Cancer Survivor Mindfulness Influences Health Characteristics of Primary Support Person

A diagnosis of cancer can be a terrifying experience not only for the patient, but for his/her primary social support person (PSSP) as well. Much of current cancer research is aimed at treating the individual with the diagnosis and increasing his/her quality of life. Up until recently, understanding the impact of a cancer diagnosis on the survivors’ surrounding social networks and PSSP had yet to receive the attention it deserved.

Dr. David Black, USC Assistant Professor of Preventive Medicine, and colleagues at the Keck School of Medicine sought to examine psycho-social health related symptoms of cancer survivors and their PSSP in order to understand interpersonal dynamics and develop future preventive interventions for this dyad.

Not only did authors target gaps in existing literature regarding survivors’ PSSPs, but also underrepresented communities including Hispanics – who often “have less access to preventive services and medical care.” The participants of this study included 409 Hispanic survivors with a colorectal cancer diagnosis and forty-seven of their PSSPs.

Participant data were collected using validated questionnaires assessing employment of daily activities, health-related behaviors (smoking, alcohol use, physical activity) and psychosocial (fatigue, perceived stress, dispositional mindfulness).

Results showed that among suvivors and PSSPs alike, mindfulness was negatively associated with stress, smoking, and alcohol consumption. Among survivors, there was also an inverse association between mindfulness and fatigue that was partially mediated by reduced stress. Interestingly, the greater level of mindfulness reported by the survivor, the lower level of stress the PSSP conveyed, perhaps indicating mindfulness as protective on interpersonal processes.

Despite initial findings suggesting the disposition of mindfulness to have a possible role in the health of cancer survivors and their PSSP, “only a small proportion of patients reported using mind–body interventions such as mindfulness-based meditation.” Thus, authors suggest “a possible role for integrating methods to enhance mindfulness in such health promotion activities in clinical and community settings.”

Augmenting mindfulness at the survivor and PSSP levels could be the focus of future efforts dedicated to improving the health and quality of life of cancer survivors and their social networks.

Mindfulness Meditation Linked with Structural Changes in the Older Adult Brain

A new study has found that mindfulness meditation is associated with structural brain changes in older adults. The exploratory longitudinal pilot study, led by researchers at the University of California Los Angeles and the University of Southern California, found changes in gray matter in the precuneus as well as cortical and subcortical regions in the brains of older adults who participated in a mindfulness training program focused on mitigating sleep problems.

The study appeared November 12th, 2014 in Neuro Open Journal and was directed by USC Assistant Professor of Preventive Medicine, Dr. David Black.

According to the authors, “Mindfulness-based Interventions (MBIs) have previously been associated with structural brain changes in normal healthy adults. However, it remains unknown if standardized MBIs can impart similar changes in older adults as well”. To address this gap, the researchers sought to examine the effect of a standardized MBI on gray matter volume of older adults.

The pilot study included a subsample of 6 older adult community volunteers from a larger trail that examined the efficacy of a MBI on sleep complaints. Participants received a weekly, 2-hour, group-based mindfulness meditation course for 6 sessions that was facilitated by a certified mindfulness teacher with over 20 years of mindfulness practice. Brain scans were conducted prior to and after the intervention.

Voxel-wise analysis revealed one cluster indicating a significant gray matter increase in the right precuneus and decreases in the left prefrontal cortex, right hippocampus, right thalamus, and right parietal cortex. The authors concluded that the observed increase of gray matter within the precuneus may implicate meditation-induced changes of the default mode network, and that the observed gray matter decreases in cortical and subcortical regions may have been driven by MBI-related remediation of brain architecture subserving sleep complaints.

These findings “highlight the need for future research to investigate neuroplastic changes that are associated with mindfulness meditation in older adults”. According to the authors, research examining the effects of MBIs on brain morphology in this population has broad implications pertaining to understanding training-induced changes in the older adult brain that might have implications for improved mental health in our aging population.

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Mindfulness Training Improves Stress Management in Pediatric Intensive Care Unit (PICU) Nurses

A new study has identified a promising way to improve stress management in pediatric intensive care unit (PICU) nurses. The pilot study, led by USC-affiliated Children’s Hospital of Los Angeles researchers, found that participating in a brief mindfulness meditation intervention helped nurses to reduce stress and burnout. Reduced levels of stress were also found one month after the intervention ended.

The study appeared online October 20th, 2014 in Journal of Pediatric Nursing and was directed by USC Associate Professor, Dr. Jeffrey Gold.

According to the authors, “Nurses are particularly vulnerable to stress and burnout, with little time in their schedule to commit to self-care or intensive stress reduction programs”. To address these issues, the researchers sought to determine if it would be feasible to deliver a brief mindfulness-based intervention on site at the PICU unit, and whether the intervention would be an effective method for nurses to manage stress.

The pilot intervention included 38 PICU nurses from an urban pediatric academic hospital. Participants received daily 5-minute mindfulness meditation practices over the course of 30 days. Intervention content was based on the Mindfulness-Based Stress Reduction (MBSR) program developed by Jon Kabat-Zinn, but was modified to be PICU-specific in order to address the specific challenges faced by PICU nurses.

Over one-half of the nurses on the unit showed interest in participating in the mindfulness-based intervention, and 89% of the nurses that signed up attended at least one intervention session. The authors concluded that these findings indicated an on-the-job mindfulness-based intervention is viable for this nursing population. In addition to reductions in stress and burnout, participants also reported improved job satisfaction and self-compassion.

The authors state that changes in stress, burnout, self-compassion, and job satisfaction have implications for improving nurses’ professional caregiving, career longevity, and interrelations on the unit.

