Research - Mind / Body Connection
Not Just Mind Over Matter: Reviewing With Patients How Mindfulness Relieves Chronic Low Back Pain
Natalia E. Morone, MD, MS
The current opioid crisis has spurred the need for nonpharmacological therapies for chronic low back pain. In a study published in JAMA Internal Medicine, we reported that in 282 older adults with chronic low back pain, an 8-week mind-body group program modeled on Mindfulness-Based Stress Reduction (MBSR) decreased long-term pain and increased short-term function. Barriers to uptake remain such as patient resistance to accepting the benefits of nonpharmacological treatments for chronic low back pain. They may fear the clinician does not believe their pain complaint because they are not being offered a pain pill. By not appreciating the value of the therapy in helping their chronic low back pain, the patient may not be compliant with recommendations. Resistance likely derives from lack of understanding how a mind-body approach like MBSR can help relieve the sensation of pain as well as help increase function. Clinicians can help break through this barrier by educating their patients about the different ways in which MBSR works to reduce pain and improve function. In this commentary, we will discuss how our findings can inform the discussion clinicians have with their patients regarding the ways MBSR can relieve back pain. Pain processing is complex and top-down regulation is not fully engaged when pain is treated with pharmacotherapy alone. We share that our study showed a clinically meaningful reduction in pain and improvement in function and discuss some of the possible underlying mechanisms of MBSR’s effect.
Source : Journal of Evidence-Based Integrative Medicine
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Mindfulness-based cognitive therapy for the treatment of current depressive symptoms: a meta-analysis
Simon B. Goldberg a,b,c, Raymond P. Tucker d , Preston A. Greene c , Richard J. Davidson b,e, David J. Kearney c and Tracy L. Simpson c
Mindfulness-based cognitive therapy (MBCT) appears to be a promising intervention for the prevention of relapse in major depressive disorder, but its efficacy in patients with current depressive symptoms is less clear. Randomized clinical trials of MBCT for adult patients with current depressive symptoms were included (k = 13, N = 1046). Comparison conditions were coded based on whether they were intended to be therapeutic (specific active controls) or not (non-specific controls). MBCT was superior to nonspecific controls at post-treatment (k = 10, d = 0.71, 95% confidence interval [CI] [0.47, 0.96]), although not at longest follow-up (k = 2, d = 1.47, [−0.71, 3.65], mean follow-up = 5.70 months across all studies with follow-up). MBCT did not differ from other active therapies at post-treatment (k = 6, d = 0.002, [−0.43, 0.44]) and longest follow-up (k = 4, d = 0.26, [−0.24, 0.75]). There was some evidence that studies with higher methodological quality showed smaller effects at post-treatment, but no evidence that effects varied by inclusion criterion. The impact of publication bias appeared minimal. MBCT seems to be efficacious for samples with current depressive symptoms at post-treatment, although a limited number of studies tested the long-term effects of this therapy.
Source : Journal Cognitive Behavior Therapy
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Neural mechanisms supporting the relationship between dispositional mindfulness and pain
Zeidan, Fadela,*; Salomons, Timb; Farris, Suzan R.a; Emerson, Nichole M.a; Adler-Neal, Adriennea; Jung, Youngkyooc; Coghill, Robert C.a,d
Interindividual differences in pain sensitivity vary as a function of interactions between sensory, cognitive–affective, and dispositional factors. Trait mindfulness, characterized as the innate capacity to nonreactively sustain attention to the present moment, is a psychological construct that is associated with lower clinical pain outcomes. Yet, the neural mechanisms supporting dispositional mindfulness are unknown. In an exploratory data analysis obtained during a study comparing mindfulness to placebo analgesia, we sought to determine whether dispositional mindfulness is associated with lower pain sensitivity. We also aimed to identify the brain mechanisms supporting the postulated inverse relationship between trait mindfulness and pain in response to noxious stimulation. We hypothesized that trait mindfulness would be associated with lower pain and greater deactivation of the default mode network. Seventy-six meditation-naive and healthy volunteers completed the Freiburg Mindfulness Inventory and were administered innocuous (35°C) and noxious stimulation (49°C) during perfusion-based functional magnetic resonance imaging. Higher Freiburg Mindfulness Inventory ratings were associated with lower pain intensity (P = 0.005) and pain unpleasantness ratings (P = 0.005). Whole brain analyses revealed that higher dispositional mindfulness was associated with greater deactivation of a brain region extending from the precuneus to posterior cingulate cortex during noxious heat. These novel findings demonstrate that mindful individuals feel less pain and evoke greater deactivation of brain regions supporting the engagement sensory, cognitive, and affective appraisals. We propose that mindfulness and the posterior cingulate cortex should be considered as important mechanistic targets for pain therapies.
Source : Journal Pain
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The Effect of Mind-Body Therapies on Insomnia: A Systematic Review and Meta-Analysis
Xiang Wang,1 Peihuan Li,1 Chen Pan,1 Lisha Dai,1 Yan Wu,1 and Yunlong Deng
Background/Purpose. Sleep plays an important role in individuals’ health. The functions of the brain, the cardiovascular system, the immune system, and the metabolic system are closely associated with sleep. As a prevalent sleep disorder, insomnia has been closely concerned, and it is necessary to find effective therapies. In recent years, a growing body of studies has shown that mind-body therapies (MBTs) can improve sleep quality and ameliorate insomnia severity. However, a comprehensive and overall systematic review has not been conducted. In order to examine the effect of MBTs on insomnia, we conducted a systematic review and meta-analysis evaluating the effects of MBTs on sleep quality in healthy adults and clinical populations.
Methods. PubMed, EMBASE, the Cochrane Library, and review of references were searched up to July 2018. English language studies of all designs evaluating the effect of MBTs on sleep outcomes in adults with or without diseases were examined. To calculate the SMDs and 95% CIs, we used a fixed effect model when heterogeneity was negligible and a random effect model when heterogeneity was significant.
Results. 49 studies covering 4506 participants published between 2004 and 2018 were identified. Interventions included meditation, tai chi, qigong, and yoga which lasted 4 to 24 weeks. The MBTs resulted in statistically significant improvement in sleep quality and reduction on insomnia severity but no significant effects on sleep quantity indices, which were measured by sleep diary or objective measures. We analyzed the effects of tai chi and qigong separately as two different MBTs for the first time and found that qigong had a slight advantage over tai chi in the improvement of sleep quality. Subgroup analyses revealed that the effect of MBTs on sleep quality in healthy individuals was larger than clinical populations. The effect of MBTs might be influenced by the intervention duration but not the frequency.
Conclusions. MBTs can be effective in treating insomnia and improving sleep quality for healthy individuals and clinical patients. More high-quality and well-controlled RCTs are needed to make a better conclusion in further study.
Source : Evidence Based Complementary and Alternative Medicine Journal
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Individualized Metacognitive Training (MCT+) Reduces Delusional Symptoms in Psychosis: A Randomized Clinical Trial
Ryan P. Balzan*,1 , Julie K. Mattiske1 , Paul Delfabbro2 , Dennis Liu3,4 , and Cherrie Galletly
Individualized metacognitive training (MCT+) is a novel psychotherapy that has been designed to specifically target delusional beliefs in people with psychosis. It works by developing an awareness of the implausible content of delusional beliefs, while also targeting the cognitive biases that contribute to their formation and maintenance. It was expected that MCT+ would lead to significantly greater reductions in delusional severity compared to a cognitive remediation (CR) active control condition. A total of 54 patients with a schizophrenia spectrum disorder and active delusions were randomized into four 2-hourly sessions of MCT+ (n = 27) or CR (n = 27). All participants completed posttreatment assessment, and only 2 participants did not complete 6-month follow-up assessment, resulting in MCT+ (n = 26) and CR (n = 26) for final analysis. The primary outcome measures of delusional and positive symptom severity were assessed rater-blind; secondary outcome assessment was non-blinded and included clinical and cognitive insight, the jumping to conclusions (JTC) bias, and cognitive functioning. Participants in the MCT+ condition showed significant reductions in delusional and overall positive symptom severity (large effect) and improved clinical insight (moderate effect) relative to CR controls. In contrast, CR controls showed moderate improvement in problem-solving ability relative to MCT+, but no other cognitive domain. Importantly, these findings were maintained at 6-month follow-up. The study adds further efficacy to the MCT program, and suggests that even brief psychotherapy can help to ameliorate the symptoms of psychosis.
Source : Journal of Psychosis and Related Disorders
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Mindfulness-based cognitive therapy for headache pain: An evaluation of the long-term maintenance of effects
Melissa A.Dayac Beverly E.Thorn
This study aimed to examine the durability of gain patterns following an 8-week Mindfulness-Based Cognitive Therapy (MBCT) for headache pain program.
A secondary analysis of a randomized controlled trial was conducted. Participants (N = 19) were individuals with headache pain who completed both the MBCT program as well as a 6-month follow-up assessment at a headache clinic or a university psychology clinic. Standardized measures of the primary outcomes (pain intensity and pain interference) and secondary outcomes (pain catastrophizing, mindfulness, activity engagement, pain willingness, and self-efficacy) were administered. Paired-samples t tests and effect sizes were examined.
Significant (uncorrected ps < .05) pre- to post-treatment gains were found for pain intensity, pain interference, pain catastrophizing, activity engagement and self-efficacy, and these gains were maintained at 6-months post-treatment. Effect sizes for the significant changes from pre- to post-treatment, and from pre-treatment to follow-up were mostly consistent across epochs (.62 ≤ ds ≤ −1.40), indicating steady maintenance of effects. Improvement in mindfulness and pain willingness was non-significant immediately post-treatment and at follow-up, with small effects observed.
This study adds to a growing body of literature supporting the durability of MBCT for painful conditions. Results indicated a consistent pattern of maintenance of treatment-related gains across a number of key pain-related outcomes. Future research with a larger sample is needed to investigate the mechanisms underlying these continued gains in order to optimize targeted relapse-prevention.
Source Complementary Therapies in Medicine
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Effectiveness of group art therapy on quality of life in paediatric patients with cancer: A randomized controlled trial
Deldar Morad Abdulah a Bayar Mohammed Omar
Children with cancer undergoing chemotherapy experience many adverse effects. The effectiveness of painting- and handcrafting-based art therapy on the various dimensions of health-related quality of life in paediatricoutpatients previously diagnosed with heterogeneity of malignancy was evaluated in the present study.
In an experimental randomized controlled trial, a total of 60 children aged 7–13 years previously diagnosed with malignancy together with their parents were assigned randomly either to an experimental (30 patients) or a control group (30 patients) in 2017 in Iraq. The patients in the experimental group participated in painting and handcrafting group art therapy (creative art therapy) conducted by a professional fine artist for a one-month period. The dimensions of health-related quality of life in both study groups were measured through the KIDSCREEN-10 Index after project completion.
The patients in the experimental group were significantly more physically active and energetic (P < 0.001), were less depressed and emotional, and had fewer stressful feelings (P = 0.004). Moreover, they enjoyed their social and leisure time more and participated more in social activities (P = 0.003) in addition to an improvement in their relationships with other children (P = 0.043) and had better overall health status (P < 0.001). However, the children’s overall interaction with other children, parents, and healthcare providers (P = 0.074) and their perception of cognitive capacity for school performance (P = 0.257) were not significantly different between the two groups.
The findings of the study suggest that exposure to painting- and handcrafting-based art therapy improves the overall health-related quality of life in children with cancer.
Source : Complementary Therapies in Medicine
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Reduced Symptoms of Post-traumatic Stress Disorder and Irritable Bowel Syndrome Following Mindfulness-Based Stress Reduction Among Veterans
Kaitlin Harding, , Tracy Simpson, , and David J. Kearney
Objectives: Post-traumatic stress disorder (PTSD) and irritable bowel syndrome (IBS) are highly comorbid conditions associated with reduced health-related quality of life. Comorbid prevalence is especially high among veterans, ranging from 23% to 51%, but there is limited research on integrative treatments.
Design: To improve treatment of comorbid PTSD and IBS, this study examined the impact of mindfulness-based stress reduction (MBSR) on symptom reduction and mindfulness skill building among veterans with this comorbidity. We hypothesized that veterans would report reduced trauma-related, gastrointestinal (GI) symptom-specific anxiety (GSA), and depression symptoms and greater mindfulness skills post-treatment. We also hypothesized that veterans who reported lower trauma-related GSA and depression symptoms, and reported greater mindfulness skills and MBSR session attendance would report lower irritable bowel symptoms post-treatment.
Settings/Location: VA (Veterans Administration) Puget Sound Health Care System, Seattle, Washington.
Subjects: Participants were 55 veterans with PTSD and IBS.
Interventions: Veterans participated in an 8-week open trial of MBSR group.
Outcome measures: This study measured the impact of MBSR on PTSD, IBS, GSA, and depression symptoms as well as mindfulness skills.
Results: Veterans reported reduced trauma-related, irritable bowel, GSA, and depression symptoms and greater mindfulness skills immediately post-treatment. Trauma-related and depression symptom reduction were maintained 4 months post-treatment, but irritable bowel and GSA symptoms were nonsignificant. Lower baseline GSA predicted lower irritable bowel symptoms immediately post-treatment. At 4 months post-treatment, 77.50% met PTSD criteria and 40.38% met IBS criteria compared with 100% veteran comorbidity pretreatment.
Conclusions: MBSR holds promise as a transdiagnostic intervention for individuals with comorbid trauma-related, depression, GSA, and irritable bowel symptoms, with maintenance of trauma-related and depression symptom improvement 4 months post-treatment.
Source : Journal Alternative and Complementary Medicine
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Internet-Delivered Cognitive-Behavioral Therapy for Insomnia in Breast Cancer Survivors: A Randomized Controlled Trial
Robert Zachariae Ali Amidi Malene F Damholdt Cecilie D R ClausenJesper Dahlgaard Holly Lord Frances P Thorndike Lee M Ritterband
Insomnia is two to three times more prevalent in cancer survivors than in the general population, where it is estimated to be 10% to 20%. Cognitive-behavioral therapy for insomnia (CBT-I) is the recommended treatment for chronic insomnia, but meeting survivor needs remains a challenge. Internet-delivered CBT-I (iCBT-I) has been shown efficacious in otherwise healthy adults. We tested the efficacy of iCBT-I in breast cancer survivors with clinically significant sleep disturbance.
Women from a national sample of Danish breast cancer survivors who experienced clinically significant sleep disturbance were randomly allocated to iCBT-I or waitlist control (55:45). The fully automated iCBT-I program consisted of six cores. Online measures of insomnia severity, sleep quality, and fatigue were collected at baseline, postintervention (nine weeks), and follow-up (15 weeks). Online sleep diaries were completed over two-week periods pre- and postintervention. Intention-to-treat analyses (time × group interactions) were conducted with mixed linear models and corrected for multiple outcomes. All statistical tests were two-sided.
A total of 255 women were randomly allocated to iCBT-I (n = 133) or waitlist control (n = 122). Statistically significant (P ≤ .02) time × group interactions were found for all sleep-related outcomes from pre- to postintervention. Effect sizes (Cohen’s d) ranged from 0.33 (95% confidence interval [CI] = 0.06 to 0.61) for wake after sleep onset to 1.17 (95% CI = 0.87 to 1.47) for insomnia severity. Improvements were maintained for outcomes measured at follow-up (d = 0.66–1.10).
iCBT-I appears to be effective in breast cancer survivors, with additional benefit in terms of reduced fatigue. This low-cost treatment could be incorporated in cancer rehabilitation programs.
Source : Journal of the National Cancer Institute
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Listening to yoga music at bedtime is good for the heart
Dr Naresh Sen, study author, Consultant Cardiologist at HG SMS Hospital, Jaipur, India, said: “We use music therapy in our hospital and in this study we showed that yoga music has a beneficial impact on heart rate variability before sleeping.”
Previous research has shown that music can reduce anxiety in patients with heart disease. (2) However, studies on the effects of music on the heart in patients and healthy individuals have produced inconsistent results, partly they did not state what style of music was used.
The body’s heart rate changes as a normal response to being in “fight or flight” or “rest and digest” mode. These states are regulated by the sympathetic and parasympathetic nervous systems, respectively, and together comprise the autonomic nervous system. High heart rate variability shows that the heart is able to adapt to these changes. Conversely, low heart rate variability indicates a less adaptive autonomic nervous system.
Low heart rate variability is associated with a 32–45% higher risk of a first cardiovascular event. (3) Following a cardiovascular event, people with low heart rate variability have a raised risk of subsequent events and death. Failure of the autonomic nervous system to adapt may trigger inflammation, which is linked to cardiovascular disease. Another possibility is that people with low heart rate variability already have subclinical cardiovascular disease.
This study investigated the impact of listening to yoga music, which is a type of soothing or meditative music, before bedtime on heart rate variability. The study included 149 healthy people who participated in three sessions on separate nights: (1) yoga music before sleep at night; (2) pop music with steady beats before sleep at night; and (3) no music or silence before sleep at night.
At each session, heart rate variability was measured (4) for five minutes before the music or silence started, for ten minutes during the music/silence, and five minutes after it had stopped. In addition, anxiety levels were assessed before and after each session using the Goldberg Anxiety Scale. The level of positive feeling was subjectively measured after each session using a visual analogue scale.
The average age of participants was 26 years. The researchers found that heart rate variability increased during the yoga music, decreased during the pop music, and did not significantly change during the silence.
Anxiety levels fell significantly after the yoga Sour, rose significantly post the pop music, and increased after the no music session. Participants felt significantly more positive after the yoga music than they did after the pop music.
Dr Sen noted that holistic therapies such as music cannot replace evidence-based drugs and interventions, and should only be used as an add-on.
He said: “Science may have not always agreed, but Indians have long believed in the power of various therapies other than medicines as a mode of treatment for ailments. This is a small study, and more research is needed on the cardiovascular effects of music interventions offered by a trained music therapist. But listening to soothing music before bedtime is a cheap and easy to implement therapy that cannot cause harm.”
Source : European Society of Cardiology
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The Effects of Music Intervention on Sleep Quality in Community-Dwelling Elderly
Wang Qun, Chair Sek Ying, Wong Eliza Mi Ling, and Li Xiaomei.
