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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|

Breast cancer survivors find pain and pill relief with MBCT

Posted 07.25.2016 | by AMRA

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Up to one-in-five breast cancer survivors experience persistent moderate-to-severe pain five years after treatment. Pain may result from surgery, radiation, or chemotherapy-induced tissue and nerve damage. Since pain can be both exacerbated and modulated by psychological factors, breast cancer survivors with persistent pain may potentially benefit from psychosocial interventions to lessen pain and improve quality of life.

Johannsen et al. [Journal of Clinical Oncology] conducted a randomized, controlled trial to test the efficacy of Mindfulness-Based Cognitive Therapy (MBCT) on reducing pain and improving quality of life in breast cancer survivors who reported persistent pain.

One hundred and twenty-nine Danish breast cancer survivors (average age = 57) who were at least 3 months post-surgery and had continuing pain ratings ≥ 3 on a 0-10 numerical rating scale were randomly assigned to either MBCT or a wait-list control. Self-report measures of pain, quality of life, and psychological distress were completed at baseline, after intervention, and at 3- and 6-month follow-up.

The MBCT protocol was the standard 8-week protocol used in treating recurrent depression, but modified to meet the needs of breast cancer survivors: session lengths were cut to 2 hours each, meditations were shortened to ≤ 30 minutes each, the yoga was “gentler,” and the all-day session was omitted.

MBCT participants showed significantly greater reductions than controls in pain intensity (Cohen’s d = .61) on a 0-10 numerical rating scale. Average pain intensity ratings decreased from 5.5 at baseline to 4.0 post-intervention, then dropped further to 3.6 at 3-month follow-up. In contrast, wait-list control pain intensity remained essentially unchanged (5.3 at baseline, 5.3 at post-intervention, 5.0 at 3-month follow-up).

MBCT participants improved significantly more on quality of life (d […]

July 25th, 2016|News|

Intensive meditation practice reveals itself in the breath

Posted 07.19.2016 | by AMRA

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Many forms of meditation include an aspect of increased attention to and focus on the breath. This raises the question of whether breath-focused meditations change the way people breathe over time. This question is of interest because rapid, irregular breathing is associated with stress and anxiety, while slow, deep breathing is often prescribed to overcome negative emotional states. It’s possible that slowed respiration rates may account for some of the emotional well-being associated with long-term meditation practice.

Weilgosz et al. [Scientific Reports] measured the respiration rates of long-term meditators (LTMs) and meditation-naive controls on three separate occasions over the course of a little over one year. The authors examined whether greater amounts of long-term practice were associated with greater decreases in respiration rate, and whether an intensive day of meditation practice acutely changed respiration rate.

The study recruited 31 long-term meditators (average age = 51; 55% female) with 3 or more years of mindfulness meditation experience, a daily meditation practice lasting at least 30 minutes, and a history of 3 or more intensive meditation retreats. The LTMs were recruited from meditation centers across the United States and had an average of 4,658 hours of intensive retreat experience (range = 258 to 29,710 hours). The LTMs were contrasted with a group of meditation-naive controls of roughly similar age and gender (average age = 48; 68% female) recruited from the local Madison, Wisconsin area.

Participants had their respiration rates measured in a laboratory on three separate occasions spaced approximately 4.5 months apart. Their breathing was assessed while they were at rest, but there were no instructions to meditate during these assessment sessions. Prior to two of the […]

July 19th, 2016|News|

Long-term controlled trial of mindfulness for cancer survivors shows promise

Posted 06.24.2016 | by AMRA

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Every year nearly 250,000 American women are diagnosed with breast cancer. Diagnosis and treatment can be frightening and arduous, and the interval following active treatment is often fraught with anxiety and uncertainty. Prior studies show that breast cancer survivors can benefit from psychological interventions, but little is known about which interventions yield the best outcomes.

Carlson et al. [Psycho-Oncology] conducted a randomized, controlled trial comparing two evidence-supported programs, Mindfulness-Based Cancer Recovery (MBCR) and supportive expressive group therapy (SET), in reducing stress and improving the quality of life of distressed breast cancer survivors.

