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MBSR added to residential mental health treatment for adolescents

Posted 12.04.2018 | by AMRA

While there is a fairly extensive research literature evaluating the benefits of Mindfulness Based Stress Reduction (MBSR) for adults with depression and anxiety, research into the benefits of MBSR for adolescents with mental health problems is sparse.

Vohra et al. [Child and Adolescent Mental Health] conducted a controlled trial of MBSR as an adjunctive treatment for adolescents attending an intensive residential mental health treatment program.

The researchers studied 85 non-psychotic adolescent patients (average age = 14 years; 59% male; 73% Caucasian) residing in an intensive residential mental health treatment program. Half of the residents received standard residential care and half received standard residential care plus adjunctive MBSR. Assignment to condition was based on the time of year that patients resided in the treatment program, rather than on individual randomization.

Standard residential care consisted of a structured program including daily group therapy, medication, education, recreation, and weekly family therapy. Adjunctive MBSR was offered in eight two-hour weekly sessions with a three-hour retreat in week eight. The standard MBSR protocol was modified for the age group and homework was less demanding.

Outcome measures assessed at baseline, 10 weeks, and 3 months included parent, teacher, and self-ratings using the Behavioral Assessment System for Children System (BASC) as well as self-ratings on perceived stress, mindfulness (using the Child Acceptance and Mindfulness Measure), and emotional regulation. During the course of the study, 4 participants were discharged early and one participant declined further participation. Average MBSR session attendance was 88%.

BASC teacher ratings showed significant improvements for the adjunctive MBSR group on measures of internalizing problems (depression, anxiety, somatization) and adaptive skills (social skills, study skills, leadership) compared to standard care alone. Average […]

December 4th, 2018|News|

Mindfulness coach supports women undergoing breast biopsy

Posted 11.26.2018 | by AMRA

About one in eight U.S. women will be diagnosed with breast cancer at some point in their lives. Cancer is often diagnosed by a stereotactic breast biopsy that uses a mammography-guided needle to extract suspicious tissue. The procedure requires women to remain immobile for 15-30 minutes while undergoing breast compression, which can be an uncomfortable, anxiety provoking experience.

Patients can take prescription drugs to reduce anxiety, but this requires them to be driven to and from the procedure and can delay their return to work. As a result, there is interest in non-drug interventions to reduce biopsy discomfort and anxiety.

Ratcliff et al. [Journal of the American College of Radiology] compared the effect of mindfulness meditation or focused breathing to a control group on breast biopsy pain and anxiety.

The researchers randomly assigned 76 women (average age = 55 years; 74% Caucasian and 20% Hispanic/Latina) preparing to undergo stereotactic breast biopsy to: 1) a 10-minute guided mindfulness meditation, 2) a 10-minute guided period of focused diaphragmatic breathing, or 3) a 10-minute period of listening to a neutral audio clip.

Mindfulness meditation emphasized nonjudgmental observation of the breath, sensations, thoughts, and feelings with reminders to refocus whenever the mind wandered. The meditation was guided in-person by a mind-body medicine specialist. The specialist also accompanied the patient to the biopsy, coaching them in meditation during the procedure. Focused breathing was taught and coached similarly. Audio clip patients were not accompanied or coached during the biopsy.

Measures of anxiety and pain were taken after the training interventions, every four minutes during the biopsy, and immediately following the biopsy. Additionally, an electroencephalogram (EEG) measured patient brain wave activity in regions of […]

November 26th, 2018|News|

Mindful parenting program affects parenting style and child weight gain

Posted 10.30.2018 | by AMRA

Children from low-income, high-stress families are at increased risk for obesity. Further, highly stressed parents tend towards parenting styles that are less warm, less involved, and more punitive. An intervention that improves parental nonjudgmental attention to moment-to-moment parent-child interactions might also prove helpful in preventing childhood obesity.

Jastreboff et al. [Journal of Pediatrics] explored whether a novel mindful parenting program could improve parenting style and reduce the risk for obesity in the parents’ preschool-aged children.

The researchers randomly assigned 42 highly stressed low-income parents of preschool aged children (average age = 31 years; 98% female; 62% multiracial; average BMI=36) to either an 8-week Parenting Mindfully for Health (PMH) program or an educational control group. High parental stress was defined by high scores on a perceived stress scale.

