Reduce Stigma and Perceived Devaluation in Patients with Schizophrenia with Mindfulness

Reduce Stigma and Perceived Devaluation in Patients with Schizophrenia with Mindfulness

 

By John M. de Castro, Ph.D.

 

Stigma is the number one reason people do not seek help; therefore, efforts to reduce stigma are crucial to increasing people’s help-seeking behaviors.” – Sami Boomgarden

 

Stigma is a view that a distinguishing characteristic makes the individual less acceptable to others. This can lead to discrimination where stigmatized people are treated negatively either directly with ugly remarks such as “crazy” or “weird” or indirectly by being avoided or marginalized by others. This can produce fewer work opportunities, harassment, bullying, problems with insurance, and loneliness. The social isolation can even lead to early mortality. Stigma can lead to low self-esteem and self-stigmatization in which the individual adopts those negative stereotypes and as a result there is a loss of self-efficacy This leads to the individual ceasing trying to make things better, thinking “why try?”

 

Mindfulness promotes non-judgmental awareness in which the individual perceives things just as they are without labelling or making value judgements about them. It also promotes the ability to adaptively cope with emotions and reduces worry and rumination. These can be useful in overcoming stigmas and their effects, especially self-stigmas. So, mindfulness may buffer the individual from the effects of stigma and self-stigmatization in severe mental illnesses such as schizophrenia. Mindfulness-Based Cognitive Therapy (MBCT) involves the combination of mindfulness training and cognitive behavioral therapy. It contains 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. Hence, MBCT may be particularly effective in reducing stigma in patients diagnosed with schizophrenia.

 

In today’s Research News article “Effects of Mindfulness-Based Cognitive Therapy on Stigma in Female Patients With Schizophrenia.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8342917/ ) Tang and colleagues recruited patients diagnosed with schizophrenia and randomly assigned them to either receive 8 weeks of Mindfulness-Based Cognitive Therapy (MBCT) or to a treatment as usual control condition. They were measured before and after treatment for mindfulness, insight and treatment attitudes, and stigma including subscales measuring perceived devaluation-discrimination, stigma-coping orientation, and stigma-related feeling.

 

They found that in comparison to baseline and the control group, the participants who received Mindfulness-Based Cognitive Therapy (MBCT) had significantly higher levels of mindfulness and insight and treatment attitudes, and significantly lower levels of stigma, including perceived devaluation-discrimination and stigma-coping orientation. They also found that the higher the levels of mindfulness after treatment the lower the levels of stigma and the higher the levels of insight and treatment attitudes.

 

Stigma involves “shame, evaluative thoughts, and fear of enacted stigma that results from individuals’ identification with a stigmatized group”. Stigma is an impediment to successful treatment of mental illnesses and improvement of social function. In fact, many patients high in stigma refuse treatment all together. The findings of the present study suggest that mindfulness training can help patients diagnosed with schizophrenia overcome stigma and as a result improve their attitudes toward treatment. As a result, mindfulness training may improve the patient’s prognosis and make successful treatment more likely.

 

So, reduce stigma and perceived devaluation in patients with schizophrenia with mindfulness.

 

mindfulness-based psychoeducation was effective in reducing stigma in patients with schizophrenia.” – Emine Yılmaz

 

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

 

Tang, Q., Yang, S., Liu, C., Li, L., Chen, X., Wu, F., & Huang, X. (2021). Effects of Mindfulness-Based Cognitive Therapy on Stigma in Female Patients With Schizophrenia. Frontiers in psychiatry, 12, 694575. https://doi.org/10.3389/fpsyt.2021.694575

 

Abstract

Mindfulness-based cognitive therapy (MBCT) has been increasingly recognized as effective in different mental illnesses, but these effects are limited in schizophrenia. For patients with schizophrenia, stigma is one of the most negative factors that affects treatment, rehabilitation and social function. This research aimed to determine the effects of MBCT on stigma in patients with schizophrenia. In total, 62 inpatients with schizophrenia were recruited and randomly assigned to the experimental group or control group. The experimental group received an 8-week MBCT intervention, and the control group were treated as usual. Link’s Stigma Scales (with three subscales, including perceived devaluation-discrimination (PDD), stigma-coping orientation, and stigma-related feeling), Five Facet Mindfulness Questionnaire (FFMQ), and Insight and Treatment Attitudes Questionnaire (ITAQ) were used to collect data before and after intervention. After intervention, the post-test score of PDD, stigma-coping orientation, FFMQ, and ITAQ were significantly different between the experimental group and the control group. In the experimental group, the PDD and stigma-coping orientation scores significantly decreased, and FFMQ and ITAQ scores increased remarkably (P < 0.05). In addition, correlation analysis revealed a significant negative correlation between mindfulness and stigma. MBCT was effective in reducing stigma in patients with schizophrenia, which mainly manifested as changes in the patients’ perception of stigma as well as the withdrawal and avoidance caused by schizophrenia. Enhancing mindfulness will help reduce the stigma level. MBCT is worthy of promotion and application in patients with schizophrenia.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8342917/

 

Mindfulness-Based Cognitive Therapy (MBCT) Plus Loving-Kindness Mediation is highly Effective in Depressed Patients

Mindfulness-Based Cognitive Therapy (MBCT) Plus Loving-Kindness Mediation is highly Effective in Depressed Patients

 

By John M. de Castro, Ph.D.

