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Patients with schizophrenia benefit from mindfulness, concerns debunked

Posted 01.19.2017 | by AMRA

Schizophrenia is a severe, prolonged psychiatric illness affecting over 3,000,000 Americans with symptoms including delusions, hallucinations, apathy, and social withdrawal. The standard treatment for schizophrenia involves medication, education, and social support. Despite treatment, most patients suffer from residual symptoms that can negatively impact vocational and social functioning and quality of life.

Using a randomized, controlled, multisite design, Wang et al. [Neuropsychiatric Disease and Treatment] compared the efficacy of a novel six-month mindfulness-based psycho-educational program in reducing schizophrenic symptoms and disability to that of standard psychiatric care with and without conventional psycho-education.

The researchers recruited 138 patients with schizophrenic-spectrum disorders (52% male, average age = 24) from two Hong Kong outpatient clinics and randomly assigned them to one of three conditions: 1) a Mindfulness-Based Psycho-educational Group (MBPG), 2) a Conventional Psycho-educational Group (CPG) or 3) treatment-as-usual (TAU) alone. MBPG and CPG were both offered as supplements to treatment-as-usual, and were delivered in twelve two-hour bimonthly sessions over the course of six months.

MBPG focused on increasing awareness of bodily sensations, thoughts, and feelings relating to illness, controlling negative thoughts and perceptions, and enhancing illness management, problem-solving and relapse prevention. It emphasized acceptance and de-centering strategies and included mindfulness home practice. CPG emphasized education on schizophrenia, survival and life skills, relapse prevention, and resilience promotion. TAU included medication, psychiatric consultation, brief education about illness and treatment, nurse and social work services, and referrals for medical treatment and psychological counseling as indicated.

Outcome measures were obtained at baseline, and at 1 week and 6 months after intervention completion. Measures included psychosocial functioning, re-hospitalization, psychiatric symptoms, insight into illness/treatment, recovery, and mindfulness (the Five Facet Mindfulness Questionnaire of FFMQ).

The MBPG […]

January 19th, 2017|News|

Teens in mindfulness program improve cognitive ability

Posted 12.26.2015 | by AMRA

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Working memory capacity is a measure of one’s ability to temporarily hold information in mind while completing a cognitive task. There seems to be some conceptual overlap between the focused attention required for working memory and the moment-to-moment attention that is an integral part of mindfulness. Working memory plays crucial roles in learning, cognitive development, reasoning, comprehension, and academic performance, and any intervention that can improve working memory is of great interest to specialists in child development. In a randomized, controlled study, Quach, et al. [Journal of Adolescent Health] investigated whether an MBI can improve working memory in adolescents.

The 186 participants, primarily Hispanic and Asian junior high students (62% female; average age = 13) from predominantly low-income households, were randomly assigned to either mindfulness meditation, hatha yoga, or a wait-list control. The active intervention participants learned and practiced either mindfulness meditation or hatha yoga during eight 45-minute twice-a-week training sessions, while control participants attended their regular physical education classes.

Mindfulness meditation training was based on a truncated, modified Mindfulness Based Stress Reduction (MBSR) curriculum that excluded hatha yoga. Hatha yoga training included an emphasis on non-judgmental attention to body posture and movement. Both interventions encouraged 15-30 minutes of daily home practice.

Before and after the inventions, participants completed a computerized test of working memory requiring them to memorize series of visually presented letters while simultaneously solving arithmetic equations. Working memory capacity was measured by the total number of letters participants recalled in their correct order within each presentational set, yielding a working memory score that could range from 0 to 75.

Participants also completed self-report measures of perceived stress and anxiety along with the Child […]

December 26th, 2015|News|

Veterans report reduced PTSD symptoms after a mindfulness meditation program

Posted 09.18.2015 | by AMRA

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Nearly a quarter of veterans returning from combat deployment suffer from post-traumatic stress disorder (PTSD). While the Veterans Administration treats many of these veterans with prolonged exposure or cognitive processing therapy, dropout rates remain high (30-44%) and up to half of those receiving therapy fail to improve. There is a need for new therapies that are well tolerated and effective. Polusny et al. [Journal of the American Medical Association] tested the impact of MBSR compared to Present-Centered Group Therapy (PCGT) on PTSD symptoms in a randomized, controlled trial.

Participants were 116 mostly Caucasian, male, and predominantly Vietnam era veterans with PTSD who were recruited from the Minneapolis VA Medical Center and randomly assigned to either MBSR or PCGT, a group treatment focused on resolving current life problems. Participants completed checklists assessing PTSD symptoms, depression, quality of life, and mindfulness (FFMQ) at baseline and again at 3, 6, 9, and 17 weeks. Additionally, participants were interviewed by clinicians before and after treatment and again at two-month follow-up to obtain independent evaluations of diagnoses and symptom severity.

Dropout rates were lower than previously observed with either prolonged exposure or cognitive processing therapy, but the dropout rate was significantly higher for MBSR (22%) than for PCGT (7%). Self-rated PTSD severity improved for both groups from baseline to two-month follow-up, but the average improvement was significantly greater for MBSR (9 points) than PCGT (3 points) participants (Cohen’s d=.40).

