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Gao Y, Shi L, Fu N, Yang N, Weeks-Gariepy T, Mao Y. Mobile-Delivered Mindfulness Intervention on Anxiety Level Among College Athletes: Randomized Controlled Trial. J Med Internet Res 2024; 26:e40406. [PMID: 38457201 PMCID: PMC10960210 DOI: 10.2196/40406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 12/29/2022] [Accepted: 01/31/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND College athletes are a group often affected by anxiety. Few interventional studies have been conducted to address the anxiety issues in this population. OBJECTIVE We conducted a mobile-delivered mindfulness intervention among college athletes to study its feasibility and efficacy in lowering their anxiety level and improving their mindfulness (measured by the Five Facet Mindfulness Questionnaire [FFMQ]). METHODS In April 2019, we recruited 290 college athletes from a public university in Shanghai, China, and 288 of them were randomized into an intervention group and a control group (closed trial), with the former (n=150) receiving a therapist-guided, smartphone-delivered mindfulness-based intervention and the latter receiving mental health promotion messages (n=138). We offered in-person instructions during the orientation session for the intervention group in a classroom, with the therapist interacting with the participants on the smartphone platform later during the intervention. We used generalized linear modeling and the intent-to-treat approach to compare the 2 groups' outcomes in dispositional anxiety, precompetition anxiety, and anxiety during competition, plus the 5 dimensions of mindfulness (measured by the FFMQ). RESULTS Our intent-to-treat analysis and generalized linear modeling found no significant difference in dispositional anxiety, precompetition anxiety, or anxiety during competition. Only the "observation" facet of mindfulness measures had a notable difference between the changes experienced by the 2 groups, whereby the intervention group had a net gain of .214 yet fell short of reaching statistical significance (P=.09). Participants who specialized in group sports had a higher level of anxiety (β=.19; SE=.08), a lower level of "nonjudgemental inner experience" in FFMQ (β=-.07; SE=.03), and a lower level of "nonreactivity" (β=-.138; SE=.052) than those specializing in individual sports. CONCLUSIONS No significant reduction in anxiety was detected in this study. Based on the participant feedback, the time availability for mindfulness practice and session attendance for these student athletes in an elite college could have compromised the intervention's effectiveness. Future interventions among this population could explore a more student-friendly time schedule (eg, avoid final exam time) or attempt to improve cognitive and scholastic outcomes. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1900024449; https://www.chictr.org.cn/showproj.html?proj=40865.
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Affiliation(s)
- Yu Gao
- Shanghai University of Finance and Economics, Shanghai, China
| | - Lu Shi
- Department of Health Science, Pace University, New York, NY, United States
| | - Ning Fu
- School of Public Administration and Emergency Management, Jinan University, Guangzhou, China
| | - Nan Yang
- Shanghai University of Finance and Economics, Shanghai, China
| | - Tracy Weeks-Gariepy
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
| | - Yuping Mao
- Department of Communication Studies, California State University Long Beach, Long Beach, CA, United States
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Ramon AE, Possemato K, Beehler GP. Headache Disorders in VHA Primary Care: Prevalence, Psychiatric Comorbidity, and Health Care Utilization. Behav Med 2023:1-10. [PMID: 37712622 DOI: 10.1080/08964289.2023.2249169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 09/16/2023]
Abstract
Military veterans are at increased risk for headache disorders compared to the general population, yet the prevalence and burden associated with headache disorders among veterans is not yet well understood. In this electronic medical record study, we examined the prevalence of headache disorders among veterans seen in a northeastern network of Veterans Health Administration (VHA) primary care during 2017-2018. We also examined rates of psychiatric comorbidity and health care utilization of veterans with headache disorders for the year following the date of the first headache code in the medical record. Of the total population of veterans in the network, 1.3% had a headache disorder and another 3.5% had a possible headache disorder. Migraine and chronic migraine represented the majority of cases. Posttraumatic stress disorder was the most frequent psychiatric comorbidity. Having a headache disorder was associated with higher rates of primary care, neurology, pain clinic, and mental health service use but not higher rates of emergency department or Whole Health (e.g., patient-centered, holistic health services) use. Prevalence findings are comparable to those previously found among veterans, but a substantial proportion of veterans may have been misdiagnosed. Veterans with headache disorders have high rates of psychiatric comorbidity and use several types of health services at higher rates. Findings highlight the need for interdisciplinary care and further education and support for primary care providers. Primary care settings that integrate evidence-based behavioral and Whole Health services may be an optimal way of providing more holistic care for headache disorders.