 

“MBCT can provide a viable relapse prevention intervention for people with a history of recurrent depression.” – Catherine Crane

 

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

 

Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs failMindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression. 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 has been found to be effective in treating depression.

 

Loving Kindness Meditation (LKM) is designed to develop kindness and compassion to oneself and others. The individual systematically pictures different individuals from self, to close friends, to enemies and wishes them happiness, well-being, safety, peace, and ease of well-being. Although LKM has been practiced for centuries, it has received very little scientific research attention. But it may be effective in counteracting the effects of stress and self-criticism. It is not known how effective the combination of Mindfulness-Based Cognitive Therapy (MBCT) and Loving Kindness Meditation might be in treating depression.

 

In today’s Research News article “A study on the effects of mindfulness-based cognitive therapy and loving-kindness mediation on depression, rumination, mindfulness level and quality of life in depressed patients.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8205847/ ) Wang and colleagues recruited adult patients with depression and randomly assigned them to receive either regular care or to receive 1 hour once per day for 1 week Loving Kindness Meditation followed by 8 weeks, once per week of Mindfulness-Based Cognitive Therapy (MBCT) also with Loving Kindness Meditation practice. Regular care consisted of “basic knowledge of depression, common drugs, possible adverse drug reactions, and prevention of adverse reactions . . . Face-to-face communication with patients was conducted regularly to understand their thoughts, evaluate the depression degrees of patients, so as to provide psychological support for depressed patients, and care for patients in daily life.” They were measured at baseline and at 2, 4, 6, and 8 weeks for mindfulness, depression, rumination, quality of life, self-acceptance, and sense of stigma.

 

They found that both groups significantly decreased in depression, sense of stigma, and rumination and increased in mindfulness, self-acceptance and quality of life over the 8 weeks. But the intervention group improved significantly more than the control group on all measures.

 

Previous research has shown that mindfulness training produces significant decreases in depression and rumination and increases in self-acceptance and quality of life. What is new here is that they found that the combination of Mindfulness-Based Cognitive Therapy (MBCT) and Loving Kindness Meditation was significantly more effective than the conventional psychological intervention. This is important but must be followed up to see if the improvements in the patients with depression are sustained over longer periods of time.

 

So, Mindfulness-Based Cognitive Therapy (MBCT) plus Loving-Kindness Mediation is highly effective in depressed patients.

 

MBCT leads to a decrease in depressive symptoms, reduction in depression relapse rate and improvement in terms of mindfulness.” – Zulkiflu ArgunguMusa

 

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

 

Wang, Y., Fu, C., Liu, Y., Li, D., Wang, C., Sun, R., & Song, Y. (2021). A study on the effects of mindfulness-based cognitive therapy and loving-kindness mediation on depression, rumination, mindfulness level and quality of life in depressed patients. American journal of translational research, 13(5), 4666–4675.

 

Abstract

Objective: To analyze the effects of mindfulness-based cognitive therapy (MBCT) plus loving-kindness mediation (LKM) in depressed patients. Methods: A total of 125 depressed patients diagnosed in the Department of Psychiatry of our hospital were selected as the research subjects and were randomly divided into a control group (n=62) and an observation group (n=63). The control group was treated with conventional psychological intervention, while the observation group was treated with MBCT plus LKM. The therapeutic outcomes were compared between the two groups. Results: At 2, 4, 6 and 8 weeks after intervention, the Hamilton Depression Rating Scale (HAMD) scores and the scores for introspection and deliberation, forced thinking, rumination of symptoms, treatment, ability and social relationships in the observation group were lower than those in the control group, while Five Facet Mindfulness Questionnaire (FFMQ) scores and the scores for psychology, environment, physiology, social relations, self-acceptance, and self-evaluation in the observation group were higher than those in the control group (P < 0.05). Conclusion: MBCT plus LKM can effectively improve depression, rumination, mindfulness level, quality of life, the sense of stigma and degree of self-acceptance in depressed patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8205847/

 

Decrease Stigma Effects on People Recovering from Mental Illness and HIV with Mindfulness

Decrease Stigma Effects on People Recovering from Mental Illness and HIV with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Stigma is considered a mark of disgrace, discredit, and judgment that results in discrimination and exclusion. For people struggling with mental or emotional disturbances, the experience of stigmatization can easily become internalized and result in a profound sense of shame, secrecy, and social isolation. When someone is already experiencing significant internal conflicts, interpersonal difficulties, or severe mental illness, stigmatization by others only serves to intensify suffering. Imagine the potential difference that you can make in the lives of those who are struggling with mental health issues through increasing your own awareness, adopting a mindfully nonjudgmental attitude, and expressing compassion.” – Laura Schenck

 

Stigma is a view that a distinguishing characteristic makes the individual less acceptable to others. This can lead to discrimination where stigmatized people are treated negatively either directly with ugly remarks such as “crazy” or “weird” or indirectly by being avoided or marginalized by others. This can produce fewer work opportunities, harassment, bullying, problems with insurance, and loneliness. The social isolation can even lead to early mortality. Stigma can lead to low self-esteem and self-stigmatization in which the individual adopts that negative stereotypes and as a result there is a loss of self-efficacy This leads to the individual ceasing trying to make things better, thinking “why try?”

