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Breast cancer survivors find pain and pill relief with MBCT

Posted 07.25.2016 | by AMRA


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


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


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


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


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


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


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|

Mindful attention helps regulate amount of food consumed

Posted 04.15.2016 | by AMRA


Can being mindfully aware heighten the pleasure of eating? Arch et al. [Behavior Research and Therapy] addressed this question in a series of studies while also exploring whether mindfulness promotes more healthful food choices.

In the first study, 81 male and female undergraduates were randomly assigned to either a mindful eating or a distracted eating condition. Participants in the mindful eating condition were instructed to eat a series of five chocolate chips while focusing on their sensory experience. Participants in the distraction condition ate their chocolate chips while searching for hidden words in a find-a-word puzzle. Mindful participants rated their chocolate chips as significantly more enjoyable (Cohen’s d = 0.51) and had a marginally significantly greater desire to eat another chocolate chip (d = 0.38) than distracted eaters.

In the second experiment with 136 male and female undergraduates, the researchers repeated the first study using raisins instead of chocolate chips. Mindful eaters showed a marginally significant tendency to enjoy the raisins more (d = 0.27) and a significantly higher desire to eat another raisin (d = 0.39) than distracted eaters.

The researchers wanted to know if people who ate mindfully ended up consuming more calories because they enjoyed eating more, or fewer calories because their improved attention led to greater behavioral control. In the third study, 102 male and female undergraduates again ate raisins, but were randomly assigned to either a mindful eating group that was instructed to focus on their sensory experience, a distracted eating group that was told to focus on find-a-word puzzles while eating, or a “no special instructions” control. The mindful eaters again rated the raisins as significantly more enjoyable and […]

April 15th, 2016|News|

Brief guided mindfulness meditation aids heart health

Posted 03.23.2016 | by AMRA


Heart disease is the largest cause of death among men and women in the United States. Lifestyle changes in smoking, diet, and exercise can help lower heart disease risk. Further, mindfulness has proposed stress-reducing effects and thus may have its own role to play in heart health.

In two separate studies, May et al. [Stress] examined the association between trait mindfulness and markers of cardiovascular health and state mindfulness and fluctuations in heart rhythm and blood pressure, which are modulated by the sympathetic nervous system. The sympathetic nervous system is the part of the nervous system responsible for the “fight-or-flight” stress response.

The studies employed two samples of predominantly female, Caucasian undergraduate students. All participants were assessed for self-reported trait mindfulness using the Mindful Attention Awareness Scale. In the first study, 185 participants had their cardiovascular functioning assessed by a computer-assisted method of estimating central blood pressure from peripheral arterial activity. The researchers used an estimate of central blood pressure because it is a better indicator of cardiovascular risk than the usual peripheral blood pressure measures obtained using a blood pressure cuff. This method also provided estimates of how hard the heart was working, how much oxygen it consumed, and how much blood it received through the cardiac arteries.

The first study found that while trait mindfulness wasn’t associated with blood pressure and heart rate, it was significantly associated with improved hemodynamic functioning in terms of decreased cardiac oxygen consumption and left ventricular workload. Simply put, the heart didn’t have to work as hard for those with higher levels of trait mindfulness.

In the second study, 124 participants were randomly assigned to either a mindfulness or […]

March 23rd, 2016|News|

Adding mindfulness to diet-exercise program helps people eat for the right reasons

Posted 03.18.2016 | by AMRA


Adults who lose weight in diet-and-exercise lifestyle change programs usually regain weight after the program. This is often blamed on the ready availability of good tasting high calorie food along with stress and individual tendencies toward reward-driven eating. Reward-driven eating is eating that meets emotional rather than nutritional needs; it’s often accompanied by food cravings and preoccupations, poor control of eating despite motivation to lose weight, and insensitivity to sensations of fullness.

Mason et al. [Appetite] investigated the degree to which reward-driven eating and stress impacted weight loss in 158 obese participants (82% female, 59% White, average age = 47, average BMI = 35) who were randomly assigned to one of two diet and exercise interventions — one of which included mindfulness training and the other of which included progressive muscle relaxation and cognitive-behavioral skill training.

Both interventions met in groups for 17 sessions spaced over the course of 6 months. Both interventions used the same diet-and-exercise regimen: participants reduced their daily intake by 500 calories, engaged in structured aerobic and anaerobic exercise, and increased their daily general activity.

The mindfulness intervention taught sitting, walking, and lovingkindness meditation and mindful yoga, and promoted awareness of hunger, fullness, taste, food cravings, and eating triggers. The comparison intervention taught progressive muscle relaxation and cognitive-behavioral skills as well as provided additional didactic instruction on nutrition and exercise.

Participants were weighed and assessed on self-reported reward-driven eating and perceived stress at baseline and 6, 12, and 18 months after baseline. The mindfulness group lost approximately 4.4 pounds more than the comparison group, but that difference didn’t reach statistical significance.

The mindfulness group experienced a significantly greater decrease in reward-driven eating than the […]

March 18th, 2016|News|