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Sado M, Yamada M, Ninomiya A, Nagaoka M, Goto N, Koreki A, Nakagawa A, Segal Z, Mimura M. Effectiveness and Cost-effectiveness of Online Brief Mindfulness-based Cognitive Therapy for the Improvement of Productivity in the Workplace: Study Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e36012. [PMID: 35387762 PMCID: PMC9237757 DOI: 10.2196/36012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/06/2022] [Accepted: 04/02/2022] [Indexed: 11/13/2022] Open
Abstract
Background Numerous studies have demonstrated the effectiveness of mindfulness-based programs (MBPs) among both clinical and nonclinical populations. These data document positive impacts in the workplace, including reducing perceived stress and burnout and increasing well-being. However, the effectiveness for productivity, which is of most interest to managers and administrators, is still unclear. In addition, MBPs in the workplace tend to be modified by reducing the number of the program sessions or delivering content online to improve accessibility. To date, however, the impact of MBPs that feature these modifications on productivity in the workplace has not been investigated. Objective The study aims to investigate the effectiveness and cost-effectiveness of online-delivered brief mindfulness-based cognitive therapy (bMBCT) for improving productivity and other work-related outcomes among healthy workers compared to the waitlist control. Methods We will conduct a 4-week randomized controlled trial (RCT) with a 6-month follow-up. Employees are included in the study if they (1) are between the ages of 20 and 65 years and (2) work longer than 30 hours weekly. Employees are randomly allocated to either the bMBCT group or the waitlist control group. The primary outcome of the study is the mean difference of productivity measured by the World Health Organization Health and Work Performance Questionnaire (WHO-HPQ) between the groups at 4, 16, and 28 weeks. Secondary outcomes include several clinical outcomes and health economics evaluation. Results We started recruiting participants in August 2021, and the intervention began in October 2021. A total of 104 participants have been enrolled in the study as of October 2021. The intervention is scheduled to be completed in December 2023. Data collection will be completed by the end of January 2024. Conclusions The novelty of the study is that (1) it will investigate bMBCT’s effectiveness on productivity, which is still unclear, and (2) samples are recruited from 3 companies in different industries. The limitations of the study are that (1) all measures assessed are in self-report format and (2) we lack an active control group. This study has the potential to provide new data on the relationship between MBPs and occupational health and productivity. Trial Registration University Hospital Medical Information Network Clinical Trials Registry UMIN000044721; https://tinyurl.com/4e2fh873 International Registered Report Identifier (IRRID) DERR1-10.2196/36012
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Affiliation(s)
- Mitsuhiro Sado
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Center for Stress Research, Keio University, Tokyo, Japan
| | - Masashi Yamada
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Center for Stress Research, Keio University, Tokyo, Japan
| | - Akira Ninomiya
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Center for Stress Research, Keio University, Tokyo, Japan
| | - Maki Nagaoka
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Center for Stress Research, Keio University, Tokyo, Japan
| | - Naho Goto
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Center for Stress Research, Keio University, Tokyo, Japan
| | - Akihiro Koreki
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Center for Stress Research, Keio University, Tokyo, Japan.,Department of Psychiatry, Shimofusa Psychiatric Medical Center, National Hospital Organization, Chiba, Japan
| | - Atsuo Nakagawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Zindel Segal
- Graduate Department Psychological Clinical Science, University of Toronto Scarborough, Toronto, ON, Canada
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Center for Stress Research, Keio University, Tokyo, Japan
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Ur Rehman MA, Waseem R, Habiba U, Fahad Wasim M, Alam Rehmani S, Alam Rehmani M, Abdullah M, Khabir Y, Rehan Hashmi M, Almas T, Shahan Ali S, Huzaifa Shah SM, Fatima K. Efficacy of mindfulness-based intervention for the treatment of chronic headaches: A systematic review and meta-analysis. Ann Med Surg (Lond) 2022; 78:103862. [PMID: 35734718 PMCID: PMC9207091 DOI: 10.1016/j.amsu.2022.103862] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/21/2022] [Accepted: 05/22/2022] [Indexed: 01/03/2023] Open
Abstract
Background Mindfulness-based stress reduction/cognitive therapy
has attained popularity as an adjunctive treatment for a plethora of medical and
psychiatric conditions, however, its impact on chronic headaches is inconclusive.
This review aims to assess the impact of MBSR/MBCT in alleviating the symptoms of
chronic headaches. Data sources and data selection PubMed and Cochrane CENTRAL were searched from
inception till 1st May 2021. Randomized Control Trials evaluating mindfulness-based
stress reduction/cognitive therapy with either passive comparators (usual care) or
active comparators (e.g., Health education or cognitive behavioral therapy) for
chronic headaches (Migraine, Tension-type, or cluster headaches), which evaluated
either headache frequency, pain intensity or headache duration as primary outcome
were eligible for inclusion. The Risk of Bias was evaluated using the Cochrane
Collaboration's Risk of Bias Tool. Results A total of ten Randomized Controlled Trials (five on
migraine; three on tension-type; two with mixed samples) were evaluated. In
comparison to usual care, mindfulness-based stress reduction/cognitive therapy did
not illustrate significant changes in headache frequency (MD = −0.14; 95% CI -1.26 to
0.97; P = 0.80; Moderate Certainty), headache duration (MD = −0.27; 95% CI -3.51 to
2.97, P = 0.87; Low Certainty) or pain intensity (MD = −0.19; 95% CI -0.46 to 0.07;
P = 0.15; Moderate Certainty) Conclusion The results found are insignificant for the three
primary outcomes, which may be due to the low number of participants and often a high
or unclear risk of bias in the randomized control trials included. Perhaps more
aggressive clinical trials with a larger sample size effectively demonstrate
differences in outcomes before and after therapy for MBSR/MBCT could provide a more
significant change. Mindfulness-based therapy for treatment of chronic
headache. Mindfulness vs usual care for treating patients with
chronic headache. Effect of different mindfulness-based techniques over
headache frequency, intensity and duration. Efficacy of Mindfulness-based therapy in achieving
mindfulness in pts with chronic headache.
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holistic view of management of polycystic ovarian syndrome. Int J Health Sci (Qassim) 2022. [DOI: 10.53730/ijhs.v6ns2.6011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is one of the most prevalent disorders in women which influence their endocrine and metabolic functioning. It causes physical and psychological issues which are responsible for causing disturbances in daily life of women. Apart from genetics, stress, anxiety, obesity, and sedentary life style are among several factors that contribute to this disease. Hence, the treatment must target all these factors. Yoga, diet, exercises and therapies like mindfulness based cognitive therapy (MBCT) have significant effects on management of symptoms of PCOS. Assessment of the overall health of women can assist in the treatment programme and integral plans can be designed to deal with the problem. The purpose of this qualitative study is to assess different treatment outcomes which can help the women suffering from PCOS, health experts, and mental health workers in understanding, management and treatment of this disease from a holistic point of view. This could further enhance the well-being and overall living pattern of the women.
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Eddy A, Bergman AL, Kaplan J, Goerling RJ, Christopher MS. A Qualitative Investigation of the Experience of Mindfulness Training among Police Officers. JOURNAL OF POLICE AND CRIMINAL PSYCHOLOGY 2021; 36:63-71. [PMID: 34149158 PMCID: PMC8209768 DOI: 10.1007/s11896-019-09340-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Affiliation(s)
- Ashley Eddy
- School of Graduate Psychology, Pacific University, Forest Grove, OR
| | - Aaron L Bergman
- School of Graduate Psychology, Pacific University, Forest Grove, OR
| | - Josh Kaplan
- School of Graduate Psychology, Pacific University, Forest Grove, OR
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Recruitment, retention, and adherence in a randomized feasibility trial of mindfulness-based stress reduction for patients with migraine. Complement Ther Med 2020; 55:102610. [PMID: 33227624 DOI: 10.1016/j.ctim.2020.102610] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 08/07/2020] [Accepted: 10/30/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Increasing evidence demonstrates effectiveness of Mindfulness-Based Stress Reduction (MBSR) for pain-related and functional disorders. In order to conduct successful and efficient trials of MBSR, evidence regarding the relative performance of strategies to improve recruitment, retention, and adherence is required, but few studies have examined these issues specifically. DESIGN In preparation for a fully powered trial, we conducted a 2-arm, parallel comparison randomized controlled feasibility trial of MBSR vs. usual-care for 60 patients with migraine headache. SETTING Two large U.S. health systems in Northern California. INTERVENTION MBSR is an 8-week classroom-based intervention that combines mindfulness meditation and yoga, with didactic presentations about stress psychology and group process/experiential education. Participants received the intervention at their choice of one of several existing, vetted community-based classes. MAIN OUTCOME MEASURES Successful recruitment was defined a priori as 18 participants within any 9-week period or 60 participants enrolled within a 36-week period. We considered participants adherent to the intervention if they attended at least 5 of the 8 weekly classes and the day-long retreat. RESULTS We successfully enrolled 18 participants within a 7-week period, however, we did not attain our second goal of recruiting 60 participants within a 36-week period. Sixty-eight percent of our participants were adherent to the intervention. CONCLUSIONS We found that close monitoring of recruitment activities, flexibility in protocol modifications, and integration within the delivery system were crucial factors for successful participant recruitment, retention, and adherence in mindfulness research.
