness of the Mindfulness-Based Stress Reduction (MBSR) program to improve the psychological well-being of undergraduate medical students. MBSR includes training in meditation, body scan, and yoga, and group discussions normally over an 8-week period. They identified 9 published studies.

 

They report that the published research found that Mindfulness-Based Stress Reduction (MBSR) produced significant increases in undergraduate medical students mood, mental health, satisfaction with life, and self-compassion and significant reductions in psychological distress, perceived stress, and depression. One study followed up these students 6 years later and found persisting effects of MBSR.

 

The published research paints a clear picture that participating in a Mindfulness-Based Stress Reduction (MBSR) program produces lasting benefits for the psychological health of undergraduate medical students. This is important as stress and burnout is prevalent in the medical professions and intervening early may prevent or ameliorate future problems. Incorporation of MBSR into the undergraduate medical curriculum should be considered.

 

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

 

in medical students, higher empathy, lower anxiety, and fewer depression symptoms have been reported by students after participating in MSBR. In summary, mindfulness meditation may be used to elicit positive emotions, minimize negative affect and rumination, and enable effective emotion regulation.”- Michael Minichiello

 

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

 

Polle, E., & Gair, J. (2021). Mindfulness-based stress reduction for medical students: a narrative review. Canadian medical education journal, 12(2), e74–e80. https://doi.org/10.36834/cmej.68406

 

Abstract

Background

Medical students are at high risk of depression, distress and burnout, which may adversely affect patient safety. There has been growing interest in mindfulness in medical education to improve medical student well-being. Mindfulness-based stress reduction (MBSR) is a commonly used, standardized format for teaching mindfulness skills. Previous research has suggested that MBSR may be of particular benefit for medical students. This narrative review aims to further investigate the benefits of MBSR for undergraduate medical students.

Methods

A search of the literature was performed using MedLine, Embase, ERIC, PSYCInfo, and CINAHL to identify relevant studies. A total of 102 papers were identified with this search. After review and application of inclusion and exclusion criteria, nine papers were included in the study.

Results

MBSR training for medical students was associated with increased measures of psychological well-being and self-compassion, as well as improvements in stress, psychological distress and mood. Evidence for effect on empathy was mixed, and the single paper measuring burnout showed no effect. Two studies identified qualitative themes which provided context for the quantitative results.

Conclusions

MBSR benefits medical student well-being and decreases medical student psychological distress and depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8105581/

 

Improve Psychological Well-Being in Patients with Fever Undergoing Covid-19 Screening with Mindfulness

Improve Psychological Well-Being in Patients with Fever Undergoing Covid-19 Screening with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness-based approaches appear well-suited to deal with the challenges presented by the time of unpresented uncertainty, change, and loss, which can take many forms in the context of COVID-19 pandemic.” – Elena Antonova

 

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. The COVID-19 pandemic is extremely stressful particularly for patients running a fever and being screened for Covid-19.  So, mindfulness, because of its ability to improve stress responding, may be helpful in coping with the mental challenges of awaiting COVID-19 test results.

 

In today’s Research News article “Using Mindfulness to Reduce Anxiety and Depression of Patients With Fever Undergoing Screening in an Isolation Ward During the COVID-19 Outbreak.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.664964/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1651992_69_Psycho_20210603_arts_A )  Liu and colleagues recruited adult patients who had a fever and were undergoing screening in a hospital for Covid-19. They were randomly assigned either to no-treatment or a very brief (25 minute) mindfulness instruction while awaiting test results. They were measured at the time of admissions and again just before test results for positive and negative emotions, distress, satisfaction with life, anger, anxiety, and depression.

 

They found that in comparison to baseline and the no-treatment controls, the participants who had received brief mindfulness instruction had significantly lower anger, distress, anxiety, depression, and need for help and higher satisfaction with life. Hence, the brief mindfulness instruction improved the mood and psychological well-being of these patients during a very stressful time of awaiting Covid-19 test results.

 

Mindfulness has been previously found to be effective in reducing anger, distress, anxiety, and depression, and increasing satisfaction with life. What the present study demonstrates is that these benefits can occur after a very brief instruction for patients in a very stressful situation. This suggests that brief mindfulness instruction should be incorporated into the routine treatment of patients under high short-term stress.

 

So, improve psychological well-being in patients with fever undergoing Covid-19 screening with mindfulness.

