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MBCT reduces symptoms of children hospitalized with cancer

Posted 11.30.2020 | by AMRA

Children with cancer often have significant cognitive, emotional, behavioral, and academic problems. These result not only from the illness itself, but also the anxieties associated with diagnosis and prognosis, the negative side-effects of oncology treatments, and the lengthy separations from familiar settings and social supports entailed by hospitalization. Psychosocial interventions are needed that can more effectively bolster children’s resilience over the course of arduous treatment.

Abedini et al. [Mindfulness] assessed the value of a modified version of Mindfulness-Based Cognitive Therapy for Children (MBCT-C) in reducing internalizing psychological problems (anxiety, depression, and somatization) and attentional problems in school-age children undergoing hospitalization for cancer.

The researchers randomly assigned 40 Iranian children hospitalized for cancer (age range = 11-13 years; 53% male) who met the diagnostic criteria for acute stress disorder and showed elevated internalizing and attentional problems to a modified version of MBCT-C or to treatment as usual. The children were continuously hospitalized throughout the length of the intervention.

MBCT-C was delivered in the Farsi language to small groups of 2-4 participants meeting 5 times a week. The standard MBCT-C protocol was modified to meet the children’s physical, motivational, and attentional needs and the demands of the hospital schedule. Group sessions were shortened to 45 minutes each, delivered over a shortened 4-week time-course, and without the usual raisin, yoga, and mindful movement meditations.

Treatment as usual included limited medical social worker support and a playroom available for 2 hours daily. Children were assessed before and after treatment and at 2-month follow-up for internalizing behavioral problems and attentional difficulties using a parent-completed behavioral checklist, and a child-completed self-report inventory.

The results showed significantly greater reductions in parent-rated (η2=.53) and […]

November 30th, 2020|News|

MBCT supports vocational competencies in couseling trainees

Posted 09.14.2020 | by AMRA

Psychological counseling as a profession can be emotionally taxing, and counseling trainees may experience compassion fatigue and elevated stress. Counseling training programs focus on teaching counseling skills, yet they often are insufficient to support trainee self-care and wellness.

Teaching trainees mindfulness may enhance their professional growth and increase their resistance to vocational stressors.

Chan et al. [Patient Education and Counseling] conducted a randomized crossover study to test the effects of Mindfulness-Based Cognitive Therapy (MBCT) on wellness and perceived vocational competencies among undergraduate counseling trainees.

The researchers randomly assigned 50 undergraduate counseling trainees (60% female; age range 18-23 years) at a Hong Kong university to either MBCT or a wait-list control. MBCT was delivered once per week for 8 weeks in 2-hour group sessions.

Trainees were assessed at baseline and 3 months on self-report measures of empathy, self-compassion, psychological distress, counseling self-efficacy, and mindfulness (Five Facet Mindfulness Questionnaire). Self-efficacy assessed trainee self-confidence in applying helping skills (e.g., being attentive, listening, reflecting feelings, asking open-ended questions) and managing boundaries and problematic client behaviors.

Brain activity and physiology were also assessed. Trainees had their brain EEG frontal midline theta-wave activity (a measure of internal attention), and their respiration rate and skin conductance (measures of autonomic arousal) measured while resting listening to either classical music or a guided meditation audiotape.

At baseline both groups listened to classical music, and at 3- month assessment the MBCT group listened to the meditation audiotape while the control group listened to classical music. After the 3-month assessment, the wait-list controls then completed MBCT as part of the crossover design.

Both groups were then reassessed on all measures at 6 months after baseline. At the 6-months, both groups […]

September 14th, 2020|News|

Post-chemo cancer survivors have less cognitive impairment after mindfulness training

Posted 08.26.2020 | by AMRA

Up to 78% of women undergoing chemotherapy for cancer report impairment in cognitive functioning, commonly referred to as “chemo fog.” These complaints are accompanied by functional connectivity changes in regions of the brain involved in attention and executive functioning. Functional connectivity is a measure of the degree to which different brain regions act in tandem. While the efficacy of mindfulness training for cancer-related emotional difficulties is supported, the effect on cognitive impairment remains unknown.