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Wells RE, Seng EK, Edwards RR, Victorson DE, Pierce CR, Rosenberg L, Napadow V, Schuman-Olivier Z. Mindfulness in migraine: A narrative review. Expert Rev Neurother 2020; 20:207-225. [PMID: 31933391 DOI: 10.1080/14737175.2020.1715212] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Introduction: Migraine is the second leading cause of disability worldwide, yet many patients are unable to tolerate, benefit from, or afford pharmacological treatment options. Non-pharmacological migraine therapies exist, especially to reduce opioid use, which represents a significant unmet need. Mindfulness-based interventions (MBI) have potential as a non-pharmacological treatment for migraine, primarily through the development of flexible attentional capacity across sensory, cognitive, and emotional experiences.Areas covered: The authors review efficacy and potential mechanisms of MBIs for migraine, including mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT).Expert opinion: While most mindfulness research studies for migraine to date have been pilot trials, which are small and/or lacked rigor, initial evidence suggests there may be improvements in overall headache-related disability and psychological well-being. Many research questions remain to help target the treatment to patients most likely to benefit, including the ideal dosage, duration, delivery method, responder characteristics, and potential mechanisms and biomarkers. A realistic understanding of these factors is important for patients, providers, and the media. Mindfulness will not 'cure' migraine; however, mindfulness may be an important tool as part of a comprehensive treatment approach to help patients 'mindfully' engage in valued life activities.
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Affiliation(s)
- Rebecca Erwin Wells
- Comprehensive Headache Program, Center for Integrative Medicine, Department of Neurology, Wake Forest School of Medicine, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Elizabeth K Seng
- Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA
| | - Robert R Edwards
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham & Women's Hospital, Boston, MA, USA
| | - David E Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Charles R Pierce
- Department of Neurology, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Lauren Rosenberg
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Vitaly Napadow
- Center for Integrative Pain NeuroImaging (CiPNI), Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Zev Schuman-Olivier
- Center for Mindfulness and Compassion, Addictions, Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA
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Liu H, Gao X, Hou Y. Effects of mindfulness-based stress reduction combined with music therapy on pain, anxiety, and sleep quality in patients with osteosarcoma. ACTA ACUST UNITED AC 2020; 41:540-545. [PMID: 31116262 PMCID: PMC6899366 DOI: 10.1590/1516-4446-2018-0346] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 01/22/2019] [Indexed: 01/08/2023]
Abstract
Objectives: To evaluate the effects of mindfulness-based stress reduction (MBSR) combined with music therapy (MT) on clinical symptoms in patients with osteosarcoma. Methods: Patients diagnosed with osteosarcoma were assessed for eligibility. A total of 101 patients were ultimately randomized into the intervention and control groups. Both groups received routine care. Eight sessions of MBSR and MT psychotherapy were conducted in the intervention group, while the control group received no psychological intervention. Patients were assessed regarding pain, anxiety, and sleep quality at two distinct stages: before and after the intervention. Results: There were no significant differences in sociodemographic and clinical parameters between the intervention and control groups at baseline. The intervention program significantly alleviated psychological and physiological complications in patients with osteosarcoma. Specifically, the study revealed that 8 weeks of the combined MBSR/MT intervention effectively reduced pain and anxiety scores and improved the quality of sleep in patients. Conclusion: MBSR combined with MT significantly alleviated clinical symptoms, and could be considered a new, effective psychotherapeutic intervention for patients with osteosarcoma.
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Affiliation(s)
| | | | - Yuxin Hou
- Liaocheng People's Hospital, Shandong, China
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Mindfulness and Chronic Headache/Migraine: Mechanisms Explored Through the Fear-Avoidance Model of Chronic Pain. Clin J Pain 2019; 34:638-649. [PMID: 29271796 DOI: 10.1097/ajp.0000000000000580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To replicate a study by Schutze and colleagues on a headache sample, rather than a heterogenous chronic pain sample, investigating whether level of mindfulness predicts key components in the Fear-Avoidance Model of chronic pain (pain intensity, negative affect, pain catastrophizing, pain-related fear, pain hypervigilance, and functional disability); to investigate the relationships between level of mindfulness and headache/migraine pain intensity, frequency, and duration. MATERIALS AND METHODS Participants were 217 individuals who self-reported chronic headache/migraine (51 male, 166 female), aged between 18 and 65 years. Participants completed an online survey measuring demographics, mindfulness, the key components of the Fear-Avoidance Model, and headache pain intensity, duration, and frequency. RESULTS Mindfulness had significant negative correlations (P<0.05) with all variables except headache pain intensity and headache frequency. Mindfulness significantly predicted negative affect, pain catastrophizing, fear of pain, pain hypervigilance, and headache duration (P<0.05). Mindfulness remained a significant predictor of negative affect and pain hypervigilance after controlling for other key components and background characteristics (P<0.05). Mindfulness did not moderate the relationship between pain intensity and pain catastrophizing (P=0.204). DISCUSSION Findings suggest that mindfulness may be integrated into the Fear-Avoidance Model of chronic pain for individuals with chronic headache/migraine. Directions for future research are discussed.