The PMH and control participants both attended 8 weekly 2-hour group sessions that included 20 minutes of nutrition and physical activity education and counseling. The remainder of the time in the PMH group was modeled after MBSR, which included a focus on mindful parenting, eating, and physical activity. The remainder of the control group’s time was devoted to viewing and discussing nature videos.

Parents were assessed pre- and post-intervention for mindfulness (using the Mindful Attention Awareness Scale), perceived stress, nutritional intake, pedometer-measured physical activity, and BMI. Their preschool children wore an activity sensor to measure levels of physical activity and also had their BMI calculated from their height and weight.

Parent-child dyads were videotaped during a “Toy Wait Test” in which the children had to wait five minutes until their parents completed some paperwork before they could play with a toy. Toy Wait Test videotapes were rated for the quality […]

October 30th, 2018|News|

Mindfulness intervention supports eye health in glaucoma patients

Posted 10.23.2018 | by AMRA

Glaucoma is a leading cause of blindness that affects 65 million people worldwide. It is caused by increased fluid buildup inside of the eye (intraocular pressure) that results in progressive damage to the optic nerve. Psychological stress is known to increase several glaucoma risk factors (oxidative stress, inflammation, glutamate toxicity, and vascular dysregulation) while simultaneously reducing several protective factors (neurotrophins and glial activity). This finding has led some to wonder whether stress reduction interventions might benefit glaucoma patients.

Dada et al. [Journal of Glaucoma] conducted a randomized, controlled study to test if a mindfulness-based intervention (MBI) could reduce intraocular pressure and affect psychological stress-related biomarkers as well as alter gene expression in glaucoma patients.

The researchers randomly assigned 90 patients (average age = 57 years; 55% male) with moderate-to-severe glaucoma to either a MBI or a wait-list control group. MBI participants engaged in daily hour-long teacher-led group sessions for 21 consecutive days. The sessions included 15 minutes of slow-breathing exercises followed by 45 minutes of mindfulness meditation. Attrition rate was 18% in the MBI group and 7% in the wait-list control group.

Intraocular pressure was assessed pre- and post-intervention, as were biomarkers of psychological stress (cortisol and β-endorphins), inflammation (IL-6 and TNF-α), oxidative stress (the imbalance between free radicals and antioxidants as measured by ROS and TAC), and a protein that protects nerve cells (BDNF). Whole blood RNA was assessed for post-intervention differences in gene expression, and participants completed the World Health Organization Quality of Life Questionnaire.

MBI participants showed a significant 6 mmHg reduction in intraocular pressure, while controls only decreased by about 1 mmHg. Seventy-five percent of the participants who completed the MBI reduced […]

October 23rd, 2018|News|

Daily brief meditation takes more than four weeks to boost mood

Posted 09.27.2018 | by AMRA

Meditation practice reliably demonstrates beneficial effects for memory, attention, mood, and emotional regulation. It is unclear, however, whether there is a minimum dosage necessary to attain these benefits.

Basso et al. [Behavioural Brain Research] measured the benefits of meditation in a group of meditation-naïve participants by assigning them to either daily brief guided meditations or to a control group, and measuring their changes in mood and cognition over time.

The researchers randomly assigned 72 meditation-naïve participants to either a meditation audio or a podcast audio. The meditation group listened to 13-minute guided meditations daily for 8 weeks. The meditations included breath-focused exercises and a body scan practice. The podcast group listened to 13-minute excerpts from NPR’s Radiolab podcast daily for 8 weeks.

Participants underwent neuropsychological and psychological evaluations and salivary cortisol (a stress hormone) assessments at baseline, 4 weeks, and 8 weeks. Computer-administered neuropsychological tests included measures of attention, working and recognition memory, and response inhibition. The psychological tests measured mindfulness (Mindful Attention Awareness Scale or MAAS), mood, stress, depression, anxiety, rumination, sleep quality, fatigue, quality of life, self-esteem, and life satisfaction.

Following the final assessments, participants were subjected to a stress-inducing task. They were told to prepare for a job interview and deliver a five-minute presentation on why they should be hired in front of two stone-faced judges. They were then told to perform a difficult serial subtraction problem. Whenever they made an arithmetic mistake, they were instructed to start the problem over from the beginning.