Gucht et al. [Cancer] tested mindfulness training against a wait-list control on cancer survivors’ subjective and objective cognitive impairment, psychological symptoms, and brain connectivity.

The researchers randomly assigned 33 Belgian female breast cancer survivors (average age = 45 years) with self-reported subjective cognitive impairment to either mindfulness training or a wait-list control. Mindfulness training was based on Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT), and delivered in four group-based sessions, each lasting three hours. Home practice was encouraged and brief between-session telephone calls for encouragement and support were offered over an 8-week period.

Participants were assessed at baseline, one week after the intervention, and at 3 months after on a subjective measure of cognitive functioning and an objective battery of attention, concentration, memory, executive functioning, and processing speed. Other subjective measures were used to assess emotional distress, fatigue, and mindfulness (Comprehensive Inventory of Mindfulness Experiences).

Participants also underwent resting-state fMRI brain scans at all three assessment points. Six mindfulness participants and one control did not complete the study.

Results showed the mindfulness training group had significantly greater improvement in subjective cognitive impairment at post-treatment (Hedge’s g=0.99) and follow-up (g=0.95) than controls. The mindfulness group also had significantly greater decreases in […]

August 26th, 2020|News|

MBCT reduces negative attentional bias and depressive symptoms

Posted 04.15.2020 | by AMRA

People with major depressive disorder (MDD) show an attentional bias in which they over-attend to negative information while often ignoring positive information. This attentional bias feeds, reinforces, and prolongs depressive thought patterns, and serves as an underlying risk factor for depressive symptom onset and relapse.

Mindfulness-Based Cognitive Therapy (MBCT) is an approach to psychotherapy that combines features of mindfulness meditation and cognitive behavioral therapy. The program has been shown to effectively reduce the odds of depressive relapse among people with MDD. Less is known about the efficacy of the program for alleviating current depressive symptoms.

Holas et al. [Mindfulness] conducted a randomized controlled trial to test if MBCT reduces attentional bias and depressive symptoms in patients with current MDD.

The researchers randomly assigned 53 adults with untreated current major depressive episodes (100% Polish Caucasian; 74% female; average age = 35 years) to an 8-week MBCT program or a wait-list control. Participants completed a self-report measure of depressive symptoms (CESD) and were assessed on an eye movement tracking task, measuring attentional bias immediately before and after the intervention period.

In that task, participants viewed slides with sad, angry, happy, and neutral faces in each of the four quadrants of the slide while their eye movements and fixations were recorded in milliseconds. This enabled researchers to calculate the relative amount of time participants spent gazing at each of the different faces.

The results showed that MBCT affected how long participants gazed at the various faces. Participants in the MBCT group significantly increased the amount of time they gazed at happy faces from pretest to posttest (ηp2=.23) and decreased their gaze at sad (ηp2=.09) and angry (ηp2=.14 ) faces, whereas […]

April 15th, 2020|News|

MBCT shows cost savings of $2,225 per patient with MDD

Posted 03.25.2020 | by AMRA

Major Depressive Disorder (MDD) is a severe recurrent mood disorder that affects 4-5% of the North American population at any given point in time. The average patient with MDD suffers 5-9 episodes over the course of a lifetime, and the personal, familial, and social costs of severe depression make relapse prevention a priority. Previous research shows Mindfulness-Based Cognitive Therapy (MBCT) to be roughly as effective as antidepressant medication maintenance in preventing MDD relapse.

While antidepressant medication maintenance is effective, many patients have difficulty tolerating medication side-effects including insomnia, dizziness, drowsiness, dry mouth, nausea, loss of libido and might prefer a non-drug intervention.

Pahlevan et al. [Canadian Journal of Psychology] used already extant data sets to calculate the efficacy, utility, and cost effectiveness of MBCT vs. antidepressant medication maintenance for preventing relapse over 24-months in patients with recurrent MDD treated within the Canadian healthcare system.