 

mindfulness is an increasingly accessible intervention available world-wide that may reduce psychological distress during this isolating public health crisis.” – Susan Farris

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Liu Y, Huyang S, Tan H, He Y, Zhou J, Li X, Ye M, Huang J and Wu D (2021) Using Mindfulness to Reduce Anxiety and Depression of Patients With Fever Undergoing Screening in an Isolation Ward During the COVID-19 Outbreak. Front. Psychol. 12:664964. doi: 10.3389/fpsyg.2021.664964

 

The coronavirus disease 2019 (COVID-19) continues to spread globally. This infectious disease affects people not only physically but also psychologically. Therefore, an effective psychological intervention program needs to be developed to improve the psychological condition of patients screened for fever during this period. This study aimed to investigate the effect of a brief mindfulness intervention on patients with suspected fever in a screening isolation ward awaiting results of the COVID-19 test. The Faces Scale and the Emotional Thermometer Tool were used to investigate 51 patients who were randomly divided into an intervention group and a control group. All patients completed self-rating questionnaires online at the time they entered the isolation ward and before they were informed of the results. The intervention group listened to the mindfulness audios through hospital broadcasts in the isolation ward before their lunch break and while they slept. Compared with the control group, the intervention group’s life satisfaction score increased (F = 4.02, p = 0.051) and the emotional thermometer score decreased (F = 8.89, p = 0.005). The anxiety scores (F = 9.63, p = 0.003) and the needing help scores decreased significantly (F = 4.95, p = 0.031). Distress (F = 1.41, p = 0.241), depression (F = 1.93, p = 0.171), and anger (F = 3.14, p = 0.083) also decreased, but did not reach significance. Brief mindfulness interventions can alleviate negative emotions and improve the life satisfaction of patients in the isolation ward who were screened for COVID-19 during the waiting period.

https://www.frontiersin.org/articles/10.3389/fpsyg.2021.664964/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1651992_69_Psycho_20210603_arts_A

 

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/

 

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/

 

Improve Mental Health with Mindfulness

Improve Mental Health with Mindfulness

 

By John M. de Castro, Ph.D.

 

Mindfulness is recommended as a treatment for people with mental ill-health as well as those who want to improve their mental health and wellbeing.” – Mental Health Foundation

 

Over the last several decades, research and anecdotal experiences have accumulated an impressive evidential case that the development of mindfulness has positive benefits for the individual’s mental, physical, and spiritual life. Mindfulness appears to be beneficial both for healthy people and for people suffering from a myriad of mental and physical illnesses. It appears to be beneficial across ages, from children to the elderly. And it appears to be beneficial across genders, personalities, race, and ethnicity.

 

The breadth and depth of benefits is unprecedented. There is no other treatment or practice that has been shown to come anyway near the range of mindfulness’ positive benefits. Mindfulness appears to work well in clinical settings. But does it work well when mindfulness is trained in groups in community settings. It makes sense to step back and summarize what has been learned.

 

In today’s Research News article “Mindfulness-based programmes for mental health promotion in adults in nonclinical settings: A systematic review and meta-analysis of randomised controlled trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7799763/ ) Galante and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials of the effectiveness of mindfulness-based programs to improve mental health. They identified 136 trials including a total of 11,605 participants of the effectiveness of community-based group mindfulness programs.

 

They report that in comparison to no treatment controls, mindfulness-based programs produced significant improvements in anxiety, depression, psychological distress, and mental well-being. In comparison to non-therapeutic active controls mindfulness-based programs produced significant improvements in depression, and mental well-being. Finally, mindfulness-based programs did not appear to improve mental health to a greater extent that other therapeutic treatments. They further found that mindfulness-based programs appeared to work best for high-risk participants or those with subclinical levels of mental disorders.

 

There appears to be extensive research findings that suggest that group mindfulness-based programs in non-clinical, community, are as effective in improving mental health as other therapies. In particular they appear to decrease symptoms of anxiety, depression, and psychological distress and increase mental well-being. But, these programs do not appear to further improve mental health in people who already have excellent mental health. This suggests that mindfulness-based community programs should be implemented to improve the mental health of at-risk individuals or those who have metal health issues.

 

So, improve mental health with mindfulness.

