Treatment of non-chemical (behavioural) addictions

Shonin, E., Gordon, W. V., & Griffiths, M. D. (2014). Mindfulness as a Treatment for Behavioural Addiction. Journal of Addiction Research & Therapy, 5, e122. Full text.

Mindfulness is one of the fastest growing areas of psychological research and over 70% of general practitioners in the United Kingdom now believe that mindfulness/meditation can be beneficial for patients with mental health issues. In a previous issue of the Journal of Addiction Research and Therapy, Penberthy focused on an intervention known as mindfulness-based relapse prevention [MBRP] and argued that MBRP appears to be an effective treatment for reducing substance use relapse.

Following a critical review of the latest empirical and clinical evidence, we argue that there may also be applications for mindfulness approaches in the treatment of non-chemical (i.e., behavioural) addictions.

Recommended intervention for anxiety and depressive disorder

Strauss, C., Cavanagh, K., Oliver, A., & Pettman, D. (2014). Mindfulness-Based Interventions for People Diagnosed with a Current Episode of an Anxiety or Depressive Disorder: A Meta-Analysis of Randomised Controlled Trials. PLOS ONE, 9(4), e96110. Full text.

Mindfulness-based interventions (MBIs) can reduce risk of depressive relapse for people with a history of recurrent depression who are currently well. However, the cognitive, affective and motivational features of depression and anxiety might render MBIs ineffective for people experiencing current symptoms. This paper presents a meta-analysis of randomised controlled trials (RCTs) of MBIs where participants met diagnostic criteria for a current episode of an anxiety or depressive disorder.

This is the first meta-analysis of RCTs of MBIs where all studies included only participants who were diagnosed with a current episode of a depressive or anxiety disorder. Effects of MBIs on primary symptom severity were found for people with a current depressive disorder and it is recommended that MBIs might be considered as an intervention for this population.

Positive effect on attention, memory, verbal fluency, cognitive flexibility

Marciniak, R., et al. (2014). Effect of meditation on cognitive functions in context of aging and neurodegenerative diseases. Frontiers in Behavioral Neuroscience, 8. Full text.

Abstract. Effect of different meditation practices on various aspects of mental and physical health is receiving growing attention. The present paper reviews evidence on the effects of several mediation practices on cognitive functions in the context of aging and neurodegenerative diseases.

The effect of meditation in this area is still poorly explored. Seven studies were detected through the databases search, which explores the effect of meditation on attention, memory, executive functions, and other miscellaneous measures of cognition in a sample of older people and people suffering from neurodegenerative diseases. Overall, reviewed studies suggested a positive effect of meditation techniques, particularly in the area of attention, as well as memory, verbal fluency, and cognitive flexibility. These findings are discussed in the context of MRI studies suggesting structural correlates of the effects.

Meditation can be a potentially suitable non-pharmacological intervention aimed at the prevention of cognitive decline in the elderly. However, the conclusions of these studies are limited by their methodological flaws and differences of various types of meditation techniques. Further research in this direction could help to verify the validity of the findings and clarify the problematic aspects.

Improves cognition and memory with neurodegenerative diseases

Newberg, A. B., et al. (2014). Meditation and neurodegenerative diseases. Annals of the New York Academy of Sciences, 1307(1), 112-123. Full text.

Abstract. Neurodegenerative diseases pose a significant problem for the healthcare system, doctors, and patients. With an aging population, more and more individuals are developing neurodegenerative diseases and there are few treatment options at the present time. Meditation techniques present an interesting potential adjuvant treatment for patients with neurodegenerative diseases and have the advantage of being inexpensive, and easy to teach and perform.

There is increasing research evidence to support the application of meditation techniques to help improve cognition and memory in patients with neurodegenerative diseases. This review discusses the current data on meditation, memory, and attention, and the potential applications of meditation techniques in patients with neurodegenerative diseases.

Positive affect buffers maladaptive pain responses

Finan, P. H., & Garland, E. L. (2014). The Role of Positive Affect in Pain and Its Treatment. The Clinical Journal of Pain. Abstract ahead of publication.

This narrative review summarizes and integrates the available literature on positive affect (PA) and pain to: (1) Provide a brief overview of PA and summarize the key findings that have emerged in the study of PA and chronic pain; (2) Provide a theoretical foundation from which to understand how PA operates in the context of chronic pain; and (3) Highlight how the prevailing psychosocial treatments for chronic pain address PA in the therapeutic context, and offer suggestions for how future treatment development research can maximize the benefit of PA for patients with chronic pain.

To that end, we review experimental studies that have assessed the association of evoked PA and pain sensitivity, as well as clinical studies that have assessed the association of naturally occurring PA and clinical pain in the context of chronic pain. The evidence suggests PA influences pain, over and above the influence of NA. We offer an “upward spiral” model of positive affect, resilience and pain self-management, which makes specific predictions that PA will buffer maladaptive cognitive and affective responses to pain, and promote active engagement in valued goals that enhance chronic pain self-management.

MBI and somatization disorders

Lakhan, S. E., & Schofield, K. L. (2013). Mindfulness-based therapies in the treatment of somatization disorders: a systematic review and meta-analysis. PloS one, 8(8), e71834. Full Text.