The data were drawn from previously published studies comparing the efficacy of MBCT and antidepressant medication. MBCT is an 8-week group-based intervention combining elements of MBSR and cognitive therapy to prevent MDD relapse. Antidepressant medication maintenance uses antidepressant medication to prevent relapse.

Estimated parameters for adherence, relapse, and quality-adjusted life years (QALYs) were drawn from 11 Canadian randomized controlled trials. MBCT patients who attended at least 4 MBCT classes, and antidepressant medication patients who took their medication (venlafaxine, 375 mgs. daily) regularly, according to prescription refill and self-report data, were considered treatment compliant. Outcomes for treatment compliant and non-compliant patients were assessed at 12 and 24 months (only one of the 11 studies followed patients for 24 months).

Data on the estimated costs of MBCT, antidepressant medication, and relapse treatment were drawn from […]

March 25th, 2020|News|

Women with epilepsy report improved sexual health after MBCT

Posted 12.30.2019 | by AMRA

Women diagnosed with epilepsy often report diminished sexual interest and arousal. This is due to a variety of factors including the side-effects of anti-epileptic medication and fear of triggering seizures during sexual activity. Mindfulness-based interventions have previously been shown to improve sexual functioning in women with difficulties in sexual interest and arousal, women with gynecological cancer, and men with erectile dysfunction.

Lin et al. [Seizure] conducted a randomized controlled study to assess the efficacy of Mindfulness-Based Cognitive Therapy for Sexuality (MBCT-S) in improving sexual functioning and quality of life in women with epilepsy and their partners.

The researchers randomly assigned 660 women aged 65 or older with epilepsy (average age = 71 years) drawn from 15 Iranian neurology clinics to one of three experimental conditions: 1) MBCT-S for women and their sexual partners, 2) MBCT-S for women and their sexual partners plus a 3-session sexual counseling training program provided to their neurology health care provider, and 3) treatment-as-usual for epilepsy.

MBCT-S was offered in an 8-week small-group format delivered in 90-minute weekly sessions. The intervention was similar to standard MBCT, but included psychoeducation about sexual desire, arousal, and intimate relationships, cognitive therapy regarding sexual beliefs, and sensate focus.

The women and their partners were assessed at baseline, 1-month post-intervention, and 6-months post-intervention. The primary outcome measure was the women’s self-report of desire, arousal, lubrication, orgasm, satisfaction, and pain.

Secondary measures included self-report measures of emotional and sexual intimacy, sexual distress, mindfulness during sex (using the Five-Facet Mindfulness Scale adapted for sexual behaviors), quality of life, and others.

Both MBCT-S groups showed significant improvement in sexual mindfulness, women’s sexual functioning and sexual distress, women’s and partners’ emotional and sexual […]

December 30th, 2019|News|

MBCT reduces migraine-related disability among chronic sufferers

Posted 10.15.2019 | by AMRA

Episodic and chronic migraines affect approximately one billion people worldwide. Symptoms including migraine aura, headache, nausea, and light sensitivity can significantly impair functioning at work, home, and in social situations. Existing behavioral treatments including biofeedback, relaxation and cognitive therapy, and pharmacological treatments have limited efficacy, but no treatment works for everyone.

Seng et al. [Headache] evaluated the efficacy of Mindfulness-Based Cognitive Therapy for Migraine (MBCT-M) compared to a control in reducing migraine-related disability.

The authors randomly assigned 60 migraine patients (average age=40 years; 82% Caucasian; 92% female; average headache days per month=16) to MBCT-M or a treatment-as-usual waitlist control. Thirty-six percent of MBCT-M participants and 62% of control participants came to the study on prescribed prophylactic migraine medication that was continued throughout the study. The groups did not differ on headache frequency, intensity, or disability at baseline.

All participants kept a 30-day headache diary both before and after intervention. In addition, participants were assessed on two measures of headache disability: the Headache Disability Inventory (HDI) and Migraine Disability Assessment (MIDAS) at baseline, and 1, 2, and 4 months.

