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Adding mindfulness to meds helps Alzheimer’s patients

Posted 01.22.2016 | by AMRA

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Alzheimer’s Disease is a progressive neurodegenerative illness characterized by short-term memory loss, disorientation, and impairments in socialization, self-care and behavioral regulation. It is primarily a disease of old age and affects over 5,000,000 Americans. Medications are often prescribed to manage its symptoms, but no medication has been shown to halt or delay the progression of the disease.

Given the enormous personal, social, and economic consequences of this illness, researchers are actively seeking novel ways to slow and forestall its devastating effects.

In a randomized clinical trial, Quintana-Hernández et al. [Journal of Alzheimer’s Disease] compared the effectiveness of a Mindfulness-Based Alzheimer’s Stimulation (MBAS) program in maintaining cognitive functioning in Alzheimer’s patients to that of two current non-pharmacological interventions for Alzheimer’s disease; namely, Progressive Muscle Relaxation (PMR) and Cognitive Stimulation Therapy (CST).

The researchers randomly assigned 168 Spanish-speaking men and women with Alzheimer’s Disease who were Canary Islands residents to one of four treatment groups: 1) Medication Alone, 2) MBAS+Medication, 3) PMR+Medication, or 4) CST+Medication. The medication was donepezil, a cholinesterase inhibitor that has a small beneficial effect on cognition in Alzheimer’s patients but does not slow or halt the progression of the disease.

All of the non-pharmacological treatments were delivered three times weekly in 90-minute group sessions that continued over a two-year period.

MBAS was based on MBSR, Mindfulness-Based Elder Care, Kirtan Kriya technique, chair yoga, and multi-sensory stimulation. The MBAS patients’ caretakers also assisted the patients in brief moments of mindfulness during home practice.

The CST group employed visual imagery, errorless learning, spaced retrieval, encoding specificity, and external memory aids. The PMR group employed a standard 16 muscle group tensing and releasing sequence. Patient cognition was longitudinally assessed […]

January 22nd, 2016|News|

Fertility treatment supported by mindfulness program

Posted 01.08.2015 | by AMRA

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Infertility is a heartbreaking condition affecting approximately 6% of American married women. In vitro fertilization (IVF) is a voluntary fertility treatment that involves combining a sperm and egg outside of a woman’s body and implanting the resulting embryo in her uterus. IVF success rates vary widely depending on multiple factors including a woman’s age, general health status, and the specific IVF method used.

IVF can be emotionally and physically taxing due to the demands of the procedure and the uncertainty of success. There is currently a need to improve the quality of life of women undergoing this procedure. Li et al. [Behaviour Research and Therapy] investigated whether a mindfulness-based intervention can improve both the quality of life and pregnancy rates of women undergoing first-time IVF treatment.

The researchers assigned 108 women (average age = 30 years) seeking IVF at a Chinese medical center to either IVF plus a mindfulness-based intervention or IVF alone. Assignment was not random, but based on patient convenience in terms of time constraints and travel distance to the medical center.

The six-week mindfulness program was a group-based intervention that was specifically tailored to IVF and infertility concerns and contained elements of MBSR, MBCT, Mindfulness-Based Childbirth and Parenting, and Acceptance and Commitment Therapy.

Participants completed self-report measures of mindfulness (the Five Facet Mindfulness Questionnaire), self-compassion, fertility quality of life, difficulties in emotional regulation, and infertility coping styles both at baseline and post-intervention. Mindfulness and control participants did not differ in any of these self-report measures at baseline. Pregnancy status was assessed at six-months post-intervention.

Mindfulness participants showed significantly greater increases in self-reported levels of mindfulness (partial η2=.10), self-compassion (partial η2=.08), and quality of life […]

January 8th, 2016|News|

Which MBSR practice is most useful for veterans with PTSD?

Posted 11.29.2015 | by AMRA

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Depending on the arena of combat in which they were deployed, up to 31% of all veterans suffer from posttraumatic stress disorder (PTSD). The symptoms of PTSD include hyperarousal, emotional numbing, flashbacks, and nightmares coupled with avoidance of the cues that trigger them. Veterans are also at increased risk for co-morbid depression, substance abuse, relationship difficulties, and medical illness.

While the Department of Defense and the Veterans Administration employ several empirically-supported PTSD treatments, less than 30% of those who start treatment complete it, and up to 60% of those who complete treatment fail to obtain significant symptom relief.