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Cramer H, Hehlke M, Vasmer J, Rampp T, Anheyer D, Saha FJ, Paul A, Lauche R, Dobos G. Integrated care for migraine and chronic tension-type headaches: A prospective observational study. Complement Ther Clin Pract 2019; 36:1-6. [DOI: 10.1016/j.ctcp.2019.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 03/19/2019] [Accepted: 04/10/2019] [Indexed: 01/03/2023]
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Namjoo S, Seirafi M, Assarzadegan F, Borjali A. Cognitive Processing Styles and Mindfulness on Pain Intensity Prediction in People with Primary Headache. Anesth Pain Med 2019; 8:e82470. [PMID: 30719414 PMCID: PMC6347729 DOI: 10.5812/aapm.82470] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 10/21/2018] [Accepted: 11/11/2018] [Indexed: 12/27/2022] Open
Abstract
Background Primary headaches are the most common cause of absence from work and school and one of the most common reasons for referring to the neurologists. Objectives The present study was designed to investigate the relationship of cognitive processing style and mindfulness with pain intensity and the ultimate aim was to provide the role of pain-related cognitive processes and mindfulness in the prediction of headache intensity. Methods The study was conducted descriptively by using the correlation method. The statistical population of this study was composed of 85 patients (56 females and 29 males) with one type of primary headache, which were selected through purposive sampling after the diagnosis of a headache by a neurologist at Imam Hossein Hospital in Tehran province. To measure the variables of the study, the numeric pain rating scale (NRS) and the pain-related cognitive processes questionnaire (PCPQ) were used. All data were analyzed using descriptive statistics (frequency and percentages). Bivariate correlation matrix and hierarchical stepwise linear regression statistics were used. Results The results showed that there was a significant and negative association between pain intensity (NRS) and mindfulness (P < 0.01) and all pain-related cognitive processes, except pain focus (P < 0.01). The results of stepwise linear regression indicated that mindfulness only explains 39% of total score changes in pain intensity (P < 0.05 and ΔF (1 and 83) = 53.63, ΔR = 0.385). Adding cognitive processing styles to the model led to an 18% increase of the explained variance (R2 change = 0.179). In total, the present research model justifies 54% of the severity of headache variance (P < 0.01, ΔR = 0.54). Conclusions The results suggest that pain-related cognitive processes and mindfulness are effective on pain intensity prediction. In other words, this result can explain the role of mindfulness and adaptive cognitive processing in primary headache pain management.
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Affiliation(s)
- Sarah Namjoo
- Department of Health Psychology, Islamic Azad University of Alborz, Karaj, Iran
- Corresponding Author: Department of Health Psychology, Islamic Azad University of Alborz, Karaj, Iran.
| | | | - Farhad Assarzadegan
- Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Corresponding Author: Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Abstract
Background: Several studies have reported that mindfulness meditation has a potential effect in controlling headaches, such as migraine and tension-type headache; however, its role remains controversial. This review assessed the evidence regarding the effects of mindfulness meditation for primary headache pain. Methods: Only English databases (PubMed, Cochrane Central Register of Controlled Trials [the Cochrane Library], PsycINFO, Psychology and behavioral science collection, PsyArticles, Web of Science, and Scopus) were searched from their inception to November 2016 with the keywords (“meditation” or “mindfulness” or “vipassana” or “dzogchen” or “zen” or “integrative body-mind training” or “IBMT” or “mindfulness-based stress reduction” or “MBSR” or “mindfulness-based cognitive therapy” or “MBCT” and “Headache” or “Head pain” or “Cephalodynia” or “Cephalalgia” or “Hemicrania” or “Migraine”). Titles, abstracts, and full-text articles were screened against study inclusion criteria: controlled trials of structured meditation programs for adult patients with primary headache pain. The quality of studies included in the meta-analysis was assessed with the Yates Quality Rating Scale. The meta-analysis was conducted with Revman 5.3. Results: Ten randomized controlled trials and one controlled clinical trial with a combined study population of 315 patients were included in the study. When compared to control group data, mindfulness meditation induced significant improvement in pain intensity (standardized mean difference, −0.89; 95% confidence interval, −1.63 to −0.15; P = 0.02) and headache frequency (−0.67; −1.24 to −0.10; P = 0.02). In a subgroup analysis of different meditation forms, mindfulness-based stress reduction displayed a significant positive influence on pain intensity (P < 0.000). Moreover, 8-week intervention had a significant positive effect (P < 0.000). Conclusions: Mindfulness meditation may reduce pain intensity and is a promising treatment option for patients. Clinicians may consider mindfulness meditation as a viable complementary and alternative medical option for primary headache.
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Affiliation(s)
- Qiang Gu
- School of Medicine, Zhejiang University, Hangzhou, Zhejiang 210029, China
| | - Jin-Chao Hou
- Department of Anesthesiology, School of Medicine, The First Affiliated Hospital, Zhejiang University, Hangzhou, Zhejiang 210029, China
| | - Xiang-Ming Fang
- School of Medicine, Zhejiang University, Hangzhou, Zhejiang 210029, China
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Anheyer D, Leach MJ, Klose P, Dobos G, Cramer H. Mindfulness-based stress reduction for treating chronic headache: A systematic review and meta-analysis. Cephalalgia 2018; 39:544-555. [PMID: 29863407 DOI: 10.1177/0333102418781795] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Mindfulness-based stress reduction/cognitive therapy are frequently used for pain-related conditions, but their effects on headache remain uncertain. This review aimed to assess the efficacy and safety of mindfulness-based stress reduction/cognitive therapy in reducing the symptoms of chronic headache. DATA SOURCES AND STUDY SELECTION MEDLINE/PubMed, Scopus, CENTRAL, and PsychINFO were searched to 16 June 2017. Randomized controlled trials comparing mindfulness-based stress reduction/cognitive therapy with usual care or active comparators for migraine and/or tension-type headache, which assessed headache frequency, duration or intensity as a primary outcome, were eligible for inclusion. Risk of bias was assessed using the Cochrane Tool. RESULTS Five randomized controlled trials (two on tension-type headache; one on migraine; two with mixed samples) with a total of 185 participants were included. Compared to usual care, mindfulness-based stress reduction/cognitive therapy did not improve headache frequency (three randomized controlled trials; standardized mean difference = 0.00; 95% confidence interval = -0.33,0.32) or headache duration (three randomized controlled trials; standardized mean difference = -0.08; 95% confidence interval = -1.03,0.87). Similarly, no significant difference between groups was found for pain intensity (five randomized controlled trials; standardized mean difference = -0.78; 95% confidence interval = -1.72,0.16). CONCLUSIONS Due to the low number, small scale and often high or unclear risk of bias of included randomized controlled trials, the results are imprecise; this may be consistent with either an important or negligible effect. Therefore, more rigorous trials with larger sample sizes are needed.