 

Stigmas are associated with a number of different characteristics, situations, and diseases. Very common stigmas involve mental illness and HIV infection, both of which are viewed negatively. Indeed, in some studies, it has been found that over half of the interviewees had very negative attitudes toward people with either mental illness or HIV infection. Although efforts are being made to reduce these stigmas there is also a need to address the self-stigmatization process and the effect of the stigma on the individuals with mental illness and HIV infection.

 

Mindfulness promotes non-judgmental awareness in which the individual perceives things just as they are without labelling or making value judgements about them. It also promotes the ability to adaptively cope with emotions and reduces worry and rumination. These can be useful in overcoming stigmas and their effects, especially self-stigmas. Self-compassion by promoting positive self-perceptions can be an antidote to self-stigmatization. So, mindfulness and self-compassion may buffer the individual from the effects of stigma and self-stigmatization.

 

In today’s Research News article “The Differential Moderating Roles of Self-Compassion and Mindfulness in Self-Stigma and Well-Being Among People Living with Mental Illness or HIV.” (See summary below). Yang and Mak recruited adult individuals with mental illness or with HIV. They completed measures of mindfulness, self-compassion, self-stigma content and process, and life-satisfaction. These data were then used in a regression analysis to determine the interrelationships between stigma, mindfulness, and self-compassion, and the effects of stigmas.

 

They found that the higher the levels of mindfulness and self-compassion in the individuals with mental illness or HIV, the higher the levels of life satisfaction. Conversely, they found that the higher the levels of self-stigma content the lower the levels of life satisfaction. They also found that when self-compassion and mindfulness were low, self-stigma content was significantly and negatively associated with life satisfaction. But when self-compassion and mindfulness were high, self-stigma content was not significantly associated with life satisfaction. Hence mindfulness and self-compassion had beneficial associations on the quality of life in stigmatized individuals both directly and indirectly by buffering them against the negative effects of stigma.

 

It needs to be kept in mind that these results are correlational and causation cannot be concluded. But, the beneficial associations of mindfulness and self-compassion with reduced stigma effects, suggests that training in mindfulness and self-compassion may be beneficial for people with mental illness and HIV in overcoming stigma effects and improving their quality of life. The present results are sufficiently encouraging to justify a randomized controlled trial of the effects of mindfulness and self-compassion training on stigmatized individuals. Developing mindfulness and self-compassion in stigmatized individuals may markedly improve the lives of these suffering individuals.

 

So, Decrease Stigma Effects on People Recovering from Mental Illness and HIV with Mindfulness.

 

“So, the bad news is that there may not be a way to stop processing automatic, stigmatizing thoughts. However, the good news, according to Inzlicht and Segal, is that we don’t need to. Instead, we should focus on having good intentions to not stigmatize and remain aware and nonjudgmentally accepting of these automatic thoughts–so as not to act on them. Considering the thousands of automatic thoughts each person has everyday, mindfulness may be a good start to ensuring that what we believe coincides with how we act. And this may, ultimately, contribute to the betterment of the live’s of those afflicted with mental illness.” – Veerpal Bambrah

 

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

 

Yang, X. & Mak, W.W.S. The Differential Moderating Roles of Self-Compassion and Mindfulness in Self-Stigma and Well-Being Among People Living with Mental Illness or HIV. Mindfulness (2017) 8: 595. doi:10.1007/s12671-016-0635-4

 

Abstract

In addition to endorsing the content of stigmatizing thoughts (self-stigma “content”), how frequently and automatically individuals think about these thoughts (self-stigma “process”) also have implications for their well-being. The present study examined the roles of self-compassion and mindfulness in moderating the relationships of self-stigma content and process with subjective well-being of people in recovery of mental illness (PMI) and people living with HIV (PLHIV). Participants included 169 PMI and 291 PLHIV in Hong Kong who reported their levels of self-compassion, mindfulness, self-stigma content and process, and life satisfaction. Path analyses indicated that the proposed model fitted the two samples well, χ2(10) = 19, p = .04, CFI = .98, NNFI = .93, and RMSEA = .04. In both groups, self-compassion and mindfulness were significantly associated with life satisfaction. Self-compassion moderated the relationship between self-stigma content and life satisfaction among PLHIV, while mindfulness moderated the relationship between self-stigma process and life satisfaction among PMI. The differential moderating roles of self-compassion and mindfulness in buffering the effects of self-stigma content and process among PMI and PLHIV were identified, and implications for stigma reduction and well-being promotion in different stigmatized groups were discussed.