There is a growing interest in exploring mindfulness-based interventions (MBIs) as integrative treatments for PTSD. MBIs are multidimensional interventions, however, and there is a lack of knowledge as to the relative benefit of their various intervention components (e.g., the body scan, breath awareness) on symptoms. Colgan et al. [Mindfulness] examined the efficacy of two stand-alone MBSR components (the body scan and mindful breathing) in a randomized controlled trial of veterans with PTSD.

The researchers randomly assigned 102 predominantly male (96%), middle-aged (average age = 52), Caucasian (77%) combat veterans with chronic PTSD to one of four treatment groups: two “mindful” conditions — either the Body Scan or Mindful Breathing, and two “non-mindful” control conditions — either Slow Breathing or Sitting Quietly.

The groups met for six one-hour sessions over a six-week period. Each group session included 20 minutes of practice in the designated technique along with reviews of home practice and, for the mindfulness groups only, discussions of the principles of mindfulness.

The Slow Breathing condition learned how to reduce their respiration rate through biofeedback, and the Sitting […]

November 29th, 2015|News|

Wearable brain feedback technology to support mindfulness practice

Posted 10.30.2015 | by AMRA

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The basic mindfulness instruction to “attend to the present moment without judgment” seems straightforward, but novices are often unsure whether they are practicing mindfulness “correctly.” There are no existing objective behavioral markers of mindfulness, and descriptions of what mindfulness “feels like” are often metaphorical (e.g., “spacious” or “intimate”) and hard to interpret.

This lends a hit-or-miss quality to training, and has led some to wonder whether neurofeedback (a form of biofeedback that uses electro-encephalogram (EEG) data to alter brain rhythms) might be a useful way to support mindfulness practice. Previous research has identified a group of EEG parameters (e.g., the appearance of alpha frequencies, increasing alpha amplitude, and a gradual shift towards lower alpha and theta frequencies) that accompany the meditative state. Neuro-feedback devices that help meditators achieve these EEG patterns may help assist in cultivating mindfulness.

Sas & Chopra [Personal and Ubiquitous Computing] developed a wearable mindfulness neurofeedback device (MeditAid) and tested it with novice and experienced meditators. The MeditAid prototype includes a wearable, wireless headset to record scalp EEGs and software to translate EEG patterns into auditory feedback. The auditory feedback is delivered as either monaural beats (sounds of differing frequencies presented to both ears simultaneously) or binaural beats (sounds of differing frequencies presented to each ear separately) through headphones. Each method produces a rhythmic pattern of beats that corresponds to the user’s EEG frequency.

The difference between monaural and binaural beats is that monaural beat perception is a function of the mechanics of the inner ear, whereas binaural beat perception is a function of the integrative activity of the brain. Listeners hear lower monaural and binaural beat frequencies as having a […]

October 30th, 2015|News|

Mindful awareness program offered to elite athletes on the USA cycling team

Posted 09.28.2015 | by AMRA

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Skilled athletes must retain focus and maintain bodily awareness while resisting distractions. Using functional magnetic resonance imaging (fMRI), Haase et al. [Frontiers in Behavioral Neuroscience] explored whether a Mindful Performance Enhancement, Awareness, and Knowledge (mPEAK) intervention improved elite athletes’ bodily awareness and examined the underlying brain patterns associated with improved awareness.

Seven young adult, male members of the USA BMX cycling team underwent fMRI scans before and after participating in a 7-week mPEAK intervention. The intervention included traditional mindfulness practices along with didactic presentations on topics such as mindfulness, mind-wandering, self-compassion, and self-criticism. Athletes were assessed before and after training on measures of bodily awareness, emotional awareness, and mindfulness (FFMQ).

During fMRI scanning, athletes engaged in a computer-assisted attentional focus task while breathing through a mouthpiece that could variably restrict airflow making breathing more labored and effortful. At various times during the task they were given visual cues about the likelihood of future airflow restriction, so that the fMRI measured the brain changes associated with anticipating, experiencing, and recovering from restricted airflow.

Following mPEAK training, the athletes significantly improved their abilities to identify feelings (Cohen’s d = 1.1), self-regulate distress by attending to the body (Cohen’s d = 1.5), trust bodily sensations (Cohen’s d = 1.0), and describe emotions (Cohen’s d = 0.8).