 

simple changes in lifestyle can lead to improved mental health and wellbeing.  Mindfulness is one such practice—with strong research supporting its usefulness for those suffering from anxiety, depression, or even just daily stress.” – U Minnesota

 

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

 

Galante, J., Friedrich, C., Dawson, A. F., Modrego-Alarcón, M., Gebbing, P., Delgado-Suárez, I., Gupta, R., Dean, L., Dalgleish, T., White, I. R., & Jones, P. B. (2021). Mindfulness-based programmes for mental health promotion in adults in nonclinical settings: A systematic review and meta-analysis of randomised controlled trials. PLoS medicine, 18(1), e1003481. https://doi.org/10.1371/journal.pmed.1003481

 

Abstract

Background

There is an urgent need for mental health promotion in nonclinical settings. Mindfulness–based programmes (MBPs) are being widely implemented to reduce stress, but a comprehensive evidence synthesis is lacking. We reviewed trials to assess whether MBPs promote mental health relative to no intervention or comparator interventions.

Methods and findings

Following a detailed preregistered protocol (PROSPERO CRD42018105213) developed with public and professional stakeholders, 13 databases were searched to August 2020 for randomised controlled trials (RCTs) examining in–person, expert–defined MBPs in nonclinical settings. Two researchers independently selected, extracted, and appraised trials using the Cochrane Risk–of–Bias Tool 2.0. Primary outcomes were psychometrically validated anxiety, depression, psychological distress, and mental well–being questionnaires at 1 to 6 months after programme completion. Multiple testing was performed using p < 0.0125 (Bonferroni) for statistical significance. Secondary outcomes, meta–regression and sensitivity analyses were prespecified. Pairwise random–effects multivariate meta–analyses and prediction intervals (PIs) were calculated.

A total of 11,605 participants in 136 trials were included (29 countries, 77% women, age range 18 to 73 years). Compared with no intervention, in most but not all scenarios MBPs improved average anxiety (8 trials; standardised mean difference (SMD) = −0.56; 95% confidence interval (CI) −0.80 to −0.33; p–value < 0.001; 95% PI −1.19 to 0.06), depression (14 trials; SMD = −0.53; 95% CI −0.72 to −0.34; p–value < 0.001; 95% PI −1.14 to 0.07), distress (27 trials; SMD = −0.45; 95% CI −0.58 to −0.31; p–value < 0.001; 95% PI −1.04 to 0.14), and well–being (9 trials; SMD = 0.33; 95% CI 0.11 to 0.54; p–value = 0.003; 95% PI −0.29 to 0.94). Compared with nonspecific active control conditions, in most but not all scenarios MBPs improved average depression (6 trials; SMD = −0.46; 95% CI −0.81 to −0.10; p–value = 0.012, 95% PI −1.57 to 0.66), with no statistically significant evidence for improving anxiety or distress and no reliable data on well–being. Compared with specific active control conditions, there is no statistically significant evidence of MBPs’ superiority. Only effects on distress remained when higher–risk trials were excluded. USA–based trials reported smaller effects. MBPs targeted at higher–risk populations had larger effects than universal MBPs. The main limitation of this review is that confidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach is moderate to very low, mainly due to inconsistency and high risk of bias in many trials.

Conclusions

Compared with taking no action, MBPs of the included studies promote mental health in nonclinical settings, but given the heterogeneity between studies, the findings do not support generalisation of MBP effects across every setting. MBPs may have specific effects on some common mental health symptoms. Other preventative interventions may be equally effective. Implementation of MBPs in nonclinical settings should be partnered with thorough research to confirm findings and learn which settings are most likely to benefit.

Author summary

Why was this study done?

Mindfulness courses to increase well–being and reduce stress have become very popular; most are in community settings.

Many randomised controlled trials (RCTs) tested whether mindfulness courses show benefit, but results are varied and, to our knowledge, there are no reviews combining the data from these studies to show an overall effect.

What did the researchers do and find?

Worldwide, we identified 136 RCTs on mindfulness training for mental health promotion in community settings. We reviewed them all, assessed their quality, and calculated their combined effects.

We showed that, compared with doing nothing, mindfulness reduces anxiety, depression, and stress, and increases well–being, but we cannot be sure that this will happen in every community setting.

In these RCTs, mindfulness is neither better nor worse than other feel–good practices such as physical exercise, and RCTs in this field tend to be of poor quality, so we cannot be sure that our combined results represent the true effects.