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Affiliation(s)
- Dennis Anheyer
- 1 Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Matthew J Leach
- 2 Department of Rural Health, Division of Health Sciences, University of South Australia, Adelaide, South Australia, Australia.,3 Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Petra Klose
- 1 Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Gustav Dobos
- 1 Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Holger Cramer
- 1 Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.,3 Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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Tavallaei V, Rezapour-Mirsaleh Y, Rezaiemaram P, Saadat SH. Mindfulness for female outpatients with chronic primary headaches: an internet-based bibliotherapy. Eur J Transl Myol 2018; 28:7380. [PMID: 29991985 PMCID: PMC6036307 DOI: 10.4081/ejtm.2018.7380] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Accepted: 03/29/2018] [Indexed: 01/03/2023] Open
Abstract
Our aim was to investigate effectiveness of mindfulness by bibliotherapy on disability, distress, perceived pain and mindfulness in women with tension headaches and migraines. Primary headaches have been of great interest to mental health researchers because of the high prevalence, as well as significant disability and distress in the affected people. Despite the promising results of in-person treatment and some limitations that such interventions may cause, patients may be encountered with problems when using health care services. The present study is a quasi-experimental randomized design with pre-test, post-test, and control group. The study population consisted of 1396 women with migraine headache referring to headache clinic of Baqiyatallah Hospital in Tehran. Of these, 30 patients (including tboh experimental and control group) were selected by objective sampling method and were randomly assigned to the two groups. The experimental group, in addition to medical treatment as usual, was treated for a period of 8 sessions by Mindfulness-based Stress Reduction Internet-based Bibliotherapy, but the control group used only the medical treatment. The sample had no attritions. Data were collected by the four scales of (DASS-21), Migraine Disability Assessment Test (MIDAS), McGill's Short Form Questionnaire (MPQ-SF), and Mindfulness Inventory (MAAS). We used covariance analysis to analyze the findings in the measured scales. MBSR-IBB treatment had no significant effect on pain sensory dimension (P <0.44), despite improvement of mindfulness (P <0.0001). In contrast, the greatest effect was on the level of disability (P <0.0001). We observed also a significant improvement in distress (P <0.0001). In conclusion, in spite of the presence of headaches, the mindfulness improved the quality of life and reduced the level of mental distress. In addition, using the Internet-based bibliotherapy method, these services can be used with easier access, lower cost, and more flexibility.
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Affiliation(s)
- Vahid Tavallaei
- Counseling Department, Education & Psychology Faculty, Ardakan University, Ardakan, Iran
| | | | - Peyman Rezaiemaram
- Psychology Department, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran
| | - Seyed Hassan Saadat
- Behavioral Science Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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17
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Hilton L, Hempel S, Ewing BA, Apaydin E, Xenakis L, Newberry S, Colaiaco B, Maher AR, Shanman RM, Sorbero ME, Maglione MA. Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis. Ann Behav Med 2017; 51:199-213. [PMID: 27658913 PMCID: PMC5368208 DOI: 10.1007/s12160-016-9844-2] [Citation(s) in RCA: 439] [Impact Index Per Article: 62.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Chronic pain patients increasingly seek treatment through mindfulness meditation. PURPOSE This study aims to synthesize evidence on efficacy and safety of mindfulness meditation interventions for the treatment of chronic pain in adults. METHOD We conducted a systematic review on randomized controlled trials (RCTs) with meta-analyses using the Hartung-Knapp-Sidik-Jonkman method for random-effects models. Quality of evidence was assessed using the GRADE approach. Outcomes included pain, depression, quality of life, and analgesic use. RESULTS Thirty-eight RCTs met inclusion criteria; seven reported on safety. We found low-quality evidence that mindfulness meditation is associated with a small decrease in pain compared with all types of controls in 30 RCTs. Statistically significant effects were also found for depression symptoms and quality of life. CONCLUSIONS While mindfulness meditation improves pain and depression symptoms and quality of life, additional well-designed, rigorous, and large-scale RCTs are needed to decisively provide estimates of the efficacy of mindfulness meditation for chronic pain.
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Affiliation(s)
- Lara Hilton
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA.
| | - Susanne Hempel
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Brett A Ewing
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Eric Apaydin
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Lea Xenakis
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Sydne Newberry
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Ben Colaiaco
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Alicia Ruelaz Maher
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Roberta M Shanman
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Melony E Sorbero
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Margaret A Maglione
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
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18
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Heppner WL, Spears CA, Correa-Fernández V, Castro Y, Li Y, Guo B, Reitzel LR, Vidrine JI, Mazas CA, Cofta-Woerpel L, Cinciripini PM, Ahluwalia JS, Wetter DW. Dispositional Mindfulness Predicts Enhanced Smoking Cessation and Smoking Lapse Recovery. Ann Behav Med 2017; 50:337-47. [PMID: 26743533 DOI: 10.1007/s12160-015-9759-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Although mindfulness has been hypothesized to promote health behaviors, no research has examined how dispositional mindfulness might influence the process of smoking cessation. PURPOSE The current study investigated dispositional mindfulness, smoking abstinence, and recovery from a lapse among African American smokers. METHODS Participants were 399 African Americans seeking smoking cessation treatment (treatments did not include any components related to mindfulness). Dispositional mindfulness and other psychosocial measures were obtained pre-quit; smoking abstinence was assessed 3, 31 days, and 26 weeks post-quit. RESULTS Individuals higher in dispositional mindfulness were more likely to quit smoking both initially and over time. Moreover, among individuals who had lapsed at day 3, those higher in mindfulness were more likely to recover abstinence by the later time points. The mindfulness-early abstinence association was mediated by lower negative affect, lower expectancies to regulate affect via smoking, and higher perceived social support. CONCLUSIONS Results suggest that mindfulness might enhance smoking cessation among African American smokers by operating on mechanisms posited by prominent models of addiction.