Right insula and left anterior cingulate cortex (ACC) activation increased after mPEAK training during the time periods when athletes were anticipating restricted airflow. The magnitude of increased ACC activation during anticipation periods correlated with increases in the ability to describe emotions (ρ =.78).

There was also a negative association between increased insula activation during periods of recovery from restricted breathing and the ability […]

September 28th, 2015|News|

Brain imaging study of adolescents links cortical changes and mindfulness

Posted 08.25.2015 | by AMRA

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Adolescence is a time of rapid growth in young people’s capacity to self-regulate their emotions and maintain focus on goals, as well as a time of rapid brain development. In a longitudinal study, Friedel et al. [Developmental Cognitive Neuroscience] explored the relationship between changes in brain areas previously linked to mindfulness and the development of a tendency to be mindful of experience (dispositional mindfulness) in adolescents.

The brain regions of interest included the prefrontal cortex (an area involved in goal directed behavior and emotional regulation) and the insula (an area involved in the awareness of internal bodily states). As adolescents mature, the gray matter in their cerebral cortexes tends to thin out as neurons are selectively pruned and circuits become more efficient. The researchers predicted that a higher degree of cortical thinning would correlate with higher levels of dispositional mindfulness.

The researchers analyzed the magnetic resonance imaging (MRI) scans of 82 male and female adolescents who, as part of a larger study, underwent repeated scans at ages 16 and 19, and completed the Mindfulness Attention and Awareness Scale (MAAS) at age 19. The participants were also assessed on measures of temperament, emotional regulation, and intelligence.

Dispositional mindfulness was positively correlated with self-report measures of cognitive reappraisal, attention, and inhibitory control, and negatively correlated with measures of frustration, aggression, and depressed mood. The researchers analyzed possible relationships between cortical thinning and dispositional mindfulness in twenty different regions of the prefrontal and insular cortex. Contrary to expectation, prefrontal cortical thinning was unrelated to dispositional mindfulness — although prefrontal thinning was related to IQ.

There was, however, a significant correlation between a lesser degree of left anterior insular […]

August 25th, 2015|News|

Does mindfulness reduce stress by altering brain function?

Posted 07.21.2015 | by AMRA

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Does mindfulness reduce stress by altering brain function? The amygdala—a small, almond-shaped structure located in the brain’s limbic system—is known to play a key role in the stress response. Previous research has shown that increased connectivity (a measure of the degree to which brain structures inter-coordinate) between the amygdala and other limbic and cortical structures is associated with greater stress levels.

In two separate studies, Taren et al. [Social Cognitive and Affective Neuroscience] investigated how the amygdala’s resting connectivity with nearby brain structures correlates with stress, and whether that connectivity changed in response to a mindfulness-based intervention (MBI). In doing so, the researchers aimed to identify one of the main brain pathways underlying the effect of mindfulness practice on stress levels. In an initial study, 130 healthy men and women self-reported perceived stress levels and participated in functional magnetic resonance imaging (fMRI) to assess the resting functional connectivity between the amygdala and nearby brain structures.

In a second randomized, single-blind study using an active control group, 35 unemployed adults with moderate-to-high levels of perceived stress were assigned to either a three-day intensive residential mindfulness retreat modeled after MBSR which included the body scan, sitting and walking meditation, and mindful eating and yoga, or a three day intensive relaxation retreat which included walking, stretching, and didactics emphasizing relaxation rather than mindfulness.

Amygdala connectivity was assessed by fMRI before and after each intervention. Four months later, hair samples were taken and assayed for stress hormone (cortisone and cortisol) levels over the post-intervention period. This study demonstrated that participants with higher levels of perceived stress had significantly greater degrees of connectivity between the right side of the […]

July 21st, 2015|News|

Mindfulness integrated in supportive cancer care

Posted 04.24.2015 | by AMRA

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Cancer survivors often suffer from mental distress, and there is a growing interest in evidence-based integrative approaches that address survivor’s psychological, social, and spiritual needs. Dobos et al. [Supportive Care in Cancer] tracked the emotional well-being of 117 cancer survivors referred to an 11-week Mindfulness-Based Day Care (MBDC) offered at a clinic in Essen, Germany.