Although future, larger studies are needed to expand on the results, according to the authors, the findings demonstrate that “brief interventions that support on-the-job self-care and stress-reduction may prove useful in hospital settings”.

Mindfulness Training Improves Sleep Problems in Older Adults

by Stephani Sutherland, PhD

As we get older, our sleep patterns naturally shift, but many people—as many as half of those over 55—develop sleep disturbances. When we don’t get enough sleep, we might feel groggy or grumpy, but the shortfall can also have serious health consequences. Experts recommend improving our “sleep hygiene”—habits that promote healthy sleep. But in a recent study by researchers at USC and University of California, Los Angeles (UCLA), mindfulness trumped sleep education for improving sleep in people over 55.

The researchers presented the study in April at the 2014 annual meeting of the Society of Behavioral Medicine in Philadelphia, PA.

For the study, David S. Black, director of the BioMind Lab at Keck Medicine of USC, and colleagues recruited 49 volunteers aged 55-90 from the Los Angeles area who were suffering from sleep disturbances but not diagnosed with clinical insomnia. For six weeks, half the subjects attended a sleep education course, in which they learned from a trained health professional about the biology of sleep, stress-busting techniques, and how to promote better sleep, like turning off the TV well before bedtime and getting out of bed when you sleep eludes you.

The other half of the group trained in mindfulness meditation through the Mindful Awareness Practices program at UCLA. Under the tutelage of an experienced mindfulness teacher, students learned practices like sitting mindfulness, in which one sits quietly while keeping their attention on their breath; mindful eating, which focuses attention on the sensations experienced while eating a grape, for example; and walking meditation.

Whereas sleep improved only slightly in those with the sleep-hygiene training, mindfulness practitioners saw a 28% improvement in overall sleep quality. In addition to measuring sleep characteristics, the researchers assessed elements of mental health in the participants like quality of life, depression and well-being. These too improved more with mindfulness than with the educational course.

Six of the subjects in the mindfulness training also underwent brain scans before and after the training. The researchers used a technique called voxel-based morphometry to determine from the images the volume of gray matter in the cortex, the brain’s outer layer that gives rise to thought. Compared to the start of the study, after learning mindfulness the subjects had more gray matter in a part of the cortex called the right precuneus, which is key to our self-awareness. Some other areas, including the left prefrontal cortex and the right hippocampus, diminished over the six-week mindfulness course.

It remains unclear what exactly underlies the changes in cortical volume. The researchers hypothesize that the subjects’ lost sleep may have impacted the brain’s structure, and these changes might have been righted by mindfulness meditation, but the question will require further study.

So if, as you get up in years, your sleep starts to deteriorate, by all means clean up your sleep habits. But you might also consider a mindfulness course, according to the findings.

Read more here.

Improving Sustained Attention with Mindfulness Meditation

by Stephani Sutherland, PhD

Mindfulness has been widely touted as a way to improve attention—in fact the term is often used to mean attention management—but how does practice really affect our mind’s focus? A study by USC researcher Randye J. Semple set out to answer that question and found that some but not all aspects of attention improved with practice.

Forty-five subjects were assigned to practice either mindfulness meditation or progressive muscle relaxation, which mimics the physical benefits of mindfulness, or were placed on a wait-list for mindfulness training and served as control subjects. Those in the mindfulness group received two individual training sessions, and then were asked to practice mindfulness for twenty minutes twice daily for four weeks with the help of an audiotape, written instructions and an activity log.

After the four weeks, subjects underwent a series of tests meant to measure qualities of attention. In one task, for example, participants were instructed to press a red button each time a letter appeared in the center of a computer screen, but to press a blue button when they saw the letter “X” specifically preceded by the letter “A.” Participants also performed tests to measure their mood and anxiety level.

The tests gauged four aspects of attention: Sustained vigilance describes how well one keeps their attention on the task at hand; concentration marks the ability to focus on a task; inhibition of distraction keeps our mind from wandering to other stimuli; and executive control describes the ability to override pre-learned assumptions.

Semple’s analysis revealed that subjects who practiced mindfulness meditation showed improvements in sustained attention not seen in those who trained in physical relaxation. Concentration and inhibition of distraction, in contrast, did not differ between the groups.

Although the study was small and short, it makes some progress toward our understanding of how mindfulness practice enhances specific aspects of attention.

The study was published in Mindfulness in 2010.

Read more here.

Mindfulness Linked with Less Alcohol Use in Medical Students

by Stephani Sutherland, PhD

The so-called higher functions of our brains reside in the cerebral cortex, the domain of executive function. The term refers to our control over the flow of thoughts that run through our minds at any given time. Researchers have determined that executive function can be parsed out into specific workings. In a recent study, USC researchers examined how these components interact, and whether meditation practice influences them.

Three processes defined as components of executive function include mindfulness, self-control, and working memory. Brain areas thought to be responsible for these mental musings are the posterior medial frontal cortex (pMFC), which is thought to monitor the brain’s chatter, and the lateral prefrontal cortex (LPFC), which acts to reign in aberrant activity when necessary.

For the study, published in Mindfulness in 2011, the researchers presented 28 subjects—all first-year medical students—with several online surveys to gauge these three processes. The participants also completed tests aimed at measuring mental health. While participants did not undertake any mindfulness practice as part of the study, the questionnaire assessed whether subjects employed such practices and then looked for any inter-relationship between meditation and the components of executive function.

From their analysis of the surveys, the researchers determined that the three elements of executive function operate for the most part independently, but with some overlap, indicating how complex this broad category of brain activity may be.

Interestingly, what did emerge from the surveys was that the medical students who meditated—about a quarter of the subjects, according to their own self-report—were less likely to use or abuse alcohol. That finding suggests that meditation can help protect against substance abuse in this highly stressed population.

Read more here.