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Distress not lowered by MBCT in men with advanced stage cancer

Posted 12.22.2016 | by AMRA

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Prostate cancer is the second most frequently diagnosed cancer in men, and one-fifth of those diagnosed go on to develop either metastatic or incurable progressive forms of the disease. Men with advanced prostate cancer have higher rates of depression, anxiety, PTSD, and suicide risk than the general population, and may be able to benefit from group treatments to reduce the psychological suffering associated with both the illness and the unintended effects of treatment.

Mindfulness-Based Cognitive Therapy (MBCT) has been shown to be an effective treatment for preventing relapse in recurrent depression, and Chambers et al. [Journal of Clinical Oncology] conducted a randomized, controlled study to see whether it could also be of benefit to advanced prostate cancer patients.

The researchers randomly assigned 189 Australian men (average age = 71 years) with advanced prostate cancer to either an 8-week MBCT group intervention delivered by teleconferencing, or a minimally enhanced treatment-as-usual condition. Teleconferencing allowed patients who lived in rural/remote areas or who were too ill to travel to participate.

MBCT telephone sessions were held once a week, lasted for 1.25 hours, included short 15-minute meditation periods, and encouraged daily home practice. The enhanced treatment-as-usual condition provided patients with a consumer guide to advanced prostate cancer, a relaxation CD, coping-with-cancer booklets, and similar information.

Outcome measures included self-report measures of general psychological distress, cancer-specific distress, anxiety concerning prostate-specific antigen (PSA) tests, quality of life, posttraumatic growth, and mindfulness (using the Five Facet Mindfulness Questionnaire or FFMQ). Measures were obtained at baseline and at 3, 6, and 9 month follow-ups.

There were no significant differences between the MBCT group and the control group on any of the self-reported outcome variables, including […]

December 22nd, 2016|News|

Mindful mothers get health benefit during and after pregnancy

Posted 12.19.2016 | by AMRA

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Pregnancy profoundly affects women’s bodies. Women’s heart rate, blood pressure, and autonomic nervous system functioning undergo significant changes as pregnancy proceeds, and many women experience degrees of emotional distress. Some of these changes have the potential to deleteriously affect the mother’s long-term health as well as her infant’s social and emotional development.

Braeken et al. [Psychophysiology] conducted a longitudinal study of how differing levels of trait mindfulness are associated with differing levels of cardiovascular and autonomic functioning in pregnant mothers and with their newborn infant’s social and emotional development in the months following birth.

The researcher’s recruited 156 pregnant Dutch women who volunteered for inclusion in the study (average age = 33 years). Repeated measures of maternal cardiovascular function (blood pressure, heart rate, heart rate variability, and the length of the time interval between ventricular contraction and blood injection into the aorta known as the “pre-ejection period”) were taken during the first and third trimesters of pregnancy, along with a self-report measure of emotional distress.

Trait mindfulness was measured during the second trimester using the Freiburg Mindfulness Inventory. Maternal emotional distress was again measured 2-4 months after delivery, and infant social-emotional development was assessed by maternal report the fourth month after delivery using the Ages and Stages Questionnaire-Social Emotional (ASQ-SE).

Maternal mindfulness was significantly associated with higher levels of general heart rate variability and high frequency heart rate variability. The more mindful the women were, the less their high frequency heart rate variability declined and the less their pre-ejection period shortened from the first to the third trimester. These results are interpreted as showing that more versus less mindful women have lower decreases in parasympathetic nervous […]

December 19th, 2016|News|

Scope of mindfulness activity in American medical schools

Posted 11.28.2016 | by AMRA

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While anecdotal evidence suggests that an increasing number of medical students and physicians are gaining exposure to mindfulness-related concepts and practices, there have been no formal surveys of the extent and scope of mindfulness-related activities in U.S. medical schools. If mindfulness is to be more than a passing fad, MBI-related concepts and practices need to be integrated into medical education, and institutions must be created that will sustain medical MBI education, practice, and research into the future. To what extent is that happening across the nation?