Objectives: To examine the effects of music intervention on sleep quality in community-dwelling elderly people.
Design: Two-armed randomized controlled trial.
Settings: Four urban communities in Xi`an, China.
Participants: People aged 60 years or older with poor sleep quality (Pittsburgh Sleep Quality Index [PSQI] score >7).
Interventions: All participants received one sleep hygiene education session and biweekly telephone calls. Each participant in the intervention group received an MP3 player with a music database. The participants selected the preferred music and listened for 30–45 minutes per night for 3 months.
Outcome measures: Sleep quality, the main study outcome, was measured by PSQI at baseline, 1 month, 2 months, and 3 months.
Results: Sixty-four elderly people with a mean age of 69.38 ± 5.46 years were randomly assigned to the control group (n = 32) or the intervention group (n = 32). All participants completed the study, and none reported discomfort related to the music intervention. The intervention group demonstrated continuous improvements in sleep quality, with a global PSQI score of 13.53 at baseline, 9.28 at 1 month, 8.28 at 2 months, and 7.28 at 3 months. Although the global PSQI score in the control group also decreased from 12.26 at baseline to 8.72 at 3 months, the intervention group achieved greater improvements at each measurement (all p < 0.05). Repeated-measures analysis of variance revealed significant group-by-time interaction effects in global PSQI score and three component scores: sleep latency, sleep efficiency, and daytime dysfunction (all p < 0.05).
Conclusion: Music is a safe and effective nonpharmacological intervention for improving the sleep quality of community-dwelling elderly people, especially in improving sleep latency, sleep efficiency, and daytime dysfunction.
Source : Journal Alternative and Complementary Medicine
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Neural Processing of Emotional Musical and Nonmusical Stimuli in Depression
- Rebecca J. Lepping ,
- Ruth Ann Atchley,
- Evangelia Chrysikou,
- Laura E. Martin,
- Alicia A. Clair,
- Rick E. Ingram,
- W. Kyle Simmons,
- Cary R. Savage
Anterior cingulate cortex (ACC) and striatum are part of the emotional neural circuitry implicated in major depressive disorder (MDD). Music is often used for emotion regulation, and pleasurable music listening activates the dopaminergic system in the brain, including the ACC. The present study uses functional MRI (fMRI) and an emotional nonmusical and musical stimuli paradigm to examine how neural processing of emotionally provocative auditory stimuli is altered within the ACC and striatum in depression.
Nineteen MDD and 20Sou never-depressed (ND) control participants listened to standardized positive and negative emotional musical and nonmusical stimuli during fMRI scanning and gave subjective ratings of valence and arousal following scanning.
ND participants exhibited greater activation to positive versus negative stimuli in ventral ACC. When compared with ND participants, MDD participants showed a different pattern of activation in ACC. In the rostral part of the ACC, ND participants showed greater activation for positive information, while MDD participants showed greater activation to negative information. In dorsal ACC, the pattern of activation distinguished between the types of stimuli, with ND participants showing greater activation to music compared to nonmusical stimuli, while MDD participants showed greater activation to nonmusical stimuli, with the greatest response to negative nonmusical stimuli. No group differences were found in striatum.
These results suggest that people with depression may process emotional auditory stimuli differently based on both the type of stimulation and the emotional content of that stimulation. This raises the possibility that music may be useful in retraining ACC function, potentially leading to more effective and targeted treatments.
Source : PLOSOne
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Effects of Group Drumming Interventions on Anxiety, Depression, Social Resilience and Inflammatory Immune Response among Mental Health Service Users
Growing numbers of mental health organizations are developing community music-making interventions for service users; however, to date there has been little research into their efficacy or mechanisms of effect. This study was an exploratory examination of whether 10 weeks of group drumming could improve depression, anxiety and social resilience among service users compared with a non-music control group (with participants allocated to group by geographical location.) Significant improvements were found in the drumming group but not the control group: by week 6 there were decreases in depression (-2.14 SE 0.50 CI -3.16 to -1.11) and increases in social resilience (7.69 SE 2.00 CI 3.60 to 11.78), and by week 10 these had further improved (depression: -3.41 SE 0.62 CI -4.68 to -2.15; social resilience: 10.59 SE 1.78 CI 6.94 to 14.24) alongside significant improvements in anxiety (-2.21 SE 0.50 CI -3.24 to -1.19) and mental wellbeing (6.14 SE 0.92 CI 4.25 to 8.04). All significant changes were maintained at 3 months follow-up. Furthermore, it is now recognised that many mental health conditions are characterised by underlying inflammatory immune responses. Consequently, participants in the drumming group also provided saliva samples to test for cortisol and the cytokines interleukin (IL) 4, IL6, IL17, tumour necrosis factor alpha (TNFα), and monocyte chemoattractant protein (MCP) 1. Across the 10 weeks there was a shift away from a pro-inflammatory towards an anti-inflammatory immune profile. Consequently, this study demonstrates the psychological benefits of group drumming and also suggests underlying biological effects, supporting its therapeutic potential for mental health
Source : PLOS One
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The Effects of Perioperative Music Interventions in Pediatric Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
- Marianne J. E. van der Heijden ,
- Sadaf Oliai Araghi,
- Monique van Dijk,
- Johannes Jeekel,
- M. G. Myriam Hunink
Music interventions are widely used, but have not yet gained a place in guidelines for pediatric surgery or pediatric anesthesia. In this systematic review and meta-analysis we examined the effects of music interventions on pain, anxiety and distress in children undergoing invasive surgery.
We searched 25 electronic databases from their first available date until October 2014.
Included were all randomized controlled trials with a parallel group, crossover or cluster design that included pediatric patients from 1 month to 18 years old undergoing minimally invasive or invasive surgical procedures, and receiving either live music therapy or recorded music.
Data Extraction and Synthesis
4846 records were retrieved from the searches, 26 full text reports were evaluated and data was extracted by two independent investigators.
Main Outcome Measures
Pain was measured with the Visual Analogue Scale, the Coloured Analogue Scale and the Facial Pain Scale. Anxiety and distress were measured with an emotional index scale (not validated), the Spielberger short State Trait Anxiety Inventory and a Facial Affective Scale.
Three RCTs were eligible for inclusion encompassing 196 orthopedic, cardiac and day surgery patients (age of 1 day to 18 years) receiving either live music therapy or recorded music. Overall a statistically significant positive effect was demonstrated on postoperative pain (SMD -1.07; 95%CI-2.08; -0.07) and on anxiety and distress (SMD -0.34 95% CI -0.66; -0.01 and SMD -0.50; 95% CI -0.84; - 0.16.
Conclusions and Relevance
This systematic review and meta-analysis indicates that music interventions may have a statistically significant effect in reducing post-operative pain, anxiety and distress in children undergoing a surgical procedure. Evidence from this review and other reviews suggests music therapy may be considered for clinical use.
Source : PLOS One
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Effect of Mindfulness-Based Stress Reduction vs Cognitive Behavioral Therapy or Usual Care on Back Pain and Functional Limitations in Adults With Chronic Low Back PainA Randomized Clinical Trial
Daniel C. Cherkin, PhD1,2,3; Karen J. Sherman, PhD1,4; Benjamin H. Balderson, PhD1; Andrea J. Cook, PhD1,5; Melissa L. Anderson, MS1; Rene J. Hawkes, BS1; Kelly E. Hansen, BS1; Judith A. Turner, PhD6,7
Importance Mindfulness-based stress reduction (MBSR) has not been rigorously evaluated for young and middle-aged adults with chronic low back pain.
Objective To evaluate the effectiveness for chronic low back pain of MBSR vs cognitive behavioral therapy (CBT) or usual care.
Design, Setting, and Participants Randomized, interviewer-blind, clinical trial in an integrated health care system in Washington State of 342 adults aged 20 to 70 years with chronic low back pain enrolled between September 2012 and April 2014 and randomly assigned to receive MBSR (n = 116), CBT (n = 113), or usual care (n = 113).
Interventions CBT (training to change pain-related thoughts and behaviors) and MBSR (training in mindfulness meditation and yoga) were delivered in 8 weekly 2-hour groups. Usual care included whatever care participants received.
Main Outcomes and Measures Coprimary outcomes were the percentages of participants with clinically meaningful (≥30%) improvement from baseline in functional limitations (modified Roland Disability Questionnaire [RDQ]; range, 0-23) and in self-reported back pain bothersomeness (scale, 0-10) at 26 weeks. Outcomes were also assessed at 4, 8, and 52 weeks.
Results There were 342 randomized participants, the mean (SD) [range] age was 49.3 (12.3) [20-70] years, 224 (65.7%) were women, mean duration of back pain was 7.3 years (range, 3 months-50 years), 123 (53.7%) attended 6 or more of the 8 sessions, 294 (86.0%) completed the study at 26 weeks, and 290 (84.8%) completed the study at 52 weeks. In intent-to-treat analyses at 26 weeks, the percentage of participants with clinically meaningful improvement on the RDQ was higher for those who received MBSR (60.5%) and CBT (57.7%) than for usual care (44.1%) (overall P = .04; relative risk [RR] for MBSR vs usual care, 1.37 [95% CI, 1.06-1.77]; RR for MBSR vs CBT, 0.95 [95% CI, 0.77-1.18]; and RR for CBT vs usual care, 1.31 [95% CI, 1.01-1.69]). The percentage of participants with clinically meaningful improvement in pain bothersomeness at 26 weeks was 43.6% in the MBSR group and 44.9% in the CBT group, vs 26.6% in the usual care group (overall P = .01; RR for MBSR vs usual care, 1.64 [95% CI, 1.15-2.34]; RR for MBSR vs CBT, 1.03 [95% CI, 0.78-1.36]; and RR for CBT vs usual care, 1.69 [95% CI, 1.18-2.41]). Findings for MBSR persisted with little change at 52 weeks for both primary outcomes.
Conclusions and Relevance Among adults with chronic low back pain, treatment with MBSR or CBT, compared with usual care, resulted in greater improvement in back pain and functional limitations at 26 weeks, with no significant differences in outcomes between MBSR and CBT. These findings suggest that MBSR may be an effective treatment option for patients with chronic low back pain.
Source : JAMA
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Mindfulness Meditation Relieves Pain, but Works Differently Than Opioids in the Body
Previous research has shown that mindfulness meditation helps relieve pain, but researchers have been unclear about how the practice induces pain relief—specifically, if meditation is associated with the release of naturally occurring opiates. Results from a new study, funded in part by the National Center for Complementary and Integrative Health, demonstrate that mindfulness meditation does not rely on the endogenous opioid activity to reduce pain, which is an important consideration for using meditation to treat chronic pain. The study, conducted by researchers at Wake Forest School of Medicine and Cincinnati Children’s Hospital Medical Center, was published in The Journal of Neuroscience.
Researchers recorded pain reports in 78 healthy adults during meditation or a non-meditation control in response to painful heat stimuli and intravenous administration of the opioid antagonist naloxone (a drug that blocks the transmission of opioid activity) or placebo saline. Participants were randomized to one of four treatment groups: 1) meditation plus naloxone; 2) control plus naloxone; 3) meditation plus saline; or 4) control plus saline. People in the control groups were instructed to “close your eyes and relax until the end of the experiment.”
The researchers found that participants who meditated during saline administration had significantly lower pain intensity and unpleasantness ratings compared to those who did not meditate while receiving saline. Importantly, data from the meditation plus naloxone group showed that naloxone did not block meditation’s pain-relieving effects. No significant differences in reductions of pain intensity or pain unpleasantness were seen between the meditation plus naloxone and the meditation plus saline groups. Participants who meditated during naloxone administration also had significantly greater reductions in pain intensity and unpleasantness than the control groups.
These findings demonstrate that mindfulness meditation reduces pain independently of opioid neurotransmitter mechanisms. The researchers noted that because opioid and non-opioid mechanisms of pain relief interact synergistically, the results of this study suggest that combining mindfulness-based and pharmacologic/nonpharmacologic pain-relieving approaches that rely on opioid signaling may be particularly effective in treating pain.
- Zeidan F, Adler-Neal AL, Wells RE, et al. Mindfulness-meditation-based pain relief is not mediated by endogenous opioids. Journal of Neuroscience. March 26, 2016. Epub ahead of print.
Source : NIH National Centres for Complementary and Integrative Health
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Everyday mindfulness linked to healthy glucose levels
Brown University researchers investigating how mindfulness may affect cardiovascular health have measured a significant association between a high degree of ‘everyday’ mindfulness and a higher likelihood of having normal, healthy glucose levels. Their analysis showed that a lower risk of obesity and greater sense of control among more mindful people may play mediating roles.
PROVIDENCE, R.I. [Brown University] —Dispositional, or “everyday” mindfulness is the inherent trait of being aware of one’s present thoughts and feelings. In a new study of 399 people that measured health indicators including dispositional mindfulness and blood glucose, researchers found that those with higher scores for mindfulness were significantly more likely than people with low scores to have healthy glucose levels.
The results show an association and do not prove a cause, but they are part of a program led by Brown University where researchers are studying whether interventions that increase mindfulness can improve cardiovascular health. Their overarching hypotheses are that people practicing higher degrees of mindfulness may be better able to motivate themselves to exercise, to resist cravings for high-fat, high-sugar treats, and to stick with diet and exercise regimens recommended by their doctors.
The researchers therefore sought to identify factors that might explain the connection they saw between higher mindfulness and healthier glucose levels. Their analysis of the data showed that obesity risk (mindful people are less likely to be obese) and sense of control (mindful people are more likely to believe they can change many of the important things in their life) both contribute to the link.
“This study demonstrated a significant association of dispositional mindfulness with glucose regulation, and provided novel evidence that obesity and sense of control may serve as potential mediators of this association,” wrote the authors led by Eric Loucks, assistant professor of epidemiology in the Brown University School of Public Health. “As mindfulness is likely a modifiable trait, this study provides preliminary evidence for a fairly novel and modifiable potential determinant of diabetes risk.”
The study, published in the American Journal of Health Behavior, did not show a direct, statistically significant link between mindfulness and type 2 diabetes risk, which is the medical concern related to elevated blood glucose. Participants with high levels of mindfulness were about 20 percent less likely to have type 2 diabetes, but the total number of people in the study with the condition may have been too small to allow for definitive findings, Loucks said.
Measuring mindfulness, gauging glucose
To gather their data, Loucks and his team enrolled 399 volunteers who’ve been participating in the New England Family Study. The subjects participated in several psychological and physiological tests including glucose tests and the Mindful Attention Awareness Scale (MAAS), a 15-item questionnaire to assess dispositional mindfulness on a 1 to 7 scale. The researchers also collected data on a host of other potentially relevant demographic and health traits including body-mass index, smoking, education, depression, blood pressure, perceived stress, and sense of control.
After adjusting their data to account for such confounding factors as age, sex, race or ethnicity, family history of diabetes, and childhood socioeconomic status, the researchers found that people with high MAAS scores of 6 or 7 were 35 percent more likely to have healthy glucose levels under 100 milligrams per deciliter than people with low MAAS scores below 4.
The analysis found that obesity made about a 3-percentage point difference of the total 35-percent point risk difference. Sense of control accounted for another 8 percentage points of the effect. The rest may derive from factors the study didn’t measure, but at least now researchers have begun to elucidate the possible mechanisms that link mindfulness to glucose regulation.
“There’s been almost no epidemiological observational study investigations on the relationship of mindfulness with diabetes or any cardiovascular risk factor,” Loucks said. “This is one of the first. We’re getting a signal. I’d love to see it replicated in larger sample sizes and prospective studies as well.”
Source : Brown University
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Mind–Body Approaches to Treating Mental Health Symptoms Among Disadvantaged Populations: A Comprehensive Review
Mind–body approaches are commonly used to treat a variety of chronic health conditions, including depression and anxiety. A substantial proportion of individuals with depression and anxiety disorders do not receive conventional treatment; disadvantaged individuals are especially unlikely to receive treatment. Mind–body approaches offer a potentially more accessible and acceptable alternative to conventional mental health treatment for disadvantaged individuals, who may not otherwise receive mental health treatment. This review examines evidence for the efficacy of mind–body interventions for mental health symptoms among disadvantaged populations. While rates of utilization were relatively lower for racial/ethnic minorities, evidence suggests that significant proportions of racial/ethnic minorities are using complementary health approaches as health treatments, especially prayer/healers and natural or herbal remedies. This review of studies on the efficacy of mind–body interventions among disadvantaged populations found evidence for the efficacy of mind–body approaches for several mental and physical health symptoms, functioning, self-care, and overall quality of life.
.....The reviewed studies provide preliminary evidence of the feasibility and acceptability of mindfulness-based interventions among high-risk disadvantaged populations. The studies of MBSR among disadvantaged individuals reported program completion rates ranging from 66% to 70%,57,61,64 which is slightly higher than retention rates that have been reported for other evidence-based mental health treatments. These relatively high completion rates are particularly significant given the time-intensive nature of MBSR. Rates of completion were similarly high among incarcerated individuals (69%).53 Furthermore, several studies indicated that participants believed the skills they acquired were important; they were interested and willing to practice MBSR techniques on their own, even after intervention ended; and the mindfulness techniques they learned became an integral part of their lives......Finally, one study showed that practicing mindfulness can lead to substantial changes in mental and physical well-being even when the implementation time period is shortened
Source : Journal Alternative and Complementary Medicine
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Imaging-Guided Core-Needle Breast Biopsy: Impact of Meditation and Music Interventions on Patient Anxiety, Pain, and Fatigue
Mary Scott Soo, MD Jennifer A. Jarosz, MD Anava A. Wren, PhD Adrianne E. Soo, BS, Yvonne M. Mowery, MD, PhD ,
Karen S. Johnson, MD, Sora C. Yoon, MD, Connie Kim, MD , E. Shelley Hwang, MD, MPH,Francis J. Keefe, PhD, Rebecca A. Shelby, PhD
Purpose To evaluate the impact of guided meditation and music interventions on patient anxiety, pain, and fatigue during imaging-guided breast biopsy.