What do these findings mean?

Mindfulness courses in the community need to be implemented with care, because we cannot assume that they work for everyone, everywhere.

We need good quality collaborative research to find out which types of communities benefit from the different types of mindfulness courses available.

The courses that work best may be those aimed at people who are most stressed or in stressful situations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7799763/

 

Spirituality is Associated with Reduced Emotional Distress in Lung Cancer Survivors

Spirituality is Associated with Reduced Emotional Distress in Lung Cancer Survivors

 

By John M. de Castro, Ph.D.

 

“However you define spirituality, studies show that it can play an important role in coping with the recovery and healing process from cancer treatment and its after effects.” – LungCancer.org

 

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

 

Religion and spirituality become much more important to people when they’re diagnosed with cancer or when living with cancer. It is thought that people take comfort in the spiritual when facing mortality. Hence, spirituality may be a useful tool for the survivors of cancer to cope with their illness and the consequent emotional distress. Thus, it makes sense to study the relationships of spirituality with the mental health of cancer survivors.

 

In today’s Research News article “Spirituality and Emotional Distress Among Lung Cancer Survivors.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6859202/ ) Gudenkauf and colleagues recruited adult patients with lung cancer and had them complete questionnaires measuring spirituality, emotional distress, and quality of life. within 1 year of their diagnosis and 1 year later.

 

They found that the lung cancer survivors, not surprisingly, were generally high in emotional distress. But those survivors who were high in spirituality, including the meaning, peace, and faith dimensions, were high in quality of life and low in emotional distress. In addition, those survivors who were high in distress at the first measurement, if they were also high in spirituality meaning, were more likely to have low emotional distress 1 year later.

 

It should be kept in mind that the present study was observational and as a result causation cannot be determined. But it appears that in these lung cancer survivors, spirituality is associated with better quality of life and lower emotional distress and that spirituality tends to predict lower emotional distress a year later. Hence, spirituality appears to help survivors cope with their emotional reactions to their diagnosis. Future studies should investigate whether promoting spirituality in these survivors may improve their emotions and quality of life.

 

So, spirituality is associated with reduced emotional distress in lung cancer survivors.

 

While having a spiritual or religious foundation can’t change your diagnosis or the effectiveness of treatment, some patients find their beliefs help them find meaning and cope. “It may not impact your prognosis, but it can help improve your overall outlook during treatment,” – Tiffany Meyer

 

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

 

Gudenkauf, L. M., Clark, M. M., Novotny, P. J., Piderman, K. M., Ehlers, S. L., Patten, C. A., Nes, L. S., Ruddy, K. J., Sloan, J. A., & Yang, P. (2019). Spirituality and Emotional Distress Among Lung Cancer Survivors. Clinical lung cancer, 20(6), e661–e666. https://doi.org/10.1016/j.cllc.2019.06.015

 

Abstract

Background:

Emerging research is highlighting the importance of spirituality in cancer survivorship as well as the importance of early distress screening. The purpose of this study was to prospectively examine the relationships among spirituality, emotional distress, and sociodemographic variables during the early period of lung cancer survivorship.

Patients and Methods:

864 lung cancer survivors completed the Functional Assessment of Chronic Illness Therapy – Spiritual Well-Being (FACIT-Sp), and the Short-Form-8 (SF-8) for emotional distress within the first year following lung cancer diagnosis, and 474 of these survivors completed the survey again one year later.

Results:

At baseline, spirituality was associated with lower prevalence of emotional distress, being married, fewer years of cigarette smoking, and better ECOG performance status. Additionally, high baseline spirituality was associated with lower rates of high emotional distress at one-year follow-up.

Conclusion:

These findings suggest that spirituality may serve as a protective factor for emotional distress among lung cancer survivors. Further research is warranted to explore the role of spirituality in promoting distress management among lung cancer survivors.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6859202/

 

Improve Psychological Health with a Self-Guided, Smartphone-Based Mindfulness App

Improve Psychological Health with a Self-Guided, Smartphone-Based Mindfulness App

 

By John M. de Castro, Ph.D.