Barnes et al. [Mindfulness] performed a systematic search of all of the 140 accredited U.S. medical school websites for information concerning MBI education, practice programs, and research activity. Whenever the schools were found to have affiliated academic mindfulness centers, the directors of those centers were surveyed about program content and sustainability.

The researchers evaluated over 5,000 web links that were harvested in an Internet search of links that included a medical school name and a reference to mindfulness. Mindfulness activities in those links were categorized as clinical activity, medical school curricular activity, student/staff wellness activity, or research activity. The search also identified potential academic mindfulness centers associated with the medical schools (AMCAMS).

To be identified as an AMCAMS, centers had to be a distinct administrative entity, be affiliated with the medical school, and offer at least one MBI course. Center directors were asked to complete an online survey requesting detailed information about their programs, participants, staffing, revenue sources, and whether the center had an exclusive mindfulness focus or a broader integrative medicine focus.

Results showed that in 2014, 79% (111/140) of U.S. medical schools provided online information about mindfulness-related activities. […]

November 28th, 2016|News|

Mindfulness training reduces smoking, brain mechanism uncovered

Posted 11.14.2016 | by AMRA

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Life expectancy of tobacco smokers is cut by 10 years, and smoking is responsible for nearly a half-million deaths in the United States each year. The vast majority of smokers want to quit, but unassisted attempts usually fail, and those that succeed often end in relapse. Studies show that acute stress increases both the likelihood of smoking and the risk of relapse. That is the reason why stress reduction techniques are often offered as a key component in smoking cessation programs.

Kober et al. [Neuroimage] investigated differences in the brain’s response to stress in cigarette smokers participating in one of two smoking cessation interventions: mindfulness training for smoking (MT) or the American Lung Association’s Freedom from Smoking (FFS) program.

The study reported on 23 adult smokers (average age = 48, 70% male, 58% Caucasian) who volunteered for a smoking cessation intervention. The participants were randomly assigned to either MT or FFS, and the relative success of these interventions was reported on in a separate publication (both interventions were effective, with MT participants demonstrating a greater improvement in smoking reduction). Both group interventions met twice a week over a four-week period. The MT program emphasized present-moment awareness and acceptance as strategies for coping with negative emotions and cravings and utilized mindfulness and loving-kindness meditations. The FFS program emphasized self-monitoring, identifying triggers, developing individualized quitting plans, maintaining a healthy lifestyle, and cognitive-behavioral coping strategies.

The participants underwent functional magnetic resonance brain imaging (fMRI) immediately after smoking cessation treatment. The participants listened to recordings of individualized stressful and neutral scenarios during their brain scans. The individualized scenarios were developed based on actual stressful life events the participants had […]

November 14th, 2016|News|

Mindful eating of sweets boosts food enjoyment and mood

Posted 10.25.2016 | by AMRA

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Who doesn’t love chocolate? It’s one of the world’s most craved after foods due to its combined taste, pleasant physiologic effects, and past association with pleasant social events and youthful memories. It’s also alleged to have a positive effect on mood. Meier et al. [Appetite] explored chocolate’s ability to induce a pleasant mood and the degree to which mindfulness while eating influences its possible mood effect.

The researchers recruited 258 college students (65% female, 82% Caucasian, average age = 19) and randomly assigned them to one of four experimental conditions: a mindful chocolate condition, a mindful cracker condition, a non-mindful chocolate condition, and a non-mindful cracker condition. Participants were given either five pieces of chocolate candy or five plain water table crackers.

Before eating, participants listened to either an audio recording of mindfulness instructions similar to those used in the MBSR raisin eating meditation, or to brief control instructions telling them to eat one cracker at a time. The participants completed several self-report mood questionnaires both immediately before and after eating the chocolate or crackers. They also completed a food liking scale immediately after eating and rated mindfulness while eating using the Toronto Mindfulness Scale (TMS).

Participants in the mindfulness conditions scored significantly higher on the TMS, showing that the experimental manipulation effectively induced a mindful state (partial η2=.03). Participants in the mindfulness conditions enjoyed their food significantly more (partial η2=.02) than those in the non-mindful conditions, and those who ate the chocolate enjoyed their food significantly more than those who ate the crackers (partial η2=.08).