The researchers randomly assigned 271 distressed Canadian breast cancer survivors (average age = 55 years) to either MBCR or SET. MBCR is an 8-week group mindfulness-based intervention modeled after Mindfulness Based Stress Reduction. SET is a 12-week group treatment developed at Stanford University that aims to mobilize social support, facilitate emotional openness and expressiveness, and strengthen coping skills.

All participating survivors had been diagnosed with Stage I-III breast cancer, completed surgical, chemotherapy, and/or radiation treatment, and scored ≥ 4 on a 10-point distress scale. Participants completed self-report measures of mood, stress, quality-of-life, perceived social support, spiritual well-being and post-traumatic growth before treatment, immediately after treatment, and at 6 month and 12 month follow-up.

Dropout rates during treatment were relatively high (MBCR=32%, SET=28%), with additional attrition (MBCR=28%, SET=23%) prior to post-treatment and follow-up assessments. The results included data from all the participants who enrolled in the trial.

Both groups improved on all of the mood subscales, but the improvement was significantly greater for MBCR participants, especially on measures of fatigue, anxiety, and confusion (average Cohen’s d = 0.37). Both groups also significantly improved on most of […]

June 24th, 2016|News|

Emotional reactivity lessens with mindfulness, brain study shows

Posted 06.17.2016 | by AMRA

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One advantage of being mindful is that it allows one to respond to situations with equanimity rather than reacting emotionally in a “knee-jerk” fashion. How does mindfulness help us to do this? According to one theory, mindfulness helps to extinguish our negative emotional reactions. It does this by increasing our exposure to the stimuli that provoke these reactions while helping us to maintain an open, nonjudgmental stance.

Uusberg et al. [Biological Psychology] tested this theory using an electroencephalogram (EEG) to measure the effects of repeatedly viewing negative and neutral images under both mindful and control conditions. They hypothesized that repeated viewing of emotionally-charged images while maintaining mindful awareness would cause a greater reduction in emotional reactions to the images than viewing them without mindfulness.

The researchers recruited 37 meditation-naive volunteers (84% female, average age=27). The participants were shown a series of 30 neutral and 30 negative images while an EEG recorded their late positive potentials (LPPs) in response to those images. LPPs are electrical brain waves that occur 260-1500 milliseconds after viewing a stimulus. They reflect ongoing emotional processing, with larger LPPs reflecting greater degrees of emotional processing. The mean difference in LPP amplitude between negative and neutral images served as a measure of emotional reactivity.

The negative stimuli featured images such as car accidents and brutal attacks, while the neutral stimuli were images of everyday scenes and objects such as hairdryers. Participants viewed subsets of these neutral and negative images under three different conditions: an “attentiveness” condition in which they focused on the visual details of the images; an open-monitoring “mindfulness” condition in which they viewed the images while also attending nonjudgmentally to thoughts, […]

June 17th, 2016|News|

Media multi-tasking impairs attention, breath meditation helps

Posted 05.26.2016 | by AMRA

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Personal computing devices have introduced us to the phenomenon of “media multitasking,” in which we constantly switch attention between e-mailing, texting, web-browsing, and listening to music, all while ostensibly working. Research has shown that people who engage in large amounts of media multitasking perform significantly more poorly on measures of attentional ability than those who engage in it less.

Gorman et al. [Scientific Reports] explored whether a brief breath-counting meditation might temporarily ameliorate the attentional deficits associated with media multitasking.

The researchers conducted an online survey of media multitasking in 1,683 college undergraduates. They then selected a research sample of 22 heavy media multitaskers who scored at least a standard deviation above the mean, and a sample of 20 light media multitaskers who scored at least a standard deviation below the mean in frequency of media multitasking.