After giving informed consent, 121 women needing percutaneous imaging-guided breast biopsy were randomized into three groups: (1) guided meditation; (2) music; (3) standard-care control group. During biopsy, the meditation and music groups listened to an audio-recorded, guided, loving-kindness meditation and relaxing music, respectively; the standard-care control group received supportive dialogue from the biopsy team. Immediately before and after biopsy, participants completed questionnaires measuring anxiety (State-Trait Anxiety Inventory Scale), biopsy pain (Brief Pain Inventory), and fatigue (modified Functional Assessment of Chronic Illness Therapy-Fatigue). After biopsy, participants completed questionnaires assessing radiologist–patient communication (modified Questionnaire on the Quality of Physician–Patient Interaction), demographics, and medical history.
The meditation and music groups reported significantly greater anxiety reduction (P values < .05) and reduced fatigue after biopsy than the standard-care control group; the standard-care control group reported increased fatigue after biopsy. The meditation group additionally showed significantly lower pain during biopsy, compared with the music group (P = .03). No significant difference in patient-perceived quality of radiologist–patient communication was noted among groups.
Listening to guided meditation significantly lowered biopsy pain during imaging-guided breast biopsy; meditation and music reduced patient anxiety and fatigue without compromising radiologist–patient communication. These simple, inexpensive interventions could improve women’s experiences during core-needle breast biopsy.
Source : Journal of The American College of Radiology
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Mindfulness-Based Intervention for Adolescents with Recurrent Headaches: A Pilot Feasibility Study
Toni Hesse,1 Laura G. Holmes,2 Vicki Kennedy-Overfelt,3 Lynne M. Kerr,4 andLisa L. Giles5
Recurrent headaches cause significant burden for adolescents and their families. Mindfulness-based interventions (MBIs) have been shown to reduce stress and alter the experience of pain, reduce pain burden, and improve quality of life. Research indicates that MBIs can benefit adults with chronic pain conditions including headaches. A pilot nonrandomized clinical trial was conducted with 20 adolescent females with recurrent headaches. Median class attendance was 7 of 8 total sessions; average class attendance was 6.10 + 2.6 . Adherence to home practice was good, with participants reporting an average of 4.69 (SD = 1.84) of 6 practices per week. Five participants dropped out for reasons not inherent to the group (e.g., extracurricular scheduling); no adverse events were reported. Parents reported improved quality of life and physical functioning for their child. Adolescent participants reported improved depression symptoms and improved ability to accept their pain rather than trying to control it. MBIs appear safe and feasible for adolescents with recurrent headaches. Although participants did not report decreased frequency or severity of headache following treatment, the treatment had a beneficial effect for depression, quality of life, and acceptance of pain and represents a promising adjunct treatment for adolescents with recurrent headaches.
Source : Evidence Based Complementary and Alternative Medicine
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Playing a Musical Instrument as a Protective Factor against Dementia and Cognitive Impairment: A Population-Based Twin Study
M. Alison Balbag,1 Nancy L. Pedersen,2,3 and Margaret Gatz2,3
Increasing evidence supports that playing a musical instrument may benefit cognitive development and health at young ages. Whether playing an instrument provides protection against dementia has not been established. In a population-based cotwin control study, we examined the association between playing a musical instrument and whether or not the twins developed dementia or cognitive impairment. Participation in playing an instrument was taken from informant-based reports of twins’ leisure activities. Dementia diagnoses were based on a complete clinical workup using standard diagnostic criteria. Among 157 twin pairs discordant for dementia and cognitive impairment, 27 pairs were discordant for playing an instrument. Controlling for sex, education, and physical activity, playing a musical instrument was significantly associated with less likelihood of dementia and cognitive impairment (odds ratio [OR] = 0.36 [95% confidence interval 0.13–0.99]). These findings support further consideration of music as a modifiable protective factor against dementia and cognitive impairment.
Source : Intl Journal of Alzheimer's Disease
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Treating Depressive Symptoms in Psychosis: A Network Meta-Analysis on the Effects of Non-Verbal Therapies
The aim of this study was to examine whether non-verbal therapies are effective in treating depressive symptoms in psychotic disorders.
Material and Methods
A systematic literature search was performed in PubMed, Psychinfo, Picarta, Embase and ISI Web of Science, up to January 2015. Randomized controlled trials (RCTs) comparing a non-verbal intervention to a control condition in patients with psychotic disorders, whilst measuring depressive symptoms as a primary or secondary outcome, were included. The quality of studies was assessed using the ‘Clinical Trials Assessment Measure for psychological treatments’ (CTAM) scale. Cohen’s d was calculated as a measure of effect size. Using a Network Meta-analysis, both direct and indirect evidence was investigated.
10 RCTs were included, of which three were of high quality according to the CTAM. The direct evidence demonstrated a significant effect on the reduction in depressive symptoms relative to treatment as usual (TAU), in favor of overall non-verbal therapy (ES: -0.66, 95% C.I. = -0.88, -0.44) and music therapy (ES: -0.59, 95% C.I. = -0.85, -0.33). Combining both direct and indirect evidence, yoga therapy (ES: -0.79, 95% C.I. = -1.24, -0.35) had a significant effect on depressive symptoms, and occupational therapy (ES: 1.81, 95% C.I. = 0.81, 2.81) was less effective, relative to TAU. Exercise therapy did not show a significant effect on depressive symptoms in comparison to TAU (ES: -0.02 95% C.I. = -0.67, 0.62). Due to inconsistency of study evidence, the indirect effects should be interpreted cautiously.
Non-verbal therapies appear to be effective in reducing depressive symptomatology in psychotic disorders, in particular music therapy and yoga therapy.
Source : PLOSone
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A Randomized Controlled Trial for the Effectiveness of Progressive Muscle Relaxation and Guided Imagery as Anxiety Reducing Interventions in Breast and Prostate Cancer Patients Undergoing Chemotherapy
Andreas Charalambous,1 Margarita Giannakopoulou,2 Evangelos Bozas,2 and Lefkios Paikousis3
Objective. To test the effectiveness of guided imagery (GI) and progressive muscle relaxation (PMR) as stress reducing interventions in patients with prostate and breast cancer who undergo chemotherapy.
Methods. Patients were randomly assigned to either the control group or the intervention group (PMR and GI). Patients were observed for a total duration of 3 weeks and assessed with the SAS and BECK-II questionnaires for anxiety and depression, respectively, in addiotion to two biological markers (saliva cortisol and saliva amylase) (trial registration number: NCT01275872).
Results. 256 patients were registered and 236 were randomly assigned. In total 104 were randomised to the control group and 104 to the intervention group. Intervention’s mean anxiety score and depression score changes were significantly different compared to the control’s (b=-29.4, p<0.001. b=-29.4,p<0.001 resp). Intervention group’s cortisol levels before the intervention (0.30+0.25) gradually decreased up to week 3 (0.16+0.18), whilst the control group’s cortisol levels before the intervention (0.21+0.22) gradually increased up to week 3 (0.44+0.35). The same interaction appears for the Amylase levels (p<0.001).
Conclusions. The findings showed that patients with prostate and breast cancer undergoing chemotherapy treatment can benefit from PMR and GI sessions to reduce their anxiety and depression.
Source : Evidence Based Complementary and Alternative Medicine
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Can Music Help People with Epilepsy?
Scans show brainwaves of those with disorder appear to synchronize with music
The brains of people with epilepsy appear to react to music differently from the brains of those who do not have the disorder, a finding that could lead to new therapies to prevent seizures, according to research presented at the American Psychological Association’s 123rd Annual Convention.
“We believe that music could potentially be used as an intervention to help people with epilepsy,” said Christine Charyton, PhD, adjunct assistant professor and visiting assistant professor of neurology at The Ohio State University Wexner Medical Center, who presented the research.
Approximately 80 percent of epilepsy cases are what is known as temporal lobe epilepsy, in which the seizures appear to originate in the temporal lobe of the brain. Music is processed in the auditory cortex in this same region of the brain, which was why Charyton wanted to study the effect of music on the brains of people with epilepsy.
Charyton and her colleagues compared the musical processing abilities of the brains of people with and without epilepsy using an electroencephalogram, where electrodes are attached to the scalp to detect and record brainwave patterns. They collected data from 21 patients who were in the epilepsy monitoring unit at The Ohio State University Wexner Medical Center between September 2012 and May 2014.
The researchers recorded brainwave patterns while patients listened to 10 minutes of silence, followed by either Mozart’s Sonata in D Major, Andante Movement II (K448) or John Coltrane’s rendition of My Favorite Things, a second 10-minute period of silence, the other of the two musical pieces and finally a third 10-minute period of silence. The order of the music was randomized, meaning some participants listened to Mozart first and other participants listened to Coltrane first.
The researchers found significantly higher levels of brainwave activity in participants when they were listening to music. More important, said Charyton, brainwave activity in people with epilepsy tended to synchronize more with the music, especially in the temporal lobe, than in people without epilepsy.
“We were surprised by the findings,” said Charyton. “We hypothesized that music would be processed in the brain differently than silence. We did not know if this would be the same or different for people with epilepsy.”
While she does not believe music would replace current epilepsy therapy, Charyton said this research suggests music might be a novel intervention used in conjunction with traditional treatment to help prevent seizures in people with epilepsy.
Source : Newswise
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Laughter and Stress Relief in Cancer Patients: A Pilot Study
S. H. Kim,1 Y. H. Kim,1 and H. J. Kim2
1Department of Nursing, ASAN Medical Center, Seoul 138-736, Republic of Korea
2Department of Preventive Medicine, University of Ulsan College of Medicine, 43-Gil Olympic-ro, Songpa-gu, Seoul 138-736, Republic of Korea
The purpose of this study was to examine the effect of a therapeutic laughter program and the number of program sessions on anxiety, depression, and stress in breast cancer patients. A randomized controlled trial was conducted involving 31 patients who received four sessions of therapeutic laughter program comprised and 29 who were assigned to the no-program control group. Scores for anxiety, depression, and stress were measured using an 11-point numerical rating scale. While no change was detected in the control group, the program group reported reductions of 1.94, 1.84, and 2.06 points for anxiety, depression, and stress, respectively (p<0.01, p<0.01, and p<0.01). Scores decreased significantly after the first therapeutic laughter session (p<0.05, p<0.01, and p<0.01). As the therapeutic laughter program was effective after only a single session in reducing anxiety, depression, and stress in breast cancer patients, it could be recommended as a first-line complementary/alternative therapy.
Source : Evidence Based Complementary and Alternative Medicine
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Effects of Mindfulness Meditation on Chronic Pain: A Randomized Controlled Trial
- Peter la Cour PhD1,* and
- Marian Petersen PhD2
Objective This randomized controlled clinical trial investigated the effects of mindfulness meditation on chronic pain.
Design A total of 109 patients with nonspecific chronic pain were randomized to either a standardized mindfulness meditation program (mindfulness-based stress reduction [MBSR]) or to a wait list control.
Methods Pain, physical function, mental function, pain acceptance, and health-related quality of life were measured. The SF36 vitality scale was chosen as the primary outcome measure; the primary end point was after completing the MBSR course. Within a 2.5-year period, 43 of the 109 randomized patients completed the mindfulness program, while 47 remained in the control group. Data were compared at three time points: at baseline, after completion of the course/waiting period, and at the 6-month follow-up.
Results Significant effect (Cohen's d = 0.39) was found on the primary outcome measure, the SF36 vitality scale. On the secondary variables, significant medium to large size effects (Cohen's d = 0.37–0.71) were found for lower general anxiety and depression, better mental quality of life (psychological well-being), feeling in control of the pain, and higher pain acceptance. Small (nonsignificant) effect sizes were found for pain measures. There were no significant differences in the measures just after the intervention vs the 6-month follow-up.
Conclusion A standardized mindfulness program (MBSR) contributes positively to pain management and can exert clinically relevant effects on several important dimensions in patients with long-lasting chronic pain.
Source : Journal Pain Medicine
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Decreased Symptoms of Depression After Mindfulness-Based Stress Reduction: Potential Moderating Effects of Religiosity, Spirituality, Trait Mindfulness, Sex, and Age
Jeffrey M. Greeson, PhD,1,2,3 Moria J. Smoski, PhD,2 Edward C. Suarez, PhD,1,2 Jeffrey G. Brantley, MD,1,2Andrew G. Ekblad, PhD,4,5 Thomas R. Lynch, PhD,6 and Ruth Quillian Wolever, PhD1,2
1Duke Integrative Medicine, Duke University Medical Center, Durham, NC.
2Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC.
3Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.
4Department of Psychiatry, McMaster University, Hamilton, Ontario, Canada.
5Broadleaf Health, Guelph, Ontario, Canada.
6School of Psychology, University of Southampton, Southampton, United Kingdom.
Objective: Mindfulness-based stress reduction (MBSR) is a secular meditation training program that reduces depressive symptoms. Little is known, however, about the degree to which a participant's spiritual and religious background, or other demographic characteristics associated with risk for depression, may affect the effectiveness of MBSR. Therefore, this study tested whether individual differences in religiosity, spirituality, motivation for spiritual growth, trait mindfulness, sex, and age affect MBSR effectiveness.
Methods: As part of an open trial, multiple regression was used to analyze variation in depressive symptom outcomes among 322 adults who enrolled in an 8-week, community-based MBSR program.
Results: As hypothesized, depressive symptom severity decreased significantly in the full study sample (d=0.57;p<0.01). After adjustment for baseline symptom severity, moderation analyses revealed no significant differences in the change in depressive symptoms following MBSR as a function of spirituality, religiosity, trait mindfulness, or demographic variables. Paired t tests found consistent, statistically significant (p<0.01) reductions in depressive symptoms across all subgroups by religious affiliation, intention for spiritual growth, sex, and baseline symptom severity. After adjustment for baseline symptom scores, age, sex, and religious affiliation, a significant proportion of variance in post-MBSR depressive symptoms was uniquely explained by changes in both spirituality (β=−0.15;p=0.006) and mindfulness (β=−0.17; p<0.001).
Conclusions: These findings suggest that MBSR, a secular meditation training program, is associated with improved depressive symptoms regardless of affiliation with a religion, sense of spirituality, trait level of mindfulness before MBSR training, sex, or age. Increases in both mindfulness and daily spiritual experiences uniquely explained improvement in depressive symptoms.
Source : The Journal of Alternative and Complementary Medicine
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Eight weeks to a better brain - Meditation study shows changes associated with awareness, stress
Participating in an eight-week mindfulness meditation program appears to make measurable changes in brain regions associated with memory, sense of self, empathy, and stress. In a study that will appear in the Jan. 30 issue of Psychiatry Research: Neuroimaging, a team led by Harvard-affiliated researchers at Massachusetts General Hospital (MGH) reported the results of their study, the first to document meditation-produced changes over time in the brain’s gray matter. “Although the practice of meditation is associated with a sense of peacefulness and physical relaxation, practitioners have long claimed that meditation also provides cognitive and psychological benefits that persist throughout the day,” says study senior author Sara Lazar of the MGH Psychiatric Neuroimaging Research Program and a Harvard Medical School instructor in psychology. “This study demonstrates that changes in brain structure may underlie some of these reported improvements and that people are not just feeling better because they are spending time relaxing.”
Previous studies from Lazar’s group and others found structural differences between the brains of experienced meditation practitioners and individuals with no history of meditation, observing thickening of the cerebral cortex in areas associated with attention and emotional integration. But those investigations could not document that those differences were actually produced by meditation.
For the current study, magnetic resonance (MR) images were taken of the brain structure of 16 study participants two weeks before and after they took part in the eight-week Mindfulness-Based Stress Reduction (MBSR) Program at the University of Massachusetts Center for Mindfulness. In addition to weekly meetings that included practice of mindfulness meditation — which focuses on nonjudgmental awareness of sensations, feelings, and state of mind — participants received audio recordings for guided meditation practice and were asked to keep track of how much time they practiced each day. A set of MR brain images was also taken of a control group of nonmeditators over a similar time interval.
Meditation group participants reported spending an average of 27 minutes each day practicing mindfulness exercises, and their responses to a mindfulness questionnaire indicated significant improvements compared with pre-participation responses. The analysis of MR images, which focused on areas where meditation-associated differences were seen in earlier studies, found increased gray-matter density in the hippocampus, known to be important for learning and memory, and in structures associated with self-awareness, compassion, and introspection.
Participant-reported reductions in stress also were correlated with decreased gray-matter density in the amygdala, which is known to play an important role in anxiety and stress. Although no change was seen in a self-awareness-associated structure called the insula, which had been identified in earlier studies, the authors suggest that longer-term meditation practice might be needed to produce changes in that area. None of these changes were seen in the control group, indicating that they had not resulted merely from the passage of time.
“It is fascinating to see the brain’s plasticity and that, by practicing meditation, we can play an active role in changing the brain and can increase our well-being and quality of life,” says Britta Hölzel, first author of the paper and a research fellow at MGH and Giessen University in Germany. “Other studies in different patient populations have shown that meditation can make significant improvements in a variety of symptoms, and we are now investigating the underlying mechanisms in the brain that facilitate this change.”
Amishi Jha, a University of Miami neuroscientist who investigates mindfulness-training’s effects on individuals in high-stress situations, says, “These results shed light on the mechanisms of action of mindfulness-based training. They demonstrate that the first-person experience of stress can not only be reduced with an eight-week mindfulness training program but that this experiential change corresponds with structural changes in the amygdala, a finding that opens doors to many possibilities for further research on MBSR’s potential to protect against stress-related disorders, such as post-traumatic stress disorder.” Jha was not one of the study investigators.
James Carmody of the Center for Mindfulness at University of Massachusetts Medical School is one of the co-authors of the study, which was supported by the National Institutes of Health, the British Broadcasting Company, and the Mind and Life Institute. For more information on the work of Lazar’s team.
Source : Harvard Edu
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Psychological, immunological and physiological effects of a Laughing Qigong Program (LQP) on adolescents
One objective of this study was to assess the effects of laughter on the psychological, immunological and physiological systems of the body. Another objective was to introduce the Laughing Qigong Program (LQP), as a method of standardization for simulated laughter interventions.