Participants in the mindfulness conditions also had significantly larger increases in positive mood after eating than did those in the […]

October 25th, 2016|News|

Present-moment awareness during stress promotes confidence to cope

Posted 10.12.2016 | by AMRA

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Our everyday hassles — traffic jams, minor arguments with coworkers— can add up to significantly affect our overall sense of well-being. It’s possible that mindfulness may increase our resilience to the impact of these daily stressors. It may be that the more one is mindful during negative events, the greater one’s odds of responding wisely to them rather than merely reacting out of habit and emotion.

Donald et al. [Journal of Research in Personality] tested whether increased levels of present-moment awareness—one component of mindfulness—increased the likelihood of acting in accordance with one’s values and one’s sense of efficacy during stressful events. They measured these variables through self-ratings in the participants’ daily diaries.

The authors recruited 143 Australian university students and staff (average age = 34, 76% female, 74% Caucasian) to participate in the study, which was part of a larger study involving a mindfulness-based intervention (the interventional part of the study was not relevant to the results reported here.) Participants of both the intervention and wait-list control groups completed 20 daily diaries over a four-week period in which they selected the most challenging or stressful event of each day to report on.

They then rated six variables: 1) the degree of threat posed by the event, 2) the degree of their present-moment awareness during the event, 3) their confidence in being able to effectively handle the event, 4) the degree to which their response to the event was consistent with their values, 5) the degree to which they relied on distraction to take their mind off the event during the day, and 6) the extent of their negative emotions during the day. The researchers then […]

October 12th, 2016|News|

Workplace mindfulness intervention may lower overall healthcare costs

Posted 09.26.2016 | by AMRA

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Healthcare costs in the United States rose to over 17% of the Gross Domestic Product in 2015. Employers are increasingly turning to workplace-based lifestyle interventions to control employee healthcare costs. Mindfulness-based interventions (MBIs) are sometimes offered in workplaces to enhance employee self-care and decrease illness-causing stress. How well do workplace-based MBIs succeed in lowering employee healthcare utilization costs?

Using a quasi-experimental design, Klatt et al. [Complementary Therapies in Medicine] retrospectively analyzed 5-year healthcare utilization and the associated costs for participants in a workplace-based MBI and a workplace-based didactic diet-and-exercise program. The researchers then compared these utilization rates and costs with those of matched controls drawn from a health care database.

A sample of 170 faculty and staff members from a large Midwestern university was recruited and randomly assigned to either a MBI or the diet-and-exercise (DE) intervention. The participants were selected, in part, on the basis of their high C-reactive protein levels (3.0-10.0 mg/ml), which are a known risk factor in cardiovascular disease. The MBI was an 8-week program modeled after MBSR, but truncated to fit a lunch hour schedule. The weekly workplace-based group meetings lasted 1 hour, recommended home practice was 20 minutes per day, yoga consisted of standing and chair yoga, and a 2-hour retreat replaced the usual “all day” session. The DE intervention consisted of a series of 8, 1-hour-long, group didactic sessions focusing on nutrition, diet, and exercise along with associated home readings.

After the experiment was concluded, an additional cohort of 258 “controls” was selected from the university health plan database by matching the study participants as closely as possible on age, gender, relative health risk, and prior healthcare utilization. […]

September 26th, 2016|News|

Mindfulness practice impacts medical students’ compassionate behaviors

Posted 09.19.2016 | by AMRA

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Physician compassion is a key element in good doctor-patient relationships. Nevertheless, nearly 50% of doctors and patients feel that medical care is often insufficiently compassionate. Between 20-70% of physicians suffer from compassion fatigue, a state of emotional exhaustion and diminished empathy brought on by the unceasing demands of patient care. As a consequence, medical educators are interested in finding ways to enhance compassion in medical students who are in training to become future physicians.

Fernando et al. [Mindfulness] tested whether a set of audio-guided mindfulness exercises could increase medical students’ compassionate behaviors, and whether the exercises had differential effects depending on the students’ self-compassion levels.