Participants were assessed before, immediately after, and three months following treatment on a variety of self-report questionnaires. The clinic, which combined Mindfulness-Based Stress Reduction (MBSR) with relaxation, cognitive restructuring, diet, exercise, and naturopathic interventions, met once weekly for six hours over the 11 week period. Participants were mostly female (91%) and mostly breast cancer survivors (65%) (average age = 54 years).

Over the course of the study, the cancer survivors reported significant improvements in their physical, emotional, role, social, and cognitive quality of life, and significant decreases in their depression, anxiety, fatigue, pain, and insomnia. The magnitude of improvements ranged from an 8% improvement in physical quality of life to a 34% decrease in depression.

They also reported significantly greater life and health satisfaction, greater mindfulness (on the Freiburg Mindfulness Inventory) and improved adaptive coping, including spiritual and religious coping.

The study documented a significant improvement in the quality of life and mental well being of the cancer survivors attending the MBDC clinic.

Since it lacked a control arm, no definitive inference can be made as to whether the improvements were due to participation in the program or confounding factors such as the passage of time. Effect sizes were not reported, so it is challenging to evaluate the clinical significance of the improvements. Lastly, the combination of so many different therapeutic […]

April 24th, 2015|News|

Building mindful awareness to help people in need

Posted 03.24.2015 | by AMRA

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Can mindfulness training increase real-life compassionate behavior, and can it do so when the training is delivered via a smartphone? If mindfulness training improves compassion, does it do so by enhancing one’s ability to accurately judge other people’s emotional states, or by some other means? To address these questions, Lim et al. [PLOS One] randomly assigned 69 college undergraduates to either a mindfulness meditation (MM) or cognitive skills (CS) training program. Both programs were delivered over self-guided web-based smartphone applications.

A total of 56 participants completed the three week long interventions. The MM participants engaged in 14 mindfulness meditation sessions lasting an average of 12 minutes each. The sessions did not include loving-kindness or compassion content. The CS participants engaged in 14 game-playing sessions designed to enhance memory, attention, speed, and problem solving.

After completing training, participants were asked to return to a lab waiting area that contained three chairs, two of which were already occupied by alleged “participants,” who were actually researcher confederates (i.e. actors who played participants), and the third of which was to be occupied by the participant. As they sat waiting, another confederate entered with crutches and a walking boot, acting as if in pain. The seated confederates showed indifference to the newcomer.

Researchers then observed whether or not the participants yielded their seats to the newcomer. Following this assessment of compassionate behavior, participants were assessed on their ability to identify emotions from photographs and audio clips, a test of whether the mindfulness training had also improved their ability to read other people’s emotions.

MM participants were more than twice as likely to yield their chairs than were CS participants (37% […]

March 24th, 2015|News|

Elementary school-based program boosts cognitive skills in children

Posted 02.23.2015 | by AMRA

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Educators and administrators seek out school-based programs that help students develop self-awareness, self-regulation, relationship, and decision-making skills. Schonert-Reichl et al. [Developmental Psychology] evaluated a mindfulness-based social and emotional learning curriculum (MindUP) to see if it improved children’s cognitive control, well-being, prosocial behavior, and academic performance.

Ninety-nine British Columbian public school 4th and 5th graders had their classrooms randomly assigned to either the MindUP program or a routine social responsibility curriculum. The 4-month MindUP intervention included 3-minute mindfulness exercises (breathing and listening) repeated 3 times daily. It also included twelve 40-50 minute weekly lessons on mindfulness, perspective taking, optimism, empathy, gratitude, kindness, and community service.

The control group followed the standard British Columbian public school curriculum. The children were assessed before and after the interventions on computerized tests of executive function, self-report measures of pro-sociality, and year-end math grades were also obtained from school records.

The MindUP children showed significantly greater improvement in executive function reaction time. They also showed significant moderate-sized improvements on self-report measures of empathy, perspective taking, optimism, emotional control, self-concept depressive symptoms, and mindfulness. In contrast, controls decreased over time on these self-report measures.

MindUP children were significantly more likely to show moderate to large improvements on peer behavioral nominations for sharing, trustworthiness, helpfulness, and taking other’s points of view, while exhibiting significantly greater decreases in rule breaking and starting fights. There was also a trend towards higher math scores for MindUP participants relative to controls.

These results show that mindfulness training may provide added value to programs aimed at improving children’s emotional and social competencies. Classroom interventions like MindUp offer the promise of making a meaningful contribution to children’s future academic and […]

February 23rd, 2015|News|