A randomized, prospective, experimental study of the LQP was conducted in a group of adolescents (n = 67) in Taiwan. During study-hall sessions, experimental subjects (n = 34) attended the LQP for eight-weeks. Simultaneously, control subjects (n = 33) read or did their homework. All subjects were tested before and after the intervention on the following: Rosenberg Self-Esteem scale (RSE), Chinese Humor Scale (CHS) and Face Scale (FS) as psychological markers; saliva cortisol (CS) as an immunological marker; blood pressure (BP), heart rate (HR), and heart rate variability (HRV) as physiological markers of the body's response to stress. Mood states (FS) were measured before/after each LQP session.
Mood states (p = .00) and humor (p = .004; p = .003) improved in the experimental group; no significant changes were found in the controls (p = 69; p = 60). The immunological marker of stress, cortisol levels, decreased significantly for those who participated in the LQP (p = .001), suggesting lower levels of stress after completion of the program.
The LQP is a non-pharmacological and cost-effective means to help adolescents mitigate stresses in their everyday life.
Source : Complementary Therapies in Medicine
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The power of the mind: the cortex as a critical determinant of muscle strength/weakness
Brian C. Clark , Niladri K. Mahato , Masato Nakazawa , Timothy D. Law , James S. Thomas
We tested the hypothesis that the nervous system, and the cortex in particular, is a critical determinant of muscle strength/weakness and that a high level of corticospinal inhibition is an important neurophysiological factor regulating force generation. A group of healthy individuals underwent 4 wk of wrist-hand immobilization to induce weakness. Another group also underwent 4 wk of immobilization, but they also performed mental imagery of strong muscle contractions 5 days/wk. Mental imagery has been shown to activate several cortical areas that are involved with actual motor behaviors, including premotor and M1 regions. A control group, who underwent no interventions, also participated in this study. Before, immediately after, and 1 wk following immobilization, we measured wrist flexor strength, voluntary activation (VA), and the cortical silent period (SP; a measure that reflect corticospinal inhibition quantified via transcranial magnetic stimulation). Immobilization decreased strength 45.1 ± 5.0%, impaired VA 23.2 ± 5.8%, and prolonged the SP 13.5 ± 2.6%. Mental imagery training, however, attenuated the loss of strength and VA by ∼50% (23.8 ± 5.6% and 12.9 ± 3.2% reductions, respectively) and eliminated prolongation of the SP (4.8 ± 2.8% reduction). Significant associations were observed between the changes in muscle strength and VA (r = 0.56) and SP (r = −0.39). These findings suggest neurological mechanisms, most likely at the cortical level, contribute significantly to disuse-induced weakness, and that regular activation of the cortical regions via imagery attenuates weakness and VA by maintaining normal levels of inhibition.
Source : Journal of Neurophysiology
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Brief mindfulness meditation training alters psychological and neuroendocrine responses to social evaluative stress
Objective To test whether a brief mindfulness meditation training intervention buffers self-reported psychological and neuroendocrine responses to the Trier Social Stress Test (TSST) in young adult volunteers. A second objective evaluates whether pre-existing levels of dispositional mindfulness moderate the effects of brief mindfulness meditation training on stress reactivity.
Methods Sixty-six (N = 66) participants were randomly assigned to either a brief 3-day (25-min per day) mindfulness meditation training or an analytic cognitive training control program. All participants completed a standardized laboratory social-evaluative stress challenge task (the TSST) following the third mindfulness meditation or cognitive training session. Measures of psychological (stress perceptions) and biological (salivary cortisol, blood pressure) stress reactivity were collected during the social evaluative stress-challenge session.
Results Brief mindfulness meditation training reduced self-reported psychological stress reactivity but increased salivary cortisol reactivity to the TSST, relative to the cognitive training comparison program. Participants who were low in pre-existing levels of dispositional mindfulness and then received mindfulness meditation training had the greatest cortisol reactivity to the TSST. No significant main or interactive effects were observed for systolic or diastolic blood pressure reactivity to the TSST.
Conclusions The present study provides an initial indication that brief mindfulness meditation training buffers self-reported psychological stress reactivity, but also increases cortisol reactivity to social evaluative stress. This pattern may indicate that initially brief mindfulness meditation training fosters greater active coping efforts, resulting in reduced psychological stress appraisals and greater cortisol reactivity during social evaluative stressors.
Source : Psychoneuroendocrinology
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Experienced Practitioners Reap Genetic Changes After a Day of Mindfulness Meditation
Results of a recent study cofunded by NCCAM suggest that one day of intense mindfulness by experienced meditators led to biological changes including expression of certain genes that play roles in inflammation and pain. Anti-inflammatory and pain-relieving drugs have similar effects on these genes. Findings from the study appear in the journal Psychoneuroendocrinology.
Mindfulness meditation practices are a form of training that focuses attention on breathing to develop increased awareness of the present. The study, conducted in 40 participants, focused on gaining more knowledge about molecular and genetic effects of this type of meditation and also on testing the feasibility of the study approach for future work.
Researchers divided participants into two groups. The first (active) group, which consisted of 19 people who had practiced daily meditation for at least 3 years, performed 8 hours of intensive mindfulness practice during one day. The other group, a control group of 21 people who had no experience with meditation, spent 8 hours performing quiet leisure activities in the same setting as the meditators. The researchers took blood samples before and after both interventions and analyzed them for certain biological factors, including the expression of various genes important in the regulatory processes for inflammation, circadian rhythms (which refer to the body’s internal “clock”), or histones (proteins in cells that attach to DNA). Researchers also took samples of participants’ saliva to determine the levels of the hormone cortisol as an indicator of recovery time after participants took a test that put them under acute stress.
The investigators found no significant differences between the active and control groups in these biological factors at the study’s start. However, after the interventions, the meditators showed some changes not seen in the control group. These included reduced expression levels of certain genes related to inflammation and histones. The reduced levels for two of these genes were associated with faster recovery from the stress test. No significant differences occurred between groups with respect to circadian genes.
The researchers suggested that their findings may offer a possible mechanism for explaining beneficial effects from meditation on inflammatory disorders, and an avenue for future research in chronic inflammatory conditions.
- Kaliman P, Álvarez-López MJ, Cosín-Tomás M, et al. Rapid changes in histone deacetylases and inflammatory gene expression in expert meditators. Psychoneuroendocrinology. 2014;40:96–107.
Source : NNCAM
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Mindfulness Meditation May Reduce Risk of Suicidal Thoughts in Middle Schoolers
Results of a recent pilot study suggest that middle school-aged students who meditated during a 6-week, classroom-based mindfulness meditation program were significantly less likely than non-meditators to develop suicidal thoughts or self-harming thoughts or behaviors. The study also found that both mindfulness meditation and a matched activity condition showed improvements in internalizing problems, externalizing problems, attention problems, and affect, but there were no statistically significant differences between the groups. Findings from the study, co-funded by NCCAM, were published in the Journal of School Psychology.
A total of 100 sixth graders were randomly assigned to an Asian history class with daily mindfulness practice or an African history class with a matched activity (control group) that involved constructing a life-sized model of a Pharaoh’s coffin. During the study, the teacher in the meditation group led students in silent meditation at the beginning of the class. The initial meditation periods lasted 3 minutes, and the final meditation periods lasted up to 12 minutes. Participants learned breath awareness and breath counting, labeling of body sensations, labeling of thoughts and emotions, and body sweeps. During the final 2 weeks, students could choose any of the various meditation techniques. Participants completed questionnaires before and after the 6-week study period.
Although the children in the meditation group had a reduced risk of developing suicidal thoughts and thoughts of self-harm compared with the control group, the researchers noted that the small sample size and limited followup make it difficult to conclude that these effects were due to meditation. They suggested further research with a larger sample to determine the extent to which meditation can produce long-term beneficial effects.
- Britton WB, Lepp NE, Niles HF, et al. A randomized controlled pilot trial of classroom-based mindfulness meditation compared to an active control condition in sixth-grade children. Journal of School Psychology. 2014;52(3):263–278.
Source : NCCAM
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The Paradox of Music-Evoked Sadness: An Online Survey
Liila Taruffi mail, Stefan Koelsch
This study explores listeners’ experience of music-evoked sadness. Sadness is typically assumed to be undesirable and is therefore usually avoided in everyday life. Yet the question remains: Why do people seek and appreciate sadness in music? We present findings from an online survey with both Western and Eastern participants (N = 772). The survey investigates the rewarding aspects of music-evoked sadness, as well as the relative contribution of listener characteristics and situational factors to the appreciation of sad music. The survey also examines the different principles through which sadness is evoked by music, and their interaction with personality traits. Results show 4 different rewards of music-evoked sadness: reward of imagination, emotion regulation, empathy, and no “real-life” implications. Moreover, appreciation of sad music follows a mood-congruent fashion and is greater among individuals with high empathy and low emotional stability. Surprisingly, nostalgia rather than sadness is the most frequent emotion evoked by sad music. Correspondingly, memory was rated as the most important principle through which sadness is evoked. Finally, the trait empathy contributes to the evocation of sadness via contagion, appraisal, and by engaging social functions. The present findings indicate that emotional responses to sad music are multifaceted, are modulated by empathy, and are linked with a multidimensional experience of pleasure. These results were corroborated by a follow-up survey on happy music, which indicated differences between the emotional experiences resulting from listening to sad versus happy music. This is the first comprehensive survey of music-evoked sadness, revealing that listening to sad music can lead to beneficial emotional effects such as regulation of negative emotion and mood as well as consolation. Such beneficial emotional effects constitute the prime motivations for engaging with sad music in everyday life.
Source : PLOS One
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Meditation programs for psychological stress and well-being: a systematic review and meta-analysis
Review published: 2014.
Goyal M, Singh S, Sibinga EM, Gould NF, Rowland-Seymour A, Sharma R, Berger Z, Sleicher D, Maron DD, Shihab HM, Ranasinghe PD, Linn S, Saha S, Bass EB, Haythornthwaite JA.
IMPORTANCE: Many people meditate to reduce psychological stress and stress-related health problems. To counsel people appropriately, clinicians need to know what the evidence says about the health benefits of meditation.
OBJECTIVE: To determine the efficacy of meditation programs in improving stress-related outcomes (anxiety, depression, stress/distress, positive mood, mental health-related quality of life, attention, substance use, eating habits, sleep, pain, and weight) in diverse adult clinical populations.
EVIDENCE REVIEW: We identified randomized clinical trials with active controls for placebo effects through November 2012 from MEDLINE, PsycINFO, EMBASE, PsycArticles, Scopus, CINAHL, AMED, the Cochrane Library, and hand searches. Two independent reviewers screened citations and extracted data. We graded the strength of evidence using 4 domains (risk of bias, precision, directness, and consistency) and determined the magnitude and direction of effect by calculating the relative difference between groups in change from baseline. When possible, we conducted meta-analyses using standardized mean differences to obtain aggregate estimates of effect size with 95% confidence intervals.
FINDINGS: After reviewing 18 753 citations, we included 47 trials with 3515 participants. Mindfulness meditation programs had moderate evidence of improved anxiety (effect size, 0.38 [95% CI, 0.12-0.64] at 8 weeks and 0.22 [0.02-0.43] at 3-6 months), depression (0.30 [0.00-0.59] at 8 weeks and 0.23 [0.05-0.42] at 3-6 months), and pain (0.33 [0.03- 0.62]) and low evidence of improved stress/distress and mental health-related quality of life. We found low evidence of no effect or insufficient evidence of any effect of meditation programs on positive mood, attention, substance use, eating habits, sleep, and weight. We found no evidence that meditation programs were better than any active treatment (ie, drugs, exercise, and other behavioral therapies).
CONCLUSIONS AND RELEVANCE: Clinicians should be aware that meditation programs can result in small to moderate reductions of multiple negative dimensions of psychological stress. Thus, clinicians should be prepared to talk with their patients about the role that a meditation program could have in addressing psychological stress. Stronger study designs are needed to determine the effects of meditation programs in improving the positive dimensions of mental health and stress-related behavior.
Source : Jama Internal Medicine
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Positive Associations of Dispositional Mindfulness with Cardiovascular Health: the New England Family Study
- Eric B. Loucks,
- Willoughby B. Britton,
- Chanelle J. Howe,
- Charles B. Eaton,
- Stephen L. Buka
Mindfulness (the ability to attend nonjudgmentally to one’s own physical and mental processes) is receiving substantial interest as a potential determinant of health. However, little is known whether mindfulness is associated with cardiovascular health.
The aim of this study is to evaluate whether dispositional mindfulness is associated with cardiovascular health.
Study participants (n = 382) were from the New England Family Study, born in Providence, RI, USA, with mean age 47 years. Dispositional mindfulness was assessed using the Mindful Attention Awareness Scale (MAAS). Cardiovascular health was assessed based on American Heart Association criteria. Cross-sectional multivariable-adjusted log binomial regression analyses were performed.
Analyses demonstrated that those with high vs. low MAAS had prevalence ratio (PR) for good cardiovascular health of 1.83 (95 % confidence interval (CI) 1.07, 3.13), adjusted for age, gender, and race/ethnicity. There were significant associations of high vs. low mindfulness with nonsmoking (PR = 1.37, 95 % CI 1.06, 1.76), body mass index <25 kg/m2 (PR = 2.17, 95 % CI 1.16, 4.07), fasting glucose <100 mg/dL (PR = 1.47, 95 % CI 1.06, 2.04), and high physical activity (PR = 1.56, 95 % CI 1.04, 2.35), but not blood pressure, total cholesterol, or fruit/vegetable consumption. Exploratory mediation analyses suggested that sense of control and depressive symptomatology may be mediators.
This study demonstrated preliminary cross-sectional evidence that dispositional mindfulness is positively associated with cardiovascular health, with the associations particularly driven by smoking, body mass index, fasting glucose, and physical activity. If in future research mindfulness-based practices are found to consistently improve cardiovascular disease risk factors, such interventions may have potential to strengthen effects of cardiovascular health promotion programs.
Source : International Journal of Behavioral Medicine
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Sedative Music Facilitates Deep Sleep in Young Adults
Chih-Kuang Chen, MD,1,2 Yu-Cheng Pei, MD, PhD,1,2,3 Ning-Hung Chen, MD,2,4 Li-Ting Huang, MD,1 Shih-Wei Chou, MD, PhD,1,2 Katie P. Wu, MD,1,2 Pei-Chih Ko, MD,1 Alice M.K. Wong, MD,1,3,5 and Chih-Kuan Wu, MD1
1Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Taoyuan/Linkou, Taoyuan, Taiwan.2School of Medicine, Chang Gung University, Taoyuan, Taiwan.3Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.4Division of Pulmonary and Critical Care Medicine, Sleep Center, Chang Gung Memorial Hospital at Taoyuan, Taoyuan, Taiwan.5Graduate Institute of Rehabilitation Science, Chang Gung University, Taoyuan, Taiwan.
Objectives: To investigate the effect of sedative music on the different stages of the sleep cycle in young adults with various sleep latencies by using polysomnography (PSG).
Design: Prospective, randomized, controlled, crossover study.
Setting: Sleep center of a teaching hospital.
Participants: Young adults with different sleep latencies. Poor sleepers (Pittsburgh Sleep Quality Index score ≥5) were excluded.
Interventions: Each participant stayed one night in the sleep center for adaptation and on each of the following two nights was assigned to (1) music and (2) control (without music) conditions in random order. In the music condition, sedative music composed by certified music therapists was played on a compact disc player for the first hour the participant was in bed.
Outcome measures: Sleep measures recorded with PSG, including sleep latency and durations of sleep stages.
Results: Twenty-four young adults (mean±standard deviation, 24.5±2.6 years) participated. They were classified into the short sleep latency (SL) group if the baseline SL of the adaptation night was shorter than 10 minutes or into the long SL group if the baseline SL was 10 minutes or longer. Sedative music did not alter the SL in either group. Sedative music reduced stage II sleep in both SL groups (main effect of music, p=0.03; interaction effect, p=0.87) but increased the duration of deep sleep (stages III and IV) only in the long SL group (main effect of music, p=0.15; interaction effect, p=0.02).
Conclusions: In participants with long SL, sedative music improved the quality of sleep by prolonging the duration of deep sleep. This effect provides an alternative and noninvasive way to improve sleep in selected persons experiencing sleep problems.
Source ; Journal Alternative and Complementary Medicine
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Effects of Buddhism Walking Meditation on Depression, Functional Fitness, and Endothelium-Dependent Vasodilation in Depressed Elderly.
Prakhinkit S1, Suppapitiporn S, Tanaka H, Suksom D.
Objectives: The objectives of this study were to determine the effects of the novel Buddhism-based walking meditation (BWM) and the traditional walking exercise (TWE) on depression, functional fitness, and vascular reactivity. Design: This was a randomized exercise intervention study. Settings/location: The study was conducted in a university hospital setting.
Subjects: Forty-five elderly participants aged 60-90 years with mild-to-moderate depressive symptoms were randomly allocated to the sedentary control, TWE, and BWM groups. Interventions: The BWM program was based on aerobic walking exercise incorporating the Buddhist meditations performed 3 times/week for 12 weeks.
Outcome measures: Depression score, functional fitness, and endothelium-dependent vasodilation as measured by the flow-mediated dilation (FMD) were the outcome measures used.
Results: Muscle strength, flexibility, agility, dynamic balance, and cardiorespiratory endurance increased in both exercise groups (p<0.05). Depression score decreased (p<0.05) only in the BWM group. FMD improved (p<0.05) in both exercise groups. Significant reduction in plasma cholesterol, triglyceride, high-density lipoprotein cholesterol, and C-reactive protein were found in both exercise groups, whereas low-density lipoprotein cholesterol, cortisol, and interleukin-6 concentrations decreased only in the BWM group.
Conclusions: Buddhist walking meditation was effective in reducing depression, improving functional fitness and vascular reactivity, and appears to confer greater overall improvements than the traditional walking program.