The researchers recruited 83 medical students (54% female, average age=21) for what they were told was a study of “emotional and clinical decision making.” The students completed a self-report measure of self-compassion, a personality disposition that involves self-kindness, recognition of one’s common humanity, and mindful awareness.

The students were then randomly assigned to listen to 10-minute audio recordings of either experiential mindfulness exercises or a speech on civic service. The mindfulness recording included an explanation of mindfulness and exercises involving mindfulness of the breath and of emotions. The students completed the Toronto Mindfulness Scale (TMS) after hearing the recordings.

Participants were then presented with a series of hypothetical clinical scenarios involving interactions with “difficult” patients. Participants rated how much they liked, wanted to help, and felt caring towards the patients, and their degree of subjective closeness to them. They also decided how much consultation time to allot to each of the patients. After being told the study was finished, the research assistant requested participants to help with an unrelated administrative task. […]

September 19th, 2016|News|

Lesbian and bisexual women benefit from mindful eating program

Posted 08.23.2016 | by AMRA

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Studies show that older lesbian and bisexual women are more likely to be overweight than their heterosexual peers, but there is a dearth of reported interventions specific to this population. Ingraham et al. [Women’s Health Issues] investigated whether mindful eating programs specifically designed for older lesbian and bisexual women can improve their physical and emotional health. The researchers also compared the outcomes of these programs with traditional diet-and-exercise programs that were also tailored for this population.

The U.S. Department of Health and Human Services funded five different interventions at five separate locations to gain information about the how to best reduce overweight status. Two of the sites adopted slightly different mindful eating approaches, while three sites opted for variations on traditional diet-and-exercise approaches. Each site designed its own program curriculum based on the concerns and beliefs of the organizations hosting the programs at each site. All five sites recruited lesbian and bisexual participants 40 years of age or older with a BMI ≥ 25 kg/m2. Assignment to groups was based on proximity to sites and was not randomized.

The two different mindful eating interventions were both 12-week group programs employing aspects of Mindfulness-Based Stress Reduction along with the Health At Every Size program’s emphasis on acceptance of body size and shape, and the Intuitive Eating program’s emphasis on attending to hunger and satiety cues. The three traditional diet-and-exercise programs met 12-16 times in weekly support groups and employed techniques such as food logs, recipe handouts, gym memberships, pedometers and personal trainers. There were a total of 160 participants in the mindful eating groups, and 106 in the diet-and-exercise groups.

All participants completed assessments immediately before […]

August 23rd, 2016|News|

Mindfulness and social cooperation in economic decision making

Posted 08.11.2016 | by AMRA

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Cooperating with others sometimes requires that we set irrelevant negative emotions aside in order to stay focused on achieving common goals. Can mindfulness meditation improve cooperation with others by strengthening our resistance to being distracted by negative emotions? If so, how is the brain involved in this process?

Kirk et al. [Neuroimage] studied the effects of mindfulness meditation vs. relaxation training on the decision making and brain functioning of volunteers playing a cooperative economic decision making game.

The researchers randomly assigned 51 healthy adult participants (82% Caucasian, 53% female, average age = 32) who volunteered to participate in a stress reduction program to either an 8-week mindfulness training based on Mindfulness-Based Stress Reduction (MBSR), or an 8-week stress reduction program utilizing progressive muscle relaxation, exercise, stretching, and group discussion of stress-reduction topics.

The participants played the computer-based Ultimatum Game before and after training while their brain function was monitored using functional magnetic resonance imaging (fMRI). They also completed the Five Facet Mindfulness Questionnaire (FFMQ) before and after training.

The Ultimatum Game asks participants to consider offers to split $20 between themselves and another player. For example, the computer screen informs participants that someone named “Tom” is offering to split $20 with them 50/50, so that they each would receive $10. Participants then either accept or reject the offer. In reality, the offers weren’t from real people but were computer generated. The offers ranged from equal (50/50) splits to vastly unequal (19/1) splits.

While it makes economic sense to accept all offers since rejecting any offer means getting nothing, participants tend to reject offers that are inequitable and seem unfair. Past research shows that the tendency to reject […]

August 11th, 2016|News|