MBCT-M consisted of once weekly 75-minute individual training sessions for 8 weeks. Sessions included didactic training, cognitive exercises, mindfulness meditation practice and homework review. Most sessions were conducted in person; however, participants were allowed up to 3 telephone-delivered sessions when headaches prevented in-person attendance.

The trainers were clinical psychology graduate students with 12 hours of MBCT training. The trainers received continuous supervision from licensed psychologists with expertise in headaches, and sessions were monitored to assure treatment fidelity. The control group continued whatever treatment they were getting prior to the onset of the study and were placed on an MBCT-M […]

October 15th, 2019|News|

Firefighter resilience increases after iPad mindfulness program

Posted 04.01.2019 | by AMRA

First responders such as firefighters, police, and EMTs are regularly exposed to stressful and traumatic experiences. These experiences put them at increased risk for depression, anxiety disorders, PTSD, and alcoholism. There is a considerable interest in developing workplace programs that can increase first responders’ resilience to and recovery from stressful experiences.

Joyce et al. [Journal of Medical internet Research] tested the efficacy of an online Resilience-at-Work (RAW) Mindfulness Program on firefighter resilience and wellbeing.

The researchers randomly selected 12 Australian fire stations as workplaces where firefighters could receive RAW training and 12 additional stations as attention-matched controls. A total of 143 firefighters (96% male, average age = 42) volunteered to participate, 79 of whom were available for post-treatment assessment, and 69 for a 6-month follow-up. Controls had a higher 6-week drop-out rate (54%) than RAW participants (32%).

RAW training consisted of six self-paced 20-25 minute iPad lessons that were to be completed over a period of up to 6 weeks. The lessons included aspects of Mindfulness-Based Cognitive Therapy and Acceptance and Commitment Therapy with additional training in self-compassion. The control condition completed six 20-minute Healthy Living lessons covering a range of topics such as skin health, maintaining a healthy home, and using cell phones wisely.

Self-reports were completed at baseline, post-intervention, and 6-month follow-up on measures of resilience (adaptation to stressful life events), bounce-back resilience, and other psychological measures.

RAW participants completed an average of 3.5 of the six trainings with only 37% completing the entire program. RAW participants increased their resilience scores more than controls. This difference approached significance at immediate post-testing and reached significance by the 6-month follow-up (a moderate-to-large effect). There were no group […]

April 1st, 2019|News|

MBCT associated with less grief after death of loved one

Posted 02.27.2019 | by AMRA

The death of a loved one is a powerful stressor. Bereavement is not only painful and distressing, but can also trigger the onset of a variety of mental and medical disorders. Bereaved individuals may experience difficulty regulating their emotions and intrusive unpleasant thoughts and feelings that can disrupt cognitive functioning.

Huang et al. [Frontiers in Human Neuroscience] tested whether Mindfulness-Based Cognitive Therapy (MBCT) can improve emotional regulation and executive cognitive functioning in bereaved individuals.

The researchers recruited 23 participants reporting unresolved grief (91% female; average age = 48) who had lost at least one significant relative in the previous four years. All the participants attended an 8-week MBCT program. Self-report measures of grief, anxiety, depression, emotional regulation difficulty, and mindfulness (using the Five Facet Mindfulness Questionnaire) were obtained pre- and post-intervention.

Neurocognitive functioning was assessed before and after the intervention by having participants perform a Stroop task while monitoring their brain activity with functional magnetic resonance imaging. The Stroop task required participants to judge which of two visually presented digits was numerically larger. In each presentation, the relative physical sizes of the digits were either congruent or incongruent with their relative numerical size.

People usually take longer to correctly respond on incongruous Stroop trials. Their reaction time on those trials was used as a measure of executive cognitive function—the ability to make judgments in the presence of conflicting information.

After MBCT, participants reported significantly reduced grief (Cohen’s d = -0.89), anxiety (d = -0.65), depression (d = -1.17), and emotional regulation difficulty (d = -0.76), as well as increased mindfulness (d = 0.80). Post-MBCT mindfulness scores were significantly associated with lower post-MBCT grief (r = -.52), anxiety […]

February 27th, 2019|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|