Clinician symptom ratings showed significantly greater improvement for MBSR participants (Cohen’s d=.41). MBSR participants also reported significantly greater improvements in mindfulness and quality of life. Increases in mindfulness were significantly associated with improvements in PTSD (r=-.46), depressive symptoms (r=-.44), and […]

September 18th, 2015|News|

Motor symptoms from Parkinson’s Disease reduced with MBSR

Posted 06.24.2015 | by AMRA

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Parkinson’s Disease (PD) in a neurological disorder affecting movement, cognition, and mood. It is caused by the loss of dopamine-secreting neurons deep within the brain. It is primarily managed with medication, but psychological factors like stress and depression can exacerbate its symptoms, and 40% of American PD patients turn to complementary and integrative medicine for help.

Pickut et al. [Parkinson’s Disease] conducted a randomized, controlled exploratory study of whether a mindfulness-based intervention (MBI) can help reduce the disability and suffering associated with PD.

Thirty cognitively intact men and women with PD (mean age = 62) were randomly assigned to either an eight-week MBI closely following the MBSR protocol, or a treatment-as-usual control. Participants completed the Five Facet Mindfulness Questionnaire (FFMQ) and rated their PD symptoms, depression, and quality of life at baseline and at eight-weeks. Their motor symptoms (e.g., tremor, rigidity, agility, gait) were rated by movement disorder specialists who were blind to treatment assignment.

The MBI participants showed a significant 20% decease in their objectively rated motor symptoms and a significant 13% increase on the FFMQ “Observe” scale. There were no significant group differences in self-rated depression or quality of life.

This is one of the first studies to explore the efficacy of a MBI in PD patients, and it supports the use of a MBI as a complementary treatment option. It is unclear whether the clinically meaningful decrease in motor symptoms seen in this study was due to either stress reduction, the MBI-induced grey matter growth seen in previous MBI research with PD patients, or the placebo effect. The study is limited by its small sample size and lack of active controls.

Reference:

Pickut, B., […]

June 24th, 2015|News|

Mindfulness training improves sleep of older adults, clinical trial shows

Posted 03.16.2015 | by AMRA

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About half of adults aged 55 and over report some difficulty falling and/or staying asleep. Moderate sleep disturbances are often accompanied by daytime fatigue and disturbances in mood, and may be precursors to clinical insomnia. Current treatments for sleep disturbances include medications which can have residual daytime effects and lead to dependency, and cognitive and behavioral treatments which can be costly and require access to skilled therapists. There is an ongoing need for novel treatments that are safe, effective, low cost, and accessible in the broader community.

In a randomized, controlled study, Black et al. [JAMA Internal Medicine] evaluated the Mindfulness Awareness Practices for Daily Living (MAPs) program as a treatment for moderate sleep disturbance in older adults. Prospective participants aged 55 and above were recruited through advertising and screened for the presence of moderate sleep disturbance and the absence of other diagnoses that could aversely affect sleep (e.g., sleep apnea, restless leg syndrome). Forty-nine predominantly Caucasian (84%), female (67%) participants (average age=66) were randomly assigned to either MAPS or to Sleep Hygiene Education (SHE), a widely accepted sleep intervention designed to match MAPS in format, participant involvement, and participant expectations for benefit.

The programs were delivered in six two-hour group sessions that included home practice or study. MAPs participants practiced sitting, walking, movement, eating, and loving-kindness meditations. SHE participants were instructed in sleep education and sleep self-monitoring, relaxation techniques, and sleep hygiene strategies. Pittsburgh Sleep Quality Index scores served as the primary outcome measure. Self-report measures of depression, anxiety, stress, fatigue, and mindfulness (the Five Factor Mindfulness Questionnaire, or FFMQ) were also included, as well as a blood drawn measure of NF-κB, […]

March 16th, 2015|News|

MBSR’s Impact on Ulcerative Colitis Flare-Ups

Posted: 03.27.2014 | by AMRA

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Ulcerative colitis is an inflammatory bowel disease that is a chronic autoimmune disorder of the colon. Despite the best medical management, ulcerative colitis patients often experience episodic flare-ups with symptoms that include abdominal pain, diarrhea, and rectal bleeding. Flare-ups are sometimes triggered by stress, and there is a great deal of interest in stress-reduction interventions that might improve quality of life and reduce flare-ups, and defining those ulcerative colitis subpopulations that might benefit most from such techniques.

Jedel et al. [Digestion] studied MBSR’s effectiveness in preventing ulcerative colitis flare-ups in a randomized, double-blind study. Fifty-five moderately severe ulcerative colitis patients in remission were assigned to either MBSR or a placebo (lectures and videos on mind/body medicine). Moderate severity of disease status was defined by a Mayo Ulcerative Colitis Disease Activity Index of 6–12. Measures taken at baseline, post-treatment, and 6 and 12-month follow-up included inflammation markers (calprotectin, C-reactive protein, and cytokines), stress markers (ACTH, cortisol), measures of perceived stress and IBD quality of life, and measures of mood and mindfulness (MAAS).

There was no difference in the number or severity of flare-ups or the length of the inflammation-free interval prior to flare-ups between groups, but MBSR participants who flared had significantly better quality of life and lower perceived stress than control subjects who flared (quality of life was also higher for MBSR participants regardless of whether or not they flared). There were no group differences on measures of mood or mindfulness, possibly due to a ceiling effect in this mentally healthy cohort.

MBSR participants with the highest number of gastrointestinal symptoms at baseline benefited the most. MBSR participants with the highest perceived stress and/or […]

March 27th, 2014|News|