 

“Another part of the appeal of smartphone-based apps is their anonymity. “The apps also allow for privacy and confidentiality and can be a safe space for individuals who may be too ashamed to admit their mental health issues in person or who may feel that they will be negatively labeled or stigmatized by others,” – Sal Raichback

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health. But the vast majority of the mindfulness training techniques, however, require 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 with smartphone apps has 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 via smartphone apps can be effective for improving the health and well-being of the participants.

 

In today’s Research News article “Testing the Efficacy of a Multicomponent, Self-Guided, Smartphone-Based Meditation App: Three-Armed Randomized Controlled Trial. JMIR mental health.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732708/ ) Goldberg and colleagues recruited adults who did not have extensive meditation experience and randomly assigned them to a wait-list control condition or to receive either of 2 8-week smartphone app mindfulness training with the Healthy Minds Program. They received 4 weeks of awareness training including awareness of breathing and awareness of sounds. They were then again randomly assigned to receive 4 weeks of either Connection training consisting or gratitude and kindness practices or Insight Training consisting of “the changing nature of the phenomenon (ie, impermanence) and examining how thoughts and emotions influence perception” practices. They were measured before after the first 4-week module and after the second 4-week module for mindfulness, psychological distress, perceived stress, interpersonal connections, interpersonal reactivity, compassion, self-reflection, rumination, and defusion.

 

They found that compared to baseline and the wait-list control group both intervention conditions produced significant increases in mindfulness, social connection, self-reflection and defusion and significant decreases in psychological distress, and rumination with no significant differences between the smartphone interventions. There were no differences between the wait-list controls and the intervention in compassion and empathy.

 

These are interesting findings that correspond to the finding in prior research that training the increases mindfulness produces significant increases in social connection, self-reflection and defusion and significant decreases in psychological distress, and rumination. They demonstrate that smartphone trainings that improve mindfulness produce improvement in the psychological health of the participants.

 

It was a bit surprising that the benefits of the awareness plus connection training did not significantly differ from the benefits of awareness plus insight training. But since both trainings equivalently higher mindfulness and increased mindfulness has been shown to produce these benefits, it is reasonable to conclude that any training the improves mindfulness will improve psychological health..

 

So, improve psychological health with a self-guided, smartphone-based mindfulness App.

 

Using a smartphone app, may provide immediate effects on mood and stress while also providing long-term benefits for attentional control. . . there is evidence that with continued usage, [mindfulness training] via a smartphone app may provide long-term benefits in changing how one relates to their inner and outer experiences.” – Kathleen Marie Walsh

 

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

 

Goldberg, S. B., Imhoff-Smith, T., Bolt, D. M., Wilson-Mendenhall, C. D., Dahl, C. J., Davidson, R. J., & Rosenkranz, M. A. (2020). Testing the Efficacy of a Multicomponent, Self-Guided, Smartphone-Based Meditation App: Three-Armed Randomized Controlled Trial. JMIR mental health, 7(11), e23825. https://doi.org/10.2196/23825

 

Abstract

Background

A growing number of randomized controlled trials (RCTs) suggest psychological benefits associated with meditation training delivered via mobile health. However, research in this area has primarily focused on mindfulness, only one of many meditative techniques.

Objective

This study aims to evaluate the efficacy of 2 versions of a self-guided, smartphone-based meditation app—the Healthy Minds Program (HMP)—which includes training in mindfulness (Awareness), along with practices designed to cultivate positive relationships (Connection) or insight into the nature of the self (Insight).

Methods

A three-arm, fully remote RCT compared 8 weeks of one of 2 HMP conditions (Awareness+Connection and Awareness+Insight) with a waitlist control. Adults (≥18 years) without extensive previous meditation experience were eligible. The primary outcome was psychological distress (depression, anxiety, and stress). Secondary outcomes were social connection, empathy, compassion, self-reflection, insight, rumination, defusion, and mindfulness. Measures were completed at pretest, midtreatment, and posttest between October 2019 and April 2020. Longitudinal data were analyzed using intention-to-treat principles with maximum likelihood.

Results

A total of 343 participants were randomized and 186 (54.2%) completed at least one posttest assessment. The majority (166/228, 72.8%) of those assigned to HMP conditions downloaded the app. The 2 HMP conditions did not differ from one another in terms of changes in any outcome. Relative to the waitlist control, the HMP conditions showed larger improvements in distress, social connectedness, mindfulness, and measures theoretically linked to insight training (d=–0.28 to 0.41; Ps≤.02), despite modest exposure to connection- and insight-related practice. The results were robust to some assumptions about nonrandom patterns of missing data. Improvements in distress were associated with days of use. Candidate mediators (social connection, insight, rumination, defusion, and mindfulness) and moderators (baseline rumination, defusion, and empathy) of changes in distress were identified.