Source : Journal Alternative Complementary Medicine
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Acute effects of violent video-game playing on blood pressure and appetite perception in normal-weight young men: a randomized controlled trial
M Siervo1, S Sabatini2, M S Fewtrell2 and J C K Wells2
- 1Human Nutrition Research Centre, Institute for Ageing and Health, Newcastle University, Newcastle on Tyne, UK
- 2Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK
Watching television and playing video game being seated represent sedentary behaviours and increase the risk of weight gain and hypertension. We investigated the acute effects of violent and non-violent video-game playing on blood pressure (BP), appetite perception and food preferences. Forty-eight young, normal-weight men (age: 23.1±1.9 years; body mass index: 22.5±1.9 kg/m2) participated in a three-arm, randomized trial. Subjects played a violent video game, a competitive, non-violent video game or watched TV for 1 h. Measurements of BP, stress and appetite perception were recorded before a standardized meal (~300 kcal) and then repeated every 15 min throughout the intervention. Violent video-game playing was associated with a significant increase in diastolic BP (Δ±s.d.=+7.5±5.8 mm Hg; P=0.04) compared with the other two groups. Subjects playing violent video games felt less full (P=0.02) and reported a tendency towards sweet food consumption. Video games involving violence appear to be associated with significant effects on BP and appetite perceptions compared with non-violent gaming or watching TV.
Source : EU Journal of Clinical Nutrition
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Mind-Body Medicine for Multiple Sclerosis: A Systematic Review
Angela Senders,1 Helané Wahbeh,1 Rebecca Spain,1,2 and Lynne Shinto1
1Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA
2Department of Neurology, Portland Veterans Affairs Medical Center, Portland, OR 97239, USA
Background. Mind-body therapies are used to manage physical and psychological symptoms in many chronic health conditions. Objective. To assess the published evidence for using mind-body techniques for symptom management of multiple sclerosis.
Methods. MEDLINE, PsycINFO, and Cochrane Clinical Trials Register were searched from inception to March 24, 2012. Eleven mind-body studies were reviewed (meditation, yoga, biofeedback, hypnosis, relaxation, and imagery).
Results. Four high quality trials (yoga, mindfulness, relaxation, and biofeedback) were found helpful for a variety of MS symptoms.
Conclusions. The evidence for mind-body medicine in MS is limited, yet mind-body therapies are relatively safe and may provide a nonpharmacological benefit for MS symptoms.
Source : Autoimmune Diseases
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Faith as a Resource in Patients with Multiple Sclerosis Is Associated with a Positive Interpretation of Illness and Experience of Gratitude/Awe
Arndt Büssing,1,2 Anne-Gritli Wirth,1 Knut Humbroich,3 Kathrin Gerbershagen,4 Sebastian Schimrigk,5 Michael Haupts,6 Klaus Baumann,2,7 and Peter Heusser8
1Quality of Life, Spirituality and Coping, Institute of Integrative Medicine, Witten/Herdecke University, 58313 Herdecke, Germany
2Freiburg Institute for Advanced Studies (FRIAS), Universität Freiburg, 79098 Freiburg, Germany
3Department of Neurology, Communal Hospital Herdecke, 58313 Herdecke, Germany
4Department of Neurology and Palliative Care, Köln-Merheim Hospital, 51109 Cologne, Germany
5Neurological Hospital, Clinic of Lüdenscheid, 58515 Lüdenscheid, Germany
6Augusta Hospital Anholt, Neurological Hospital, 46419 Isselburg, Germany
7Caritas Science and Christian Social Work, Faculty of Theology, Albert-Ludwigs University, 79104 Freiburg, Germany
8Institute of Integrative Medicine, Witten/Herdecke University, 58313 Herdecke, Germany
The aim of this cross-sectional anonymous survey with standardized questionnaires was to investigate which resources to cope were used by patients with multiple sclerosis (MS). We focussed on patients' conviction that their faith might be a strong hold in difficult times and on their engagement in different forms of spirituality. Consecutively 213 German patients (75% women; mean age 43 ± 11 years) were enrolled. Fifty-five percent regarded themselves as neither religious nor spiritual (R−S−), while 31% describe themselves as religious. For 29%, faith was a strong hold in difficult times. This resource was neither related to patients' EDSS scores, and life affections, fatigue, negative mood states, life satisfaction nor to Positive attitudes. Instead it was moderately associated with a Reappraisal strategy (i.e., and positive interpretation of illness) and experience of gratitude/awe. Compared to spiritual/religious patients, R−S− individuals had significantly ( ) lower Reappraisal scores and lower engagement in specific forms of spiritual practices. The ability to reflect on what is essential in life, to appreciate and value life, and also the conviction that illness may have meaning and could be regarded as a chance for development was low in R−S− individuals which either may have no specific interest or are less willing to reflect these issues.
Source : Evidence Based Complementary and Alternative Medicine
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Mindfulness-Based Stress Reduction Helps Lower Blood Pressure, Study Finds
Blood pressure is effectively lowered by mindfulness-based stress reduction (MBSR) for patients with borderline high blood pressure or "prehypertension," according to new research.
The finding is reported in the October issue of Psychosomatic Medicine: Journal of Biobehavioral Medicine, the official journal of the American Psychosomatic Society. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.
"Our results provide evidence that MBSR, when added to lifestyle modification advice, may be an appropriate complementary treatment for BP in the prehypertensive range," writes Joel W. Hughes, PhD, of Kent State (Ohio) University and colleagues.
Mindfulness Practice Leads to Drop in Blood Pressure
The study included 56 women and men diagnosed with prehypertension -- blood pressure that was higher than desirable, but not yet so high that antihypertensive drugs would be prescribed. Prehypertension receives increasing attention from doctors because it is associated with a wide range of heart disease and other cardiovascular problems. About 30% of Americans have prehypertension and may be prescribed medications for this condition.
One group of patients was assigned to a program of MBSR: eight group sessions of 2½ hours per week. Led by an experienced instructor, the sessions included three main types of mindfulness skills: body scan exercises, sitting meditation, and yoga exercises. Patients were also encouraged to perform mindfulness exercises at home.
The other "comparison" group received lifestyle advice plus a muscle-relaxation activity. This "active control" treatment group was not expected to have lasting effects on blood pressure. Blood pressure measurements were compared between groups to determine whether the mindfulness-based intervention reduced blood pressure in this group of people at risk of cardiovascular problems.
Patients in the mindfulness-based intervention group had significant reductions in clinic-based blood pressure measurements. Systolic blood pressure (the first, higher number) decreased by an average of nearly 5 millimeters of mercury (mm Hg), compared to less than 1 mm Hg with in the control group who did not receive the mindfulness intervention.
Diastolic blood pressure (the second, lower number) was also lower in the mindfulness-based intervention group: a reduction of nearly 2 mm Hg, compared to an increase of 1 mm Hg in the control group.
Mindfulness-based interventions Could 'Prevent or Delay' Need for Antihypertensive Drugs Ambulatory monitoring is an increasingly used alternative to clinic-based blood pressure measurements. However, 24-hour ambulatory blood pressure monitoring showed no significant difference in blood pressure with the mindfulness-based intervention.
"Mindfulness-based stress reduction is an increasingly popular practice that has been purported to alleviate stress, treat depression and anxiety, and treat certain health conditions," according to Dr Hughes and coauthors. It has been suggested that MBSR and other types of meditation may be useful in lowering blood pressure. Previous studies have reported small but significant reductions in blood pressure with Transcendental Meditation; the new study is the first to specifically evaluate the blood pressure effects of mindfulness-based intervention in patients with prehypertension.
Although the blood pressure reductions associated with mindfulness-based interventions are modest, they are similar to many drug interventions and potentially large enough to lead to reductions in the risk of heart attack or stroke. Further studies are needed to see if the blood pressure-lowering effects are sustained over time.
The researchers argue that mindfulness-based interventions may provide a useful alternative to help "prevent or delay" the need for antihypertensive medications in patients with borderline high blood pressure.
Source : Newswise
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The Role of Mindfulness and Psychological Flexibility in Somatization, Depression, Anxiety, and General Psychological Distress in a Nonclinical College Sample
Akihiko Masuda, PhD1 and Erin C. Tully, PhD1
The current study investigated whether mindfulness and psychological flexibility uniquely and separately accounted for
variability in psychological distress (somatization, depression, anxiety, and general psychologicaldistress).Anethnicallydiverse,
nonclinical sample of college undergraduates (N=494, 76% female) completed a Web-based survey that included the self-
report measures of interest. Consistent with prior research, psychological flexibility and mindfulness were positively associated
with each other, and tested separately, both variables were negatively associated with somatization, depression, anxiety, and
general psychological distress. Results also revealed that psychological flexibility and mindfulness accounted for unique variance
in all 4 measures of distress. These findings suggest that mindfulness and psychological flexibility are interrelated but not redun-
dant constructs and that both constructs are important for understanding the onset and maintenance of somatization, depres-
sion,anxiety,and general distress.
Source : Journal of Evidence Based Complementary and Alternative Medicine
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Sexual Health for Women With Hot Flashes Is Improved by Hypnotic Relaxation Therapy
Hypnotic relaxation therapy improves sexual health in postmenopausal women who have moderate to severe hot flashes, according to Baylor University researchers who presented their findings at the American Psychological Association's recent annual meeting.The study, which examined sexual comfort, sexual satisfaction and sexual pleasure, is a first step toward a safe and effective alternative toward hormone replacement therapy, which carries associated risks of cancer and heart disease, said Gary Elkins, Ph.D., director of Baylor's Mind-Body Medicine Research Laboratory and a professor of psychology and neuroscience in Baylor's College of Arts & Sciences.
The conclusion was based on a study funded by the National Institutes of Health. For the research, 187 women were randomly assigned to receive either five weekly sessions of hypnotic relaxation therapy or supportive counseling, said lead researcher Aimee Johnson, a doctoral student in psychology and neuroscience at Baylor University.
Led by researchers at Baylor's Mind-Body Medicine Research Laboratory, all study sessions were conducted by master's-level therapists trained in clinical hypnosis. Participants in the hypnotic relaxation therapy group received a hypnotic induction followed by suggestions for relaxation, coolness and mental imagery. Participants who received sessions of supportive counseling discussed their symptoms with a trained therapist but did not receive any hypnosis.
Women completed questionnaires at the beginning of the study, at the end of treatment and at a 12-week follow-up. They also were asked to complete a self-report questionnaire assessing the extent to which hot flashes interfered with sexual intimacy. The decrease in estrogen that accompanies menopause is associated with hot flashes, night sweats, weight gain and vaginal dryness, discomfort or pain.
"The most common complaints are being too tired, anxiety, depression, hot flashes and the fear of close contact," Elkins said. Because warmth that comes from closeness can trigger a hot flash, some women grow to fear intimacy, he said.
At treatment's end, women who had received hypnotic relaxation therapy reported significantly higher sexual satisfaction and pleasure, as well as less discomfort. This improvement also was seen at the 12-week follow-up assessment.
"Women's sexual health improved, whether because of sleeping better, less stress or fewer hot flashes, or perhaps other unknown mechanisms," Elkins said.
Researchers noted that postmenopausal sexual health can be affected by factors other than hot flashes, among them fatigue, self-esteem, a partner's health, relationship quality and a lack of interest by either or both partners.
For many women -- among them those who have had breast cancer -- hormone replacement therapy is not an option for menopause-related symptoms. Estrogen, for example, has been associated with more rapid growth of breast cancer.
Previous research by Elkins has shown that clinical hypnosis can effectively reduce hot flashes and associated symptoms among postmenopausal women, including a lessening of anxiety and depression
Source : Newswise
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Music for pain relief
- M Soledad Cepeda1,*,
- Daniel B Carr2,
- Joseph Lau3,
- Hernando Alvarez4
Background The efficacy of music for the treatment of pain has not been established.
Objectives To evaluate the effect of music on acute, chronic or cancer pain intensity, pain relief, and analgesic requirements.
Search methods We searched The Cochrane Library, MEDLINE, EMBASE, PsycINFO, LILACS and the references in retrieved manuscripts. There was no language restriction.
Selection criteria We included randomized controlled trials (RCTs) that evaluated the effect of music on any type of pain in children or adults. We excluded trials that reported results of concurrent non-pharmacological therapies.
Data collection and analysis Data was extracted by two independent review authors. We calculated the mean difference in pain intensity levels, percentage of patients with at least 50% pain relief, and opioid requirements. We converted opioid consumption to morphine equivalents. To explore heterogeneity, studies that evaluated adults, children, acute, chronic, malignant, labor, procedural, or experimental pain were evaluated separately, as well as those studies in which patients chose the type of music.
Main results Fifty-one studies involving 1867 subjects exposed to music and 1796 controls met inclusion criteria.
In the 31 studies evaluating mean pain intensity there was a considerable variation in the effect of music, indicating statistical heterogeneity ( I2 = 85.3%). After grouping the studies according to the pain model, this heterogeneity remained, with the exception of the studies that evaluated acute postoperative pain. In this last group, patients exposed to music had pain intensity that was 0.5 units lower on a zero to ten scale than unexposed subjects (95% CI: -0.9 to -0.2). Studies that permitted patients to select the music did not reveal a benefit from music; the decline in pain intensity was 0.2 units, 95% CI (-0.7 to 0.2).
Four studies reported the proportion of subjects with at least 50% pain relief; subjects exposed to music had a 70% higher likelihood of having pain relief than unexposed subjects (95% CI: 1.21 to 2.37). NNT = 5 (95% CI: 4 to 13).
Three studies evaluated opioid requirements two hours after surgery: subjects exposed to music required 1.0 mg (18.4%) less morphine (95% CI: -2.0 to -0.2) than unexposed subjects. Five studies assessed requirements 24 hours after surgery: the music group required 5.7 mg (15.4%) less morphine than the unexposed group (95% CI: -8.8 to -2.6). Five studies evaluated requirements during painful procedures: the difference in requirements showed a trend towards favoring the music group (-0.7 mg, 95% CI: -1.8 to 0.4).
Authors' conclusions Listening to music reduces pain intensity levels and opioid requirements, but the magnitude of these benefits is small and, therefore, its clinical importance unclear.
Plain language summary
Music for pain relief Music should not be considered a first line treatment for pain relief as the magnitude of its benefits is small. Listening to music for treatment of pain offers potential advantages of low cost, ease of provision, and safety. This systematic review included 51 studies involving 3663 subjects. The review authors found that music reduced pain, increased the number of patients who reported at least 50% pain relief, and reduced requirements for morphine-like analgesics. However, as the magnitude of these positive effects is small, the clinical relevance of music for pain relief in clinical practice is unclear
Source : The Cochrane Library
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Study Identifies Genes, Pathways Altered During Relaxation Response Practice
A new study from investigators at the Benson-Henry Institute for Mind/Body Medicine at Massachusetts General Hospital (MGH) and Beth Israel Deaconess Medical Center (BIDMC) finds that elicitation of the relaxation response -- a physiologic state of deep rest induced by practices such as meditation, yoga, deep breathing and prayer -- produces immediate changes in the expression of genes involved in immune function, energy metabolism and insulin secretion. Published in the open-access journal PLOS ONE, the study combined advanced expression profiling and systems biology analysis to both identify genes affected by relaxation response practice and determine the potential biological relevance of those changes.
"Many studies have shown that mind/body interventions like the relaxation response can reduce stress and enhance wellness in healthy individuals and counteract the adverse clinical effects of stress in conditions like hypertension, anxiety, diabetes and aging," says Herbert Benson, MD, director emeritus of the Benson-Henry Institute and co-senior author of the PLOS ONE report. "Now for the first time we've identified the key physiological hubs through which these benefits might be induced."
Towia Libermann, PhD -- director of the Beth Israel Deaconess Medical Center (BIDMC) Genomics, Proteomics, Bioinformatics and Systems Biology Center and co-senior author of the study -- adds, "Some of the biological pathways we identify as being regulated by relaxation response practice are already known to play specific roles in stress, inflammation and human disease. For others, the connections are still speculative, but this study is generating new hypotheses for further investigation."
Benson first described the relaxation response -- the physiologic opposite of the fight-or-flight response -- almost 40 years ago, and his team has pioneered the application of mind/body techniques to a wide range of health problems. Studies in many peer-reviewed journals have documented how the relaxation response both alleviates symptoms of anxiety and many other disorders and also affects factors such as heart rate, blood pressure, oxygen consumption and brain activity. In 2008, Benson and Libermann led a study finding that long-term practice of the relaxation response changed the expression of genes involved with the body's response to stress. The current study examined changes produced during a single session of relaxation response practice, as well as those taking place over longer periods of time.
The study enrolled a group of 26 healthy adults with no experience in relaxation response practice, who then completed an 8-week relaxation response training course. Prior to starting their training, the participants went through what was essentially a control group session -- blood samples were taken before and immediately after they listened to a 20-minute health education CD and again 15 minutes later. After completing the training course, a similar set of blood tests was taken before and after participants listened to a 20-minute CD used to elicit the relaxation response as part of daily practice.
The sets of blood tests taken before the training program were designated "novice," and those taken after training completion were categorized as from "short-term practitioners." For further comparison a similar set of blood samples was taken from a group of 25 individuals with 4 to 25 years experience regularly eliciting the relaxation response through many different techniques before and after they listened to the same relaxation response CD. Blood samples from all participants were analyzed to determine the expression of more than 22,000 genes at the different time points.
The results revealed significant changes in the expression of several important groups of genes between the novice samples and those from both the short- and long-term sets, with even more pronounced changes in the long-term practitioners. A systems biology analysis of known interactions among the proteins produced by the affected genes revealed that pathways involved with energy metabolism, particularly the function of mitochondria, were upregulated during the relaxation response. Pathways controlled by activation of a protein called NF-κB -- known to have a prominent role in inflammation, stress, trauma and cancer -- were suppressed after relaxation response elicitation. The expression of genes involved in insulin pathways was also significantly altered.
"The combination of genomics and systems biology in this study provided great insight into the key molecules and physiological gene interaction networks that might be involved in relaying beneficial effects of relaxation response in healthy subjects," says Manoj K. Bhasin, PhD, co-lead author of the study and co-director of the BIDMC Genomics, Proteomics, Bioinformatics and Systems Biology Center. He notes that these insights should provide a framework for determining, on a genomic basis, whether the relaxation response will help alleviate symptoms of diseases triggered by stress and developing biomarkers that may suggest how individual patients will respond to interventions.