Subjective measures of anxiety were taken at baseline, immediately after, and at 10, 20, and 30-minute intervals after the stress-inducing tasks. Salivary cortisol levels were also assessed at each of […]

September 27th, 2018|News|

MBCT helps patients with treatment-resistant depression

Posted 09.20.2018 | by AMRA

About one-in-five major depressive episodes are not responsive to either medication or psychotherapy and go on to become chronic illnesses. Mindfulness-Based Cognitive Therapy (MBCT) has been shown to be useful as an adjunctive treatment in acute depressions and the prevention of depressive relapse in patents with a history of multiple depressive episodes. Its effectiveness in chronic treatment-resistant depressions has not yet been established.

Cladder-Micus et al. [Depression and Anxiety] compared the effectiveness of MBCT as an adjunctive treatment to treatment-as-usual in patients with treatment-resistant chronic depression.

The researchers randomly assigned 106 patients with treatment-resistant chronic depression (female = 62%; mean age = 47 years; mean length of depressive episode = 70 months; mean number of previous episodes = 2.7) to either treatment-as-usual (TAU) or TAU combined with adjunctive MBCT. MBCT was offered in the standard 8-week group format. TAU consisted of medication, psychological treatment, psychiatric nursing support, and day hospitalization as needed. There was no difference between conditions as to the type and amount of TAU received.

Participants were assessed at baseline and post-treatment on symptom severity, remission of illness (no symptoms for two weeks), quality of life, rumination, self-compassion, and mindfulness (using the Five Facet Mindfulness Questionnaire).

The MBCT attrition rate was 24.5%, with participants dropping out due to physical complaints, trouble awakening in the morning, and practical considerations (e.g., moving away from the area). Completers did not differ from non-completers in terms of baseline depressive symptoms.

The main analyses were performed using an intention-to-treat (ITT) protocol using data from all participants available for post-testing, whether or not they successfully completed the MBCT program. Secondary analyses were conducted using only those MBCT participants who completed 4 […]

September 20th, 2018|News|

Brain connectivity differs for short- and long-term meditators

Posted 08.28.2018 | by AMRA

Mindfulness-based interventions can enhance emotional regulation and improve mood, but we are only just beginning to understand the brain mechanisms responsible for these benefits. Kral et al. [Neuroimage] compared the brain activity of long-term meditators, short-term meditators, and non-meditators in response to emotionally positive, negative, and neutral images. The researchers sought to discover whether or not the amount of an individual’s meditation practice correlated with their response to emotional stimuli.

The researchers recruited a sample of 31 long-term Vipassana mediators (average age = 50 years, 55% female, average meditation practice = 9,000 hours) and compared them to a sample of 127 meditation-naive recruits. Following initial data collection, 86 of the meditation-naïve recruits (average age = 48, 63% female) were randomly assigned to a standard 8-week Mindfulness-Based Stress Reduction (MBSR) program or a Health Enhancement program (HEP) which served as a time-and-attention control.

The long-term mediators and the meditation-naive participants spent a day in the laboratory prior to the meditation-naive group’s random assignment to intervention. Following intervention, the meditation-naive group returned to the laboratory for re-assessment.

In the laboratory, participants were shown emotionally positive, negative, and neutral images while undergoing functional magnetic resonance imaging (fMRI), a procedure that measures metabolic activity in different regions of the brain. The researchers measured fMRI activity in two specific brain regions: the amygdala, which plays a role in generating emotion, and the ventromedial prefrontal cortex (VMPFC), which plays a role in regulating emotion. Participants also completed a self-report measure of mindfulness, the Five Facet Mindfulness Questionnaire (FFMQ).

Results from the pre-intervention data showed that meditation-naive participants had significantly greater right amygdala activity in response to positive images than long-term meditators. While […]

August 28th, 2018|News|

MBSR program safe and feasible for people with multiple sclerosis

Posted 08.16.2018 | by AMRA

Multiple sclerosis is a central nervous system disorder in which the body’s immune system attacks the fatty layer of insulation surrounding nerve cells. Symptoms may include visual and sensory disturbances, muscle weakness and discoordination, fatigue, pain, and problems with mood and cognition. Stress can worsen these symptoms, and stress management can reduce the risk of the illness spreading to other brain regions.

Senders et al. [Multiple Sclerosis Journal] tested the feasibility of using Mindfulness-Based Stress Reduction (MBSR) with multiple sclerosis patients, and whether MBSR worked better than an active control intervention in improving psychological symptoms and wellbeing.