Conclusions

This study provides initial evidence of efficacy for the HMP app in reducing distress and improving outcomes related to well-being, including social connectedness. Future studies should attempt to increase study retention and user engagement.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732708/

 

Mindfulness is Associated with Reduced Psychological Distress in Kindergarten Teachers

Mindfulness is Associated with Reduced Psychological Distress in Kindergarten Teachers

 

By John M. de Castro, Ph.D.

 

“mindfulness—the ability to stay focused on one’s present experience with nonjudgmental awareness—can help us to promote the calm, relaxed, but enlivened classroom environment that children need to learn. Mindfulness can also help us to be more effective at reducing conflict and developing more positive ways of relating in the classroom, which can help us feel more job satisfaction.” – Patricia Jennings

 

Stress is epidemic in the workplace with almost two thirds of workers reporting high levels of stress at work. This often produces burnout; fatigue, cynicism, emotional exhaustion, and professional inefficacy. In a school setting, this burnout and exhaustion not only affects teachers and administrators personally, but also the students and schools, as it produces a loss of enthusiasm, empathy, and compassion.

 

Hence, there is a need to identify methods of reducing stress and improving teachers’ psychological health. Mindfulness has been demonstrated to be helpful in reducing the psychological and physiological responses to stress and for treating and preventing burnout in a number of work environments. But the effects of mindfulness on kindergarten teachers has not been explored.

 

In today’s Research News article “Mindfulness and Psychological Distress in Kindergarten Teachers: The Mediating Role of Emotional Intelligence.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7664406/ ) Cheng and colleagues recruited kindergarten teachers in China and had them complete measures of mindfulness in teaching, emotional intelligence, perceived stress, anxiety, and depression. These data were then subjected to regression and mediation analyses.

 

They found that the higher the levels of mindfulness in the teachers the higher the levels of emotional intelligence including self-emotional appraisal, others-emotional appraisal, use of emotion, and regulation of emotion. They also found that the higher the levels of mindfulness, the lower the levels of anxiety, depression, psychological distress, and perceived stress. In addition, the higher the levels of emotional intelligence, the lower the levels of anxiety, depression, psychological distress, and perceived stress.

 

They performed a mediation analysis on the data and found that the association of mindfulness with psychological distress was both direct and indirect via emotional intelligence. That is mindfulness was not only associated directly with lower levels of psychological distress but also indirectly by being associated with higher levels of emotional intelligence which, in turn, was associated with lower levels of psychological distress. Further mediation analyses revealed that regulation of emotion was the aspect of emotional intelligence that was responsible for the mediation.

 

It should be kept in mind that these results are correlational and causation cannot be definitively concluded. But, it has been established in previous research the mindfulness training produces increased emotional intelligence and decreased levels of anxiety, depression, psychological distress, and perceived stress. So, the present results likely represent causal effects. Hence, it appears that mindfulness in teaching improves the psychological and emotional well-being of kindergartner teachers. This should not only make the teachers more effective in the classroom but also reduce the likelihood of teacher burnout.

 

So, mindfulness is associated with reduced psychological distress in kindergarten teachers.

 

Practicing mindfulness in your own life can organically lead to integrating it into your classes in a variety of ways, whether by inviting students to take two feet one breath or by beginning class with a moment of mindful breathing.” – Alison Cohen

 

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

 

Cheng, X., Ma, Y., Li, J., Cai, Y., Li, L., & Zhang, J. (2020). Mindfulness and Psychological Distress in Kindergarten Teachers: The Mediating Role of Emotional Intelligence. International journal of environmental research and public health, 17(21), 8212. https://doi.org/10.3390/ijerph17218212

 

Abstract

Kindergarten teachers are often exposed to great stress. Considering that, mindfulness has been demonstrated to act as a critical role in the psychological well-being of kindergarten teachers. The present study assessed mindfulness in teaching (MT), psychological distress and emotional intelligence (EI) among 511 kindergarten teachers in mainland China and investigated the mediating role of EI to explore the association mechanism between kindergarten teachers’ MT and psychological distress. The major results suggested that kindergarten teachers’ MT was negatively related to their psychological distress (depression, anxiety, and stress). Results of path analyses indicated that the total score of EI and dimension of regulation of emotion (ROE) could serve as significant mediators. The findings suggest that mindfulness might be beneficial to relieve kindergarten teachers’ psychological distress through the mediating role of EI.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7664406/

 

Manage Symptoms in Cancer Survivors with Yoga

Manage Symptoms in Cancer Survivors with Yoga

 

By John M. de Castro, Ph.D.