Benson stresses that the long-term practitioners in this study elicited the relaxation response through many different techniques -- various forms of meditation, yoga or prayer -- but those differences were not reflected in the gene expression patterns. "People have been engaging in these practices for thousands of years, and our finding of this unity of function on a basic-science, genomic level gives greater credibililty to what some have called 'new age medicine,' " he says.
Libermann says, "While this and our previous studies focused on healthy participants, we currently are studying how the genomic changes induced by mind/body interventions affect pathways involved in hypertension, inflammatory bowel disease and irritable bowel syndrome. We have also started a study -- a collaborative undertaking between the Dana Farber Cancer Institute, the Massachusetts General Hospital and the Beth Israel Deaconess Medical Center -- in patients with precursor forms of multiple myeloma, a condition known to involve activation of NF-κB pathways."
Source : Science Daily
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How meditation makes us much nicer people
New research proves that a spiritual practice, such as meditation, leads to a kinder world. Hazel Sillver explores a number of different types of meditation.
It is well established that meditation reduces stress and improves concentration, but now researchers have found it affects the way we vote. Last month (February 2013) scientists at the University of Toronto published the results of studies that compared the political views of ‘religious’ and ‘spiritual’ Americans.
Religiousness was defined as ‘devotion to a set of principles or code of conduct’, while the spirituality was termed as ‘a direct experience of self-transcendence and the feeling that we’re all connected.’
First it was found that religious types tend to be conservative and fond of tradition, while spiritual people are more liberal and regard equality and social harmony as important.
Then, after inducing a spiritual experience, via guided meditation, the researchers discovered that both groups (conservatives and liberals) became a lot more liberal in their outlook, expressing inclusive and egalitarian views.
Meditation comes in all shapes and sizes. If you fancy giving it a go, here are four of the most common types practised in the UK:
Metta (also known as Metta bhavana and ‘Compassion meditation’) is the practice of cultivating of loving-kindness. It involves sending love from the heart to four people: first to yourself, then someone you love, a neutral person (such as a stranger) and, finally, somebody you find very difficult. After this, you flood your heart with love and send it out to all beings. A monk practising Metta meditation during neurological research in the US produced the happiest brain waves ever recorded.
Now recommended by the NHS, mindfulness involves observing the inflow and outflow of the breath, in order to still the mind. Thoughts are observed (like clouds passing overhead), but not entered into. Over time an ability to exist in the present moment develops, so we are less likely to be swept into thoughts of the past and the future. Research shows that Mindfulness increases creativity and reduces stress, depression and loneliness. The various mindfulness books by Thich Nhat Hanh are highly recommended.
Arguably the easiest form of meditation, the repetition of a sacred word or ‘mantra’ stills the mind by giving it something to focus on. Meditators use a simple word (such as ‘peace’) or lengthy mantras, such as the Buddhist ‘Om tare, Tuttare, Ture, Soha’, which is said to bring healing. Many people move their fingers over a bead necklace (such as a mala or rosary) as they chant, to aid focus. Research shows that mantra meditation can reduce the risk of heart disease and strokes.
Visualisation involves selecting thoughts that are beneficial, in order to reduce negative thinking patterns. This was the practice used by researchers at the University of Toronto who were investigating how spirituality might affect political views. Participants were asked to imagine themselves in a natural setting and then encouraged to cultivate a feeling of being connected to their environment. Another common visualisation practice is imagining yourself fit and well, if you are ill.
All the meditations above are best performed straight backed with a relaxed jaw and neck, to allow free breathing. Sit cross-legged on the floor or upon a cushion, or sit on a firm chair with feet flat on the floor. Either shut the eyes or let the gaze rest downwards to the floor in front of you.
Source : The Ecologist
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Spirituality May Boost Outcomes in Ovarian Cancer
Ovarian cancer patients who reported high levels of spirituality presurgery had better outcomes for stress and depression, as well as factors known to regulate tumor angiogenesis and inflammation, researchers reported here.Self-report of high spirituality was associated with significantly lower perceived stress and depression (P<0.001), according to Premal Thaker, MD of the Washington University School of Medicine in St. Louis, and colleagues.
These same patients also had significantly lower levels of IL-6, both in peripheral blood (P=0.001) and in ascites (P=0.013) after adjusting for stress and depression, Thaker reported at the meeting of the Society of Gynecologic Oncology.
"Spirituality is an important psychosocial resource that positively influences quality of life," Thaker noted, adding that "less is known about the role of positive stress buffers, such as spirituality and cytokines, in tumor angiogenesis and inflammation in ovarian cancer patients."
She also noted that patient's spirituality was defined as "an individual's sense of peace, purpose, and connection to others, and beliefs about the meaning of life." These beliefs and feelings are important for patients at the time of diagnosis and at the end of life by offering comfort, hope, improved quality of life, and meaning, she explained.
To analyze the effects of spirituality on preoperative patients with ovarian cancer, the researchers performed a prospective cohort study of 165 women with histologically confirmed epithelial ovarian cancer.
Patients were surveyed for stress, depression, and self-reported spirituality through the Perceived Stress Scale, Beck Depression Inventory, and FACT-Spirituality survey, respectively.
Participants also had blood drawn on the morning of surgery, which was used to obtain data on concentrations of patients' IL-6, IL-8, and vascular endothelial growth factor (VEGF).
Thaker noted that earlier studies had linked depression with worse IL-6 outcomes and high social support with better IL-6 outcomes.
Participants were mostly white (96.1%), married or living with a partner (64%), normal or overweight (61%), and had an average age of 59.9. Disease in patients was mostly at stage III or 1V (72%), grade III (86.6%), had serous histology (75%), and had optimal debulking (76.8%).
A regression analysis showed a significantly negative association between spirituality and depression, stress, and IL-6, which maintained significance after adjustment for disease stage, histology, disease grade, age, and body mass index. Additional adjustment for stress and depression showed that the relationship between spirituality and IL-6 outcomes were unaffected (P=0.002).
There was no significant associations between spirituality and VEGF or IL-8 concentrations.
"These results indicate relationships between patient self-reports of spirituality presurgery and an important proinflammatory and proangiogenic cytokine, as well as important psychosocial correlates of spirituality," the authors concluded, noting potential implications for future patient treatment.
Thaker noted the study was limited by self-reported measures and a single measure of spirituality.
Source : MedPage Today via Society of Gynecologic Oncology
Thaker PH, et al. "Spirituality, depression, and interleukin-6 in ovarian cancer patients" SGO 2013; Abstract 14.
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Can We Help Just by Good Intentions? A Meta-Analysis of Experiments on Distant Intention Effects
Stefan Schmidt, PhD123
1Academic Section Evaluation Research in Complementary and Alternative Medicine, University Medical Center Freiburg, Freiburg, Germany
2Institute of Transcultural Health Sciences, Europe University Viadrina, Frankfurt/Oder, Germany.
3Brain, Mind and Healing Program, Samueli Institute, Alexandria, VA.
Objectives: In recent years, several clinical trials have assessed effects of distant healing. The basic question raised by these studies is whether a positive distant intention can be related to some outcome in a target person. There is a specific simple experimental setup that tests such a basic assumption. The task is to focus attention and to indicate unwanted mind wandering by a button press while at the same time a second remote person is either supporting this performance or not according to a randomized schedule. A meta-analysis was conducted to assess the overall effect of this experimental approach.
Methods: A systematic literature search yielded 11 eligible studies, with 576 single sessions and almost identical design, that were conducted on three different continents. Study parameters were extracted and combined with a random-effects model.
Results: The model yielded an overall effect size of d=0.11 (p=0.03). Furthermore, there was a significant difference of the frequency of button presses between studies conducted in Indonesia and the Western hemisphere (p<0.001). Two (2) similar experimental setups applying electrodermal activity as dependent variable meta-analyzed earlier showed almost identical effect sizes. This can be considered as mutual validation of the three data sets.
Conclusions: The hypothesis of the positive effect of benevolent intentions is supported by the data presented. It is concluded that especially the intentional aspect common to all three different tasks may be responsible for these unorthodox findings. These finding may have implications for distant healing research and health care as well as for meditation performance.
Source : Journal of Alternative and Complementary Medicine
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Good Mood Helps Boost Brain Power in Older Adults
Older adults can improve their decision making and working memory simply by putting on a happy face, a new study suggests.Researchers found that easy mood-boosters -- like giving people a small bag of candy -- helped seniors do significantly better on tests of decision-making and working memory.
This is the first study to show the power of positive moods in helping older people with these brain tasks.
“There has been lots of research showing that younger adults are more creative and cognitively flexible when they are in a good mood. But because of the cognitive declines that come with aging, we weren’t sure that a good mood would be able to help older adults,” said Ellen Peters, co-author of the study and professor of psychology at Ohio State University.
“So these results are good news. There are ways for older adults to overcome some of the cognitive declines that come with aging.”
The study was done with Stephanie Carpenter of the University of Michigan; David Västfjäll of Linköping University in Sweden; and the late Alice Isen, of Cornell University. It appears in the current issue of the journal Cognition and Emotion.
The study involved 46 adults aged 63 to 85. Half of them were put into a good mood by receiving a thank-you card and two small bags of candy, tied with a red ribbon, when they arrived at the lab for the experiment. The other “neutral mood” participants did not receive a card or candy.
The participants completed the study on a computer. Those who were induced into the positive mood had a background screen that was designed to help keep them feeling positive -- it featured smiling suns on a sky-blue background. The neutral-mood participants had a similar background, but with neutral round images with no face.
In the decision-making task, the participants were given $3 in quarters and presented with eight virtual decks of cards over the course of experiment. Each of the decks had a different pattern on its back so that participants could identify them. Four of the decks were “gain” decks, meaning that the participants won a quarter 75 percent of the time if they chose a card from that deck, while the other 25 percent they did not win or lose. The other four decks were “loss” decks, meaning they lost a quarter 75 percent of the time that they chose a card from the deck.
Participants could choose to accept or reject the top card of each deck that was offered to them. They were told the goal of the experiment was to win as much money as possible.
The researchers wanted to see how quickly and accurately the participants would learn which decks generally won them money, and which decks lost them money.
The findings were clear: older adults who were put into a good mood chose significantly better than those who were in the neutral mood.
These results are significant because this decision-making task was experiential, meaning that the participants knew nothing about the card values at the beginning of the experiment and had to learn through trial and error.
“We used an experiential task because real life is experiential,” Peters said.
“For example, you meet a new person and she is like one of these decks of cards. You don’t know anything about her and you have to learn if she is someone you can trust. What this study suggests is that people who are in a good mood are going to learn faster and make better decisions.”
Later in the experiment, the researchers tested working memory -- how much information people can hold in their mind at any one time. Researchers read aloud a group of intermixed letters and numbers (such as T9A3) and participants were to repeat the group back in numeric and then alphabetic order (in this case, 39AT). The participants received groups with increasingly more letters and numbers.
Results showed that the older adults who were induced into a good mood scored better on this test of working memory.
“Working memory is important in decision making,” Peters said.
“If you’re working your way through different options, how much you can remember of each option -- and can therefore compare and contrast in your head -- has a big impact on how well you can make a decision.”
A positive mood did not help these older adults on some cognitive measures, such as speed of processing or vocabulary.
Still, Peters said the results provide some good news for a fast-growing population segment in the United States.
“Given the current concern about cognitive declines in the aged, our findings are important for showing how simple methods to improve mood can help improve cognitive functioning and decision performance in older adults, just like they do in younger people.”
Source : Newswise
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Mindfulness Meditation May Relieve Chronic Inflammation
People suffering from chronic inflammatory conditions, such as rheumatoid arthritis, inflammatory bowel disease and asthma -- in which psychological stress plays a major role -- may benefit from mindfulness meditation techniques, according to a study by University of Wisconsin-Madison neuroscientists with the Center for Investigating Healthy Minds at the Waisman Center.
Mindfulness-based stress reduction, originally designed for patients with chronic pain, consists of continuously focusing attention on the breath, bodily sensations and mental content while seated, walking or practicing yoga.
While interest in meditation as a means of reducing stress has grown over the years, there has been little evidence to support benefits specific to mindfulness meditation practice. This was the first study designed to control for other therapeutic mechanisms, such as supportive social interaction, expert instruction, or learning new skills.
A class in stress reduction can be beneficial in many ways, some of which have little to do with mindfulness, according to Melissa Rosenkranz, assistant scientist at the center and lead author on the paper, which was published recently in the journal Brain, Behavior and Immunity. For example, learning to manage stress by engaging in regular physical activity may be therapeutic.
"We wanted to develop an intervention that was meant to produce positive change and compare the mindfulness approach to an intervention that was structurally equivalent," Rosenkranz says.
The study compared two methods of reducing stress: a mindfulness meditation-based approach, and a program designed to enhance health in ways unrelated to mindfulness.
The comparison group participated in the Health Enhancement Program, which consisted of nutritional education; physical activity, such as walking; balance, agility and core strengthening; and music therapy. The content of the program was meant to match aspects of the mindfulness instruction in some way. For example, physical exercise was meant to match walking meditation, without the mindfulness component. Both groups had the same amount of training, the same level of expertise in the instructors, and the same amount of home practice required by participants.
"In this setting, we could see if there were changes that we could detect that were specific to mindfulness," Rosenkranz explains.
Using a tool called the Trier Social Stress Test to induce psychological stress, and a capsaicin cream to produce inflammation on the skin, immune and endocrine measures were collected before and after training in the two methods. While both techniques were proven effective in reducing stress, the mindfulness-based stress reduction approach was more effective at reducing stress-induced inflammation.
The results show that behavioral interventions designed to reduce emotional reactivity are beneficial to people suffering from chronic inflammatory conditions.
The study also suggests that mindfulness techniques may be more effective in relieving inflammatory symptoms than other activities that promote well-being.
Rosenkranz emphasizes that the mindfulness-based approach is not a magic bullet.
"This is not a cure-all, but our study does show that there are specific ways that mindfulness can be beneficial, and that there are specific people who may be more likely to benefit from this approach than other interventions."
Significant portions of the population do not benefit from available pharmaceutical treatment options, for example. Some of these patients suffer from negative side effects of the drugs, or simply do not respond to the standard-of-care for treatment of the disorder.
"The mindfulness-based approach to stress reduction may offer a lower-cost alternative or complement to standard treatment, and it can be practiced easily by patients in their own homes, whenever they need," Rosenkranz says.
Scientists at the Center for Investigating Healthy Minds conduct rigorous research on the physiological effects of meditation on the brain, and the power of the brain to influence human health. This study adds to the growing body of knowledge concerning the mechanisms of mindfulness and how it affects the body.
Source : Science Daily
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The happy face of mindfulness: Mindfulness meditation is associated with perceptions of happiness as rated by outside observers
The last decade has witnessed an enormous increase in research examining the effects of mindfulness meditation. One of the basic assumptions guiding this research is that meditation ultimately makes people happier. In this article, in two studies we tested whether meditators actually look happier. To address this question, outside raters judged the happiness of meditators and non-meditators based on a 15-s video clip of their behaviour. Study 1 demonstrated that novice meditators looked happier after an intensive 9-day meditation retreat (as compared to before the retreat), while Study 2 demonstrated that experienced mindfulness meditators looked happier as compared to controls. The interpersonal implications of these findings are discussed.
Source : The Journal of Positive Psychology
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Hypnosis for hot flashes: results from a randomized clinical trial and future directions
G Elkins*, W Fisher, A Johnson
From International Research Congress on Integrative Medicine and Health 2012 Portland, Oregon, USA. 15-18 May 2012
Hot flashes are a significant clinical problem for many women. Currently there are limited options to hormone replacement therapy as non-hormonal pharmacological agents are associated with only modest activity and many adverse side effects. Hypnosis is one mind-body therapy that seems particularly promising for treating hot flashes and was investigated in the present study. This study examined the efficacy of hypnosis in reducing both self-reported and physiologically determined hot flash frequency and severity among post-menopausal women.
One-hundred and seventy post-menopausal women with moderate to severe hot flashes were randomly assigned to either a 5-session hypnosis intervention or a 5-session structured-attention control condition. All sessions were provided consistent with a treatment manual and all therapists were trained to criteria for consistency and treatment fidelity. Primary outcome measures were selfreported hot flash frequency and severity (determined via daily diaries) and physiologically monitored hot flashes (determined via sternal skin conductance). Physiological assessment of hot flashes were made using 24-hour recordings of sternal skin conductance. Measures were obtained at baseline, at the end of the five weeks intervention, and at 12 week follow-up.
Results demonstrated that hot flash scores (self-report of frequency and severity of hot flashes) for the participants that received the therapist delivered hypnosis intervention decreased by approximately 70% at 5 weeks and continued to decline to approximately 80% at the 12 week follow-up. Physiologically assessed hot flashes demonstrated a 50% reduction at 5 weeks and approximately 60% reduction at 12 weeks for participants in the therapist delivered hypnosis condition.
To our knowledge, this is the first study to demonstrate a clinically significant reduction in physiologically measured
hot flashes using a hypnosis intervention. This study has important implications for women experiencing hot flashes who are contraindicated for hormone replacement therapy.
Source : BMC Complementary and Alternative Medicine 2012, 12(Suppl 1):O57
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Hypnosis Should Be Offered to Patients With IBS, Swedish Research Suggests
Hypnotherapy helps fight IBS symptoms. These are the findings of a thesis from Sahlgrenska Academy, University of Gothenburg, Sweden which proposes implementing this treatment method into the care of severe sufferers of this common disease.
Irritable bowel syndrome, or IBS, is an very common stomach disease that manifests as abdominal pain and discomfort, disturbed bowel movements, abdominal swelling and bloating. Recent studies indicate that 10-15 percent of all Swedes suffer from IBS to varying degrees. Yet researchers still do not know what causes the condition and no effective treatment is available for those suffering from most severe symptoms.
Studies at Sahlgrenska Academy, University of Gothenburg, show that psychological treatment using hypnosis may offer effective, lasting relief. The studies are part of a thesis which concludes that hypnotherapy should be used in clinical care of patients with severe IBS.
"We have four different studies showing that hypnotherapy helps treat IBS, even when the treatment is not provided by highly specialized hypnotherapy centers. The treatment improves gastrointestinal symptoms and quality of life, and patient satisfaction is very high. The method also makes efficient use of health care resources," says Perjohan Lindfors, doctoral student at Sahlgrenska Academy, University of Gothenburg.
