Anxiety in chronic pain patients

Kim, R. O. D. (2015). Observing The Effects Of Mindfulness-Based Meditation On Anxiety And Depression In Chronic Pain Patients. International Journal of Psychology and Behavioral Sciences, 5(4), 143-147. Full text.

Background: People whose chronic pain limits their independence are especially likely to become anxious and depressed. Mindfulness training has shown promise for stress-related disorders.

Methods: Chronic pain patients who complained of anxiety and depression and who scored higher than moderate in the Hamilton Depression Rating Scale (HDRS) and Hospital Anxiety and Depression Scale (HADS) as well as moderate in Quality of Life Scale (QOLS) were observed for eight weeks, three days a week for an hour of Mindfulness Meditation training with an hour daily home Mindfulness Meditation practice. Pain was evaluated on study entry and completion, and patients were given the Patients’ Global Impression of Change (PGIC) to score at the end of the training program.

Results: Forty-seven (47) patients completed the Mindfulness Meditation Training program. Over the year-long observation, patients demonstrated noticeable improvement in depression, anxiety, pain, and global impression of change.

Conclusions: Chronic pain patients who suffer with anxiety and depression may benefit from incorporating Mindfulness Meditation into their treatment plans.

Comparing mindfulness meditation and guided imagery in patients with acute depression

Costa, A., & Barnhofer, T. (2015). Turning Towards or Turning Away: A Comparison of Mindfulness Meditation and Guided Imagery Relaxation in Patients with Acute Depression. Behavioural and cognitive psychotherapy, 1-10. Abstract.

Background: Disengaging from maladaptive thinking is an important imperative in the treatment of depression. Mindfulness training is aimed at helping patients acquire relevant skills for this purpose. It remains unclear, however, whether this practice is helpful when patients are acutely depressed.

Aims: In order to investigate effects of mindfulness on symptoms and self-regulatory capacities in this group, the current study compared a brief training in mindfulness (n = 19) to guided imagery relaxation (n = 18).

Method: Participants were introduced to the respective techniques in a single session, and practised daily over one week. Self-reported severity of symptoms, difficulties in emotion-regulation, attentional control, the ability to decentre, and mindfulness were assessed pre and post-intervention, and at a one-week follow-up.

Results: Symptoms of depression significantly decreased and self-regulatory functioning significantly increased in both groups, with changes being maintained during follow-up. When controlling for change in depressive symptoms, results showed significantly higher improvements in emotion regulation at follow-up in the mindfulness group. The ability to decentre predicted changes in symptoms from pre to post-intervention, while mindfulness skills predicted changes in symptoms during the maintenance phase.

Conclusions: The findings suggest that both practices can help to instigate reductions in symptoms and enhance self-regulatory functioning in depression. However, in order to improve emotion regulation above levels explained by reductions in symptoms more intentional mental training seems necessary. Furthermore, while the ability to disengage from negative patterns of thinking seems crucial for initial reduction of symptoms, maintenance of gains might require broader skills in mindfulness.

Efficacy of meditation on stress-related outcomes (review)

Goyal, M., et al.  (2014). Meditation Programs for Psychological Stress and Well-Being. Comparative Effectiveness Reviews, No. 124. Full text.

Objective: Meditation, a mind-body method, employs a variety of techniques designed to facilitate the mind’s capacity to affect bodily function and symptoms. An increasing number of patients are using meditation programs despite uncertainty about the evidence supporting the health benefits of meditation. We aimed to determine the efficacy and safety of meditation programs on stress-related outcomes (e.g., anxiety, depression, stress, distress, well-being, positive mood, quality of life, attention, health-related behaviors affected by stress, pain, and weight) compared with an active control in diverse adult clinical populations.

Conclusions: Meditation programs, in particular mindfulness programs, reduce multiple negative dimensions of psychological stress. Stronger study designs are needed to determine the effects of meditation programs in improving the positive dimensions of mental health as well as stress-related behavioral outcomes.

Mediating role of mindfulness on eating pathology

Pepping, C. A., et al. (2015). Individual differences in attachment and eating pathology: The mediating role of mindfulness. Personality and Individual Differences, 75, 24-29. Abstract.