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Affiliation(s)
- Whitney L Heppner
- Department of Psychological Science, Georgia College & State University, Milledgeville, GA, USA.
| | - Claire Adams Spears
- Department of Psychology, The Catholic University of America, Washington, DC, USA
| | | | - Yessenia Castro
- School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Yisheng Li
- Department of Biostatistics, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Beibei Guo
- Department of Experimental Statistics, Louisiana State University, Baton Rouge, LA, USA
| | - Lorraine R Reitzel
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX, USA
| | - Jennifer Irvin Vidrine
- Stephenson Cancer Center and Department of Family & Preventive Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Carlos A Mazas
- Department of Health Disparities Research, UT MD Anderson Cancer Center, Houston, TX, USA
| | | | - Paul M Cinciripini
- Department of Behavioral Science, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Jasjit S Ahluwalia
- Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| | - David W Wetter
- Department of Psychology, Rice University, Houston, TX, USA
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Lee AC, Harvey WF, Price LL, Morgan LPK, Morgan NL, Wang C. Mindfulness is associated with psychological health and moderates pain in knee osteoarthritis. Osteoarthritis Cartilage 2017; 25:824-831. [PMID: 27349461 PMCID: PMC5183521 DOI: 10.1016/j.joca.2016.06.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 05/05/2016] [Accepted: 06/17/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Previous studies suggest that higher mindfulness is associated with less pain and depression. However, the role of mindfulness has never been studied in knee osteoarthritis (OA). We evaluate the relationships between mindfulness and pain, psychological symptoms, and quality of life in knee OA. METHOD We performed a secondary analysis of baseline data from our randomized comparative trial in participants with knee OA. Mindfulness was assessed using the Five Facet Mindfulness Questionnaire (FFMQ). We measured pain, physical function, quality of life, depression, stress, and self-efficacy with commonly-used patient-reported measures. Simple and multivariable regression models were utilized to assess associations between mindfulness and health outcomes. We further tested whether mindfulness moderated the pain-psychological outcome associations. RESULTS Eighty patients were enrolled (60.3 ± 10.3 years; 76.3% female, body mass index: 33.0 ± 7.1 kg/m2). Total mindfulness score was associated with mental (beta = 1.31, 95% CI: 0.68, 1.95) and physical (beta = 0.69, 95% CI:0.06, 1.31) component quality of life, self-efficacy (beta = 0.22, 95% CI:0.07, 0.37), depression (beta = -1.15, 95% CI:-1.77, -0.54), and stress (beta = -1.07, 95% CI:-1.53, -0.60). Of the five facets, the Describing, Acting-with-Awareness, and Non-judging mindfulness facets had the most associations with psychological health. No significant association was found between mindfulness and pain or function (P = 0.08-0.24). However, we found that mindfulness moderated the effect of pain on stress (P = 0.02). CONCLUSION Mindfulness is associated with depression, stress, self-efficacy, and quality of life among knee OA patients. Mindfulness also moderates the influence of pain on stress, which suggests that mindfulness may alter the way one copes with pain. Future studies examining the benefits of mind-body therapy, designed to increase mindfulness, for patients with OA are warranted.
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Affiliation(s)
- Augustine C. Lee
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA, USA
| | - William F. Harvey
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA, USA
| | - Lori Lyn Price
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA,Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA
| | - Lucas P. K. Morgan
- Department of Psychology, University of Massachusetts Boston, Boston, MA, USA; I Ola Lahui Rural Hawai'i Behavioral Health, Honolulu, HI, USA
| | - Nani L. Morgan
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA, USA,Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Chenchen Wang
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA, USA
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Grazzi L, Sansone E, Raggi A, D'Amico D, De Giorgio A, Leonardi M, De Torres L, Salgado-García F, Andrasik F. Mindfulness and pharmacological prophylaxis after withdrawal from medication overuse in patients with Chronic Migraine: an effectiveness trial with a one-year follow-up. J Headache Pain 2017; 18:15. [PMID: 28161874 PMCID: PMC5292107 DOI: 10.1186/s10194-017-0728-z] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 01/27/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Chronic Migraine (CM) is a disabling condition, worsened when associated with Medication Overuse (MO). Mindfulness is an emerging technique, effective in different pain conditions, but it has yet to be explored for CM-MO. We report the results of a study assessing a one-year course of patients' status, with the hypothesis that the effectiveness of a mindfulness-based approach would be similar to that of conventional prophylactic treatments. METHODS Patients with CM-MO (code 1.3 and 8.2 of the International Classification of Headache Disorders-3Beta) completed a withdrawal program in a day hospital setting. After withdrawal, patients were either treated with Prophylactic Medications (Med-Group), or participated in a Mindfulness-based Training (MT-Group). MT consisted of 6 weekly sessions of guided mindfulness, with patients invited to practice 7-10 min per day. Headache diaries, the headache impact test (HIT-6), the migraine disability assessment (MIDAS), state and trait anxiety (STAI Y1-Y2), and the Beck Depression Inventory (BDI) were administered before withdrawal and at each follow-up (3, 6, 12 after withdrawal) to patients from both groups. Outcome variables were analyzed in separate two-way mixed ANOVAs (Group: Mindfulness vs. Pharmacology x Time: Baseline, 3-, 6-, vs. 12-month follow-up). RESULTS A total of 44 patients participated in the study, with the average age being 44.5, average headache frequency/month was 20.5, and average monthly medication intake was 18.4 pills. Data revealed a similar improvement over time in both groups for Headache Frequency (approximately 6-8 days reduction), use of Medication (approximately 7 intakes reduction), MIDAS, HIT-6 (but only for the MED-Group), and BDI; no changes on state and trait anxiety were found. Both groups revealed significant and equivalent improvement with respect to what has become a classical endpoint in this area of research, i.e. 50% or more reduction of headaches compared to baseline, and the majority of patients in each condition no longer satisfied current criteria for CM. CONCLUSIONS Taken as a whole, our results suggest that the longitudinal course of patients in the MT-Group, that were not prescribed medical prophylaxis, was substantially similar to that of patients who were administered medical prophylaxis.