The researchers randomly assigned 67 patients with multiple sclerosis (average age = 53 years, 77% female, 97% Caucasian) to a standard 8-week MBSR intervention or to an education control group matched for time and attention. The control group curriculum covered topics such as medication, symptom management, financial planning, knowing one’s rights, and connecting with resources.

The groups were assessed on a variety of self-report measures of psychological symptoms, stress, and wellbeing at baseline, immediately after program completion, and at twelve months post-intervention.

Attention and cognition were assessed using a serial addition task in which participants listened to an audio recording of single digits presented at three-second intervals. Participants had to add each newly presented digit to the previously presented one. Participant expectations for the success of their respective interventions were assessed at baseline, with MBSR assignees having significantly higher expectations.

In regard to feasibility, 85% of the MBSR patients attended at least 6 of the 8 group sessions, thus meeting the author’s standard for course completion. They completed their at-home meditation on 55% of the assigned days for an average […]

August 16th, 2018|News|

Mindful people less distressed after social rejection, brain activity shows

Posted 07.26.2018 | by AMRA

Social rejection can be hurtful, but people differ in how distressed they become following rejection. People also vary in the strategies they use to reduce distress.

Some people subdue feelings of distress by employing a “top-down” strategy in which cognitive-related brain centers suppress the activity of emotion-related brain centers. This “top-down” strategy is taxing on cognitive resources, and if those resources become depleted, feelings of distress can re-emerge.

Other people employ “bottom-up” strategies such as mindfulness of negative emotions that do not require suppression by cognitive-related brain centers.

Martelli et al. [Social Cognitive and Affective Neuroscience] studied whether highly mindful people feel less distress when socially rejected, and examined whether cognitive- and emotion-related brain responses to rejection varied according to levels of mindfulness.

The researchers assessed dispositional mindfulness levels among 40 participants (54% male, average age = 19 years) using the Mindful Attention Awareness Scale. Participants then played a computerized Cyberball game while undergoing functional magnetic resonance imaging.

Cyberball involves a pair of computer-generated characters playing virtual catch with the participant. Participants are misled into believing the computer-generated characters are avatars for real people playing the game. Initially, the computer-generated characters toss the ball between themselves and the participant equally, but in the final minute of play, they toss the ball only between themselves, effectively excluding the participant from the social interaction.

Approximately an hour after the game, participants completed a questionnaire measuring their level of social distress. Participants also completed a manipulation check that showed they believed they were playing Cyberball with live co-participants.

The neurobiology of distress and its suppression is complicated. Feelings of distress are associated with increased activity in the dorsal anterior cingulate cortex (dACC), […]

July 26th, 2018|News|

MBSR and exercise both reduce cold and flu frequency, severity

Posted 07.17.2018 | by AMRA

Acute respiratory infections including colds and flu affect over 50% of the population annually. Interestingly, our psychological states and behaviors can affect our susceptibility to these infections. People who are under stress or otherwise unhappy are more likely to catch acute respiratory infections, while people who exercise regularly are less likely to catch them.

Barrett et al. [PLOS One] conducted a randomized controlled study to test the effects of Mindfulness-Based Stress Reduction (MBSR) and moderate intensity sustained exercise on the frequency, duration, and severity of colds and flu compared to a control group.

The researchers recruited 413 volunteers (average age = 50 years, 76% female, 85% white, 77% college educated) and randomly assigned them to a MBSR, exercise, or non-active control group. The MBSR and exercise interventions were matched on group size, program length, session frequency, and the amount of home practice (20-45 minutes).

The interventions were conducted in the fall, and participants were monitored for colds and flu from fall through spring. During this time, participants completed weekly health reports. If participants developed an infection, they completed daily reports until symptoms abated.

Additionally, they provided oral and nasal swabs to assess their immune response and identify viruses. Participants completed a variety of mental health and personality measures at baseline and at various points along the study timeline. Absenteeism, the number of respiratory infection-related medical appointments, and illness related costs were also assessed.

The study found that the MBSR and exercise groups both reduced acute respiratory infection incidence, duration, and severity. Compared to controls, the MBSR group showed a 16%, reduction in incidence, a 14% reduction in duration, and a 21% reduction in severity. Compared to controls, […]

July 17th, 2018|News|