Mindfulness-based therapy (MBT) has been used effectively to treat a variety of physical and psychological disorders, including depression, anxiety, and chronic pain. Recently, several lines of research have explored the potential for mindfulness-therapy in treating somatization disorders, including fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome.

Thirteen studies were identified as fulfilling the present criteria of employing randomized controlled trials to determine the efficacy of any form of MBT in treating somatization disorders. A meta-analysis of the effects of mindfulness-based therapy on pain, symptom severity, quality of life, depression, and anxiety was performed to determine the potential of this form of treatment.

Preliminary evidence suggests that MBT may be effective in treating at least some aspects of somatization disorders. Further research is warranted.

Responding rather than reacting to back pain

Doran, N. J. (2014). Experiencing Wellness Within Illness: Exploring a Mindfulness-Based Approach to Chronic Back Pain. Qualitative Health Research, 1049732314529662. From the Abstract.

I explore how mindfulness-based techniques affect perceptions and management of back pain and discuss these findings in relation to embodiment theory and liminality. Sixteen volunteers attending… for persistent back pain took part in this study.

The theme of “embodied awareness” formed the core category, as all participants reported a change in their experience of pain. Such embodied changes are described in relation to five subthemes: unpacking the pain experience, changing relationship to pain, letting go of the label, self-compassion and acceptance, and wellness within illness.

Learning to respond rather than react, and living moment by moment enabled participants to replace a cycle of suffering with one of acceptance. Rather than fearing pain, participants found ways to move through it and live with it. Although some expressed finding a sense of wellness despite ongoing pain, all participants reported greater acceptance and a better quality of life.

Improvements in rumination and emotional clarity

Caldwell, J. G., & Shaver, P. R. (2014). Promoting Attachment-Related Mindfulness and Compassion: a Wait-List-Controlled Study of Women Who Were Mistreated During Childhood. Mindfulness, 1-13. Abstract.

Numerous studies have shown that mindfulness-based interventions contribute to a variety of positive outcomes in physical, cognitive, and affective domains. Less is known about how mindfulness influences variables associated with close interpersonal relationships.

The present study evaluated a novel mindfulness-based intervention for promoting cognitive-emotional processes that are underdeveloped in people who have experienced unhealthy attachment relationships. In a sample of women who were mistreated in childhood, baseline measures confirmed that attachment anxiety was related to rumination and negative emotion; attachment avoidance was related to emotion suppression and lack of emotional clarity; and both kinds of insecurity were related to emotion dysregulation and lower levels of mindfulness.

Across three measurement periods, a treatment group (N = 17), relative to a wait-list control group (N = 22), evinced significant improvements in the domains of rumination, emotion suppression, clarity of emotions, emotion regulation, and mindfulness. A multiple mediation analysis showed that, of these variables, improvements in rumination and emotional clarity mediated the gains in mindfulness for the treatment group. Also, participants in the treatment group showed significant changes in their use of mindfulness-based language when writing about stressful or traumatic childhood attachment experiences.

Taken together, the results suggest that the intervention led to increases in mindfulness, primarily due to decreased rumination and increased emotional clarity, and these treatment-related changes were specifically related to participants’ thoughts and emotions regarding attachment.

Framework for understanding neurobiological mechanisms of mindfulness

Vago, D. R., & Silbersweig, D. A. (2012). Self-awareness, self-regulation, and self-transcendence (S-ART): a framework for understanding the neurobiological mechanisms of mindfulness. Frontiers in human neuroscience, 6.

Mindfulness—as a state, trait, process, type of meditation, and intervention–has proven to be beneficial across a diverse group of psychological disorders as well as for general stress reduction. Yet, there remains a lack of clarity in the operationalization of this construct, and underlying mechanisms.

Here, we provide an integrative theoretical framework and systems-based neurobiological model that explains the mechanisms by which mindfulness reduces biases related to self-processing and creates a sustainable healthy mind. Mindfulness is described through systematic mental training that develops meta-awareness (self-awareness), an ability to effectively modulate one’s behavior (self-regulation), and a positive relationship between self and other that transcends self-focused needs and increases prosocial characteristics (self-transcendence). >>> continue with full text

Stress in mothers of children with autism

Conner, C. M., & White, S. W. (2014). Stress in mothers of children with autism: Trait mindfulness as a protective factor. Research in Autism Spectrum Disorders, 8(6), 617-624. Abstract.

Mindfulness-based interventions may reduce parents’ stress and improve parent–child relationships. Given the chronic nature of autism spectrum disorder (ASD) and its influence on parents’ stress, interventions to promote mindfulness may be especially helpful for parents of children with ASD.

Prior to undertaking intervention development, it is first necessary to establish the relationship between mindfulness and stress, as other factors like child behavioral difficulties may overshadow the mother’s regulation strategies. In a sample of mothers of children with ASD (n = 67) and a comparison sample of mothers without ASD (n = 87), mindfulness was significantly associated with the level of maternal stress above and beyond child behavior problems.

Results suggest that interventions to promote mindfulness may be helpful in reducing parenting stress among mothers of children with ASD, as well as mothers of typically developing children. Due to the chronic nature of ASD, such interventions may be particularly applicable.