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Affiliation(s)
- Licia Grazzi
- Neurological Institute "C. Besta" IRCCS Foundation, Headache and Neuroalgology Unit, Via Celoria 11, 20133, Milan, Italy.
| | - Emanuela Sansone
- Neurological Institute "C. Besta" IRCCS Foundation, Neurology, Public Health and Disability Unit, Milan, Italy
| | - Alberto Raggi
- Neurological Institute "C. Besta" IRCCS Foundation, Neurology, Public Health and Disability Unit, Milan, Italy
| | - Domenico D'Amico
- Neurological Institute "C. Besta" IRCCS Foundation, Headache and Neuroalgology Unit, Via Celoria 11, 20133, Milan, Italy
| | | | - Matilde Leonardi
- Neurological Institute "C. Besta" IRCCS Foundation, Neurology, Public Health and Disability Unit, Milan, Italy
| | - Laura De Torres
- Neurological Institute "C. Besta" IRCCS Foundation, Neurology, Public Health and Disability Unit, Milan, Italy
| | | | - Frank Andrasik
- Department of Psychology, Univeristy of Memphis, Memphis, TN, USA
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21
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George MC, Wongmek A, Kaku M, Nmashie A, Robinson-Papp J. A Mixed-Methods Pilot Study of Mindfulness-Based Stress Reduction for HIV-Associated Chronic Pain. Behav Med 2017; 43:108-119. [PMID: 26651852 PMCID: PMC6005203 DOI: 10.1080/08964289.2015.1107525] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Treatment guidelines for chronic pain recommend nonpharmacologic modalities as part of a comprehensive management plan. Chronic pain is common among people living with HIV/AIDS, but there is little data to guide the choice of nonpharmacologic therapies in this complex population. We performed a mixed-methods feasibility study of Mindfulness-Based Stress Reduction (MBSR) versus health education control with 32 inner city, HIV-infected participants. Outcome measures included: the Brief Pain Inventory, Perceived Stress Scale, HIV Symptoms Index, autonomic function testing, and audiotaped focus groups. Post-intervention, participants reported modest improvements in pain measures and perceived stress, but no effect of group assignment was observed. At 3-month follow-up, 79% of MBSR participants were still practicing, and pain intensity was improved, whereas in the control group pain intensity had worsened. Qualitative analysis revealed a strong sense of community in both groups, but only MBSR was perceived as useful for relaxation and pain relief.
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Affiliation(s)
- Mary Catherine George
- Icahn School of Medicine at Mount Sinai Department of Neurology, Research Program Manager, fax: 212-987-3301,
| | - Arada Wongmek
- Icahn School of Medicine at Mount Sinai Department of Neurology, Visiting Research Scholar, fax: 212-987-3301,
| | - Michelle Kaku
- Icahn School of Medicine at Mount Sinai Department of Neurology, Neurology Resident, fax: 212-987-3301,
| | - Alexandra Nmashie
- Icahn School of Medicine at Mount Sinai Department of Neurology, Research Coordinator, fax: 212-987-3301,
| | - Jessica Robinson-Papp
- Icahn School of Medicine at Mount Sinai Department of Neurology, Assistant Professor, fax: 212-987-3301,
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Hölzel BK, Brunsch V, Gard T, Greve DN, Koch K, Sorg C, Lazar SW, Milad MR. Mindfulness-Based Stress Reduction, Fear Conditioning, and The Uncinate Fasciculus: A Pilot Study. Front Behav Neurosci 2016; 10:124. [PMID: 27378875 PMCID: PMC4908122 DOI: 10.3389/fnbeh.2016.00124] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 06/03/2016] [Indexed: 12/02/2022] Open
Abstract
Mindfulness has been suggested to impact emotional learning, but research on these processes is scarce. The classical fear conditioning/extinction/extinction retention paradigm is a well-known method for assessing emotional learning. The present study tested the impact of mindfulness training on fear conditioning and extinction memory and further investigated whether changes in white matter fiber tracts might support such changes. The uncinate fasciculus (UNC) was of particular interest in the context of emotional learning. In this pilot study, 46 healthy participants were quasi-randomized to a Mindfulness-Based Stress Reduction (MBSR, N = 23) or waitlist control (N = 23) group and underwent a two-day fear conditioning, extinction learning, and extinction memory protocol before and after the course or control period. Skin conductance response (SCR) data served to measure the physiological response during conditioning and extinction memory phases. Diffusion tensor imaging (DTI) data were analyzed with probabilistic tractography and analyzed for changes of fractional anisotropy in the UNC. During conditioning, participants were able to maintain a differential response to conditioned vs. not conditioned stimuli following the MBSR course (i.e., higher sensitivity to the conditioned stimuli), while controls dropped the response. Extinction memory results were not interpretable due to baseline differences. MBSR participants showed a significant increase in fractional anisotropy in the UNC, while controls did not (group by time interaction missed significance). Pre-post changes in UNC were correlated with changes in the response to the conditioned stimuli. The findings suggest effects of mindfulness practice on the maintenance of sensitivity of emotional responses and suggest underlying neural plasticity. (ClinicalTrials.gov, Identifier NCT01320969, https://clinicaltrials.gov/ct2/show/NCT01320969).
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Affiliation(s)
- Britta K Hölzel
- Department of Neuroradiology, Klinikum Rechts der Isar, Technical University of MunichMunich, Germany; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical SchoolBoston, MA, USA
| | - Vincent Brunsch
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School Boston, MA, USA
| | - Tim Gard
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical SchoolBoston, MA, USA; Institute for Complementary and Integrative Medicine, University Hospital Zurich and University ZurichZurich, Switzerland; Translational Neuromodeling Unit (TNU), Institute for Biomedical Engineering, University of Zurich and Swiss Federal Institute of Technology (ETH)Zurich, Switzerland
| | - Douglas N Greve
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School Boston, MA, USA
| | - Kathrin Koch
- Department of Neuroradiology, Klinikum Rechts der Isar, Technical University of Munich Munich, Germany
| | - Christian Sorg
- Department of Neuroradiology, Klinikum Rechts der Isar, Technical University of Munich Munich, Germany
| | - Sara W Lazar
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School Boston, MA, USA
| | - Mohammed R Milad
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School Boston, MA, USA
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Abstract
In this article, the use of complementary and integrative medicine for the management of pediatric headache is reviewed. Despite limited numbers of studies for pediatric headaches, children and families seek these services. Integrative medicine focuses on treating the whole person, integrating conventional medicine with mind-body-spirit methods. Nutriceuticals include dietary supplements in the form of vitamins (vitamin D), minerals (magnesium), coenzyme Q, butterbur, and melatonin. Acupuncture, stimulation, physical therapy and Transcutaneous Electrical Nerve Stimulations (TENS) or Transcranial Magnetic Stimulation (TMS) may also be useful in selected patients. The efficacy of all these therapeutic alternatives in pediatric headache is presented here. Primary care providers, neurologists, and headache specialists alike need to be informed of such interventions and integrate these approaches, when appropriate, in the management of children with headaches.