Source : ScienceDaily
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Immediate and Long-term Effects of Meditationon Acute Stress Reactivity, Cognitive Functions,and Intelligence
Yogesh Singh, MD ; Ratna Sharma, PhD ; Anjana alwar, MD
With the current globalization of the world’seconomy and demands for enhanced performance, stress is present universally. Life’s stressful events and daily stresses cause both deleterious and cumulative effects on the human body. The practice of meditation might offer away to relieve that stress.
The research team intended to study the effects of meditation on stress-induced changes in physi-ological parameters, cognitive functions, intelligence, and emotional quotients.
The research team conducted the study in two phases, with a month between them. Each participant served as his own control, and the frst phase served as thecontrol for the second phase. In phase 1, the research team studied the effects of a stressor (10 minutes playing a computer game) on participants’ stress levels. In phase 2, the research team examined the effects of meditation on stress levels.
The research team conducted the study in a labsetting at the All India Institute of Medical Sciences (AIIMS), New Delhi, India.
The participants were 34 healthy, male volunteers who were students.
To study the effects of long-term meditation on stress levels , intelligence, emotional quotients,and cognitive functions participants meditated daily for 1month, between phases 1 and 2. to study the immediate effects of meditation on stress levels, participants meditated for 15 minutes after playing a computer game to induce stress.
The research team measured galvanic skin response (GSR), heart rate (HR), and salivary cortisol and administered tests for the intelligence and emotional quotients (IQ and EQ), acute and perceived stress (AS and PS), and cognitive functions (ie, the Sternberg memory test [short-term memory] and the Stroop test [cognitive flexibility]). Using a pre–post study design, the team performed this testing (1) prior to the start of the study (baseline); (2) in phase 1, after induced stress; (3) in part 1 of phase 2, after 1 month of daily meditation, and (4) in part 2 of phase 2, after induced stress, both before and after 15 minutes of meditation.
Induced stress from the computer game resultedin a signifcant increase in physiological markers of stress such as GSR and HR. In the short term, meditation was associated with a physiological relaxation response (significant decrease in GSR) and an improvement in scores on the Stroop test of reaction times. In the long term,meditation brought signifcant improvements in IQ and scores for cognitive functions, whereas participants’ stresslevels (GSR and AS) decreased. EQ, salivary cortisol, and HR showed no significant changes.
The practice of meditation reduced psychological stress responses and improved cognitive functions, and the effects were pronounced with practice of meditation for a longer duration (1 month).
Source : Altern Ther Health Med
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Mind-body education helps irritable bowel syndrome
Patients who go through a mind-body educational course are better able to manage irritable bowel syndrome (IBS), according to a new study.
The benefits of the course were modest, about as large as what are typically seen from taking medications, said Dr. Emeran Mayer, the senior author of the study and a professor at the University of California, Los Angeles, School of Medicine.
The program doesn't work for everybody, said Mayer, but for others "it changed their lives."
The researchers couldn't describe exactly how patients' lives were changed, but those in the study reported having somewhat less severe symptoms and a higher quality of life after they went through the program.
Irritable bowel syndrome is a collection of symptoms, including stomach pain and diarrhea, that don't have a known inflammatory component like inflammatory bowel disease.
According to Mayer's study, published in Alimentary Pharmacology and Therapeutics, up to 15 percent of people experience IBS.
Although fiber supplements, antidiarrheal drugs and antidepressants can be used to ease some of the symptoms of IBS, there is no cure.
Some studies have found success with talk therapy, meditation and hypnosis (see Reuters Health reports of November 1, 2011 reut.rs/uOYJ8l, June 29, 2011 reut.rs/kbJOwu, and May 4, 2010 reut.rs/h2R0Ac).
In the current study, Mayer and his colleagues developed a group education program, in which patients attended two-hour sessions once a week for five weeks. The discussions centered on the role of the brain in regulating digestion, how responses to stressful events can affect IBS, and strategies to better manage symptoms.
The researchers compared the symptoms, quality of life, and mental health between 34 people who went through the course to 35 patients who were told they were on a wait list.
By the end of the sessions, patients reported that the severity of their symptoms dropped from about 10 down to about 8 on a 20-point scale. And three months after the program ended, these patients reported that the severity of their symptoms was at about 7.
In comparison, the wait-listed group reported that their symptoms went from about 13 to about 11 at the end of five weeks, and down to about 10 three months later.
The researchers could not describe just what these changes mean in day-to-day terms.
Similarly, the quality of life for patients in the education group rose from about 67 to nearly 76 on a 100-point scale by the end of the sessions, whereas the quality of life reported by the wait-listed group had a small drop from about 64 to about 62.
Patients in the mind-body course also showed some signs of better coping skills. For instance, people were less likely make the worst out of a given situation if they had gone through the sessions.
The findings are "part of larger set of data that says that the brain seems to be really important in the brain-gut interactions as they relate to IBS symptoms," said Jeffrey Lackner, a professor at the State University of New York at Buffalo who was not involved in the study.
Lackner said it's not entirely clear yet how meaningful the improvements on these measures will be to people's everyday lives. He said that future research should explore just how much, in a practical way, patients' lives change.
The changes seen after the educational program are not huge, Mayer said, but they would be noticeable to the patients. "I would prefer to see much larger changes," he told Reuters Health.
Dr. Arnold Wald, a professor of medicine at the University of Wisconsin who was not involved in the study, said he's not surprised to see that the program made some difference to people's illness.
He explained that one of the premises of the mind-body approach to treating IBS "is that the mind and the body are linked, physically, neurologically, as well as emotionally, and that things that affect the mind can affect the gut and vice versa. So if you can do something to alleviate mind stressors, you can improve body functions."
"Instead of when symptoms happen to them, saying, 'I'm going to have the worst abdominal pain of my life and I'm not going to make it to this meeting,'...they can say, 'I know about stress, I can rationally implement specific steps" to reduce it, Mayer said.
But whether such treatments will reach large numbers of people is unclear. Lackner said there are few therapists in the U.S. who focus on IBS.
Mayer's group is developing online programs to help make his approach more accessible.
Source : Reuters Health via: bit.ly/U8hjKn Alimentary Pharmacology and Therapeutics, online December 3, 2012.
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Meditation Combined With Art Therapy Can Change Your Brain and Lower Anxiety
Cancer and stress go hand-in-hand, and high stress levels can lead to poorer health outcomes in cancer patients. The Jefferson-Myrna Brind Center of Integrative Medicine combined creative art therapy with a Mindfulness-based Stress Reduction (MBSR) program for women with breast cancer and showed changes in brain activity associated with lower stress and anxiety after the eight-week program. Their new study appears in the December issue of the journal Stress and Health.
Daniel Monti, MD, director of the Jefferson-Myrna Brind Center of Integrative Medicine and lead author on the study, and colleagues have previously published on the success of Mindfulness-based Art Therapy (MBAT) at helping cancer patients lower stress levels and improve quality of life.
"Our goal was to observe possible mechanisms for the observed psychosocial effects of MBAT by evaluating the cerebral blood flow (CBF) changes associated with an MBAT intervention in comparison with a control of equal time and attention," says Monti. "This type of expressive art and meditation program has never before been studied for physiological impact and the correlation of that impact to improvements in stress and anxiety."
Eighteen patients were randomly assigned to the MBAT program or an education program control group. All had received the diagnosis of breast cancer between six months and three years prior to enrollment and were not in active treatment. The MBAT group consisted of the MBSR curriculum (awareness of breathing, awareness of emotion, mindful yoga, walking, eating and listening), paired with expressive art tasks to provide opportunities for self-expression, facilitate coping strategies, improve self-regulation, and provide a way for participants to express emotional information in a personally meaningful manner.
Patient response to the MBAT program was measured using a 90-item symptom checklist, completed by each patient before and after the eight-week program. In addition, functional magnetic resonance imaging (fMRI) was used pre and post-program to evaluate cerebral blood flow, corresponding to changes in the brain's activity. Scans were performed at rest, during a "neutral task" (control), meditation task, stressor task and at rest again -- designed to evaluate the general as well as specific effects and provide a thorough analysis of the CBF changes between the pre and post-program scans.
Participants in the MBAT group demonstrated significant effects on cerebral blood flow compared with the control group. The MBAT group showed increases in the emotional centers of the brain including the left insula which helps us to perceive our emotions, the amygdala which helps us experience stress, the hippocampus that regulates stress responses, and the caudate nucleus that is part of our brain's reward system. These increases correlated significantly with a lowering of stress and anxiety, as also reflected in the results of the pre and post-program anxiety scores among the MBAT intervention group.
The observed psychological and neuropsychological changes are consistent with current literature that states that MBSR interventions have shown to reduce anxiety, depression and psychological distress in a variety of populations. These have been associated with improved immune function, quality of life and coping effectiveness in women with breast cancer.
Given the improvements in anxiety levels and observed changes in CBF in the MBAT participants, these findings suggest that the MBAT program helps mediate emotional responses in women with breast cancer. "With the sample size enlarged, perhaps we can extrapolate these results to other disease populations and gain a fuller understanding of the physiological mechanisms by which mindfulness practices confer psychological benefits," says Monti.
Source : Science Daily
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Bothered by Negative, Unwanted Thoughts? Just Throw Them Away
If you want to get rid of unwanted, negative thoughts, try just ripping them up and tossing them in the trash.In a new study, researchers found that when people wrote down their thoughts on a piece of paper and then threw the paper away, they mentally discarded the thoughts as well.
On the other hand, people were more likely to use their thoughts when making judgments if they first wrote them down on a piece of paper and tucked the paper in a pocket to protect it.
“However you tag your thoughts -- as trash or as worthy of protection -- seems to make a difference in how you use those thoughts,” said Richard Petty, co-author of the study and professor of psychology at Ohio State University.
Some types of psychological therapy use variations of this concept by trying to get patients to discard their negative thoughts. But Petty said this is the first study he is aware of that has validated that approach.
“At some level, it can sound silly. But we found that it really works -- by physically throwing away or protecting your thoughts, you influence how you end up using those thoughts. Merely imagining engaging in these actions has no effect.”
The findings suggest that people can treat their thoughts as material, concrete objects, Petty said. That is evident in the language we use.
“We talk about our thoughts as if we can visualize them. We hold our thoughts. We take stances on issues, we lean this way or that way. This all makes our thoughts more real to us.”
Petty conducted the research with Pablo Briñol, Margarita Gascó and Javier Horcajo, all of the Universidad Autónoma de Madrid in Spain.
The results are published online in the journal Psychological Science and will appear in a future print edition.
For the study, the researchers conducted three related experiments.
In the first experiment, 83 Spanish high school students participated in a study they were told was about body image. Each participant was told to write down either positive or negative thoughts about his or her body during a three-minute period.
All the participants were asked to look back at the thoughts they wrote. Researchers told half of the students to contemplate their thoughts and then throw them in the trash can located in the room, “because their thoughts did not have to remain with them.” The other half were told to contemplate their thoughts and check for any grammar or spelling mistakes.
The participants then rated their attitudes about their own bodies on three 9-point scales (bad-good, unattractive-attractive, like-dislike).
Results showed that for those who kept their thoughts and checked them for mistakes, it mattered whether they generated positive or negative thoughts about their bodies. As would be expected, participants who wrote positive thoughts had more positive attitudes toward their bodies a few minutes later than did those who wrote negative thoughts.
However, those who threw their thoughts away showed no difference in how they rated their bodies, regardless of whether they wrote positive or negative thoughts.
“When they threw their thoughts away, they didn’t consider them anymore, whether they were positive or negative,” Petty said.
In a second study, 284 students participated in a similar experiment, except this time they were asked to write negative or positive thoughts about something most people believe is good: the Mediterranean diet (the diet emphasizes high consumption of fruits, vegetables, legumes and unrefined cereals, with olive oil as the basic fat).
In this case, some threw the thoughts away, some left them on their desk, and some were told to put the paper in their pocket, wallet or purse and keep it with them.
All participants were then asked to rate their attitudes toward the diet and intentions to use the diet for themselves.
As in the first study, those who kept the list of thoughts at their desk were more influenced by them when evaluating the diet than were those who threw them away. However, those who protected their thoughts by putting them in a pocket or purse were even more influenced than those who kept the thoughts on their desk.
In other words, those who wrote positive thoughts about the Mediterranean diet and put those thoughts in their pocket rated the diet more favorably than those who wrote positive thoughts and simply kept those thoughts on their desk. And, those who wrote negative thoughts and put them in their pocket rated the diet more negatively than those who kept their thoughts on the desk.
“This suggests you can magnify your thoughts, and make them more important to you, by keeping them with you in your wallet or purse,” Petty said.
But how important is the physical action of throwing these thoughts away or keeping them in your pocket? To find out, the researchers conducted a third experiment using computers. In this case, 78 Spanish college students wrote their thoughts in a computer word-processing document. Some later used a mouse to drag the file into the computer recycle bin, while others moved the file to a storage disk.
Just as in the previous studies, participants made less use of negative thoughts that they had trashed -- by dragging them to the recycle bin -- than did those who saved the thoughts by transferring them to a disk.
In one other condition, some participants were told to simply imagine dragging their negative thoughts to the recycle bin or saving them to a disk. But that had no effect on their later judgments.
“The more convinced the person is that the thoughts are really gone, the better,” Petty said. “Just imagining that you throw them away doesn’t seem to work.
“Of course, even if you throw the thoughts in a garbage can or put them in the recycle bin on the computer, they are not really gone -- you can regenerate them. But the representations of those thoughts are gone, at least temporarily, and it seems to make it easier to not think about them.”
Petty said the researchers plan to see if this technique could work to help people who have recurrent negative thoughts that are intrusive and bothersome, such as thoughts about the death of a loved one.
“It is often difficult to get rid of these thoughts. We want to find out if there is a way to keep those thoughts from coming back, at least for longer periods of time.”
Source : Newswise
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Menopause: Relaxation Good Therapy for Hot Flushes
Women who have undergone group therapy and learned to relax have reduced their menopausal troubles by half, according to results of a study at Linköping University and Linköping University Hospital in Sweden.
Seven out of every ten women undergoing menopause have at some point experienced problems with hot flushes and sweating. For one in ten women, the problems lasted five years or longer, primarily causing discomfort in social situations and insomnia.
The background to this is not known. What is known is that the decreasing amounts of the female hormone estrogen -- which occurs after menopause -- affects the brain's heat regulation centre in the hypothalamus.
Medication with estrogen has proven to have a good effect. At the end of the 1990s, Swedish doctors prescribed hormone tablets to around 40% of women with moderate to severe symptoms. But since new observations have shown that the treatment increased the risk of breast cancer and cardiovascular disease, their use has decreased drastically. Today, the number of women with menopausal problems receiving estrogen is down to 10%.
The situation triggered an interest in alternative forms of treatment. For her doctoral thesis, Women's Clinic consultant Elizabeth Nedstrand arranged a study where a group of women were randomly assigned to three different treatments alongside estrogen: acupuncture, exercise, and applied relaxation -- a method based on cognitive behaviour therapy developed by psychologist Lars-Göran Öst.
The results were so interesting that a larger randomised study around the effects of applied relaxation began n in 2007. 60 women who saw a doctor for moderate to severe symptoms occurring at least 50 times a week -- but who were otherwise completely healthy -- were randomly assigned to two groups: one had ten sessions of group therapy and the other received no treatment whatsoever. The results are now being published by Nedstrand and Lotta Lindh-Åstrand in the scientific journal Menopause.
Nedstrand herself conducted the therapy, which is based on learning to find the muscle groups in one's body and getting the body to relax with the help of breathing techniques.
"The participants were given exercises to practice daily at home. The goal was for them to learn to use the method on their own and to be able to manage their own symptoms.
During the intervention period and for three months thereafter, the women kept a diary of their hot flushes. They also had to fill out a "quality of life" survey on three occasions, in addition to submitting a saliva sample for analysis of the stress hormone cortisol.
The results were striking. The women in the treatment group reduced the number of hot flushes per day from an average of 9.1 to 4.4; the effect remained for three months after the last therapy session. The numbers in the control group also decreased, but only from 9.7 to 7.8.
The women in the therapy group also reported improved quality of life as regards memory and concentration, sleep, and anxiety. On the other hand, there were no statistically significant differences in stress hormone secretion.
"The study confirms that applied relaxation can help women with menopausal troubles. My hope is that women can be offered this treatment in primary care and from private health care providers," Nedstrand says.
Source : Science Daily
Positive Outlook on Aging Helps Seniors Heal
Older patients with positive attitudes on aging may be more likely to fully recover from severe disability compared with those who can't see the bright side of life, researchers found.
A positive stereotype about aging was associated with a 44% greater likelihood of recovery from severe disability versus negative stereotypes (95% CI 1.01 to 2.06, P=0.04), according to Becca Levy, PhD, from the Yale School of Public Health, and colleagues.
Holding positive stereotypes in older age was also significantly associated with a slower rate of decline in activities of daily living (P=0.001), they wrote in a research letter in the Journal of the American Medical Association online.
"Further research is needed to determine whether interventions to promote positive age stereotypes could extend independent living in later life," the authors noted.
The researchers sampled patients through the Precipitating Events Project study and included 598 mostly female patients (63.3%), with an average age of 79, who belonged to a Connecticut health plan. All participants lived in a community, were nondisabled, and experienced at least 1 month of disability from active daily life during the follow-up period.
The participants were interviewed monthly for up to 129 months and filled out home-based assessments every 18 months over 10 years.
The researchers established age stereotypes by asking participants for five terms or phrases they associated with older individuals and coding those descriptors on a five-point scale, with 1 being most negative (such as decrepit) and 5 being most positive (such as spry). The participants scored a mean 2.12 on this scale.
Participants' severity of disability was based on the number of activities of daily living compromised by disability, including bathing, dressing, transferring, and walking. Three or four compromised activities were considered severely disabled; mild to severe disability required assistance with one to two activities, and mild to no disability required no assistance with activities of daily life.