 

“when it’s used alongside conventional medical treatment, yoga may help relieve some of the symptoms linked to cancer.” – American Cancer Society

 

Because of great advances in treatment, many patients today are surviving cancer. But cancer survivors frequently suffer from anxiety, depression, mood disturbance, post-traumatic stress disorder (PTSD), sleep disturbance, fatigue, sexual dysfunction, loss of personal control, impaired quality of life, and psychiatric symptoms which have been found to persist even ten years after remission. Also, cancer survivors can have to deal with a heightened fear of reoccurrence. This is particularly true with metastatic cancer. So, safe and effective treatments for the symptoms in cancer and the physical and psychological effects of the treatments are needed.

 

Mindfulness training has been shown to help with general cancer recovery . Yoga is both an exercise and a mindfulness practice that has also been shown to be helpful with the residual symptoms in cancer survivors, the psychological and physical ability to deal with cancer treatment and improves sleep. So, it’s reasonable to review what has been learned about the benefits of yoga practice to improve the residual symptoms of patients who have survived cancer.

 

In today’s Research News article “Yoga for symptom management in oncology: A review of the evidence base and future directions for research.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6541520/ ) Danhauer and colleagues review and summarize the published randomized controlled studies of the effectiveness of yoga practice for the treatment of the symptoms of cancer survivors. They identified 29 published randomized controlled trials, 13 conducted during treatment, 12 after treatment, and 4 both before and after.

 

They report that the published research found that yoga during treatment for cancer significantly improved the patient’s quality of life, including physical, emotional social, and cognitive quality of life. They also report that yoga significantly reduced fatigue, distress, perceived stress, and biomarkers of stress and inflammation. Yoga after treatment completion was found to significantly reduce fatigue and sleep disturbance and improve quality of life. There were no serious adverse events resulting from yoga practice reported.

 

The published research then suggests that yoga practice is a safe and effective treatment both during and after cancer treatment for the relief of the patients’ residual physical and psychological symptoms. Yoga practice is a complex of practices that includes postures, breath control, and meditation. It has not been clearly established which of these components or which combination of components are required for the benefits. So, conclusions cannot be made regarding mechanisms of action by which yoga produces its benefits. But it can be concluded that yoga practice is very beneficial for cancer sufferers.

 

So, manage symptoms in cancer survivors with yoga.

 

yoga can combat fatigue and improve strength and range of motion for patients undergoing cancer treatment,” – Dr. Maggie DiNome

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Danhauer, S. C., Addington, E. L., Cohen, L., Sohl, S. J., Van Puymbroeck, M., Albinati, N. K., & Culos-Reed, S. N. (2019). Yoga for symptom management in oncology: A review of the evidence base and future directions for research. Cancer, 125(12), 1979–1989. https://doi.org/10.1002/cncr.31979

 

Abstract

As yoga is increasingly recognized as a complementary approach to cancer symptom management, patients/survivors and providers need to understand its potential benefits and limitations both during and after treatment. We reviewed randomized controlled trials (RCTs) of yoga conducted at these points in the cancer continuum (N=29; n=13 during treatment, n=12 post-treatment, n=4 with mixed samples). Findings both during and after treatment demonstrated efficacy of yoga to improve overall quality of life (QOL), with improvement in subdomains of QOL varying across studies. Fatigue was the most commonly measured outcome, and most RCTs conducted during or after cancer treatment reported improvements in fatigue. Results additionally suggest that yoga can improve stress/distress during treatment and post-treatment disturbances in sleep and cognition. A number of RCTs showed evidence that yoga may improve biomarkers of stress, inflammation, and immune function. Outcomes with limited or mixed findings (e.g., anxiety, depression, pain, cancer-specific symptoms such as lymphedema, positive psychological outcomes such as benefit-finding and life satisfaction) warrant further study. Important future directions for yoga research in oncology include: enrolling participants with cancer types other than breast, standardizing self-report assessments, increasing use of active control groups and objective measures, and addressing the heterogeneity of yoga interventions, which vary in type, key components (movement, meditation, breathing), dose, and delivery mode.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6541520/

 

Distress Is Lower during a COVID-19 Pandemic Lockdown in Mindful People

Distress Is Lower during a COVID-19 Pandemic Lockdown in Mindful People

 

By John M. de Castro, Ph.D.