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Affiliation(s)
- Sita Kedia
- PALM Integrative Health, St. Louis, MO; Department of Pediatrics, University of Colorado Denver School of Medicine, Aurora, CO; Adult and Child Center for Health Outcomes Research and Delivery of Science, Aurora, CO.
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The Effects of Mindfulness-Based Cognitive Therapy on Depression and Anxiety in Women with Premenstrual Syndrome. DEPRESSION RESEARCH AND TREATMENT 2016; 2016:9816481. [PMID: 28025621 PMCID: PMC5153465 DOI: 10.1155/2016/9816481] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 10/22/2016] [Accepted: 11/15/2016] [Indexed: 12/21/2022]
Abstract
Objective. Little research has been done regarding the role of psychotherapy in the treatment of Premenstrual Syndrome (PMS). The aim of this study was to examine the effect of mindfulness-based cognitive therapy (MBCT) on the PMS symptoms and depression and anxiety symptoms in women with PMS. Design. In a randomized controlled trial, a total of 60 students at Mazandaran University with mild to moderate PMS who had depressive symptoms (Beck depression scores 16-47) were randomly allocated to either an experimental (n = 30) or a control (n = 30) group. The experimental group received MBCT in eight group sessions (120 min each) over 8 weeks. The control group received no intervention. All participants completed the Premenstrual Assessment Scale (PAS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) at the beginning and the end of the study. Repeated-measure ANOVA was used to analyze the data. Results. At the end of study, the experimental and control groups showed the following scores, respectively (mean ± SD): depression, 15.73 ± 6.99 and 25.36 ± 7.14; anxiety, 16.96 ± 7.78 and 26.60 ± 9.38; and total PAS, 42.86 ± 8.02 and 58.93 ± 8.47. MBCT improved depression and anxiety symptoms and total PAS score. Conclusion. MBCT intervention is acceptable and potentially beneficial in women with PMS symptoms. Psychotherapy should be considered as a treatment option for mild to moderate PMS in women with depressive symptoms.
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Stonnington CM, Kothari DJ, Davis MC. Understanding and Promoting Resiliency in Patients with Chronic Headache. Curr Neurol Neurosci Rep 2015; 16:6. [DOI: 10.1007/s11910-015-0609-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Kolahkaj B, Zargar F. Effect of Mindfulness-Based Stress Reduction on Anxiety, Depression and Stress in Women With Multiple Sclerosis. Nurs Midwifery Stud 2015; 4:e29655. [PMID: 26835467 PMCID: PMC4733502 DOI: 10.17795/nmsjournal29655] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Revised: 08/30/2015] [Accepted: 08/31/2015] [Indexed: 11/28/2022] Open
Abstract
Background: Studies suggest that mindfulness-based interventions can improve anxiety, depression and stress in patients with multiple sclerosis (MS). However, no study investigated the effectiveness of this method in patients with a combination of problems such as depression, anxiety and stress simultaneously. However, comorbidities of depression and anxiety in MS are prevalent. Objectives: This study aimed to assess the effects of mindfulness-based stress reduction (MBRS) on anxiety, depression and stress in women with multiple sclerosis. Patients and Methods: This randomized controlled clinical trial was performed in 2013 in Ahvaz MS Society. Forty eight patients were selected by convenient sampling and randomly assigned in experimental and control groups. The patients in the two groups filled out depression, anxiety and stress scale (DASS-21) at initiation of study, 8 weeks later and 1 month after the end of intervention. The experimental group received 8 sessions of MBRS, while the control group treated as usual. Finally, data of 40 patients analyzed using t-test, chi square and repeated measures analysis of variance. Results: In the MBSR group, the mean depression, anxiety and stress were reduced significantly (P < 0.001). The mean depression score was 8.35 ± 1.78 before the intervention and reduced to 4.80 ± 0.83 and 4.45 ± 0.60 after the intervention and follow-up (P < 0.001). Also the mean anxiety score was 8.90 ± 1.97 before the intervention, which was significantly reduced to 4.70 ± 1.38 and 4.55 ± 0.99 after the intervention and follow-up (P < 0.001). The mean stress score was also 8.80 ± 2.35 before treatment and 4.80 ± 1.67 and 4.70 ± 1.34 after the intervention and follow-up (P < 0.001). Conclusions: This study showed that MBSR training can reduce mean depression, anxiety and stress scores in patients with MS. These findings suggest that MBSR is useful for psychological problems such as depression, anxiety and stress in patients with MS.
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Affiliation(s)
- Bentolhoda Kolahkaj
- Department of Clinical Psychology, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, IR Iran
| | - Fatemeh Zargar
- Department of Psychiatry, Isfahan University of Medical Sciences, Isfahan, IR Iran
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27
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Bakhshani NM, Amirani A, Amirifard H, Shahrakipoor M. The Effectiveness of Mindfulness-Based Stress Reduction on Perceived Pain Intensity and Quality of Life in Patients With Chronic Headache. Glob J Health Sci 2015; 8:142-51. [PMID: 26573025 PMCID: PMC4873598 DOI: 10.5539/gjhs.v8n4p142] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 06/24/2015] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to determine the effectiveness of Mindfulness-Based Stress reduction (MBSR) on perceived pain intensity and quality of life in patients with chronic headache. Thus, forty patients based on the diagnosis of a neurologist and diagnostic criteria of the International Headache Society (IHS) for migraine and chronic tension-type headache were selected and randomly assigned to the intervention group and control group, respectively. The participants completed the Pain and quality of life (SF-36) questionnaire. The intervention group enrolled in an eight-week MBSR program that incorporated meditation and daily home practice, per week, session of 90-minutes. Results of covariance analysis with the elimination of the pre-test showed significantly improvement of pain and quality of life in the intervention group compared with the control group. The findings from this study revealed that MBSR can be used non-pharmacological intervention for improvement the quality of life and development of strategies to cope with pain in patients with chronic headache. And can be used in combination with other therapies such as pharmacotherapy.
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