Attachment insecurity is related to many forms of psychopathology, including eating pathology. However, remarkably little is known as to the more specific underlying cognitive and emotional processes that may explain why attachment insecurity places individuals at greater risk of eating pathology.

In the present research, we examined whether mindfulness is one mechanism underlying the relationship between attachment insecurity and greater eating pathology in a sample of undergraduate females (Study 1) and a sample of women seeking treatment for eating pathology (Study 2). In both studies, there were indirect associations of both attachment anxiety and avoidance with increased eating pathology via lower mindfulness.

The findings suggest that attachment insecurity is related to greater eating pathology due to a reduced capacity for mindfulness.

Moderating effect on emotional distress in Diabetes patients

van Son, J., et al. (2014). The association between mindfulness and emotional distress in adults with diabetes: Could mindfulness serve as a buffer? Results from Diabetes MILES: The Netherlands. Journal of behavioral medicine, 1-10.

From the Abstract. People with diabetes have a higher risk of emotional distress (anxiety, depression) than non-diabetic or healthy controls. Therefore, identification of factors that can decrease emotional distress is relevant. The aim of the present study was to examine (1) the association between facets of mindfulness and emotional distress; and (2) whether mindfulness might moderate the association between potential adverse conditions (stressful life events and comorbidity) and emotional distress.

Analyses were conducted using cross-sectional data: 666 participants with diabetes (type 1 or type 2) completed measures of mindfulness, depressive symptoms, and anxiety symptoms. Hierarchical multiple regression analyses showed significant associations between mindfulness facets (acting with awareness, non-judging, and non-reacting) and symptoms of anxiety and depression.

These mindfulness facets appeared to have a moderating effect on the association between stressful life events and depression and anxiety. However, the association between co-morbidity and emotional distress was largely not moderated by mindfulness. In conclusion, mindfulness is negatively related to both depression and anxiety symptoms in people with diabetes and shows promise as a potentially protective characteristic against the influence of stressful events on emotional well-being.

Novel intervention reduces work-related stress

Grégoire, S., & Lachance, L. (2014). Evaluation of a Brief Mindfulness-Based Intervention to Reduce Psychological Distress in the Workplace. Mindfulness, 1-12.

From the Abstract. Employees of a call center working for a financial institution took part in a brief mindfulness-based intervention (MBI). Each day, during five consecutive weeks, they listened to two short guided meditation sessions using a headset at their workstation (10 min in the morning and 5 min after lunch). A pretest-post-test switching-replication design was used to assess changes in mindfulness, psychological distress, and client satisfaction over the course of the intervention.

The results showed that mindfulness increased while psychological distress (stress, anxiety/depression, fatigue, and negative affect) decreased for all employees throughout the intervention, especially among those with low mindfulness scores at baseline. The satisfaction level of the employees’ internal clients significantly increased over time, although the effect size was small.

This article contributes to the field of mindfulness at work by (1) introducing a novel MBI specifically designed for call centers, (2) assessing the impact of the intervention on client satisfaction, and (3) doing so using a research design and a statistical technique which have never been used in mindfulness studies.

Problems associated with meditation

Lomas, T., et al. (2014). A Qualitative Analysis of Experiential Challenges Associated with Meditation Practice. Mindfulness, 1-13. Full text.

Abstract. Although empirical interest in meditation has flourished in recent years, few studies have addressed possible downsides of meditation practice, particularly in community populations. In-depth interviews were conducted with 30 male meditators in London, UK, recruited using principles of maximum variation sampling, and analysed using a modified constant comparison approach.

Having originally set out simply to inquire about the impact of various meditation practices (including but not limited to mindfulness) on men’s wellbeing, we uncovered psychological challenges associated with its practice. While meditation was generally reported to be conducive to wellbeing, substantial difficulties accounted for approximately one quarter of the interview data. Our paper focuses specifically on these issues in order to alert health professionals to potential challenges associated with meditation.

Four main problems of increasing severity were uncovered: Meditation was a difficult skill to learn and practise; participants encountered troubling thoughts and feelings which were hard to manage; meditation reportedly exacerbated mental health issues, such as depression and anxiety; and in a few cases, meditation was associated with psychotic episodes. Our paper raises important issues around safeguarding those who practise meditation, both within therapeutic settings and in the community.