The researchers grouped patients on whether they held positive or negative age stereotypes and compared rates of recovery from severe or mild injury to no or mild disability. Patients between groups were well-matched for age, sex, nonwhite ethnicity, frailty, education, chronic conditions, mental status, depression, and whether or not they lived alone. The nature of the disabling events was not described.
Patients were significantly more likely to recover from any state of injury to either no or mild disability if they fit positive age stereotypes, including from severe disability to no disability, severe disability to mild disability (HR 1.23, 95% CI 1.03 to 1.46, P=0.02), and mild disability to no disability (HR 1.15, 95% CI 1.02 to 1.29, P=0.02).
The researchers also noted that the positive age-stereotyped patients "showed an advantage in the absolute risk increase percentages" in likelihood of recovery, in addition to "a significantly slower rate of [activities of daily life] decline."
Source : Medpage Today
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New Study Review Examines Benefits of Music Therapy for Surgery Patients
A new study review published by the University of Kentucky found that music therapy can be beneficial to patients before, during and after a surgical procedure and may reduce pain and recovery time.Published in the Southern Medical Journal, the review examined the use of music in the preoperative, intraoperative and postoperative stages of the surgical process, and music was shown to have positive results in all three stages. Patients were less anxious before the procedure and recovered more quickly and satisfactorily after by being exposed to music intra- and post-operation. They also required less sedative medication and reported better satisfaction with their medical experience.
"Music therapists have long known that music can be an effective tool to manage pain and anxiety," said Lori Gooding, UK director of music therapy and lead author on the review. "Here at UK, our music therapists regularly use music-based interventions to help patients manage both pain and anxiety.”
Some research suggests that music-based interventions can be effective in reducing anxiety, pain perception and sedative intake. Music that is selected by trained personnel is preferred because specific guidelines for music selection should be followed in order to maximize its positive effect on patients, though the patient's musical tastes should still be considered. It is suggested that several "playlists" be offered and the patient can choose one that best suits their tastes.
Characteristics of the music are also important in effective music therapy. Among other features, the tempo, rhythm and volume of the music can be carefully controlled in order to maximize the positive effect that music can have. Calm, slow, gentle music was shown to produce the most positive results and facilitate relaxation and pain reduction in patients. Data proposes that music could be beneficial in reducing cost and length of stay in intensive care units.
Other findings show that medical music therapists serve as good consultants when implementing music medicine-based interventions. Specialized training can help them to better manage pain and anxiety in surgical patients and it has been proposed that live performances for patients are more effective than recorded music.
UK began providing music therapy for patients in Kentucky Children’s Hospital, UK Chandler Hospital and UK Good Samaritan Behavioral Health in October 2010. Based on the findings from this review, Gooding and her team have begun implementing two pilot programs in the pre-op unit at UK, one for procedural support/pain and the other for patient distress.
"Our goal is to decrease patient pain and anxiety as well as improve satisfaction with the surgical experience," Gooding said. "We also hope the program benefits staff by allowing them to do their jobs more easily and effectively.”
The UK Music Therapy program, which was established as part of the Lucille Caudill Little Performing Arts in HealthCare Program, is a unique partnership between the UK School of Music and UK HealthCare. Since the program's inception, Gooding has worked to establish its clinical, academic and research components. Educating the health care, university and local communities about the evidenced-based beneﬁts of music therapy is a vital role in program development.
Source : Newswise
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Make room for faith in healthcare, study says
Despite differences in rituals and beliefs among the world’s major religions, a new study shows that spirituality often enhances health regardless of a person’s faith.
Researchers from the University of Missouri say that health care providers could take advantage of this correlation between health—particularly mental health—and spirituality by tailoring treatments and rehabilitation programs to accommodate an individual’s spiritual inclinations.
“In many ways, the results of our study support the idea that spirituality functions as a personality trait,” says Dan Cohen, assistant teaching professor of religious studies and one of the co-authors of the study.
“With increased spirituality people reduce their sense of self and feel a greater sense of oneness and connectedness with the rest of the universe.
“What was interesting was that frequency of participation in religious activities or the perceived degree of congregational support was not found to be significant in the relationships between personality, spirituality, religion, and health.”
The study used the results of three surveys to determine if correlations existed among participants’ self-reported mental and physical health, personality factors, and spirituality in Buddhists, Muslims, Jews, Catholics, and Protestants.
Across all five faiths, a greater degree of spirituality was related to better mental health, specifically lower levels of neuroticism and greater extraversion. Forgiveness was the only spiritual trait predictive of mental health after personality variables were considered.
“Our prior research shows that the mental health of people recovering from different medical conditions, such as cancer, stroke, spinal cord injury, and traumatic brain injury, appears to be related significantly to positive spiritual beliefs and especially congregational support and spiritual interventions,” says Cohen.
“Spiritual beliefs may be a coping device to help individuals deal emotionally with stress.”
Part of the whole
Cohen believes spirituality may help people’s mental health by reducing their self-centeredness and developing their sense of belonging to a larger whole. Many different faith traditions encourage spirituality though they use different names for the process.
A Christian monk wouldn’t say he had attained Nirvana, nor would a Buddhist monk say he had communed with Jesus Christ, but they may well be referring to similar phenomena.
“Health workers may also benefit from learning how to minimize the negative side of a patient’s spirituality, which may manifest itself in the tendency to view misfortune as a divine curse.”
As the authors note, spiritual interventions such as religious-based counseling, meditation, and forgiveness protocols may enhance spiritually based beliefs, practices, and coping strategies in positive ways.
The benefits of a more spiritual personality may go beyond an individual’s mental health. Cohen believes that the selflessness that comes with spirituality enhances characteristics that are important for fostering a global society based on the virtues of peace and cooperation.
Source : Futurity
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Meditation Make Your More Creative
Certain meditation techniques can promote creative thinking. This is the outcome of a study by cognitive psychologist Lorenza Colzato and her fellow researchers at Leiden University, published 19 April in Frontiers in Cognition.
This study is a clear indication that the advantages of particular types of meditation extend much further than simply relaxation. The findings support the belief that meditation can have a long-lasting influence on human cognition, including how we think and how we experience events.
Two ingredients of creativity
The study investigates the influences of different types of meditative techniques on the two main ingredients of creativity: divergent and convergent styles of thinking.
- Divergent thinking Divergent thinking allows many new ideas to be generated. It is measured using the so-called Alternate Uses Task method where participants are required to think up as many uses as possible for a particular object, such as a pen.
- Convergent thinking Convergent thinking, on the other hand, is a process whereby one possible solution for a particular probem is generated. This method is measured using the Remote Associates Task method, where three unrelated words are presented to the participants, words such as 'time', 'hair' and 'stretch'. The particpants are then asked to identify the common link: in this case, 'long'.
Colzato used creativity tasks that measure convergent and divergent thinking to assess which meditation techiques most influence creative activities. The meditation techniques analysed are Open Monitoring and Focused Attention meditation.
- In Open Monitoring meditation the individual is receptive to all the thoughts and sensations experienced without focusing attention on any particular concept or object.
- In Focused Attention meditation the individual focuses on a particular thought or object.
These findings demonstrate that not all forms of meditation have the same effect on creativity. After an Open Monitoring meditation the participants performed better in divergent thinking, and generated more new ideas than previously, but Focused Attention (FA) meditation produced a different result. FA meditation also had no significant effect on convergent thinking leading to resolving a problem.
Source : Science Daily via
The Impact of Focused-Attention and Open-Monitoring Training on Convergent and Divergent Thinking. Frontiers in Psychology, 2012; 3 DOI: 10.3389/fpsyg.2012.00116
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Meditation Reduces Lonliness
Many elderly people spend their last years alone. Spouses pass and children scatter. But being lonely is much more than a silent house and a lack of companionship. Over time, loneliness not only takes a toll on the psyche but can have a serious physical impact as well.
Feeling lonely has been linked to an increased risk of heart disease, Alzheimer's disease, depression and even premature death. Developing effective treatments to reduce loneliness in older adults is essential, but previous treatment efforts have had limited success.
What to do? Researchers at UCLA now report that a simple meditation program lasting just eight weeks reduced loneliness in older adults. Further, knowing that loneliness is associated with an increase in the activity of inflammation-related genes that can promote a variety of diseases, the researchers examined gene expression and found that this same form of meditation significantly reduced expression of inflammatory genes.
In the current online edition of the journal Brain, Behavior and Immunity, senior study author Steve Cole, a UCLA professor of medicine and psychiatry and a member of the Norman Cousins Center for Psychoneuroimmunology at UCLA, and colleagues report that the two-month program of mindfulness-based stress reduction (MBSR), which teaches the mind to simply be attentive to the present and not dwell in the past or project into the future, successfully reduced the feelings of loneliness.
Remarkably, the researchers said, MBSR also altered the genes and protein markers of inflammation, including the inflammatory marker C-reactive protein (CRP) and a group of genes regulated by the transcription factor NF-kB. CRP is a potent risk factor for heart disease, and NF-kB is a molecular signal that activates inflammation.
Inflammation is a natural component of the immune system and can help fight a wide variety of bodily insults, ranging from infections to a whack by a hammer. But chronic inflammation is now known to be a primary player in the pathology of many diseases and psychological disorders.
"Our work presents the first evidence showing that a psychological intervention that decreases loneliness also reduces pro-inflammatory gene expression," Cole said. "If this is borne out by further research, MBSR could be a valuable tool to improve the quality of life for many elderly."
In the study, 40 adults between the ages of 55 and 85 were randomly assigned to either a mindfulness meditation group or a control group that did not meditate. All the participants were assessed at the beginning and the end of the study using an established loneliness scale. Blood samples were also collected at the beginning and end to measure gene expression and levels of inflammation.
The meditators attended weekly two-hour meetings in which they learned the techniques of mindfulness, including awareness and breathing techniques. They also practiced mindfulness meditation for 30 minutes each day at home and attended a single daylong retreat.
These MBSR participants self-reported a reduced sense of loneliness, while their blood tests showed a significant decrease in the expression of inflammation-related genes.
"While this was a small sample, the results were very encouraging," said Dr. Michael Irwin, a professor of psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA and director of the Cousins Center. "It adds to a growing body of research that is showing the positive benefits of a variety of meditative techniques, including tai chi and yoga."
Just last month, for example, Dr. Helen Lavretsky, a UCLA professor of psychiatry and a Cousins Center member, published a study showing that a form of yogic meditation involving chanting also reduced inflammatory gene expression, as well as stress levels, among individuals who care for patients with Alzheimer's disease.
"These studies begin to move us beyond simply connecting the mind and genome, and identify simple practices that an individual can harness to improve human health," Irwin said.
Source : Science Daily via Journal Study - Mindfulness-Based Stress Reduction training reduces loneliness and pro-inflammatory gene expression in older adults: A small randomized controlled trial. Brain, Behavior, and Immunity, 2012; DOI: 10.1016/j.bbi.2012.07.006
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Meditation or Exercise May Help Acute Respiratory Infections, Study Finds
According to a recent study, exercising or practicing meditation may be effective in reducing acute respiratory infections. Acute respiratory infections, which are caused by influenza and other viruses, are very common illnesses and account for millions of doctor visits and lost school and work days each year. Previous research has suggested that enhancing general physical and mental health may offer protection against these illnesses. Findings from this NCCAM-funded study were published in the journal Annals of Family Medicine.
Researchers from the University of Wisconsin-Madison randomly assigned 154 people, aged 50 and older, to one of three groups: a mindfulness meditation group, an exercise group, or a wait-list control group. Participants in the meditation group received training in mindfulness-based stress reduction (a type of meditation based on the idea that an increased awareness of physical, emotional, and cognitive manifestations of stress may lead to a healthier mind-body response to stress). Participants in the exercise group received instruction and practiced moderately intensive exercise (using stationary bicycles, treadmills, and other equipment) during group sessions, and walked briskly or jogged for home exercise. Both interventions lasted 8 weeks, consisting of 2.5-hour group sessions each week and 45 minutes of daily at-home practice.
The severity of each acute respiratory infection that occurred during the study was assessed through a participant survey. In addition, a nasal wash was collected within 3 days of participants experiencing symptoms and analyzed for specific indicators, some of which are linked to the severity of symptoms. Participants answered questionnaires assessing psychosocial measures that could potentially explain links between behavioral interventions and acute respiratory illness outcomes. They also reported any visits to health care facilities or missed work or school activities.
The researchers observed substantial reductions in acute respiratory illness among those in the exercise group, and even greater benefits among those in the meditation group. While not all of the observed benefits were statistically significant, the researchers noted that the magnitude of the observed reductions in illness was clinically significant. They also found that compared to the control group, there were 48 percent fewer days of work missed due to acute respiratory infections in the exercise group, and 76 percent fewer in the meditation group. Researchers stated that these findings are especially noteworthy because apart from hand-washing, no acute respiratory infection prevention strategies have previously been proven. The researchers concluded that future studies are needed to confirm these findings.
Barrett B, Hayney MS, Muller D, et al. Meditation or exercise for preventing acute respiratory infection: a randomized controlled trial. Annals of Family Medicine. 2012;10:337-346.
Source : NCCAM
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Evidence Supports Health Benefits of 'Mindfulness-Based Practices'
Practices Derived from Buddhist Meditation Show Real Effectiveness for Certain Health Problems, Reports Journal of Psychiatric Practice
Specific types of "mindfulness practices" including Zen meditation have research-proven benefits for patients with certain physical and mental health problems, according to a report in the July Journal of Psychiatric Practice. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health."An extensive review of therapies that include meditation as a key component—referred to as mindfulness-based practices—shows convincing evidence that such interventions are effective in the treatment of psychiatric symptoms and pain, when used in combination with more conventional therapies," according to Dr William R. Marchand of the George E. Wahlen Veterans Affairs Medical Center and the University of Utah in Salt Lake City.
Mindfulness Techniques Show Health Benefits
Dr Marchand reviewed published studies evaluating the health benefits of mindfulness-based practices. Mindfulness has been described as "the practice of learning to focus attention on moment-by-moment experience with an attitude of curiosity, openness, and acceptance." Put another way, "Practicing mindfulness is simply experiencing the present moment, without trying to change anything."
The review focused on three techniques:
• Zen meditation, a Buddhist spiritual practice that involves the practice of developing mindfulness by meditation, typically focusing on awareness of breathing patterns.
• Mindfulness-based stress reduction (MBSR), a secular method of using Buddhist mindfulness, combining meditation with elements of yoga and education about stress and coping strategies.
• Mindfulness-based cognitive therapy (MBCT), which combines MBSR with principles of cognitive therapy (for example, recognizing and disengaging from negative thoughts) to prevent relapse of depression.
Dr Marchand found evidence that MBSR and MBCT have "broad-spectrum" effects against depression and anxiety and can also decrease general psychological distress. Based on the evidence, MBCT can be "strongly recommended" as an addition to conventional treatments (adjunctive treatment) for unipolar depression. Both MBSR and MBCT were effective adjunctive treatments for anxiety.
Research data also supported the effectiveness of MBSR to help reduce stress and promote general psychological health in patients with various medical and/or psychiatric illnesses. On its own, MBSR was helpful in managing stress and promoting general psychological health in healthy people. There was also evidence that Zen meditation and MBSR were useful adjunctive treatments for pain management.
How do these practices work to affect mental and physical health? Dr Marchand discusses recent research showing the impact of mindfulness practices on brain function and structure, which may in part account for their psychological benefits. "These mindfulness practices show considerable promise and the available evidence indicates their use is currently warranted in a variety of clinical situations," he concludes.
The article includes some proposed evidence-based guidelines for incorporating mindfulness-based practices into health care. So far there's little evidence on which patients are most likely to benefit, but Dr Marchand suggests that patient preferences and enthusiasm are a good guide. He comments, "The most important considerations may be desire to try a mindfulness-based practice and willingness to engage in the regular practice of seated meditation."
Source : Newswise
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MU Receives National Award for Using Mind-Body Approach to Improve Health
The belief that the mind plays an integral role in physical health dates back to the earliest days of medicine. The Greek physician Hippocrates, often referred to as the founder of medicine, wrote "natural forces within us are the true healers of disease." A University of Missouri team has tapped into the science and practice of this mind-body interaction to develop an innovative and award-winning program. Called "Taking Care of You: Body-Mind-Spirit," the program was recognized with the 15th annual Jeanne M. Priester Award. The award honors extension groups that develop and expand programs that positively impact health. MU won the award in the county/multi-county category against 28 other nominations from across the nation. Developed at MU, the program teaches approaches to deal with stress and experience healthier ways to eat.
"People struggle with developing healthy lifestyle behaviors, and stress plays a major role in that," said Molly Vetter-Smith, assistant professor and state specialist for health education with MU's School of Medicine and MU Extension. "This program examines health decisions and offers practical research-based strategies to manage stress and explore mind-body interactions, including mindfulness and other strategies from the field of positive psychology. It teaches activities to help participants better manage their stress, which our research shows results in improved health behaviors."
One of the activities involves mindful eating. The practice emphasizes the enjoyment of the eating experience by focusing on aromas, taste and texture of food. If participants slow down and savor all aspects of the eating experience, said Vetter-Smith, they realize they're much more satisfied with smaller portions of food.
"Research shows that normally when you eat a meal, you really pay attention to the taste of your food for the first two bites and the last bite," Vetter-Smith said. "For all those bites in between, we're not paying attention to the taste, textures and enjoying the satisfaction of the food we eat. That influences what we eat and how much we eat, and our program teaches approaches to bring greater awareness to eating"
Other activities in the eight-session program focus on stress management skills and identifying strategies that complement a busy lifestyle. Activities in the program are aimed at creating a resiliency to stress and improving what Hippocrates termed the "natural forces within us," or rather, the healthy mind-body interaction.
The "Taking Care of You: Body-Mind-Spirit" program was piloted in 2009 and 2010 and has been offered at worksites, churches and community centers statewide since 2011. With 45 trained specialists throughout Missouri, group sizes for the program range from 10 to 25 participants. The innovative program has garnered attention beyond Missouri, as well.
"We hope to expand the program to other states," Vetter-Smith said. "We've had lots of other states contacting us and asking how they can get the program."
Source : Newswise.com
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