The students participated in two separate assessment sessions scheduled less than 48 hours apart. They completed the same assessment battery measuring attentional control, working memory, and cognitive flexibility in each of the sessions. The attentional control measures included computer-administered tasks requiring the ability to ignore distractions, detect sameness and difference in the orientation of geometrical shapes, resist impulsive responding, and attend to visual cues requiring different responses. The working memory task involved recording strings of numbers in the reverse order in which they were presented. The cognitive flexibility measure required quickly naming as many possible alternative uses of common everyday objects as one could.

The conditions under which the assessment batteries were administered differed in each of the sessions. In one of the sessions, the assessment battery was broken into tasks that were interspersed with three ten-minute breath-counting meditations. […]

May 26th, 2016|News|

Older adult cognitive decline improves after mindfulness program

Posted 05.19.2016 | by AMRA

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Older adults who complain of subjective cognitive decline (SCD) often appear normal in day-to-day functioning and on clinical assessment, but 60% of them eventually develop either mild cognitive impairment or Alzheimer’s Disease. This makes older adults with SCD a prime target for interventions aimed at preventing or slowing cognitive decline.

Smart et al. [Journal of Alzheimer’s Disease] conducted a randomized controlled pilot study to test the effects of mindfulness training versus a psycho-educational control on measures of attention, brain structure and function, and self-reported cognitive complaints, mood, and mindfulness in adults with SCD.

A sample of 23 healthy older adults and 15 older adults with SCD (predominantly Caucasian men and women, average age = 70) were randomly assigned to either an 8-week mindfulness training based on MBSR that was tailored for older adults, or a 5-week program that provided education on memory and aging, situational factors that affect memory, and strategies to compensate for memory difficulties. Participants completed self-report measures of memory complaints, depression, and mindfulness (the Five Facet Mindfulness Questionnaire, or FFMQ).

They also completed an attentional capacity task that required them to be vigilant and respond or withhold responding to letters presented on a computer screen. An electroencephalogram (EEG) recorded the magnitude of their brain’s P3 evoked response potentials (ERPs) while performing this task. Higher P3 ERPs reflect increased attentional capacity and are known to decrease in amplitude with SCD. All these measures were obtained both before and after intervention. Structural magnetic resonance imaging (MRI) was also included to detect changes in total brain volume from pre- to post- intervention.

Adults with SCD reported a greater number of subjective memory complaints and had a […]

May 19th, 2016|News|

Online mindfulness program boosts employee wellness, not productivity

Posted 04.25.2016 | by AMRA

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Jobs can be a major source of stress. Mindfulness-based interventions (MBIs) can reduce stress, but employers may be reluctant to offer them due to time and cost concerns. Web-based MBIs may help to address such concerns, but research suggests participant engagement in online programs tends to be low. Allexandre, et al. [Journal of Occupational and Environmental Medicine] randomly assigned employees to a web-based MBI with and without group and clinical expert support in an effort to discover how to best improve web-based MBI engagement and outcomes for workers.

The researchers recruited 161 predominantly Caucasian (77%), female (83%) (average age = 40) debt collectors, customer service representatives, and fraud representatives from a pool of 900 employees working at a corporate call center in Ohio. These employees reported greater levels of stress and exhaustion than average American workers.

The employees were randomly assigned to one of four experimental conditions: 1) a web-based MBI, 2) a web-based MBI with group support, 3) a web-based MBI with both group and clinician support, and 4) a wait-list control. All three intervention conditions ran for 8 weeks and participants had access to both weekly online and weekly CD/MP3-delivered mindfulness lectures and guided meditations including a body scan, sitting, and lovingkindness meditation.

Group support consisted of small-to-medium sized practice-and-discussion groups which met weekly for one hour. All groups were employee-led, but the groups with clinician support met on three occasions with a licensed social worker or counselor who did not serve as a “mindfulness teacher” but discussed topics such as letting go, acceptance, non-judging, and compassion from a cognitive-behavioral perspective.

Participants were assessed on self-report measures of emotional wellbeing, vitality, stress, burnout, exhaustion, […]

April 25th, 2016|News|