 

“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

 

Modern living is stressful under the best of conditions. But with the COVID-19 pandemic the levels of stress have been markedly increased. These conditions markedly increase anxiety. This is true for everyone but especially for healthcare workers and people caring for patients with COVID-19 and for people with pre-existing conditions that makes them particularly vulnerable. But it is also true for healthy individuals who worry about infection for themselves or loved ones.

 

The COVID-19 pandemic has also produced considerable economic stress, with loss of employment and steady income. For the poor this extends to high levels of food insecurity. This not only produces anxiety about the present but also for the future. It is important for people to engage in practices that can help them control their responses to the stress and their levels of anxiety. Mindfulness practices have been found routinely to reduce the psychological and physiological responses to stress, reduce anxiety levels, and improve mood.

 

In today’s Research News article “Mindfulness, Age and Gender as Protective Factors Against Psychological Distress During COVID-19 Pandemic.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2020.01900/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1437459_69_Psycho_20200922_arts_A ) Conversano and colleagues solicited adult participants online during a government ordered lockdown and had them complete measures of COVID-19 experiences, mindfulness, psychological distress, and mental illness symptoms.

 

They found strong negative relationships between mindfulness and psychological distress. They found that the higher the levels of mindfulness the lower the levels of psychological distress including somatic symptoms, symptoms of obsessive-compulsive disorder, internalizing symptoms, depression, anxiety, hostility, phobia, paranoia, psychoticism, and sleep disturbance. They also found weak relationships with age and gender such that younger and female participants tended to have higher psychological distress.

 

It needs to be kept in mind that these results are correlational and as such causation cannot be determined. Mindfulness may produce reduced distress or conversely distress may produce reduced mindfulness or some third factor may produce both. Nevertheless, the results show that during a pandemic lockdown that the people who have high levels of mindfulness also have low levels of psychological distress.

 

So, distress is lower during a COVID-19 pandemic lockdown in mindful people.

 

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 Baron

 

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

 

Conversano C, Di Giuseppe M, Miccoli M, Ciacchini R, Gemignani A and Orrù G (2020) Mindfulness, Age and Gender as Protective Factors Against Psychological Distress During COVID-19 Pandemic. Front. Psychol. 11:1900. doi: 10.3389/fpsyg.2020.01900

 

Objective: Mindfulness disposition is associated with various psychological factors and prevents emotional distress in chronic diseases. In the present study, we analyzed the key role of mindfulness dispositions in protecting the individual against psychological distress consequent to COVID-19 social distancing and quarantining.

Methods: An online survey was launched on March 13, 2020, with 6,412 responses by April 6, 2020. Socio-demographic information, exposure to the pandemic, and quarantining were assessed together with psychological distress and mindfulness disposition. Multivariate linear regression analysis was performed to study the influence of predictive factors on psychological distress and quality of life in Italian responders during the early days of lockdown. Pearson correlations were calculated to study the relationship between mindfulness and psychiatric symptoms.

Results: Multivariate linear regression run on socio-demographics, COVID-19-related variables, and mindfulness disposition as moderators of overall psychological distress showed that mindfulness was the best predictor of psychological distress (β = −0.504; p < 0.0001). High negative correlations were found between mindfulness disposition and the overall Global Severity Index (r = −0.637; p < 0.0001), while moderate to high associations were found between mindfulness and all SCL-90 sub-scales.

Discussion: Findings showed that high dispositional mindfulness enhances well-being and helps in dealing with stressful situations such as the COVID-19 pandemic. Mindfulness-based mental training could represent an effective intervention to stem post-traumatic psychopathological beginnings and prevent the onset of chronic mental disorders.

https://www.frontiersin.org/articles/10.3389/fpsyg.2020.01900/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1437459_69_Psycho_20200922_arts_A